Distribution of pathogenic yeast species of vulvovaginitis and its epidemiological characteristics

Abstract

Abstract: Objective To investigate the epidemiological characteristics of vulvovaginitis caused by different yeast spp. Methods Totally 1 083 yeast isolates were collected from patients with vulvovaginal candidiasis (VVC). These isolates were identified to the species level according to the genes of 26S rRNA D1/D2 domain. The clinical characteristics VVC cases caused by these different species were analyzed. Results The results showed that Candida albicans remain the prodominent species(71.38%) causing VVC, while Non-candida albicans (NAC) account for 28.62% among which C.glabrata account for 19.02%. The risk factors included 20-40 years of age, being married,and pregnancy. NACs were more often isolated in pregnant women. The incidence of recurrent vaginal candidiasis caused by non-albicans Candida were higher. Conclusion Routine culture of secretion from VVC patients, molecular identification to species level of VVC causative agents, and identification of non-albicans Candida species would help clinicians to explore an effective therapy for VVC.

Key words: vulvovaginal candidiasis, epidemiological characteristics, yeast, molecular identification, antifungal therapy

CLC Number:

R519.3

ZHOU Yihua, DENG Shuwen, ZHANG Lu, ZHANG Hong, ZHAO Rongfen, WANG Yufeng, SUN Yanxia, ZHU Hui. Distribution of pathogenic yeast species of vulvovaginitis and its epidemiological characteristics[J]. Chinese Journal of Mycology, 2023, 18(1): 12-18.

References

[1] SOBEL J D. Vulvovaginal candidosis[J]. The Lancet, 2007, 369(9577):1961-1971.
[2] GONÇALVES B, FERREIRA C, ALVES C T, et al. Vulvovaginal candidiasis:Epidemiology, microbiology and risk factors[J]. Crit Rev Microbiol, 2016, 42(6):905-927.
[3] MAKANJUOLA O, BONGOMIN F, FAYEMIWO S A. An update on the roles of non-albicans Candida species in vulvovaginitis[J]. J Fungi (Basel), 2018, 4(4):121.
[4] DANBY C S, BOIKOV D, RAUTEMAA-RICHARDSON R, et al. Effect of pH on in vitro susceptibility of Candida glabrata and Candida albicans to 11 antifungal agents and implications for clinical use[J]. Antimicrob Agents Chemother, 2012, 56(3):1403-1406.
[5] RICHTER S S, GALASK R P, MESSER S A, et al. Antifungal susceptibilities of Candida species causing vulvovaginitis and epidemiology of recurrent cases[J]. J Clin Microbiol, 2005, 43(5):2155-2162.
[6] WORKOWSKI K A, BOLAN G A. Sexually transmitted diseases treatment guidelines, 2015[J]. MMWR Recomm Rep,2015, 64(RR-03):1-137.
[7] GEIGER A M, FOXMAN B, SOBEL J D. Chronic vulvovaginal candidiasis:characteristics of women with Candida albicans, C glabrata and no Candida[J].Genitourin Med, 1995, 71(5):304-307.
[8] MARDH P A, NOVIKOVA N, STUKALOVA E. Colonisation of extragenital sites by Candida in women with recurrent vulvovaginal candiosis[J]. BJOG, 2003, 10(110):934-937.
[9] KURTZMAN C P, ROBNETT C J. Identification of clinically important ascomycetous yeasts based on nucleotide divergence in the 5'end of the large-subunit (26S) ribosomal DNA gene[J]. J Clin Microbiol, 1997, 35(5):1216-1223.
[10] NARAYANKHEDKAR A, HODIWALA A, MANE A. Clinicoetiological characterization of infectious vaginitis amongst women of reproductive age group from Navi Mumbai, India[J].J Sex Transm Dis, 2015, 2015:817092.DOI:10.1155/2015/817092.
[11] WANG F J, ZHANG D, LIU Z H, et al. Species distribution and in vitro antifungal susceptibility of vulvovaginal Candida isolates in China[J].Chin Med J (Engl), 2016, 129(10):1161-1165.
[12] DEORUKHKAR S C, SAINI S, MATHEW S. Non-albicans Candida infection:an emerging threat[J].Interdiscip Perspect Infect Dis, 2014, 2014:615958-615964.DOI:10.1155/2014/615958.
[13] SILVA S, NEGRI M, HENRIQUES M, et al. Candida glabrata, Candida parapsilosis and Candida tropicalis:biology, epidemiology, pathogenicity and antifungal resistance[J]. FEMS Microbiol Rev, 2012, 36(2):288-305.
[14] BABIć M, HUKIć M. Candida albicans and non-albicans species as etiological agent of vaginitis in pregnant and nonpregnant women[J].Bosn J Basic Med Sci, 2010, 10(1):89-97.
[15] KALIA N, SINGH J, SHARMA S, et al. Prevalence of vulvovaginal infections and species specific distribution of vulvovaginal candidiasis in married women of north India[J]. IJCMAS, 2015, 4(8):253-266.
[16] SHI Y, ZHU Y, FAN S, et al. Molecular identification and antifungal susceptibility profile of yeast from vulvovaginal candidiasis[J]. BMC Infect Dis, 2020, 20(1):1-10.
[17] DENNING D W, KNEALE M, SOBEL J D, et al. Global burden of recurrent vulvovaginal candidiasis:a systematic review[J]. Lancet Infect Dis, 2018, 18(11):e339-e347.
[18] OLOWE O, MAKANJUOLA O, OLOWE R, et al. Prevalence of vulvovaginal candidiasis, trichomoniasis and bacterial vaginosis among pregnant women receiving antenatal care in Southwestern Nigeria[J]. Eur J Microbiol Immunol (Bp), 2014, 4(4):193-197.
[19] GUZEL A B, ILKIT M, BURGUT R, et al. An evaluation of risk factors in pregnant women with Candida vaginitis and the diagnostic value of simultaneous vaginal and rectal sampling[J]. Mycopathologia, 2011, 172(1):25-36.
[20] KALKANCI A, GVZEL A B, KHALIL I I J, et al. Yeast vaginitis during pregnancy:susceptibility testing of 13 antifungal drugs and boric acid and the detection of four virulence factors[J]. Med Mycol, 2012, 50(6):585-593.
[21] RINGDAHL E N. Treatment of recurrent vulvovaginal candidiasis[J]. Am Fam Physician, 2000, 61(11):3306-3312.
[22] WORKOWSKI K A, BERMAN S M. Sexually transmitted diseases treatment guidelines, 2006[J]. MMWR Recomm Rep, 2006, 55(RR-11):1-94.
[23] FIDEL JR P L, VAZQUEZ J A, SOBEL J D. Candida glabrata:review of epidemiology, pathogenesis, and clinical disease with comparison to C. albicans[J]. Clin Microbiol Rev, 1999, 12(1):80-96.
[24] PAPPAS P G, KAUFFMAN C A, ANDES D R, et al. Clinical practice guideline for the management of candidiasis:2016 update by the Infectious Diseases Society of America[J].Clin Infect Dis, 2016, 62(4):e1-e50.
[25] RAY D, GOSWAMI R, BANERJEE U, et al. Prevalence of Candida glabrata and its response to boric acid vaginal suppositories in comparison with oral fluconazole in patients with diabetes and vulvovaginal candidiasis[J].Diabetes Care, 2007, 30(2):312-317.
[26] POWELL A M, GRACELY E, NYIRJESY P. Non-albicans Candida vulvovaginitis:treatment experience at a tertiary care vaginitis center[J]. J Low Genit Tract Dis, 2016, 20(1):85-89.
[27] SOBEL J D. Treatment of vaginal Candida infections[J].Expert Opin Pharmacother, 2002, 3(8):1059-1065.