candidiasis Archives - Revista Brasileira de Ginecologia e Obstetrícia
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Rev Bras Ginecol Obstet. 2021;43(8):600-607
To determine the concordance between the clinical diagnosis of women with abnormal vaginal discharge (AVD) and laboratory results using molecular detection and observation of the vaginal microbiota.
Cross-sectional study conducted in 2018 in Temuco, Chile. A total of 25 midwives from 12 health centers participated. A total of 125 women>18 years old, volunteers, were recruited. The sample of the posterior vaginal fornix was obtained by speculoscopy. Characteristics of the discharge and of the external and internal genitalia were observed. Gram staining was used to observe vaginal microbiota, blastoconidia and pseudohyphae, and polymerase chain reaction was used for the detection of Trichomonas vaginalis and Candida albicans. The Cohen kappa coefficient was used in the concordance analysis.
Out of a total of 125 women with AVD, 85.6% consulted spontaneously and 14.4% were diagnosed clinically during a routine check-up. Absolute concordance was significant (p=0.0012), with an agreement of 13.6%. The relative concordance was significant, but fair for bacterial vaginosis (Kappa=0.21; p=0.003) and candidiasis (Kappa=0.22; p=0.001), and slight for trichomoniasis (Kappa=0.14; p=0.009). The percentage of coincidence of the diagnoses (single or mixed) by laboratory and midwives was: bacterial vaginosis 63.2% (12/19), candidiasis 36.5% (27/74), and trichomoniasis 12.5% (4/32). There was 20% coinfection. A total of 36% of the clinical diagnoses of AVD had negative laboratory tests.
The vulvovaginitis conditions candidiasis and trichomoniasis appear to be overdiagnosed, and bacterial vaginosis appears to be underdiagnosed by the clinical diagnosis when compared with the laboratory diagnosis. The low concordance obtained shows the importance of complementing the clinical diagnosis with a laboratory study of AVD, particularly in women with failed treatments and/or coinfections with unspecific and varying signs and symptoms.
Summary
Rev Bras Ginecol Obstet. 2021;43(8):600-607
To determine the concordance between the clinical diagnosis of women with abnormal vaginal discharge (AVD) and laboratory results using molecular detection and observation of the vaginal microbiota.
Cross-sectional study conducted in 2018 in Temuco, Chile. A total of 25 midwives from 12 health centers participated. A total of 125 women>18 years old, volunteers, were recruited. The sample of the posterior vaginal fornix was obtained by speculoscopy. Characteristics of the discharge and of the external and internal genitalia were observed. Gram staining was used to observe vaginal microbiota, blastoconidia and pseudohyphae, and polymerase chain reaction was used for the detection of Trichomonas vaginalis and Candida albicans. The Cohen kappa coefficient was used in the concordance analysis.
Out of a total of 125 women with AVD, 85.6% consulted spontaneously and 14.4% were diagnosed clinically during a routine check-up. Absolute concordance was significant (p=0.0012), with an agreement of 13.6%. The relative concordance was significant, but fair for bacterial vaginosis (Kappa=0.21; p=0.003) and candidiasis (Kappa=0.22; p=0.001), and slight for trichomoniasis (Kappa=0.14; p=0.009). The percentage of coincidence of the diagnoses (single or mixed) by laboratory and midwives was: bacterial vaginosis 63.2% (12/19), candidiasis 36.5% (27/74), and trichomoniasis 12.5% (4/32). There was 20% coinfection. A total of 36% of the clinical diagnoses of AVD had negative laboratory tests.
The vulvovaginitis conditions candidiasis and trichomoniasis appear to be overdiagnosed, and bacterial vaginosis appears to be underdiagnosed by the clinical diagnosis when compared with the laboratory diagnosis. The low concordance obtained shows the importance of complementing the clinical diagnosis with a laboratory study of AVD, particularly in women with failed treatments and/or coinfections with unspecific and varying signs and symptoms.
Summary
Rev Bras Ginecol Obstet. 2015;37(9):417-420
DOI 10.1590/SO100-720320150005217
To investigate the influence of Lactobacillus rhamnosus in the expression of virulence factors of Candida albicans in vitro.
A suspension of L. rhamnosus was initially grown in MRS agar. The other day, Sabouraud dextrose agar was added on the growth of lactobacilli and C. albicans was seeded for 24, 48 and 72 hours. Candida strains were then isolated for investigation of the ability of biofilm formation, by means of cultivation into 96 wells plaque, and reading the optical densities and counting colony forming units per mL. Also the ability of germ tube formation was investigated, after incubation in horse serum and counting of 200 cells. The results were compared to Candida strains grown in the absence of L. rhamnosus, using Student's t test for statistical analysis.
there was a significant reduction in the growth of C. albicans in the presence of lactobacilli after 24, 48 or 72 hours. Significant reduction was also observed in germ tube formation after interaction for 48 or 72 hours. For biofilm formation, no statistically significant difference was observed between the Candida strains grown in the presence or absence of lactobacilli.
The results suggest that L. rhamnosus is able to influence significantly the growth and expression of virulence factors of C. albicans in vitro, and may interfere with pathogenicity of these micro-organisms.
Summary
Rev Bras Ginecol Obstet. 2015;37(9):417-420
DOI 10.1590/SO100-720320150005217
To investigate the influence of Lactobacillus rhamnosus in the expression of virulence factors of Candida albicans in vitro.
A suspension of L. rhamnosus was initially grown in MRS agar. The other day, Sabouraud dextrose agar was added on the growth of lactobacilli and C. albicans was seeded for 24, 48 and 72 hours. Candida strains were then isolated for investigation of the ability of biofilm formation, by means of cultivation into 96 wells plaque, and reading the optical densities and counting colony forming units per mL. Also the ability of germ tube formation was investigated, after incubation in horse serum and counting of 200 cells. The results were compared to Candida strains grown in the absence of L. rhamnosus, using Student's t test for statistical analysis.
there was a significant reduction in the growth of C. albicans in the presence of lactobacilli after 24, 48 or 72 hours. Significant reduction was also observed in germ tube formation after interaction for 48 or 72 hours. For biofilm formation, no statistically significant difference was observed between the Candida strains grown in the presence or absence of lactobacilli.
The results suggest that L. rhamnosus is able to influence significantly the growth and expression of virulence factors of C. albicans in vitro, and may interfere with pathogenicity of these micro-organisms.
Summary
Rev Bras Ginecol Obstet. 2015;37(5):222-228
DOI 10.1590/SO100-720320150005183
To estimate the prevalence of bacterial vaginosis (BV), candidiasis and
trichomoniasis and compare the findings of physical examination of the vaginal
secretion with the microbiological diagnosis obtained by cytology study of a
vaginal smear using the Papanicolaou method.
A cross-sectional study of 302 women aged 20 to 87 years, interviewed and
submitted to a gynecology test for the evaluation of vaginal secretion and
collection of a cytology smear, from June 2012 to May 2013. Sensitivity analyses
were carried out and specificity, positive predictive value (PPV) and negative
predictive value (NPV) with their respective 95%CI were determined to assess the
accuracy of the characteristics of vaginal secretion in relation to the
microbiological diagnosis of the cytology smear . The kappa index (k) was used to
assess the degree of agreement between the clinical features of vaginal secretion
and the microbiological findings obtained by cytology.
The prevalence of BV, candidiasis and trichomoniasis was 25.5, 9.3 and 2.0%,
respectively. The sensitivity, specificity, PPV and NPV of the clinical
characteristics of vaginal secretion for the cytological diagnosis of BV were 74,
78.6, 54.3 and 89.9%, respectively. The sensitivity, specificity, PPV and the NPV
of the clinical characteristics of vaginal secretion for the cytological diagnosis
of candidiasis were 46.4, 86.2, 25.5 and 94%, respectively. The correlation
between the clinical evaluation of vaginal secretion and the microbiological
diagnosis of BV, candidiasis and trichomoniasis, assessed by the kappa index, was
0.47, 0.23 and 0.28, respectively.
The most common cause of abnormal vaginal secretion was BV. The clinical
evaluation of vaginal secretion presented amoderate to weak agreement with the
microbiological diagnosis, indicating the need for complementary investigation of
the clinical findings of abnormal vaginal secretion.
Summary
Rev Bras Ginecol Obstet. 2015;37(5):222-228
DOI 10.1590/SO100-720320150005183
To estimate the prevalence of bacterial vaginosis (BV), candidiasis and
trichomoniasis and compare the findings of physical examination of the vaginal
secretion with the microbiological diagnosis obtained by cytology study of a
vaginal smear using the Papanicolaou method.
A cross-sectional study of 302 women aged 20 to 87 years, interviewed and
submitted to a gynecology test for the evaluation of vaginal secretion and
collection of a cytology smear, from June 2012 to May 2013. Sensitivity analyses
were carried out and specificity, positive predictive value (PPV) and negative
predictive value (NPV) with their respective 95%CI were determined to assess the
accuracy of the characteristics of vaginal secretion in relation to the
microbiological diagnosis of the cytology smear . The kappa index (k) was used to
assess the degree of agreement between the clinical features of vaginal secretion
and the microbiological findings obtained by cytology.
The prevalence of BV, candidiasis and trichomoniasis was 25.5, 9.3 and 2.0%,
respectively. The sensitivity, specificity, PPV and NPV of the clinical
characteristics of vaginal secretion for the cytological diagnosis of BV were 74,
78.6, 54.3 and 89.9%, respectively. The sensitivity, specificity, PPV and the NPV
of the clinical characteristics of vaginal secretion for the cytological diagnosis
of candidiasis were 46.4, 86.2, 25.5 and 94%, respectively. The correlation
between the clinical evaluation of vaginal secretion and the microbiological
diagnosis of BV, candidiasis and trichomoniasis, assessed by the kappa index, was
0.47, 0.23 and 0.28, respectively.
The most common cause of abnormal vaginal secretion was BV. The clinical
evaluation of vaginal secretion presented amoderate to weak agreement with the
microbiological diagnosis, indicating the need for complementary investigation of
the clinical findings of abnormal vaginal secretion.
Summary
Rev Bras Ginecol Obstet. 2008;30(6):300-305
DOI 10.1590/S0100-72032008000600006
PURPOSE: to correlate the presence of yeast from the Candida genus in the oral and vaginal cavity of women with and without vulvovaginal candidiasis (VVC), with secretor IgA levels (IgAs) present in the saliva. METHODS: among the 51 women included, 13 presented VVC and 38 were the Control Group. An amount of 2.0 mL of saliva without stimulation was collected from each patient, plus vaginal secretion using a swab, which was then immersed in 2.0 mL of physiological solution. Samples were inseminated in Sabouraud dextrose agar with chloramphenicol for isolation and counting of colonies, and the isolated ones, phenotypically identified. IgA has been quantified in the saliva of the women from both groups, by the ELISA technique. RESULTS: in the 13 patients with clinical and mycological diagnosis of VVC, the mean of Candida colony producing unities by milliliter of vaginal secretion (cpu/mL) was 52,723, and 23.8% of the patients presented colonization in the oral mucosa with lower amount of cup/mL (6,030). The levels of IgAs in saliva were lower in the group with VVC (DO mean: 0.3), as compared to the IgA levels of the Control Group (DO mean: 0.6). Eleven patients (37%) from the Control Group presented Candida colonization in the oral cavity, with a lower cup/mL mean, when compared to the VVC Group. The Control Group also presented a lower amount of cpu/mL (1,973) in the vaginal cavity, when compared to the VVC Group (52,942). CONCLUSIONS: these results have demonstrated that patients with clinical diagnosis of vaginal candidiasis presented a higher amount of Candida both in the vaginal and in the oral cavity, and presented lower levels of anti-Candida IgA in the saliva.
Summary
Rev Bras Ginecol Obstet. 2008;30(6):300-305
DOI 10.1590/S0100-72032008000600006
PURPOSE: to correlate the presence of yeast from the Candida genus in the oral and vaginal cavity of women with and without vulvovaginal candidiasis (VVC), with secretor IgA levels (IgAs) present in the saliva. METHODS: among the 51 women included, 13 presented VVC and 38 were the Control Group. An amount of 2.0 mL of saliva without stimulation was collected from each patient, plus vaginal secretion using a swab, which was then immersed in 2.0 mL of physiological solution. Samples were inseminated in Sabouraud dextrose agar with chloramphenicol for isolation and counting of colonies, and the isolated ones, phenotypically identified. IgA has been quantified in the saliva of the women from both groups, by the ELISA technique. RESULTS: in the 13 patients with clinical and mycological diagnosis of VVC, the mean of Candida colony producing unities by milliliter of vaginal secretion (cpu/mL) was 52,723, and 23.8% of the patients presented colonization in the oral mucosa with lower amount of cup/mL (6,030). The levels of IgAs in saliva were lower in the group with VVC (DO mean: 0.3), as compared to the IgA levels of the Control Group (DO mean: 0.6). Eleven patients (37%) from the Control Group presented Candida colonization in the oral cavity, with a lower cup/mL mean, when compared to the VVC Group. The Control Group also presented a lower amount of cpu/mL (1,973) in the vaginal cavity, when compared to the VVC Group (52,942). CONCLUSIONS: these results have demonstrated that patients with clinical diagnosis of vaginal candidiasis presented a higher amount of Candida both in the vaginal and in the oral cavity, and presented lower levels of anti-Candida IgA in the saliva.
Summary
Rev Bras Ginecol Obstet. 2008;30(3):121-126
DOI 10.1590/S0100-72032008005000002
PURPOSE: to compare the frequency of vulvovaginitis in women infected with human imunnodeficiency virus (HIV) with the frequency in non-infected women. METHODS: a transversal study including 64 HIV infected women and 76 non-infected ones. The frequencies of bacterial vaginosis, candidiasis and trichomoniasis, diagnosed by Amsel's criteria, culture and fresh exam, respectively, were calculated. Chi-square test, Fisher's exact test and multiple regressions to verify the independence of associations were used to analyze the data. RESULTS: the vaginal infection was more prevalent in HIV infected patients, as compared to the control group (59.4 versus 28.9%, p<0,001; Odds Ratio=2.7, IC95%=1.33-5.83, p=0.007). Bacterial vaginosis occurred in 26.6% of the positive-HIV women; vaginal candidiasis, in 29.7% and trichomoniasis, in 12.5% of them. All the infections were significantly more frequent in the group of HIV infected women (p=0.04, 0.02 e 0.04, respectively). CONCLUSIONS: vulvovaginitis is more frequent in HIV infected women.
Summary
Rev Bras Ginecol Obstet. 2008;30(3):121-126
DOI 10.1590/S0100-72032008005000002
PURPOSE: to compare the frequency of vulvovaginitis in women infected with human imunnodeficiency virus (HIV) with the frequency in non-infected women. METHODS: a transversal study including 64 HIV infected women and 76 non-infected ones. The frequencies of bacterial vaginosis, candidiasis and trichomoniasis, diagnosed by Amsel's criteria, culture and fresh exam, respectively, were calculated. Chi-square test, Fisher's exact test and multiple regressions to verify the independence of associations were used to analyze the data. RESULTS: the vaginal infection was more prevalent in HIV infected patients, as compared to the control group (59.4 versus 28.9%, p<0,001; Odds Ratio=2.7, IC95%=1.33-5.83, p=0.007). Bacterial vaginosis occurred in 26.6% of the positive-HIV women; vaginal candidiasis, in 29.7% and trichomoniasis, in 12.5% of them. All the infections were significantly more frequent in the group of HIV infected women (p=0.04, 0.02 e 0.04, respectively). CONCLUSIONS: vulvovaginitis is more frequent in HIV infected women.