Recurrent Vulvovaginal Candidiasis: The Causative Agents, Clinical Signs and Susceptibility to Fluconazole in Gonabad City, Northeast Iran

2020 ◽  
Vol 16 (1) ◽  
pp. 46-51
Author(s):  
Mohammad Hassan Minooeianhaghighi ◽  
Marziyeh Sehatpour ◽  
Hossein Zarrinfar ◽  
Tanuka Sen
Keyword(s):  
Clinical Sign ◽  
Vaginal Discharge ◽  
Antifungal Susceptibility ◽  
Clinical Signs ◽  
Vulvovaginal Candidiasis ◽  
Genital Tract Infection ◽  
Minimum Fungicidal Concentration ◽  
Recurrent Vulvovaginal Candidiasis ◽  
Resistant Species

Background: Recurrent vulvovaginal candidiasis (RVVC) is the second most common cause of genital tract infection in females. Excessive use of fluconazole and other azoles is likely to cause the emergence of the resistant species of Candida. Objective : The purpose of this research was to identify Candida isolates from RVVC and the antifungal effect of fluconazole against them. Methods : In this study, 152 patients with vulvovaginal candidiasis were evaluated for the RVVC form. The Candida isolates were purified using CHROMagar Candida and identified based on the nuclear ribosomal internal transcribed spacer (ITS1-ITS2 rDNA) sequence analysis by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. The antifungal susceptibility of C. albicans isolates against fluconazole was determined according to document M27-A3. Results: Out of 152 patients, 20 cases (13.2%) were identified as recurrent form. The frequencies of the Candida species among the patients with RVVC were C. albicans (n = 16, 80%), C. parapsilosis (n = 3, 15%) and C. tropicalis (n = 1, 5%). The most common clinical sign was vaginal discharge (60%). The mean minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of fluconazole against Candida isolates were 32 µg/mL and 64 µg/mL, respectively. Conclusion: C. albicans was the dominant cause of RVVC. The Candida isolates showed relatively high resistance to fluconazole in vitro. Vaginal discharge was the most common clinical sign among patients with RVVC.

Value of antifungal susceptibility testing in recurrent vulvovaginal Candidiasis by Non -Albicans Candida

2021 ◽  
Vol 30 (1) ◽  
pp. 161-167
Author(s):  
Ghada A. Mokhtar ◽  
Mohamed Sh. Ramadan ◽  
Shymaa Yahia
Keyword(s):  
Amphotericin B ◽  
Candida Species ◽  
Antifungal Susceptibility ◽  
High Sensitivity ◽  
Common Species ◽  
Vulvovaginal Candidiasis ◽  
Recurrent Vulvovaginal Candidiasis ◽  
Sensitivity Pattern ◽  
Vaginal Swabs ◽  
Vitek 2

Background: Vulvovaginal candidiasis (VVC) is regarded as a prevalent vaginal infection and mainly results from Candida albicans. Nevertheless, there has recently been a prominent shift in candidiasis etiology regarding non-albicans Candida (NAC) species with achieving importance. For women with more than three episodes annually are described as recurrent vulvovaginal candidiasis (RVVC). Objectives: To isolate, speciate, and determine the value of antifungal sensitivity pattern of candida species isolated from patients developed (RVVC). Methodology: High vaginal swabs (HVS) were taken from patients with RVVC and cultured on ordinary mycological media. Any significant candida growth was identified and speciated by VITEK 2 system. Their antifungal sensitivity was done by disc diffusion approach governed by CLSI guidelines. Results: A total of 110 Candida species from 250 high vaginal swabs were isolated. Among all candida species isolated from patients with RVCC, C.albicanis accounts for 44% while NAC accounts for 56% with C.glabrata most common species isolated. Voriconazole, amphotericin B, and nystatin showed high sensitivity rates (92 %, 89%, and 84% respectively) on all candida species (C.albicans and NAC) isolated from patients with RVVC. Conclusion: In RVCC there is increase in NAC (56%) with C.glabrata most common species isolated. Voriconazole, Nystatin, and amphotericin B have the best antifungal activity against all spp.

scholarly journals Accuracy in clinical examinations for the diagnosis of vulvovaginitis by CANDIDA SPP. and IN VITRO susceptibility to the main antifungals

2020 ◽  
Vol 49 (3) ◽  
Author(s):  
Andressa Santana Santos ◽  
Ana Laura Sene Amancio Zara ◽  
Fábio Silvestre Ataídes ◽  
Elisangela Gomes da Silva ◽  
Vivianny Aparecida Queiroz Freitas ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Clinical Diagnosis ◽  
High Resistance ◽  
Antifungal Susceptibility ◽  
Vulvovaginal Candidiasis ◽  
Vaginal Mucosa ◽  
Candida Spp ◽  
In Vitro Susceptibility ◽  
Gynecology And Obstetrics

Vulvovaginal candidiasis (VVC) is a common infection. This work aims to determine the positive predictive value (PPV) of the clinical diagnosis of VVC and to characterize Candida species isolated from the vaginal mucosa. This cross-sectional study was conducted from February 2016 to February 2017 at the Gynecology and Obstetrics Outpatient Clinic of the Hospital das Clínicas, in Goiânia, Goiás State, Brazil. The study included samples of vaginal secretion from 55 women who complained of vaginal discharge and itching as their main symptoms. The PPV of the clinical diagnosis of VVC was estimated in comparison to the laboratory culture method. The phenotypic methods and molecular tests were performed to identify Candida spp. In vitro susceptibility of Candida spp. isolates to fluconazole, itraconazole, clotrimazole, nystatin, and amphotericin B was determined using the broth microdilution assay. Yeast growth using the enzymes protease, phospholipase, and hemolysin was carried out in media containing respectively bovine albumin, egg yolk, and sheep erythrocytes. A PPV of 61.8% (34/55) was determined. Among the 55 vulvovaginal samples collected, we identified 36 isolates in whichC. albicans was the most common species. High resistance to fluconazole and low minimal inhibitory concentration (MIC) values for clotrimazole, nystatin and amphotericin B were observed. All isolates were proteinase and hemolysin producers, while seven strains were phospholipase negative. The clinical diagnosis of VVC presented a moderate PPV, which meant that cultures had to be conducted in the laboratory to confirm infection. The high resistance to fluconazole and itraconazole indicated the importance of the in vitro susceptibility test.KEY WORDS: Vulvovaginal candidiasis; antifungal susceptibility; enzymatic activity

scholarly journals In vitro effects of glycyrrhetinic acid and hyaluronic acid on the growth of vulvovaginal Candida albicans and other yeasts

2017 ◽  
Vol 32 (4) ◽  
Author(s):  
Martina Stevan ◽  
Eleonora Fusato ◽  
Decio Armanini ◽  
Giulio Bertoloni ◽  
Francesco De Seta ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Hyaluronic Acid ◽  
Growth Inhibition ◽  
Clinical Laboratory ◽  
Antifungal Susceptibility ◽  
Vulvovaginal Candidiasis ◽  
Glycyrrhetinic Acid ◽  
National Committee ◽  
In Vitro Effects

Aims. The present study aimed to test the in vitro activity against Candida albicans and non-albicans strains of 18-β glycyrrhetinic acid (18-β GA) and hyaluronic acid (HA), both alone and in combination. This antimicrobial activity was assessed using the National Committee for Clinical Laboratory Standards (NCCLS) method on Candida strains that were isolated from patients with recurrent vulvovaginal candidiasis (RVVC). Results. Our results demonstrate that the anti-Candida activity is independent from antifungal susceptibility level and the fact that the growth inhibition is stronger at acidic pH level makes the two drugs a promising biological alternative for the topical treatment of vulvovaginal candidiasis (VVC) and RVVC. Conclusions. Furthermore, the reduction of both budding cells formation and germ tube elongation, on mammalian cell monolayers, may explain the observed growth inhibition and suggest a decreased virulence, respectively.

scholarly journals Recurrent Vulvovaginal Candidosis and Cluster Analysis of Clinical Signs and Symptoms: A Laboratory-Based Investigation

2020 ◽  
Vol 6 (3) ◽  
pp. 113
Author(s):  
Aleksandra Ignjatović ◽  
Valentina Arsić-Arsenijević ◽  
Milan Golubović ◽  
Saša Đenić ◽  
Stefan Momčilović ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Clinical Characteristics ◽  
Antifungal Susceptibility ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
In Vitro Susceptibility ◽  
Major Health Problem ◽  
Vulvovaginal Candidosis ◽  
Clinical Signs And Symptoms

Recurrent vulvovaginal candidosis (RVVC) represents a major health problem that significantly affects a patient’s quality of life (QoL). This infection presents with a plethora of clinical manifestation, and this is the first study that carries out a cluster analysis of these signs and symptoms (SS). The goals are to evaluate the distribution of species causing RVVC, their in-vitro susceptibility to antifungals, and the patient’s QoL. Additionally, the clinical characteristics are analyzed using cluster analysis. Prospective analysis of data was performed for women diagnosed with RVVC in the period from January 2016 to December 2019 based on the analysis of data from a single-center’s records. The standard mycological methods and antifungal susceptibility testing were done. Clinical characteristics and QoL were examined by appropriate questions. The cluster analysis was used to identify clusters of SS. A total of 320 women were diagnosed. The dominant species was Candida (C.) albicans. Non-albicans Candida (NAC) yeast was found in 24.4%, and the most common was C. glabrata. Interestingly, Saccharomyces (S.) cerevisiae was detected in 2%. All of the isolated species, except C. parapsilosis and C. kefyr, demonstrated reduced susceptibility to antifungals. We confirmed the emergence of the NAC species and S. cerevisiae with reduced susceptibility to antifungals. Cluster analysis represented by a dendrogram revealed three SS clusters: irritation, uncommon, and discharge, but further studies are needed to examine the relationship between clusters, Candida strains, and outcomes.

scholarly journals Antifungal Susceptibility Patterns,In VitroProduction of Virulence Factors, and Evaluation of Diagnostic Modalities for the Speciation of PathogenicCandidafrom Blood Stream Infections and Vulvovaginal Candidiasis

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Chaitanya Tellapragada ◽  
Vandana Kalwaje Eshwara ◽  
Ruqaiyah Johar ◽  
Tushar Shaw ◽  
Nidhi Malik ◽  
...  
Keyword(s):  
Virulence Factors ◽  
Antifungal Susceptibility ◽  
Blood Stream ◽  
Vulvovaginal Candidiasis ◽  
Clinical Isolates ◽  
Blood Stream Infections ◽  
Specific Pcr ◽  
Vitek 2 ◽  
Species Specific

Candidaspp. have emerged as successful pathogens in both invasive and mucosal infections. Varied virulence factors and growing resistance to antifungal agents have contributed to their pathogenicity. We studied diagnostic accuracy of HiCromeCandidaDifferential Agar and Vitek 2 Compact system for identification ofCandidaspp. in comparison with species-specific PCR on 110 clinical isolates ofCandidafrom blood stream infections (54, 49%) and vulvovaginal candidiasis (56, 51%).C. albicans(61%) was the leading pathogen in VVC, whileC. tropicalis(46%) was prominent among BSIs. HiCrome Agar and Vitek 2 Compact had good measures of agreement (κ) 0.826 and 0.895, respectively, in comparison with PCR. We also tested these isolates forin vitroproduction of proteinase, esterase, phospholipases, and biofilms. Proteinase production was more among invasive isolates (P=0.017), while phospholipase production was more among noninvasive isolates (P=0.001). There was an overall increase in the production of virulence factors among non-albicansCandida. Identification of clinical isolates ofCandidaup to species level either by chromogenic agar or by Vitek 2 Compact system should be routinely done to choose appropriate therapy.

Novel Penicillium species causing disseminated disease in a Labrador Retriever dog

2020 ◽  
Vol 58 (8) ◽  
pp. 1053-1063 ◽  
Author(s):  
Tatiana Rothacker ◽  
Jared A Jaffey ◽  
Erin R Rogers ◽  
William H Fales ◽  
Connie F C Gibas ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Phylogenetic Analyses ◽  
Antifungal Susceptibility ◽  
Clinical Signs ◽  
Labrador Retriever ◽  
Penicillium Species ◽  
Lipid Complex ◽  
The Right ◽  
Disseminated Disease

Abstract This report describes the phenotypic characteristics of a novel Penicillium species, Penicillium labradorum, isolated from a 3-year-old male, castrated, Labrador retriever with disseminated fungal disease. The dog's presenting clinical signs included lethargy, lymphadenopathy, tachypnea, moderate pitting edema, and nonweight bearing lameness associated with the right hind limb. Fine-needle aspirate biopsies from the sublumbar and prescapular lymph nodes were initially examined. The cytologic findings were consistent with pyogranulomatous inflammation with abundant extracellular and phagocytized fungal fragments and hyphae. Based on the morphology of the organisms and lack of endogenous pigment, hyalohyphomycosis was considered most likely, with Fusarium, Penicillium, and Paecilomyces species being considerations. Fungal isolates were obtained via culture of samples from the lymph nodes, and molecular identification testing originally identified an undescribed Penicillium species belonging to the Penicillium section Exilicaulis. BLAST searches and phylogenetic analyses performed approximately 1 year and 9 months after the isolation date revealed an isolate within the Penicillium parvum clade in the Penicillium section Exilicaulis but phylogenetically distant from the other species in the section, thus representing a new species, Penicillium labradorum. Antifungal susceptibility testing was also performed on the isolate and low minimum inhibitory concentrations were observed with terbinafine, voriconazole, and posaconazole, while in vitro resistance was observed with fluconazole. The dog had been previously treated with fluconazole, itraconazole, amphotericin B lipid complex, voriconazole, and terbinafine. Approximately 587 days after the initial diagnosis, the dog was euthanized due to worsening of clinical signs and concerns for quality of life.

Azithromycin in the management of Chlamydia trachomatis infections

1996 ◽  
Vol 7 (1_suppl) ◽  
pp. 5-8 ◽  
Author(s):  
G L Ridgway
Keyword(s):  
Chlamydia Trachomatis ◽  
Clinical Cure ◽  
Clinical Signs ◽  
In Vitro Activity ◽  
Pharmacological Profile ◽  
Genital Tract Infection ◽  
Lower Genital Tract ◽  
Lower Genital Tract Infection ◽  
Cure Rates

The unique pharmacological profile of the azalide macrolide azithromycin, coupled with its in vitro activity against both Chlamydia trachomatis and the ureaplasmas, suggested that genital infections caused by these bacteria could be successfully treated with a single dose of the antibiotic. This has now been confirmed in worldwide clinical studies. A single oral dose of azithromycin 1 g eradicates C. trachomatis in almost 100% of cases of non-gonococcal urethritis and cervicitis. Unfortunately, there are no specific clinical signs for genital chlamydial infection. It is therefore necessary to use therapy effective against known and unknown pathogens for treating lower genital tract infection. Clinical cure rates for both chlamydial and non-chlamydial, non-gonococcal infections compare favourably with standard 7-day doxycycline therapy, being in excess of 85%. Side-effects are few (<20%) and essentially minor.

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