TITLE:
Prevalence of Non-Albicans Candida Infections in Women with Recurrent Vulvovaginal Symptomatology
AUTHORS:
Jason D. Mintz, Mark G. Martens
KEYWORDS:
Recurrent Vulvovaginal Candidiasis; Non--Albicans Candida; Fluconazole; Yeast Infections; Candida Vaginitis
JOURNAL NAME:
Advances in Infectious Diseases,
Vol.3 No.4,
December
3,
2013
ABSTRACT: Background: Candida vulvovaginitis is one of the most frequently
diagnosed conditions in women’s care practices. Historically, 90% of cultured
yeast species were C. albicans. However,
due to a variety of interventions, the proportion of non-albicans
Candida (NAC) infections appears to be increasing. We sought to estimate
the current prevalence of Candida vulvovaginitis and the species-specific distribution of such infections in
recurrent cases. Methods: Women with recurrent vulvovaginal symptomatology
referred to an Obstetrics and Gynecology practice were tested by genital fungus culture, Candida-specific
polymerase chain reaction (PCR), or both between July 2010 and February 2013. Results: A total of 103 women were tested. Mean age was 45.6 years. Including
only their most recent positive test result, 29.1% (30/103) of women tested
positive for Candida by any of the
above testing measures. Of those, 50%
(15/30) tested positive for C. albicans and 50% (15/30) tested positive for a NAC species. Across all visits, 60%
(18/30) tested positive for C. albicans, 56.7% (17/30) tested positive for NAC,
and 16.7% (5/30) tested positive for both a C. albicans and a NAC species. Among all
isolated NAC species, 28.6% (6/21) were determined to be C. glabrata, 23.8% (5/21) C.
krusei, 23.8% (5/21) C. parapsilosis,
and 23.8% (5/21) other Candida species. Conclusion: Approximately
30% of women with recurrent vulvovaginal symptomatology have detectable Candida strains and it appears that NAC
species may cause half of all these infections. This is imperative because NAC
infections are usually more difficult to diagnose and are resistant to most
treatments.