An Evaluation of Risk Factors in Pregnant Women with Candida Vaginitis and the Diagnostic Value of Simultaneous Vaginal and Rectal Sampling

Abstract

In this study, we investigated the epidemiological characteristics of VVC among pregnant women. We conducted a prospective survey among 372 pregnant women to investigate the prevalence, clinical forms, etiological agents, and predisposing factors of VVC. In addition, we determined the relationship between vaginal and rectal flora by simultaneously obtaining one high vaginal swab and one rectal swab from each patient using sterile cotton-tipped swabs. Furthermore, we compared the recovery and identification performances of chromID Candida agar to Sabouraud dextrose agar with gentamicin and chloramphenicol. Clinically and mycologically confirmed cases of VVC were detected in 139 (37.4%) and vaginal colonization described in 42 (11.3%) of 372 pregnant women. Rectal cultures were also positive in 98 of the 139 (70.5%) VVC cases. Candida albicans and C. glabrata were identified in vaginal samples in 58.0 versus 19.0% and from rectal samples in 49.0 versus 13.5%, respectively. Increases in gestational week and gravidae were identified to be statistically significant in patients with acute VVC (AVVC) and symptomatic recurrent VVC (RVVC), and asymptomatic RVVC (P = 0.04 and P = 0.03, respectively). In the laboratory diagnosis of VVC, specifically tailored chromogenic media are reliable tools for both the recovery and rapid identification of common Candida spp., particularly C. albicans, as well as for the detection of polyfungal populations in vaginal samples (P > 0.05). In addition, rectal colonization is a common finding in cases of AVVC and symptomatic-RVVC cases and corresponds well with the presence of the same yeast species in the vagina.

Estrogen treatment predisposes to severe and persistent vaginal candidiasis in diabetic mice

“…Several reports have suggested that DM is a contributing factor to VC [1,2,5-8,33]. However, findings reported here suggest that DM on its own neither induces nor maintains VC.…”

“…Vaginal candidiasis (VC) represents a serious health problem to women of childbearing age worldwide [1,2]. Among the significant predisposing factors to VC are increased levels of estrogen in the reproductive tract milieu, diabetes mellitus (DM), and compromised immunity [3-8].…”

Prevalence of vulvovaginal candidiasis, trichomoniasis and bacterial vaginosis among pregnant women receiving antenatal care in Southwestern Nigeria

“…Approximately 75% of the female population suffers at least one episode during their lives [7,8]. Candida albicans is the causative agent in most cases [5,7,9]. Pregnancy, diabetes mellitus, and antibiotic treatment are the most common predisposing factors [5][6][7][8].…”

Prevalence and antifungal susceptibility of Candida species among pregnant women attending a school maternity at Natal, Brazil

“…Inappropriate use of antifungal agents has led to the emergence of antifungal resistance (Guzel et al . ). Therefore, monitoring the activity of antifungal drugs is of concern particularly among pregnant women as the choice of treatment is limited by their side effects (Sobel et al .…”