Can the Diagnosis of Recurrent Vulvovaginal Candidosis BeImproved by Use of Vaginal Lavage Samples and Cultures onChromogenic Agar?

Abstract

Objective: To investigate if introital and vaginal flushing samples inoculated on chromogenic agar could increase the recovery rate and rapid identification of Candida and non-albicans species, 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 â . Speciation of yeast isolates was made on the chromogenic agar by API 32C ® kits and by an atomized system (Vitek â ). Results: Forty-six (51%) women were positive for Candida from one 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 yielded Candida on those two media in 40 (44%) and 4l (45%) cases, respectively. Candida albicans was the most frequent species recovered, from 40 (87%) cases, followed by C. krusei in 4 (9%), C. glabrata in 2 (4%), and C. parapsilosis in one case. There was only one woman who had a mixed yeast infection, by C. albicans and C. 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 of Candida in RVVC cases as compared to cultures of posterior vaginal fornix samples. Use of chromogenic agar is a convenient and reliable means to detect colonization by Candida and differentiate between C. albicans and non-albicans species.

Candida species isolated from the vaginal mucosa of HIV-infected women in Salvador, Bahia, Brazil

“…10,11,18 In HIV-uninfected patients, our data was similar to other studies performed in Brazil, which describe the prevalence of C. albicans isolated in vaginal samples ranging from 60% to 80% 19,20 and in other countries where the prevalence of C. albicans in vaginal samples ranges between 80% to 90%. 1,11,21,22 A higher diversity of non-albicans species was found in HIV-infected patients compared to uninfected controls. C. glabrata was the most frequent non-albicans species isolated in HIV-infected patients, followed by C. parapsilosis.…”

Lactate dehydrogenase and its isoenzymes in vaginal fluid in vaginitis/vaginosis cases and in healthy controls

“…If the diagnosis of recurrent vulvovaginal candidosis is based only on history and clinical examination, up to half of all such cases will prove culture-negative for candida. Symptoms and clinical signs do not accurately distinguish candida culture-positive from such culture-negative cases 13 . Our study suggests that LD activity might discriminate patients with a positive candida culture from those who are culture-negative.…”

Molecular diagnosis of vaginal candidiasis by polymerase chain reaction (PCR) and random amplification polymorphism DNA (RAPD-PCR) in Babylon Province, Iraq

“…Paulitssch et al (2006. ) showed that Candida albicans is responsible for 70-90% of all vaginal candidiasis in Austria while many other studies showed that Candida glabrata has been the most frequent pathogen that causes vaginal Candidiasis (Novikova et al, 2002;Lopes Consolaro et al, 2004). Ozcan et al (2006) reported that C. glabrata is responsible for 14% of infections in immune competent women.…”