Vulvovaginal Candidiasis as a Chronic Disease

Hong, Esther; Dixit, Shreya; Fidel, Paul L.; Bradford, Jennifer; Fischer, Gayle

doi:10.1097/lgt.0b013e318287aced

Cited by 57 publications

(57 citation statements)

References 16 publications

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“…Lastly, the influences of host physiological processes on the development of VVC remain unclear. However, estrogen clearly plays a major role in governing disease susceptibility [32]. All animal models of VVC (mouse, rat, pig, macaque) require administration of exogenous estrogen to maintain the vaginal fungal burden, inducing keratinization and cornification of the upper squamous epithelial layer [33].…”

Section: Pathology and Epidemiology Of Vulvovaginal Candidiasismentioning

confidence: 99%

Vulvovaginal Candidiasis: A Current Understanding and Burning Questions

Willems

Ahmed

Liu

et al. 2020

JoF

186

197

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Candida albicans, along with other closely related Candida species, are the primary causative agents of vulvovaginal candidiasis (VVC)-a multifactorial infectious disease of the lower female reproductive tract resulting in pathologic inflammation. Unlike other forms of candidiasis, VVC is a disease of immunocompetent and otherwise healthy women, most predominant during their child-bearing years. While VVC is non-lethal, its high global incidence and profound negative impact on quality-of-life necessitates further understanding of the host and fungal factors that drive disease pathogenesis. In this review, we cover the current state of our understanding of the epidemiology, host response, fungal pathogenicity mechanisms, impact of the microbiome, and novel approaches to treatment of this most prevalent human candidal infection. We also offer insight into the latest advancements in the VVC field and identify important questions that still remain.

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Section: Pathology and Epidemiology Of Vulvovaginal Candidiasismentioning

confidence: 99%

Vulvovaginal Candidiasis: A Current Understanding and Burning Questions

Willems

Ahmed

Liu

et al. 2020

JoF

186

197

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“…Another smaller group of women (6-9%) experience the recurrence of this disease, called recurrent vulvovaginal candidiasis (RVVC) and defined as presenting at least 3 symptomatic episodes during the 12 previous months even though some researchers demand still, an additional episode (FOXMAN et al, 2013, JACK, SOBEL, 2016. Although various species of Candida have been involved in VVC and RVVC, Candida albicans is the predominant etiological agent, causing 85-95% of these infections (HONG et al, 2014, BEHZADI et al, 2015.…”

Section: Introductionmentioning

confidence: 99%

Study of the antifungal potential of (r)-(+)-citronellal and its association with therapeutic agents used in the treatment of vulvovaginal candidiasis

Medeiros¹,

Silva²,

Pérez³

et al. 2017

Biosci. J.

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ABSTRACT:Vulvovaginal candidiasis (VVC) is a common fungal infection that affects healthy women of all ages. At least 75% of women will develop one or more infections once during their lifetime, with 6 to 9% of those individuals developing recurrent infections. In view of this context, this study sought to evaluate the antifungal potential of the isolated (R)-(+)-citronellal [(R)-(+)-CT] and associated to therapeutic agents of clinical importance. The enantiomer was solubilized in tween 80 and dimethylsulfoxide (DMSO). Posteriorly diluted in sterile distilled water up to the concentration of 2048µg/mL. The minimum inhibitory concentration (MIC) of the product was determined by microdilution in RPMI-1640 obtaining dilutions of 1024-4µg/mL. The minimum fungicidal concentration (MFC) was determined by the Sabouraud dextrose agar (SDA) depletion technique from aliquots of 1µL of the MIC, MIC × 2 and MIC × 4. The MIC and the MFC values of (R)-(+)-CT for 90% of the C. albicans strains were 16 and 32µg/mL respectively. In the susceptibility test, C. albicans presented a high resistance to fluconazole and to itraconazole, 12 (92.30%) of the strains. However, for ketoconazole and miconazole the resistance was of 4 (30.76%) and 3 (23.07%) of the strains respectively. In the combination testing of the (R)-(+)-CT with ketoconazole and miconazole, the resistance was completely reverted. For fluconazole and itraconazole, the resistance was reverted in 9 (75%) and 7 (58.33%) of the strains respectively. The (R)-(+)-CT presented fungicide activity with MFC of MIC × 2. When in combination with ketoconazole, fluconazole, itraconazole and miconazole increased the inhibition zones of these antifungal drugs, reducing the resistance against C. albicans.

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“…The effects of estrogen on the vaginal mucosa are main factors for infection progression. Throughout the menstrual cycle, estrogen causes the thickened and cornified keratinized vaginal epithelium (17). This is further confirmed by the fact that low estrogen producers (prepubescent girls and postmenopausal women) infrequently develop vaginitis.…”

Section: Discussionmentioning

confidence: 48%

Clinical and Mycological Study of Vulvovaginal Candidiasis (VVC); Identification of Clinical Isolates by Polymerase Chain Reaction-Fragment Size Polymorphyim (PCR-FSP) Technique

Pouladian

Movahedi

Mohammadi

2017

Arch Clin Infect Dis

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Background: Vulvovaginal candidiasis is a widespread and frequent infection affecting up to 70% of healthy women, and some of them affected by recurring resistant forms of the disease. The main risk factors are hormone replacement therapy, diabetes mellitus, antibiotic usage, pregnancy, oral-contraceptives, and insufficient therapy. Candida albicans is the most etiologic agent of Candida vaginitis capable of colonizing on the mucous membrane of genitourinary tracts of healthy humans. The aim of the present study is to identify Candida species obtained from patients with vulvovaginitis by molecular techniques. Methods: Between 2015 -2016, 108 suspected patients were evaluated for vulvovaginal candidiasis. Suspected patients were divided into 3 groups and each group took only 1 antifungal agent including clotrimazole, miconazole, and nystatin, respectively. Direct microscopic examination, culture, and fragment size polymorphism (FSP) technique were used for identification of clinical isolates Results: Of the 108 patients, 59 (54.6%) had both positive culture and direct microscopic examination. The duration of disease was between 3 to 365 days. Candida albicans was the most prevalent Candida species isolated from patients (74.5%) followed by Candida glabrata (17%). The correlation between the kind of antifungal agents and recovery of patients was not statistically significant (P value = 0.056). Conclusions: Resistance to various antifungal agents and emerging of non-albicans Candida species among clinical specimens are crucial affairs in the field of medical mycology. Since VVC is a prevalent and recurrent infection, controlling of predisposing factors, personal hygiene, and appropriate antifungal therapy are extremely recommended among vulnerable population.

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Vulvovaginal Candidiasis as a Chronic Disease

Cited by 57 publications

References 16 publications

Vulvovaginal Candidiasis: A Current Understanding and Burning Questions

Vulvovaginal Candidiasis: A Current Understanding and Burning Questions

Study of the antifungal potential of (r)-(+)-citronellal and its association with therapeutic agents used in the treatment of vulvovaginal candidiasis

Clinical and Mycological Study of Vulvovaginal Candidiasis (VVC); Identification of Clinical Isolates by Polymerase Chain Reaction-Fragment Size Polymorphyim (PCR-FSP) Technique

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