1
|
Hellier SD, Wrynn AF. Beyond fluconazole: A review of vulvovaginal candidiasis diagnosis and treatment. Nurse Pract 2023; 48:33-39. [PMID: 37643144 DOI: 10.1097/01.npr.0000000000000095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
ABSTRACT Vaginitis symptoms are among the most common reasons for patients to seek acute gynecological care. NPs who care for women and other patients with vaginas need to be up-to-date on diagnosis and treatment of vulvovaginal candidiasis (VVC) and recurrent VVC (RVVC). Two new antifungal medications for VVC are available. This article reviews vaginal physiology and provides an overview of VVC and RVVC pathophysiology, diagnosis, and treatment options.
Collapse
|
2
|
Leroy J, Lecointe K, Coulon P, Sendid B, Robert R, Poulain D. Antibodies as Models and Tools to Decipher Candida albicans Pathogenic Development: Review about a Unique Monoclonal Antibody Reacting with Immunomodulatory Adhesins. J Fungi (Basel) 2023; 9:636. [PMID: 37367572 DOI: 10.3390/jof9060636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/20/2023] [Accepted: 05/29/2023] [Indexed: 06/28/2023] Open
Abstract
Candidiasis, caused mainly by Candida albicans, a natural commensal of the human digestive tract and vagina, is the most common opportunistic fungal infection at the mucosal and systemic levels. Its high morbi-mortality rates have led to considerable research to identify the molecular mechanisms associated with the switch to pathogenic development and to diagnose this process as accurately as possible. Since the 1980s, the advent of monoclonal antibody (mAb) technology has led to significant progress in both interrelated fields. This linear review, intended to be didactic, was prompted by considering how, over several decades, a single mAb designated 5B2 contributed to the elucidation of the molecular mechanisms of pathogenesis based on β-1,2-linked oligomannoside expression in Candida species. These contributions starting from the structural identification of the minimal epitope as a di-mannoside from the β-1,2 series consisted then in the demonstration that it was shared by a large number of cell wall proteins differently anchored in the cell wall and the discovery of a cell wall glycoplipid shed by the yeast in contact of host cells, the phospholipomannan. Cytological analysis revealed an overall highly complex epitope expression at the cell surface concerning all growth phases and a patchy distribution resulting from the merging of cytoplasmic vesicles to plasmalema and further secretion through cell wall channels. On the host side, the mAb 5B2 led to identification of Galectin-3 as the human receptor dedicated to β-mannosides and signal transduction pathways leading to cytokine secretion directing host immune responses. Clinical applications concerned in vivo imaging of Candida infectious foci, direct examination of clinical samples and detection of circulating serum antigens that complement the Platelia Ag test for an increased sensitivity of diagnosis. Finally, the most interesting character of mAb 5B2 is probably its ability to reveal C. albicans pathogenic behaviour in reacting specifically with vaginal secretions from women infected versus colonized by this species as well as to display higher reactivity with strains isolated in pathogenic circumstances or even linked to an unfavourable prognosis for systemic candidiasis. Together with a detailed referenced description of these studies, the review provides a complementary reading frame by listing the wide range of technologies involving mAb 5B2 over time, evidencing a practical robustness and versatility unique so far in the Candida field. Finally, the basic and clinical perspectives opened up by these studies are briefly discussed with regard to prospects for future applications of mAb 5B2 in current research challenges.
Collapse
Affiliation(s)
- Jordan Leroy
- CNRS, UMR 8576, UGSF-Unité de Glycobiologie Structurale et Fonctionnelle, University of Lille, F-59000 Lille, France
- INSERM U1285, University of Lille, F-59000 Lille, France
- CHU Lille, Laboratoire de Parasitologie-Mycologie, F-59000 Lille, France
| | - Karine Lecointe
- CNRS, UMR 8576, UGSF-Unité de Glycobiologie Structurale et Fonctionnelle, University of Lille, F-59000 Lille, France
- INSERM U1285, University of Lille, F-59000 Lille, France
| | - Pauline Coulon
- CHU Lille, Laboratoire de Parasitologie-Mycologie, F-59000 Lille, France
| | - Boualem Sendid
- CNRS, UMR 8576, UGSF-Unité de Glycobiologie Structurale et Fonctionnelle, University of Lille, F-59000 Lille, France
- INSERM U1285, University of Lille, F-59000 Lille, France
- CHU Lille, Laboratoire de Parasitologie-Mycologie, F-59000 Lille, France
| | - Raymond Robert
- Kalidiv ZA, La Garde Bâtiment 1 B, Allée du 9 Novembre 1989, F-49240 Avrillé, France
| | - Daniel Poulain
- CNRS, UMR 8576, UGSF-Unité de Glycobiologie Structurale et Fonctionnelle, University of Lille, F-59000 Lille, France
- INSERM U1285, University of Lille, F-59000 Lille, France
| |
Collapse
|
3
|
Jafarzadeh L, Ranjbar M, Nazari T, Naeimi Eshkaleti M, Aghaei Gharehbolagh S, Sobel JD, Mahmoudi S. Vulvovaginal candidiasis: An overview of mycological, clinical, and immunological aspects. J Obstet Gynaecol Res 2022; 48:1546-1560. [PMID: 35445492 DOI: 10.1111/jog.15267] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 03/11/2022] [Accepted: 04/04/2022] [Indexed: 12/28/2022]
Abstract
AIM To provide an overview of clinical, immunological, and mycological aspects of vulvovaginal candidiasis (VVC). METHODS A literature search was conducted to find relevant articles about different aspects of VVC. Related data from retrieved articles were summarized in different headings. RESULTS VVC has a global distribution and Candida albicans is the leading cause of infection except for specific patient groups like postmenopausal, diabetic, or immunocompromised women. VVC has a range of clinical presentations, accordingly, its diagnosis should be based on clinical examination coupled with laboratory investigations. The best therapeutic regimen depends on the patient's conditions and the causative agent. Moreover, factors like drug resistance of the causative agents and different mutations in the immunity-related genes could affect the treatment outcome. CONCLUSION As a globally distributed disease, VVC needs further attention, especially in areas related to the treatment failure and recurrence of the disease.
Collapse
Affiliation(s)
- Leila Jafarzadeh
- Department of Immunology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Maryam Ranjbar
- Department of Persian Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tina Nazari
- Department of Medical Geriatrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Naeimi Eshkaleti
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanaz Aghaei Gharehbolagh
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Jack D Sobel
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Shahram Mahmoudi
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
4
|
Zhao Y, Yu Z, Yue X. Evaluating the accuracy and diagnostic value of CFW and a new fluorescent reagents, fluorescent brightener 85, for the diagnosis of vulvovaginal candidiasis. J Clin Lab Anal 2021; 35:e23891. [PMID: 34251053 PMCID: PMC8373344 DOI: 10.1002/jcla.23891] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/07/2021] [Accepted: 06/20/2021] [Indexed: 01/17/2023] Open
Abstract
Background Vulvovaginal candidiasis (VVC) is a common vaginitis in females. The commonly used diagnostic method, 10% potassium hydroxide (KOH) smear microscopy, makes it not very easy to recognize fungi. Methods Vaginal secretions were collected from clinically suspected VVC patients and divided into four groups and examined using KOH, CFW (Calcofluor White), FB 85(fluorescent brightener 85), and culture. The data were statistically analyzed. Results In total, 110 patients with suspected VVC were recruited. The positive rates of KOH, CFW, FB 85, and the culture method were 68.2%, 64.5%, 61.8%, and 77%, respectively. According to the McNemar test, there was no statistically significant difference between the KOH, CFW, and the FB 85 methods (p > 0.05). However, CFW had a shorter diagnosis time than the KOH method and had a statistically significant difference (p < 0.001). Moreover, CFW has the highest sensitivity, specificity, and accuracy. In morphological recognition, it was easier to recognize fungal structures with CFW and FB 85 than with the KOH. Conclusions The fluorescent method is a good method for the diagnosis of VVC. And the fungi can be found more quickly. Similar to CFW, FB 85 is also a potential good fluorescent reagent for the diagnosis of VVC and has potential value for application in clinical fungal infection diseases.
Collapse
Affiliation(s)
- Yunzhuan Zhao
- Department of Clinical LaboratoryBeijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Zixuan Yu
- Department of Clinical LaboratoryBeijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Xueping Yue
- Department of DermatologyBeijing Tiantan HospitalCapital Medical UniversityBeijingChina
| |
Collapse
|
5
|
Baek JC, Jo HC, Lee SM, Park JE, Cho IA, Sung JH. Prevalence of Pathogens and Other Microorganisms in Premenopausal and Postmenopausal Women with Vulvovaginal Symptoms: A Retrospective Study in a Single Institute in South Korea. ACTA ACUST UNITED AC 2021; 57:medicina57060577. [PMID: 34199976 PMCID: PMC8229179 DOI: 10.3390/medicina57060577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 05/25/2021] [Accepted: 06/02/2021] [Indexed: 12/04/2022]
Abstract
Background and Objectives: Vaginitis causes vulvovaginal symptoms, including itching, irritation, vaginal discharge, burning, or foul odor. It is one of the most common diseases encountered in gynecologic practice. Hypoestrogenism due to menopause has a considerable negative effect on vaginal health and leads to changes in the vaginal pH and vaginal microflora, which are related to a change in the causes and microorganisms of vaginitis. Thus the aim here was to investigate the prevalence of pathogens and other microorganisms in premenopausal and postmenopausal women with vulvovaginal symptoms, using an STD 12-Multiplex real-time PCR test and routine culture of vaginal discharge. Materials and Methods: From January 2018 to December 2019, records of patients diagnosed with vaginitis at Changwon Gyeongsang National University Hospital were retrospectively reviewed. The premenopausal and postmenopausal subjects were categorized into Group A and Group B, respectively. and the data of symptoms, general characteristics, and results of both STD 12-Multiplex real-time PCR test and routine culture of vaginal discharge were retrieved. Results: On the STD 12-Multiplex real-time PCR test, Gardnerella vaginalis was the most common microorganism in both groups. Ureaplasma parvum was the second most common one, followed by Candida speceies. On the routine culture of vaginal discharge, Escherichia coli was the most common aerobic bacterial microorganism in both groups, followed by Streptococcus agalactiae (Group B Streptococcus, GBS). There was no significant difference between the two groups. Pathogens and other microorganisms of patients with vulvovaginal symptoms that showed a statistically significant difference between the two groups were Ureaplasa parvum, Ureaplasma urealyticulum, Trichomonas vaginalis, and Staphylococcus aureus. Conclusion: In this study, the prevalence of pathogens and other microorganisms in menopausal women with vulvovaginal symptoms did not show a significant difference from premenopausal women. Therefore, management strategies for patients with vulvovaginal symptoms should be developed through accurate diagnosis using appropriate diagnostic methods.
Collapse
Affiliation(s)
- Jong-Chul Baek
- Department of Obstetrics and Gynecology, College of Medicine, Gyeongsang National University, Gyeongsang National University Changwon Hospital, 11, Samjeongja-ro, Seongsan-gu, Changwon-si 51472, Gyeongsangnam-do, Korea; (J.-C.B.); (S.-M.L.); (J.-E.P.)
| | - Hyen-Chul Jo
- Department of Obstetrics and Gynecology, College of Medicine, Gyeongsang National University, Gyeongsang National University Changwon Hospital, 11, Samjeongja-ro, Seongsan-gu, Changwon-si 51472, Gyeongsangnam-do, Korea; (J.-C.B.); (S.-M.L.); (J.-E.P.)
- Correspondence: ; Tel.: +82-55-214-3780; Fax: +82-55-214-3253
| | - Seon-Mi Lee
- Department of Obstetrics and Gynecology, College of Medicine, Gyeongsang National University, Gyeongsang National University Changwon Hospital, 11, Samjeongja-ro, Seongsan-gu, Changwon-si 51472, Gyeongsangnam-do, Korea; (J.-C.B.); (S.-M.L.); (J.-E.P.)
| | - Ji-Eun Park
- Department of Obstetrics and Gynecology, College of Medicine, Gyeongsang National University, Gyeongsang National University Changwon Hospital, 11, Samjeongja-ro, Seongsan-gu, Changwon-si 51472, Gyeongsangnam-do, Korea; (J.-C.B.); (S.-M.L.); (J.-E.P.)
| | - In-Ae Cho
- Department of Obstetrics and Gynecology, College of Medicine, Gyeongsang National University, Gyeongsang National University Hospital, Jinju 52727, Gyeongsangnam-do, Korea;
| | - Joo-Hyun Sung
- Department of Occupational and Environmental Medicine, Institute of Health Sciences, College of Medicine, Gyeongsang National University, Gyeongsang National University Changwon Hospital, Jinju 51472, Gyeongsangnam-do, Korea;
| |
Collapse
|
6
|
Vaginal candidiasis in Konya area: Etiology, risk factors, virulence patterns, and antifungal susceptibility. REV ROMANA MED LAB 2021. [DOI: 10.2478/rrlm-2021-0012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Abstract
Vulvovaginal candidiasis (VVC), a common genital tract infection, is known to affect millions of women worldwide. In this study, it was aimed to determine the prevalence, virulence, possible risk factors and antifungal susceptibility model of Candida species. Vaginal swab samples were taken from patients aged 18 years and older who presented to the gynecology outpatient clinic with signs and symptoms suggestive of vulvovaginitis. Demographic data were recorded using a questionnaire. Standard microbiological methods were used for the identification of the isolates. Broth microdilution method was used to determine the antifungal susceptibility of Candida isolates. Virulence factors of Candida strains were determined by performing proteinase, phospholipase, hemolytic and biofilm activity tests. Sequencing of the isolates identified as Candida were performed using ITS 1-4 primers. Vaginal discharge (OR: 3.365; 95% CI: 1.595-7.101), burning complaint (OR: 9.098; 95% CI: 2.284-36.232) and history of allergy (OR: 3.396; 95% CI: 0.968) were risk factors. The results showed that the most common isolated strain was Candida albicans (57%). It was found that the prevalence of C. glabrata remained at 26%, 44 of the C. albicans isolates presented proteinase, 35 had phospholipase, 47 had biofilm, and 47 had hemolytic activity. In this study, susceptible dose-dependent and resistant rates of all Candida strains were found for fluconazole as 9% and 16%, respectively. Host and organism-related factors should be considered in the clinical treatment of VVC, and continuous monitoring of changes in the prevalence of Candida species and susceptibility rates is required for effective antifungal therapy.
Collapse
|
7
|
Validation of the SavvyCheck™ Vaginal Yeast Test for Screening Pregnant Women for Vulvovaginal Candidosis: A Prospective, Cross-Sectional Study. J Fungi (Basel) 2021; 7:jof7030233. [PMID: 33804805 PMCID: PMC8003914 DOI: 10.3390/jof7030233] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 02/06/2023] Open
Abstract
Pregnant women have an increased risk of vulvovaginal candidosis. Recurrent candidosis is under debate as a contributor to preterm birth, and vertical transmission may cause diaper dermatitis and oral thrush in the newborn. Apart from cultural methods, the gold standard for diagnosing candidosis is Gram staining, which is time-consuming and requires laboratory facilities. The objective of this prospective study was to validate a point-of-care vaginal yeast detection assay (SavvyCheck™ Vaginal Yeast Test) and to evaluate it in asymptomatic pregnant women. We enrolled 200 participants, 100 of whom had vulvovaginal candidosis according to Gram stain (study group) and 100 were healthy pregnant controls (control group). Of these, 22 participants (11%) had invalid test results. The point-of-care test of the remaining 85 and 93 study participants in the study and control groups, respectively, showed a sensitivity of 94.1%, specificity of 98.9%, positive predictive value of 90.3%, and negative predictive value of 99.4% when compared with Gram stain. In conclusion, we found a high correlation between the SavvyCheck™ Vaginal Yeast Test and Gram-stained smears during pregnancy. This suggests a potential role of this point-of-care test as a screening tool for asymptomatic pregnant women in early gestation.
Collapse
|
8
|
Salinas AM, Osorio VG, Pacha-Herrera D, Vivanco JS, Trueba AF, Machado A. Vaginal microbiota evaluation and prevalence of key pathogens in ecuadorian women: an epidemiologic analysis. Sci Rep 2020; 10:18358. [PMID: 33110095 PMCID: PMC7591572 DOI: 10.1038/s41598-020-74655-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 10/05/2020] [Indexed: 12/22/2022] Open
Abstract
Vaginal infection is a gynecological problem in women of reproductive age with multiple health outcomes. The most common forms of infection include bacterial vaginosis (BV), vulvovaginal candidiasis (VC), and aerobic vaginitis (AV). Our main goals were to evaluate different types of vaginal infections in Ecuadorian women in a large urban area (Quito) and to characterize the vaginal microbiota colonization by opportunistic species. We collected vaginal swabs and epidemiological surveys from 414 women from June 2016 to July of 2017. We analyzed vaginal samples for the presence of any vaginal infection. The microbiological examination was done through Gram-stain, wet mount smears, and polymerase chain reaction (PCR) assays using primers for target genes, such as 16S rRNA (Atopobium vaginae, Mobiluncus mulieris, and Gardnerella species), ddl (Enterococcus faecalis), adk (Escherichia coli) and KER1 (Candida albicans) genes. Most women showed a healthy vaginal microbiota (66.7%). Nearly one-tenth (10.4%) of the participants had intermediate microbiota, and the remaining women (22.9%) had a single vaginal infection (BV, AV, or VC) or coinfections. From the 95 participants that had an infection, AV was the main diagnosed vaginal infection (51.6%), followed by BV (24.2%) and finally VC (7.4%). The remaining women (16.8%) showed coinfections, being BV and AV the most common coinfection. Using univariable logistic regression analyses we found an increased odds of healthy microbiota in women with a sexual partner (P = 0.02, OR = 1.64). Also, women in a free union relationship (P = 0.000, OR = 16.65) had an increased odds of having coinfections. On the other hand, the use of birth control (condom OR = 0.388 or other contraceptive method OR = 0.363) was associated with significantly lower odds of intermediate microbiota (P ≤ 0.05). We found no statistically significant differences between women with infection and a particular group age. Using multivariate logistic regression analyses we initially found an increased odds of having BV in women with M. mulieris (P = 0.020, OR = 4.98) and Gardnerella species (P = 0.010, OR = 4.16). Women with E. coli showed an increased odds of having AV (P = 0.009, OR = 2.81). The presence of C. albicans in women showed an increased odds of having VC (P = 0.007, OR = 17.94). Finally, women with M. mulieris showed a reverse odds of having healthy microbiota (P = 0.008, OR = 0.06). We found no statistically significant differences between women with symptomatic and asymptomatic infections or the presence of Enterococcus faecalis. We found using logistic regression analyses that M. mulieris was the most prevalent opportunistic pathogen among women with vaginal infection. Further studies should evaluate the possibility to use M. mulieris as a potential key predictor for vaginal infections.
Collapse
Affiliation(s)
- Ana María Salinas
- Instituto de Microbiología, Colegio de Ciencias Biológicas y Ambientales (COCIBA), Universidad San Francisco de Quito (USFQ), Diego de Robles y Vía Interoceánica, Campus Cumbayá, Casilla Postal 17-1200-841, Quito, 170901, Ecuador
| | - Verónica Gabriela Osorio
- Instituto de Microbiología, Colegio de Ciencias Biológicas y Ambientales (COCIBA), Universidad San Francisco de Quito (USFQ), Diego de Robles y Vía Interoceánica, Campus Cumbayá, Casilla Postal 17-1200-841, Quito, 170901, Ecuador
| | - David Pacha-Herrera
- Instituto de Microbiología, Colegio de Ciencias Biológicas y Ambientales (COCIBA), Universidad San Francisco de Quito (USFQ), Diego de Robles y Vía Interoceánica, Campus Cumbayá, Casilla Postal 17-1200-841, Quito, 170901, Ecuador
| | - Juan S Vivanco
- Instituto de Microbiología, Colegio de Ciencias Biológicas y Ambientales (COCIBA), Universidad San Francisco de Quito (USFQ), Diego de Robles y Vía Interoceánica, Campus Cumbayá, Casilla Postal 17-1200-841, Quito, 170901, Ecuador
| | - Ana Francisca Trueba
- Brain and Behavior Laboratory, Colegio de Ciencias de la Salud, Universidad San Francisco de Quito (USFQ), Diego de Robles y Vía Interoceánica, Campus Cumbayá, Casilla Postal 17-1200-841, Quito, 170901, Ecuador
| | - António Machado
- Instituto de Microbiología, Colegio de Ciencias Biológicas y Ambientales (COCIBA), Universidad San Francisco de Quito (USFQ), Diego de Robles y Vía Interoceánica, Campus Cumbayá, Casilla Postal 17-1200-841, Quito, 170901, Ecuador.
| |
Collapse
|
9
|
Pacha-Herrera D, Vasco G, Cruz-Betancourt C, Galarza JM, Barragán V, Machado A. Vaginal Microbiota Evaluation and Lactobacilli Quantification by qPCR in Pregnant and Non-pregnant Women: A Pilot Study. Front Cell Infect Microbiol 2020; 10:303. [PMID: 32637367 PMCID: PMC7318849 DOI: 10.3389/fcimb.2020.00303] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 05/20/2020] [Indexed: 01/09/2023] Open
Abstract
Pregnancy outcomes and women's health are directly affected by vaginal microbiota. This microbiota consists of a dynamic ecosystem of various microbes in different ratios, which in healthy conditions protect the vaginal epithelium from infections. However, cases of vaginal infection are regularly diagnosed in women of reproductive age, contributing to more severe outcomes. Therefore, our main goal was to determine the prevalence of bacterial vaginosis (BV), aerobic vaginitis (AV), and vulvovaginal candidiasis (VVC) among Ecuadorian pregnant and non-pregnant women. A cross-sectional study was conducted among 217 women between 13 and 40 years old seeking primary healthcare in Carlos Andrade Marin Hospital (HCAM), Gynecological-Obstetric Hospital Isidro Ayora (HGOIA) and Center for Teaching Health Cipriana Dueñas during October 2018 to February 2019. The classical characterization of the vaginal microbiota was performed through microscopy by the Nugent criteria to evaluate the presence of BV, healthy and intermediate microbiota, by the criteria of Donders to determine the presence of AV and by the Marot-Leblond criteria to diagnose VVC. DNA extraction from vaginal samples and Polymerase Chain Reaction (PCR) analysis was performed to characterize the presence of Gardnerella spp., Mobiluncus mulieris, Escherichia coli, Enterococcus spp., and Lactobacillus spp. Finally, quantification of the lactobacilli was performed by quantitative real-time PCR (qPCR) for samples from women with normal vaginal microbiota and women with AV. Our results showed 52% of women with healthy microbiota, 7% with intermediate microbiota, and 41% with vaginal dysbiosis, comprising 27% with AV, 8% with BV and 4% with VVC and 2% with co-infections or co-dysbiosis. Additionally, a higher amount of lactobacilli were found in pregnant women when compared to non-pregnant women, while AV cases were characterized by a significant drop of Lactobacillus spp., more precisely, between 1E3 and 1E5 colony forming units (CFU)/ml. Finally, women with normal vaginal microbiota showed an average load of lactobacilli between 1E6 and 1E7 CFU/ml. This pilot study showed no statistically significant differences between pregnant and non-pregnant women, pointing to the possibility to use lactobacilli quantification for the prevention of future vaginal infections.
Collapse
Affiliation(s)
- David Pacha-Herrera
- Laboratorio de Bacteriología, Instituto de Microbiología, Colegio de Ciencias Biológicas y Ambientales, Universidad San Francisco de Quito, Quito, Ecuador
| | - Gabriela Vasco
- Laboratorio de Bacteriología, Instituto de Microbiología, Colegio de Ciencias Biológicas y Ambientales, Universidad San Francisco de Quito, Quito, Ecuador
- Cátedra de Microbiología de la Escuela de Medicina, Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador
| | - Cecilia Cruz-Betancourt
- Laboratorio de Biología Molecular, Unidad Técnica de Genética y Molecular, Hospital de Especialidades Carlos Andrade Marín del IESS, Quito, Ecuador
| | - Juan Miguel Galarza
- Laboratorio de Biología Molecular, Unidad Técnica de Genética y Molecular, Hospital de Especialidades Carlos Andrade Marín del IESS, Quito, Ecuador
| | - Verónica Barragán
- Laboratorio de Bacteriología, Instituto de Microbiología, Colegio de Ciencias Biológicas y Ambientales, Universidad San Francisco de Quito, Quito, Ecuador
| | - António Machado
- Laboratorio de Bacteriología, Instituto de Microbiología, Colegio de Ciencias Biológicas y Ambientales, Universidad San Francisco de Quito, Quito, Ecuador
| |
Collapse
|
10
|
Candida Infections in Immunocompetent Hosts: Pathogenesis and Diagnosis. CURRENT FUNGAL INFECTION REPORTS 2020. [DOI: 10.1007/s12281-020-00392-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
11
|
Hariyanto L, Baktir A. Development of a Gold Immunochromatographic Assay Method Using Candida Biofilm Antigen as a Bioreceptor for Candidiasis in Rats. OPEN CHEM 2019. [DOI: 10.1515/chem-2019-0146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractThe gold immunochromatography assay (GICA), a new immunochromatography technique, uses a nitrocellulose membrane as a carrier and a colloidal gold-labeled antigen or antibody as a tracer (bioreceptor). This technology has many advantages over other immunoassays, including its simplicity, rapidity, cheapness, and the lack of a requirement for special training or expensive equipment, and it can be used to detect either antigens or antibodies. Therefore, we chose to develop this method for the diagnosis of candidiasis in Indonesia. The objective of the present study was to develop a diagnostic test for Candida albicans in rats using the GICA method. GICA bioreceptors were developed from biofilm antigens isolated from biofim Candida albicans grown on the surface of nitrocellulose membranes. The formation of biofilms was confirmed using scanning electron microscopy. Antigen levels as bioreceptors were optimized by using the immuno dot method. The samples to be analyzed were antibody serum, in the form of blood serum samples from heart mice that have been induced to become candidiasis. To this end, we optimized the antigen and antibody volumes necessary to make this diagnosis. The results show that the optimum concentration of antigen to be used in the test is 2.5 μg/μL and the optimum volume of antibody is 10 μL. The control rats produced a single red stripe on the control line and the candidiasis rat samples produced a double red stripe, with the bottom line being the control line and the upper line the test line. The test chip was successfully used for the diagnosis of candidiasis in rats and given the name “Candiday Kit.”. We anticipate that this test will be suitable for the diagnosis of candidiasis in humans
Collapse
Affiliation(s)
| | - Loo Hariyanto
- Department of Biochemistry, Faculty of Medicine, Wijaya Kusuma University, Surabaya, Indonesia
| | - Afaf Baktir
- Department of Chemistry, Faculty of Science and Technology, Airlangga University, Surabaya, Indonesia
| | | |
Collapse
|
12
|
Ramírez-Lozada T, Espinosa-Hernández VM, Frías-De-León MG, Martínez-Herrera E. Update of Vulvovaginal Candidiasis in Pregnant and Non-pregnant Patients. CURRENT FUNGAL INFECTION REPORTS 2019. [DOI: 10.1007/s12281-019-00357-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
13
|
Chatzivasileiou P, Vyzantiadis TA. Vaginal yeast colonisation: From a potential harmless condition to clinical implications and management approaches-A literature review. Mycoses 2019; 62:638-650. [PMID: 31038771 DOI: 10.1111/myc.12920] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 04/23/2019] [Accepted: 04/23/2019] [Indexed: 01/11/2023]
Abstract
Vaginal yeast colonisation is a common clinical condition in premenopausal women. The potential pathogenicity and the circumstances under which it could evolve into infection are not fully clarified. Extensive review the literature regarding the definition of the vaginal yeast colonisation, its demographic features and causes as well as the risk factors favouring infection along with the necessity of treatment. Databases, namely PubMed-MEDLINE, Google Scholar, the University College London databases, e-journals, e-books and official Health Organisations websites were extensively searched in English, French, German and Greek language with no restriction in the type of publications during the last thirty years. In healthy women, vaginal yeast colonisation is an asymptomatic state with Candida albicans being the most prevalent species. Pregnant, HIV-positive and diabetic hosts are at higher risk. Other risk factors include oral contraceptives, hormonal replacement therapy and previous antibiotic use. Colonisation does not necessitate therapeutic intervention when asymptomatic. Prophylactic therapy during the third trimester of pregnancy is often recommended for reducing the risk of neonatal candidiasis. The distinction between commensalism and vaginitis is often complicated. Clinicians should be aware of the clinical context in order to decide the indicated therapeutic approach.
Collapse
Affiliation(s)
- Panagiota Chatzivasileiou
- First Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | |
Collapse
|
14
|
ElFeky DS, Gohar NM, El-Seidi EA, Ezzat MM, AboElew SH. Species identification and antifungal susceptibility pattern ofCandidaisolates in cases of vulvovaginal candidiasis. ALEXANDRIA JOURNAL OF MEDICINE 2019. [DOI: 10.1016/j.ajme.2015.10.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Dalia Saad ElFeky
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University, Egypt
| | - Noha Mahmoud Gohar
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University, Egypt
| | - Eman Ahmad El-Seidi
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University, Egypt
| | - Mona Mahmoud Ezzat
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University, Egypt
| | - Somaia Hassan AboElew
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Egypt
| |
Collapse
|
15
|
Lv C, Ming D, Lei TT. A performance evaluation of an immuno-latex chromatography card for the rapid detection of Candida spp. J Microbiol Methods 2018; 157:4-8. [PMID: 30543825 DOI: 10.1016/j.mimet.2018.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 12/08/2018] [Accepted: 12/10/2018] [Indexed: 11/19/2022]
Abstract
This report evaluates the performance and species specificity of an immuno-latex chromatography card (ICC) for rapid detection of Candida spp. Double-manipulator single-blind Gram staining smear examination (GSSE) and ICC were used to analyze 354 vaginal discharge specimens (VDS) (including 98 tested as positive by GSSE) from women with suspected candidal vaginitis, simulated specimens with a concentration gradient, and vaginitis causing organism suspensions (0.9% NaCl) of 22 species from nine genera. Limit of detection, semi-quantitative detection performance, total detection performance and species specificity were determined for ICC, and the results were compared with those of the GSSE method. The limits of detection of ICC for Candida spp. in organism suspensions with 0.9% NaCl and simulated specimens were 7 × 106 cells/L and 7 × 108 cells/L respectively. For species specificity, the results were positive for six Candida spp. (C. albicans, C. glabrata, C. parapsilosis, C. tropicalis, C. krusei and C. guilliermondii) and negative for the remaining 16 species (C. lusitaniae, Saccharomyces cerevisiae; three Gram-positive coccus species, four Gram-negative bacillus species, three Gram-negative coccus species and four common microbes causing vaginal infection) from eight genera. The overall sensitivity, specificity, accuracy, positive predictive value and negative predictive value of ICC for VDS were 93.81%, 99.10%, 97.31, 98.14% and 96.90%, respectively. The above indicators in the 98 VDS evaluated as positive were 84.39%, 92.86%, 86.74%, 96.72% and 70.27%, respectively. In summary, ICC offered better specificity, sensitivity, positive predictive value and negative predictive value for the detection of Candida spp. in VDS.
Collapse
Affiliation(s)
- Changhong Lv
- Department of Clinical Laboratory, the First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, China
| | - Desong Ming
- Department of Clinical Laboratory, the First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, China.
| | - Ting-Ting Lei
- Department of Clinical Laboratory, the First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, China
| |
Collapse
|
16
|
Blostein F, Levin-Sparenberg E, Wagner J, Foxman B. Recurrent vulvovaginal candidiasis. Ann Epidemiol 2017; 27:575-582.e3. [PMID: 28927765 DOI: 10.1016/j.annepidem.2017.08.010] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 08/03/2017] [Accepted: 08/04/2017] [Indexed: 01/13/2023]
Abstract
PURPOSE Recurrent vulvovaginal candidiasis (RVVC), multiple episodes of vulvovaginal candidiasis (VVC; vaginal yeast infection) within a 12-month period, adversely affects quality of life, mental health, and sexual activity. Diagnosis is not straightforward, as VVC is defined by the combination of often nonspecific vaginal symptoms and the presence of yeast-which is a common vaginal commensal. Estimating the incidence and prevalence is challenging: most VVC is diagnosed and treated empirically, the availability for purchase of effective therapies over the counter enables self-diagnosis and treatment, and the duration of the relatively benign VVC symptoms is short, introducing errors into any estimates relying on medical records or patient recall. METHODS We evaluate current estimates of VVC and RVVC and provide new prevalence estimates using data from a 2011 seven-country (n = 7345) internet panel survey on VVC conducted by Ipsos Health (https://www.ipsos.com/en). We also evaluate information on VVC-associated visits using the National Ambulatory Medical Care Survey. RESULTS The estimated probability of VVC by age 50 varied widely by country (from 23% to 49%, mean 39%), as did the estimated probability of RVVC after VVC (from 14% to 28%, mean 23%). CONCLUSIONS However estimated, the probability of RVVC was high suggesting RVVC is a common condition.
Collapse
Affiliation(s)
- Freida Blostein
- Center for Molecular and Clinical Epidemiology, University of Michigan, School of Public Health, Ann Arbor
| | - Elizabeth Levin-Sparenberg
- Center for Molecular and Clinical Epidemiology, University of Michigan, School of Public Health, Ann Arbor
| | | | - Betsy Foxman
- Center for Molecular and Clinical Epidemiology, University of Michigan, School of Public Health, Ann Arbor.
| |
Collapse
|
17
|
Seifinadergoli Z, Nahidi F, Safaiyan A, Javadzadeh Y, Eteraf-Oskouei T. Comparison of the efficacy of honey gel and clotrimazole cream in the treatment of vaginal candidiasis symptoms: a randomized clinical trial. Electron Physician 2017; 10:6904-6911. [PMID: 30034657 PMCID: PMC6049967 DOI: 10.19082/6904] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 12/14/2017] [Indexed: 01/22/2023] Open
Abstract
Background Reproductive tract infection is a global health problem among women, particularly in East Asia. Accordingly, researchers are seeking drugs with fewer side effects, compared to chemical agents. In this regard, the antifungal properties of honey have been confirmed. Objective This study was conducted to examine the effects of vaginal honey gel and clotrimazole cream on symptoms of candidiasis in 2014–2015. Methods This single-blind clinical trial was conducted on 106 patients with clinical complaints and positive cultures. The study was conducted in Tabriz clinics and health centers during 2014–2015. The participants were randomly divided into clotrimazole cream and honey gel groups (n, 53 per group) and were assessed both pretreatment and post treatment (before, 4 and 8 days after treatment). The results were analyzed and compared in IBM-SPSS version 22, using McNemar’s test, Cochran’s Q test, generalized mixed model, and independent-samples t-test. The significance level was set at 0.05. Results At all 3 time intervals, significant reductions were observed in vaginal symptoms, compared to pretreatment due to the use of honey gel and clotrimazole cream (p<0.001). On the other hand, the culture results were similar, and there was no significant difference between the groups (p>0.05). Conclusion Honey was effective in the treatment of candidiasis symptoms and could be used as an alternative or adjuvant for other antifungal drugs in the treatment of vaginal candidiasis symptoms. Clinical Trial Registration This study was registered in the Iranian Registry of Clinical Trials (http://www.irct.ir) with the registration code IRCT201604144317N9. Funding The authors received no financial support for the research.
Collapse
Affiliation(s)
- Zahra Seifinadergoli
- Department of Midwifery & Reproductive Health, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Nahidi
- Midwifery and Reproductive Health Research Center, Department of Midwifery & Reproductive Health, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abdolrasoul Safaiyan
- Assistant Professor, Road Traffic Center and Department of Biostatistical and Epidemiology, Tabriz Medical Science University, Tabriz, Iran
| | - Yousef Javadzadeh
- Professor, Biotechnology Research Center and Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tahereh Eteraf-Oskouei
- Associate Professor, Department Of Pharmacology and Toxicology, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
18
|
Kalaiarasan K, Singh R, Chaturvedula L. Fungal Profile of Vulvovaginal Candidiasis in a Tertiary Care Hospital. J Clin Diagn Res 2017; 11:DC06-DC09. [PMID: 28511380 DOI: 10.7860/jcdr/2017/23578.9475] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 12/11/2016] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Vulvovaginal Candidiasis (VVC) is a common medical health problem of adult women. It is most commonly caused by Candida albicans. But there is a change in fungal profile. Sabouraud's Dextrose Agar (SDA) is the most common culture medium used where mixed fungal infection may be missed. It can be detected easily by using chromogenic culture medium. AIM To know the fungal profile of vulvovaginal candidiasis using Candida CHROMagar and antifungal susceptibility pattern in patients attending tertiary care hospital. MATERIALS AND METHODS Culture confirmed cases of VVC presented at Department of Obstetrics and Gynaecology of Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India, from July 2015 to December 2015 were included in the cross-sectional study. Two high vaginal swabs were collected and inoculated on SDA and Candida CHROMagar (Hi-Media, Mumbai, India). After overnight incubation the colonies were counted and colour of the colonies were recorded from Candida CHROMagar. Candida spp. were identified by sugar fermentation and assimilation tests and other conventional tests. Antifungal susceptibility tests were performed by the disc diffusion method using fluconazole (25 μg) and voriconazole (1μg) as per the Clinical and Laboratory Standards Institute (CLSI - M44-A2) guidelines. RESULTS A total of 50 culture confirmed (23.7%) cases were detected from 211 clinically suspected VVC cases. Candida glabrata (45.1%) was the most common isolate, followed by Candidatropicalis (23.5%), Candida albicans (17.6%), Candida krusei (9.8%) and Candida parapsilosis (3.9%). One mixed infection of C. glabrata and C. albicans was identified on Candida CHROMagar. Mixed fungal infection was observed in 2% of positive culture and 0.5% of VVC cases. The antifungal susceptibility testing revealed that 15.7% and 9.8% isolates of Candida spp. were resistant and Susceptible Dose Dependent (S-DD) respectively to fluconazole. The increase resistant against fluconazole was because of increased isolation of C. glabrata strains. All strains of Candida spp. were susceptible to voriconazole. CONCLUSION C. glabrata was the most common causative agent of VVC in a tertiary care hospital. Chromogenic culture medium facilitates detection of mixed fungal infection. In vitro susceptibility testing should be used to guide the treatment especially in cases of non-albicans Candidiasis.
Collapse
Affiliation(s)
- Krishnapriya Kalaiarasan
- M.Sc (MLT), Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Rakesh Singh
- Associate Professor, Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Latha Chaturvedula
- Professor, Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| |
Collapse
|
19
|
Darvishi M, Jahdi F, Hamzegardeshi Z, Goodarzi S, Vahedi M. The Comparison of vaginal cream of mixing yogurt, honey and clotrimazole on symptoms of vaginal candidiasis. Glob J Health Sci 2015; 7:108-16. [PMID: 26153168 PMCID: PMC4803919 DOI: 10.5539/gjhs.v7n6p108] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 01/19/2015] [Indexed: 01/22/2023] Open
Abstract
Background: Vulvovaginal candidiasis is known as one of the most common fungal infection among women of reproductive age and considered as an important public health problem. In recent years, due to resistance to common antifungal medication, the use of traditional medicine of anti-fungal and herbal treatmentis increased. Therefore the objective of this study was to determine the effects of vaginal cream, mixture of yogurt and honey and comparing it with clotrimazole vaginal cream on symptoms of Vulvovaginal candidiasis in patients. Methods: In this randomized, triple blind clinical trial of 70 non-pregnant women infected with Candidalvulvovaginitis were placed in two groups of Vaginal cream mixed of yogurt and honey recipients (N = 35) and clotrimazole vaginal cream (N = 35). Both groups were treated for 7 days.At the beginning of study, Clinical and laboratory signs and symptoms were registered 7 and 14 days after treatment by questionnaire, observation formand secretions medium culture results. Data were analyzed by chi-square test, t test, McNemar tests through SPSS version 21. Significance level of 0.05 was considered. Results: The result of present study reveals the significant differences in symptom improvement of yogurt and honey, toward clotrimazole group (P < 0.05) and also Positive results of the first cultures (one week after treatment) in “yogurt and honey” and clotrimazole (20% versus 8.6%) and second time cultivation (14 days after treatment) (17.1% versus 8.6%) were similar and there was no significant differences between the two groups. (P > 0.05). Conclusion: This study indicated that the therapeutic effects of vaginal cream, yogurt and honey is not only similar with clotrimazole vaginal cream but is more effective in relieving some symptoms of vaginal candidiasis. Therefore, the use of this product can be suggested as an herbal remedy for candida infection treatment.
Collapse
Affiliation(s)
| | - Fereshteh Jahdi
- Department of Midwifery, Faculty of Nursing & Midwifery, Iran University of Medical Sciences, Tehran, Iran.
| | | | | | | |
Collapse
|
20
|
Chumpitazi BFF, Lebeau B, Faure-Cognet O, Hamidfar-Roy R, Timsit JF, Pavese P, Thiebaut-Bertrand A, Quesada JL, Pelloux H, Pinel C. Characteristic and clinical relevance of Candida mannan test in the diagnosis of probable invasive candidiasis. Med Mycol 2014; 52:462-71. [DOI: 10.1093/mmy/myu018] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
|
21
|
Zhang JE, Luo D, Chen RY, Yang YP, Zhou Y, Fan YM. Feasibility of histological scoring and colony count for evaluating infective severity in mouse vaginal candidiasis. Exp Anim 2014; 62:205-10. [PMID: 23903055 PMCID: PMC4160942 DOI: 10.1538/expanim.62.205] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Qualitative measurement of the infective level is relatively difficult in experimental
vaginal candidiasis. Female BALB/c mice aged 8 to 10 weeks were randomly divided into E1,
E2 and E0 groups, which received subcutaneous injection of 0.05 mg, 0.1 mg of estradiol
benzoate or 0.1 ml soybean oil 3 days before vaginal inoculation, respectively, and
hormone treatment continued every other day thereafter. Each group was further divided
into infected and noninfected subgroups. The infected mice were inoculated intravaginally
with 10 µl (5 × 104 conidia) of Candida
albicans suspension, while the noninfected mice were inoculated with 10
µl phosphate-buffered saline. Direct microscopic examination, colony
count and vaginal histopathology including infection degree and inflammation extent were
performed at 3, 7 and 14 days post inoculation. Estrogen treatment increased the vaginal
fungal burden and extent of infection and inflammation compared with the control group,
and 0.3 mg/week estrogen generally induced more severe infection and inflammation than
0.15 mg/week estrogen did. Colony count peaked on day 3 and decreased remarkably after 7
days. Infection score increased gradually during the first 7 days and decreased on day 14,
while inflammation extent exacerbated progressively over the course of 14 days. This study
demonstrates that the modified histological scoring system might be more feasible than
colony count for evaluation of infectivity and dynamic change in experimental vaginal
candidiasis.
Collapse
Affiliation(s)
- Jin-E Zhang
- Department of Dermatology, Affiliated Hospital of Guangdong Medical College, No.57, Renmin Avenue, Xiashan District, Zhanjiang, Guangdong, 524001, PR, China
| | | | | | | | | | | |
Collapse
|
22
|
Cuenca-Estrella M, Verweij PE, Arendrup MC, Arikan-Akdagli S, Bille J, Donnelly JP, Jensen HE, Lass-Flörl C, Richardson MD, Akova M, Bassetti M, Calandra T, Castagnola E, Cornely OA, Garbino J, Groll AH, Herbrecht R, Hope WW, Kullberg BJ, Lortholary O, Meersseman W, Petrikkos G, Roilides E, Viscoli C, Ullmann AJ. ESCMID* guideline for the diagnosis and management of Candida diseases 2012: diagnostic procedures. Clin Microbiol Infect 2013; 18 Suppl 7:9-18. [PMID: 23137134 DOI: 10.1111/1469-0691.12038] [Citation(s) in RCA: 248] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
As the mortality associated with invasive Candida infections remains high, it is important to make optimal use of available diagnostic tools to initiate antifungal therapy as early as possible and to select the most appropriate antifungal drug. A panel of experts of the European Fungal Infection Study Group (EFISG) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) undertook a data review and compiled guidelines for the clinical utility and accuracy of different diagnostic tests and procedures for detection of Candida infections. Recommendations about the microbiological investigation and detection of candidaemia, invasive candidiasis, chronic disseminated candidiasis, and oropharyngeal, oesophageal, and vaginal candidiasis were included. In addition, remarks about antifungal susceptibility testing and therapeutic drug monitoring were made.
Collapse
Affiliation(s)
- M Cuenca-Estrella
- Servicio de Micología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Abstract
Vaginal symptoms are one of the leading reasons that women visit their health care providers. Women often self-diagnose and may treat themselves inappropriately. This article describes the etiology, risk factors, symptoms, diagnosis, and treatment of the 3 most common vaginal infections: bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis.
Collapse
|
24
|
Kam YW, Lum FM, Teo TH, Lee WWL, Simarmata D, Harjanto S, Chua CL, Chan YF, Wee JK, Chow A, Lin RTP, Leo YS, Le Grand R, Sam IC, Tong JC, Roques P, Wiesmüller KH, Rénia L, Rötzschke O, Ng LFP. Early neutralizing IgG response to Chikungunya virus in infected patients targets a dominant linear epitope on the E2 glycoprotein. EMBO Mol Med 2012; 4:330-43. [PMID: 22389221 PMCID: PMC3376860 DOI: 10.1002/emmm.201200213] [Citation(s) in RCA: 149] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Revised: 12/20/2011] [Accepted: 01/04/2012] [Indexed: 12/17/2022] Open
Abstract
Chikungunya virus (CHIKV) and related arboviruses have been responsible for large epidemic outbreaks with serious economic and social impact. The immune mechanisms, which control viral multiplication and dissemination, are not yet known. Here, we studied the antibody response against the CHIKV surface antigens in infected patients. With plasma samples obtained during the early convalescent phase, we showed that the naturally-acquired IgG response is dominated by IgG3 antibodies specific mostly for a single linear epitope ‘E2EP3’. E2EP3 is located at the N-terminus of the E2 glycoprotein and prominently exposed on the viral envelope. E2EP3-specific antibodies are neutralizing and their removal from the plasma reduced the CHIKV-specific antibody titer by up to 80%. Screening of E2EP3 across different patient cohorts and in non-human primates demonstrated the value of this epitope as a good serology detection marker for CHIKV infection already at an early stage. Mice vaccinated by E2EP3 peptides were protected against CHIKV with reduced viremia and joint inflammation, providing a pre-clinical basis for the design of effective vaccine against arthralgia-inducing CHIKV and other alphaviruses.
Collapse
Affiliation(s)
- Yiu-Wing Kam
- Singapore Immunology Network, Agency for Science, Technology and Research (A*STAR), Biopolis, Singapore
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Kam YW, Simarmata D, Chow A, Her Z, Teng TS, Ong EKS, Rénia L, Leo YS, Ng LFP. Early appearance of neutralizing immunoglobulin G3 antibodies is associated with chikungunya virus clearance and long-term clinical protection. J Infect Dis 2012; 205:1147-54. [PMID: 22389226 PMCID: PMC3295607 DOI: 10.1093/infdis/jis033] [Citation(s) in RCA: 136] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background. Chikungunya virus (CHIKV) and related arboviruses have been responsible for large epidemic outbreaks with serious economic and social impact. Although infected individuals clear the virus from the blood, some develop debilitating and prolonged arthralgia. Methods. We investigated specificity and strength of antibody responses in a longitudinal study on CHIKV-infected patients and analyzed their association with viral load, cytokine profile, and severity. Results. We found that CHIKV-specific response is dominated by immunoglobulin G3 (IgG3) antibodies. The antibodies were neutralizing, and patients with high viremia rapidly developed high levels of anti-CHIKV antibodies of this specific isotype. Although these patients endured a more severe disease progression during the acute viremic phase, they cleared the virus faster and did not experience persistent arthralgia. However, significant persistent arthralgia was observed in patients with low viremia who developed IgG3 at a later stage. Conclusions. Absence of early CHIKV-specific IgG3 may therefore serve as a specific marker of patients with increased risk of disease.
Collapse
Affiliation(s)
- Yiu-Wing Kam
- Singapore Immunology Network, Agency for Science, Technology and Research (A*STAR), Singapore
| | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Ilkit M, Guzel AB. The epidemiology, pathogenesis, and diagnosis of vulvovaginal candidosis: A mycological perspective. Crit Rev Microbiol 2011; 37:250-61. [DOI: 10.3109/1040841x.2011.576332] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
27
|
Epithelial cell secretions from the human female reproductive tract inhibit sexually transmitted pathogens and Candida albicans but not Lactobacillus. Mucosal Immunol 2011; 4:335-42. [PMID: 21048705 PMCID: PMC3094926 DOI: 10.1038/mi.2010.72] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Female reproductive tract (FRT) epithelial cells protect against potential pathogens and sexually transmitted infections. The purpose of this study was to determine if epithelial cells from the upper FRT secrete antimicrobials that inhibit reproductive tract pathogens that threaten women's health. Apical secretions from primary cultures of Fallopian tube, uterine, cervical, and ectocervical epithelial cells were incubated with Neisseria gonorrhoeae, Candida albicans (yeast and hyphal forms), human immunodeficiency virus 1 (HIV-1), and Lactobacillus crispatus before being tested for their ability to grow and/or infect target cells. Epithelial cell secretions from the upper FRT inhibit N. gonorrhoeae and both forms of Candida, as well as reduce HIV-1 (R5) infection of target cells. In contrast, none had an inhibitory effect on L. crispatus. An analysis of cytokines and chemokines in uterine secretions revealed several molecules that could account for pathogen inhibition. These findings provide definitive evidence for the critical role of epithelial cells in protecting the FRT from infections, without comprising the beneficial presence of L. crispatus, which is part of the normal vaginal microflora of humans.
Collapse
|