Does vaginal douching affect the type of candidal vulvovaginal infection?

Abstract

The normal vaginal microbiota is a dynamic system that continually fluctuates under the environmental changes and different physiological conditions. Yeast infections of the vagina are caused by one of the species of fungus called Candida (C.). The study aimed to evaluate the types of mycobiota in women with vulvovaginal candidiasis (VVC) who were performing vaginal douching (VD) or not. Furthermore, it studied the antifungal sensitivity toward different fungi isolated from the vagina. In a cross-sectional study conducted in Assiut University Hospital, Egypt, women with VVC were interviewed regarding relevant history including the habit of VD. Vaginal swabs were obtained and processed by direct microscope and by culture on CHROMagar Candida and other differential media. The types of Candida in women with the habit of VD were compared with those not having this habit. We found that VD habit was practiced by 67.4% of women with VVC, and Candida albicans was the commonest (78.3%) type observed. There was no significant difference in the percentage of non-albicans types between women performing VD (23.6%) and those not reporting this habit (18.9%). Harboring non-albicans types were significantly increased in regular performers of VD compared with those who had this procedure only after sexual intercourse or after the end of menstruation (36.8%,12.5%, and 16.7%, respectively) (P = .048). Thus, vaginal douching does not influence the type of Candida infection involved in VVC. Frequent performance of VD increases the likelihood of having non-albicans types and the resistance to the common antifungal agents.

Characterization, Virulence Factors and Antifungal Susceptibility of Vulvovaginal Candida Isolated from Women at Qena, Egypt

“…The reason for the high incidence rate in this age group includes increased sexual activity and a new effect of reproductive hormones (Sobel et al, 1998). The vaginal douching increases the infection rate due to change in normal flora, but not affect the type of Candida species (La Ruche et al, 1999 andShaaban et al, 2015).…”

“…Samples were taken from patients using sterile spectrum and sterile cotton swabs with long handle. The swabs were immediately covered by its sterile cover and transported to the laboratory for quick examination and culturing (Shaaban et al, 2015).…”

“…recovered from women with vaginitis depending mainly on the population site and ecological conditions (Galan-Ladero et al, 2009). In African countries, C. albicans is the common species (78.3-96.1%) isolated from vaginitis, followed by C. glabrata (3.9-12%) and C. tropicalis (3.5-5.4) (Konate et al, 2014 andShaaban et al, 2015). The incidence of vaginitis caused by non-albicans Candida spp.…”

Qualitative Analysis of Sexually Experienced Female Adolescents: Attitudes about Vaginal Health

“…Historically, the focus about vaginal hygiene practices has centered on douching 3,4 and its ability to increase the risk of infection. 28 These adolescents did not seem to be describing practices that were inherently dangerous. However, if physicians do not query each adolescent about their particular vaginal practices, situations that may be dangerous or unnecessary may not be uncovered.…”

Douching Practices among Hausa-Fulani Pregnant Women With and Without Bacterial Vaginosis in Zaria, Northwest Nigeria

“…The surfaces of vaginal walls, which are usually moist, are easily separable due to lubrication by about 1 ml of basal vaginal fluid (BVF). Sources of BVF which collect in the vagina are from the peritoneal fluid, fluid from the entire uterine system which includes the follicles, the fallopian tubes, the uterus itself, the cervix and the vaginal The epidemiology of douching, women's behavioral pattern to it, substances used and reasons behind douching as well as its health implication have been studied extensively, mostly outside of Africa [2,3]. Surveys have shown that douching practice was common in the United States [4,5] Martino, et al stated that [6] douching prevalence varies according to race, and age cohort and Diclemente argued that increased age [7], lower socioeconomic status, and older partners are probable relevant risk factors for douching among African American adolescents.…”