Can the Diagnosis of Recurrent Vulvovaginal Candidosis Be Improved by Use of Vaginal Lavage Samples and Cultures on Chromogenic Agar?
Objective:To investigate if introital and vaginal flushing samples inoculated on chromogenic agar could increase the recovery rate and rapid identification ofCandidaand non-albicansspecies, as compared to culture of posterior vaginal fornix samples on Sabouraud agar and speciation of isolates by biochemical tests.Methods:Samples from the introitus and the posterior vaginal fornix and vaginal lavage samples were collected from 91 women with a history suggestive of recurrent vulvovaginal candidosis (RVVC), and with a suspected new attack of the condition. The specimens were cultured on Sabouraud and CHROMagar®. Speciation of yeast isolates was made on the chromogenic agar by API 32C®kits and by an atomized system (Vitek®).Results:Forty-six (51%) women were positive forCandidafromone or more of the samples. The introital cultures were positive in 43 (47%) women, both on Sabouraud and chromogenic agar. From the posterior vaginal fomix, 42 (46%) women were positive on the Sabouraud and 43 (47%) on chromogenic agar cultures, while the vaginal lavage cultures yieldedCandidaon those two media in 40 (44%) and 4l (45%) cases, respectively.Candida albicanswas the most frequent species recovered, from 40 (87%) cases, followed byC. kruseiin 4 (9%),C. glabratain 2 (4%), andC. parapsilosisin one case. There was only onewoman who had a mixed yeast infection, byC. albicansandC. krusei. There was only one discrepancy in the speciation as demonstrated by mean of chromogenic agar and API 32C kit.Conclusions:Neither cultures of introital nor of vaginal lavage samples increases the detection rate ofCandidain RVVC cases as compared to cultures of posterior vaginal fornix samples. Use of chromogenic agar is a convenient and reliable means to detect colonization byCandidaand differentiate betweenC. albicansand non-albicansspecies.