Prevalence and management of non-albicans vaginal candidiasis

Hetticarachchi, Nalin; Ashbee, H. R.; Wilson, Janet

doi:10.1136/sti.2009.040386

Cited by 38 publications

(34 citation statements)

References 11 publications

(12 reference statements)

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“…23 Non-albicans Candida infections frequently require the use of non-azole therapy, including topical therapy with boric acid, Flucytosine, or Amphotericin B. 24,26 In summary, our study found higher prevalence of Candida spp. in vaginal mucosa of HIV-infected patients than uninfected women.…”

Section: Discussionmentioning

confidence: 53%

Candida species isolated from the vaginal mucosa of HIV-infected women in Salvador, Bahia, Brazil

Oliveira¹,

Mascarenhas²,

Lacroix³

et al. 2011

Braz J Infect Dis

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Background: Vulvovaginal candidiasis (VVC) is the second most common vaginal infection. HIV-infection is a risk factor for this infection. Objective: To determine the frequency of VVC and to describe the main Candida species isolated and their susceptibility to antifungal drugs in HIV-infected patients, compared to HIV-uninfected women in Salvador, Brazil. Methods: Cross-sectional study including a group of 64 HIV-infected women and 76 uninfected women, followed up at the AIDS reference center and at the Gynecological Clinic of Escola Bahiana de Medicina e Saúde Pública (Salvador, Bahia, Brazil). Results: Frequency of Candida spp. was higher in HIV-infected women (29.7%) than in HIV-uninfected controls (14.5%) (p = 0.02). The odds ratio value for vulvovaginal candidiasis in HIV-infected patients was 2.6 (95% CI: 1.07 -6.32 p = 0.03). Candida albicans was the most commonly isolated species in both HIV-infected (52.3%) and uninfected women (85.7%), followed by C. parapsolis in 17.6% and 14.3%, respectively. In HIV-infected women, C. glabrata, C. parapsilosis, and a coinfection of C. albicans and C. glabrata were also identified. There was no significant difference between Candida species isolated from the vaginal mucosa of women with VVC and colonization of the vaginal mucosa of HIV-infected and HIV-uninfected women. One C. glabrata isolate from an HIV-infected patient was resistant to fluconazole and other two isolates exhibited a dose-dependent susceptibility. Conclusion: Our results confirm a higher frequency of Candida spp. isolated from the vaginal mucosa of HIV-infected women and a broader spectrum of species involved. Only Candida glabrata isolates showed decreased susceptibility to fluconazole.

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Section: Discussionmentioning

confidence: 53%

Candida species isolated from the vaginal mucosa of HIV-infected women in Salvador, Bahia, Brazil

Oliveira¹,

Mascarenhas²,

Lacroix³

et al. 2011

Braz J Infect Dis

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“…Infections with non-albicans Candida species frequently do not respond to standard azole treatments [17]. In the current study, the mycological and clinical cure rates of patients in the non-albicans Candida group were lower than those in the C. albicans group on days 7-14 and 30-35, but no statistically significant differences were found.…”

Section: Discussionmentioning

confidence: 59%

Miconazole Nitrate Vaginal Suppository 1,200 mg versus Oral Fluconazole 150 mg in Treating Severe Vulvovaginal Candidiasis

Fan

Liu²,

Liang³

2015

Gynecol Obstet Invest

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Aims: Miconazole is a synthetic imidazole antifungal that has a broad spectrum of activity against Candida albicans and non-albicans Candida species. The aim of this study was to evaluate the efficacy and safety of miconazole nitrate vaginal suppository and oral fluconazole in treating severe vulvovaginal candidiasis (SVVC). Methods: In this prospective, randomized case control study, 577 cases of consecutive patients with SVVC were studied at the Gynecological Clinic of Peking University Shenzhen Hospital from January 1, 2009 through December 31, 2010. Patients with SVVC were treated with two doses of miconazole nitrate vaginal suppository 1,200 mg or two doses of fluconazole 150 mg. The patients were followed up for 7-14 and 30-35 days following the second dose of therapy. Results: The mycological cure rates of the patients on days 7-14 of follow-up were 75.9% (220/290) and 84.0% (241/287) in the miconazole and fluconazole groups, respectively (p < 0.05). The mycological cure rates of the patients at the second follow-up were 64.8% (188/290) and 69.7% (200/287), respectively, in the two groups (p > 0.05). Conclusion: The study demonstrated that two doses of miconazole nitrate vaginal suppository 1,200 mg were as effective as two doses of an oral fluconazole 150 mg regimen in the treatment of patients with SVVC.

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“…Women infected with C. glabrata emerged as most difficult to predict need for treatment with conventional therapy, including vaginal boric acid and flucytosine cream [8,12]. Two components of prediction are involved.…”

Section: Discussionmentioning

confidence: 99%

Vulvovaginal Candidiasis Caused by Non-albicans Candida Species: New Insights

Kennedy

Sobel

2010

Curr Infect Dis Rep

102

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Non-albicans Candida species have increasingly been identified as the cause of vulvovaginitis. In vitro and in vivo data indicate that the various non-albicans Candida species identified in the lower genital tract differ considerably with regard to epidemiology, virulence or vaginal pathogenicity, and antimycotic drug susceptibility. Clinical experience indicates reduced virulence of these organisms in the lower genital tract, and their causal role in a symptomatic patient requires careful case-by-case determination rather than routine administration of antimycotic therapy. Accordingly, vaginal Candida isolates deserve species identification and consideration of pathogenic potential and antifungal susceptibility before therapeutic decisions are made.

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Prevalence and management of non-albicans vaginal candidiasis

Cited by 38 publications

References 11 publications

Candida species isolated from the vaginal mucosa of HIV-infected women in Salvador, Bahia, Brazil

Candida species isolated from the vaginal mucosa of HIV-infected women in Salvador, Bahia, Brazil

Miconazole Nitrate Vaginal Suppository 1,200 mg versus Oral Fluconazole 150 mg in Treating Severe Vulvovaginal Candidiasis

Vulvovaginal Candidiasis Caused by Non-albicans Candida Species: New Insights

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