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Pane M, Chisari E. Efficacy of Limosilactobacillus fermentum in the management of vulvovaginal candidiasis: comparative analysis with topical miconazole in a single-blind randomized clinical trial. Front Microbiol 2024; 15:1428590. [PMID: 39149209 PMCID: PMC11324542 DOI: 10.3389/fmicb.2024.1428590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 07/15/2024] [Indexed: 08/17/2024] Open
Abstract
Introduction Vulvovaginal candidiasis (VVC) significantly impacts women's quality of life and often shows a high recurrence rate despite conventional antifungal therapies. This study evaluates the efficacy of Limosilactobacillus fermentum (LF5), a probiotic, as an alternative treatment option to conventional miconazole therapy in managing VVC. Methods The randomized, single-blind clinical trial involved 100 premenopausal women diagnosed with VVC. Participants were assigned to either a vaginal capsule containing LF5 probiotic strain or miconazole. Treatments were administered once daily for three consecutive days. Microbiological eradication of Candida spp. and recurrence rates were assessed at 30 days post-treatment. The trial was registered with the Italian Ministry of Health. Results Both treatments achieved a high rate of microbiological eradication of Candida spp. within the three-day treatment period (96% for LF5 and 94% for miconazole). Recurrence rates within 2 weeks post-treatment were low and similar between the groups (10% for LF5 and 17% for miconazole). LF5 was found to have a significantly lower incidence of local adverse reactions compared to miconazole (4 vs. 12%). Discussion LF5 presents a viable alternative to miconazole for the treatment of VVC, offering comparable efficacy with fewer side effects. The results suggest that probiotic treatments can potentially enhance patient compliance and quality of life by reducing adverse reactions and recurrence rates. Further research is needed to confirm these findings in larger and more diverse populations.
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Recurrent vulvo-vaginal candidiasis in Abidjan (Côte d'Ivoire): Aetiology and associated factors. J Mycol Med 2019; 29:127-131. [PMID: 31010729 DOI: 10.1016/j.mycmed.2019.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 02/28/2019] [Accepted: 04/02/2019] [Indexed: 01/05/2023]
Abstract
Recurrent vulvovaginal candidiasis (RVVC) is a major health problem for sexually active women because of its severe effect on their quality of life. A thorough knowledge of their epidemiology leads to their efficient management. Therefore, a cross-sectional study was conducted in 2014 in women with leucorrhoea associated or not with other clinical signs. Recurrence was based on the occurrence of at least four annual episodes of Candida vulvo-vaginitis. An individual interview based on a questionnaire was conducted to identify the socio-demographic parameters that could be associated with the RVVC. Vaginal samples were collected at the obstetrical gynaecology department of the University Hospital of Cocody and at the Pasteur Institute of Côte d'Ivoire. On each sample, a direct examination and culture on Sabouraud-chloramphenicol medium with or without actidione were performed. Yeast identification was performed using chromogenic media (CandiSelect®4 [Bio-Rad]) and the study of sugar assimilation using the Auxacolor® 2 gallery (Bio-Rad). A total of 400 patients were included. The average age was 29.2 years (SD=7.2 years). Of these, 94 had recurrent vulvovaginal candidiasis, with a prevalence of 23.5% (CI95%: 19.49-28.02). Five species of the genus Candida have been identified: Candida albicans (59.6%), Candida glabrata (19.1%), Candida tropicalis (16%), Candida krusei (4.2%) and Candida inconspicua (1.1%). Some factors such as education level, history of sexually transmitted infection, type of underwear used, frequency of personal hygiene and type of product used for these hygiene have been associated with the occurrence of RVVCs. The occurrence of RVVCs is relatively high in our study population. Non-albicansCandida species occupy a significant place in this disease epidemiology. By addressing the factors associated with the occurrence and/or persistence of RVVCs, it will be possible to reduce their incidence in sexually active women.
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Molecular Epidemiology and In Vitro Antifungal Susceptibility of Candida Isolates from Women with Vulvovaginal Candidiasis in Northern Cities of Khuzestan Province, Iran. Jundishapur J Microbiol 2017. [DOI: 10.5812/jjm.12804] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Noumi E, Snoussi M, Noumi I, Saghrouni F, Aouni M, Valentin E. Phenotypic characterization and adhesive properties of vaginal Candida spp. strains provided by the CHU Farhat Hached (Sousse, Tunisia). Rev Iberoam Micol 2014; 32:170-9. [PMID: 25618183 DOI: 10.1016/j.riam.2014.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 03/21/2014] [Accepted: 06/02/2014] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Vulvovaginal candidiasis is a common infection among women worldwide, being Candida albicans the most commonly isolated species. Therefore, controlling this opportunistic yeast is one of the key factors for reducing nosocomial infection. AIMS We investigated several virulence properties of 28 vaginal strains of Candida isolated from Tunisian women suffering from vulvovaginitis. We also analyzed the virulence properties of a clinical Candida krusei strain and five Candida reference strains. METHODS Candida strains were subjected to microscopic analysis and culture in Candida ID2 chromogenic medium. The adhesive properties of these strains were estimated by the microtiter plate - the safranin-staining - and the Congo red agar (CRA) methods, for determining yeast ability to form biofilms on biomaterials used in urinary catheter manufacturing. Their potency to produce hydrolytic enzymes was also studied. RESULTS Our results showed that nine out of the total studied strains produced phospholipase. In addition, very high protease activity was detected in 23 Candida strains. All Candida strains were beta-hemolytic and adhered to polystyrene microtiter plates in varying degrees. Two vaginal C. albicans strains were strongly adhesive to polystyrene and glass slides. Also, our results showed that vaginal Candida strains were more adhesive to the three tested materials than the reference strains. CONCLUSIONS This study shows the presence of a range of virulence and adhesion factors in clinical isolates of vaginal Candida. Consequently, control and treatment of vaginal candidiasis as a means to prevent biofilm formation on urinary catheters is of crucial importance.
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Affiliation(s)
- Emira Noumi
- Laboratoire des Maladies Transmissibles et des Substances Biologiquement Actives, Faculté de Pharmacie, Université de Monastir, Tunisia; Departamento de Microbiologia y Ecologia, Facultad de Farmacia, Universidad de Valencia, Burjassot, Valencia, Spain.
| | - Mejdi Snoussi
- Laboratoire de Traitement des Eaux Usées, Centre de Recherches et des Technologies des Eaux (CERTE), Technopole de Borj-Cédria, BP 273, Soliman 8020, Tunisia
| | - Inès Noumi
- Institut Supérieur de Biotechnologie de Monastir, Université de Monastir, Tunisia
| | - Fatma Saghrouni
- Laboratoire de Parasitologie, Hôpital Farhat Hached de Sousse, Sousse, Tunisia
| | - Mahjoub Aouni
- Laboratoire des Maladies Transmissibles et des Substances Biologiquement Actives, Faculté de Pharmacie, Université de Monastir, Tunisia
| | - Eulogio Valentin
- Departamento de Microbiologia y Ecologia, Facultad de Farmacia, Universidad de Valencia, Burjassot, Valencia, Spain
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Ekpenyong CE, Inyang-etoh EC, Ettebong EO, Akpan UP, Ibu JO, Daniel NE. Recurrent vulvovaginal candidosis among young women in south eastern Nigeria: the role of lifestyle and health-care practices. Int J STD AIDS 2013; 23:704-9. [PMID: 23104744 DOI: 10.1258/ijsa.2012.011382] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
This work was carried out to study the association between lifestyle, health-care practices and incidence of recurrent vulvovaginal candidosis (RVVC) among young women in south eastern Nigeria. It was a multicentre case-control study of 176 women aged between 20 and 35 years recruited from the designated health facilities. Lifestyle and health-care practice structured questionnaires were used to survey the participants. Clinical examination was performed and vaginal swabs were taken from participants for microscopy, culture and sensitivity. The germ tube test was performed for identification of Candida albicans. The results of this study showed that frequent douching with water or other fluids (odds ratio [OR](adjusted) = 2.41, 95% confidence interval [CI] = 1.25-4.66, P = 0.000), wearing tight nylon/synthetic underwear (OR(adjusted) = 4.76, 95% CI = 2.28-9.95, P = 0.000), alternative medical treatment for repeated or recalcitrant cases (OR(adjusted) = 4.84, 95% CI = 2.94-15.91, P = 0.000), were significantly associated with higher odds for RVVC and self-diagnosis and use of over-the-counter antifungal medications (OR(adjusted) = 4.61, 95% CI = 2.29-9.32, P = 0.000) were associated with RVVC. Results of the fungal cultures showed that C. albicans and non-C. albicans were isolated from 83.7% and 16.3% of participants, respectively. Our results supported the association between some of the hypothesized risk factors and the occurrence of RVVC.
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Affiliation(s)
- C E Ekpenyong
- Department of Physiology, College of Health Sciences, University of Uyo, Akwa Ibom State, Nigeria.
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Mahmoudabadi AZ, Najafyan M, Moghimipour E, Alwanian M, Seifi Z. Lamisil versus clotrimazole in the treatment of vulvovaginal candidiasis. IRANIAN JOURNAL OF MICROBIOLOGY 2013; 5:86-90. [PMID: 23466900 PMCID: PMC3577561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Vaginal candidiasis is a common disease in women during their lifetime and occurs in diabetes patients, during pregnancy and oral contraceptives users. Although several antifungals are routinely used for treatment; however, vaginal candidiasis is a challenge for patients and gynecologists. The aim of the present study was to evaluate terbinafine (Lamisil) on Candida vaginitis versus clotrimazole. MATERIALS AND METHODS In the present study women suspected to have vulvovaginal candidiasis were sampled and disease confirmed using direct smear and culture examination from vaginal discharge. Then, patients were randomly divided into two groups, the first group (32 cases) was treated with clotrimazole and the next (25 cases) with Lamisil. All patients were followed-up to three weeks of treatment and therapeutic effects of both antifungal were compared. RESULTS Our results shows that 12 (37.5%) patients were completely treated with clotrimazole during two weeks and, 6(18.8%) patients did not respond to drugs and were refereed for fluconazole therapy. Fourteen (43.8%) patients showed moderate response and clotrimazole therapy was extended for one more week. When Lamisil was administrated, 19 (76.0%) patients were completely treated with Lamisil in two weeks, and 1 (4.0%) of the patients did not respond to the drug and was refereed for fluconazole therapy. Five (20.0%) of our patients showed moderate response and Lamisil therapy was extended for one more week. CONCLUSION Our results show that vaginal cream, 1% Lamisil, could be suggested as a first-line treatment in vulvovaginal candidiasis.
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Affiliation(s)
- Ali Zarei Mahmoudabadi
- Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran,Infectious Diseases and Tropical Medicine Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, Corresponding author: Dr. Ali Zarei Mahmoudabadi, Address: Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Tel: +98-611-3330074. Fax: +98-611-3332036. E-mail:
| | - Mahin Najafyan
- Department of Obstetric and Genecology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Eskandar Moghimipour
- Department of Pharmaceutics, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Alwanian
- Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Seifi
- Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Mahmoudi Rad M, Zafarghandi AS, Amel Zabihi M, Tavallaee M, Mirdamadi Y. Identification of Candida species associated with vulvovaginal candidiasis by multiplex PCR. Infect Dis Obstet Gynecol 2012; 2012:872169. [PMID: 22791958 PMCID: PMC3389677 DOI: 10.1155/2012/872169] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 04/28/2012] [Accepted: 05/17/2012] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Vulvovaginal candidiasis is a common infection. The aim of this study was to identify the species of vaginal Candida isolates by using multiplex PCR technique. METHODS 191 isolates from patients admitted to Mahdieh hospital were identified. The vaginal swab specimens were cultured on Sabouraud Dextrose Agar. The ITS1 region between the 18S and 5.8S rRNA genes and a specific DNA fragment within the ITS2 region were amplified. The multiplex PCR products were separated by electrophoresis in 2% agarose gel, visualized by staining with ethidium bromide, and photographed. Descriptive statistics, Chi-square test, and Spearman correlation were used to summarize the findings. RESULTS C. albicans and C. glabrata were the most common species isolated from the specimens. A mix of C. glabrata and C. albicans was the most common mixed infection isolated from the samples. The analysis revealed a significant positive association between older age and infection with C. glabrata isolates (Spearman's rho = 0.89, P = 0.015). CONCLUSION Multiplex PCR is a fast, yet reliable method to identify Candida species. C. albicans and then C. glabrata are the two most common causes of vulvovaginal candidiasis. The number of mixed fungal infections is higher among Iranian population compared to international reports.
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Affiliation(s)
- Mahnaz Mahmoudi Rad
- Skin Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Ameneh Sh Zafarghandi
- Department of Obstetrics and Gynecology, Mahdieh Educational Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Amel Zabihi
- Department of Obstetrics and Gynecology, Mahdieh Educational Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahkam Tavallaee
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada V5A 1S6
| | - Yasaman Mirdamadi
- Skin Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
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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]
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Candida species isolated from the vaginal mucosa of HIV-infected women in Salvador, Bahia, Brazil. Braz J Infect Dis 2011; 15:239-44. [DOI: 10.1016/s1413-8670(11)70182-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Accepted: 02/17/2011] [Indexed: 11/24/2022] Open
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Mahmoudi Rad M, Zafarghandi S, Abbasabadi B, Tavallaee M. The epidemiology of Candida species associated with vulvovaginal candidiasis in an Iranian patient population. Eur J Obstet Gynecol Reprod Biol 2011; 155:199-203. [DOI: 10.1016/j.ejogrb.2010.11.022] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2010] [Revised: 09/21/2010] [Accepted: 11/30/2010] [Indexed: 01/31/2023]
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Henić E, Thiel S, Mårdh PA. Mannan-binding lectin in women with a history of recurrent vulvovaginal candidiasis. Eur J Obstet Gynecol Reprod Biol 2010; 148:163-5. [DOI: 10.1016/j.ejogrb.2009.10.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2009] [Revised: 09/11/2009] [Accepted: 10/07/2009] [Indexed: 11/24/2022]
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Weissenbacher ER, Weissenbacher T, Spitzbart H. [The significance of interleukins and of Candida-IgE in chronic recurrent vulvovaginal candidosis]. Mycoses 2005; 47 Suppl 1:37-40. [PMID: 15667363 DOI: 10.1111/j.1439-0507.2004.01038.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We examined 104 patients with chronic recurrent vulvovaginal candidosis; 41 healthy women were selected for the control group. Vaginal samples were taken, and yeasts were grown and tested for Candida strains: 29.8% of samples contained Candida spp.; two of the control women were infected. We also identified interleukin IL-4, 5 and 13, but there was only significant increase in IL-4. In addition, prostaglandin E2, whole IgE and Candida-specific-IgE was identified. Also here prostaglandin E2 and the Candida IgE were significantly higher in comparison with the control group, while whole IgE showed no significant increase. This resulted in an allergic component in the chronic recurrent vulvovaginal candidosis, which suggested that therapy should be reconsidered.
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Affiliation(s)
- E R Weissenbacher
- Klinik und Poliklinik fur Frauenheilkunde und Geburtshilfe, Klinikum Munchen Grosshadern, Ludwig-Maximilians-Universität, Munich, Germany
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Mårdh PA, Novikova N, Stukalova E. Colonisation of extragenital sites byCandidain women with recurrent vulvovaginal candiosis. BJOG 2003. [DOI: 10.1111/j.1471-0528.2003.01445.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mårdh PA, Novikova N, Niklasson O, Bekassy Z, Skude L. Leukocyte esterase activity in vaginal fluid of pregnant and non-pregnant women with vaginitis/vaginosis and in controls. Infect Dis Obstet Gynecol 2003; 11:19-26. [PMID: 12839629 PMCID: PMC1852264 DOI: 10.1155/s1064744903000036] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To determine the leukocyte esterase (LE) activity in vaginal lavage fluid of women with acute and recurrent vulvovaginal candidosis (VVC and RVVC respectively), bacterial vaginosis (BV), and in pregnant and non-pregnant women without evidence of the three conditions. Also to compare the result of LE tests in women consulting at different weeks in the cycle and trimesters of pregnancy. The LE activity was correlated to vaginal pH, number of inflammatory cells in stained vaginal smears, type of predominating vaginal bacteria and presence of yeast morphotypes. METHODS One hundred and thirteen women with a history of RVVC, i.e. with at least four attacks of the condition during the previous year and who had consulted with an assumed new attack of the condition, were studied. Furthermore, we studied 16 women with VVC, 15 women with BV, and 27 women attending for control of cytological abnormalities, who all presented without evidence of either vaginitis or vaginosis. Finally, 73 pregnant women were investigated. The LE activity in vaginal fluid during different weeks in the cycle of 53 of the women was measured. RESULTS In the non-pregnant women, an increased LE activity was found in 96, 88, 73 and 56% of those with RVVC, VVC and BV and in the non-VVC/BV cases, respectively. In 73% of pregnant women in the second trimester, and 76% of those in the third, the LE test was positive. In all groups of non-pregnant women tested, the LE activity correlated with the number of leukocytes in vaginal smears, but it did not in those who were pregnant. There was no correlation between LE activity and week in cycle. The vaginal pH showed no correlation to LE activity in any of the groups studied. CONCLUSIONS The use of commercial LE dipsticks has a limited value in the differential diagnosis of RVVC, VVC and BV. There is no correlation between the LE activity in vaginal secretion on one hand and vaginal pH, week in the menstrual cycle and trimester in pregnancy on the other. Women with BV often have signs of inflammation as evidenced by a positive LE test and inflammatory cells in genital smears.
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Affiliation(s)
- Per-Anders Mårdh
- Department of Obstetrics and Gynecology, University Hospital, Lund, Sweden.
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Novikova N, Mårdh PA. Characterization of women with a history of recurrent vulvovaginal candidosis. Acta Obstet Gynecol Scand 2002. [DOI: 10.1034/j.1600-0412.2002.811109.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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