Candidal Vaginitis: Natural History, Predisposing Factors and Prevention

Differential Susceptibility of Two Species of Macaques to Experimental Vaginal Candidiasis

“…Stationary-phase C. albicans strain 3153A (National Collection of Pathogenic Fungi, London, UK, kindly provided by D. Soll, University of Iowa, Iowa City) blastoconidia were grown in 1% phytone-peptone medium (Beckton Dickinson) supplemented with 0.1% glucose (Sigma) for 18 h at 25ЊC in a shaking water bath. Thereafter, the blastoconidia were collected, washed twice, counted with a hemcytometer, and added to individual wells of a microtiter plate (Costar) at cells/mL in a volume of 100 5 1 ϫ 10 mL complete media. The epithelioid cells were then added to triplicate wells containing C. albicans at various effector-to-target (E : T) ratios in a volume of 100 mL CM.…”

“…In fact, in the United States alone, there are approximately 13 million cases of VVC annually, which account for 10 million visits to gynecologists [2]. Candida albicans, a commensal organism of the gastrointestinal and reproductive tracts, is the causative agent in 85%-90% of all VVC cases [3][4][5]. Up to 5% of women who experience VVC caused by C. albicans will subsequently develop recurrent VVC (RVVC) [4,6,7].…”

Candida vulvovaginitis in pregnancy

“…Moreover, there is a widespread belief that the overall prevalence of vaginal yeast colonization continues to increase with duration of pregnancy and is maximum in the third trimester [5]. In a unique study investigating the increased susceptibility of pregnant women to yeast colonization, Bland [6] inoculated the vagina of pregnant and nonpregnant women, inducing infection in more than 80% of the gravid women and only one third of the nongravid women.…”

“…However, in all studies, Candida colonization rates appear to be significantly higher in gravid women. Although it is widely thought that the prevalence of Candida colonization increases with gestational duration [3,5], Cotch et al [7••] reported that the third trimester prevalence rate was identical to the rate found at 23 to 26 weeks gestation. Moreover, in the same study, Candida colonization was found to be intermittent among individual women.…”

“…Accordingly, symptomatic VVC was observed in 60% to 90% of pregnant vaginal carriers [5,13,14]. Furthermore, recurrent attacks are also considered to be more common in pregnant women, with almost 50% of the symptomatic women suffering a second episode during the same pregnancy [15].…”