Effect of simultaneous oral and vaginal treatment on the rate of cure and relapse in vaginal candidosis.

Milne, Judith; Warnock, David W.

doi:10.1136/sti.55.5.362

Cited by 16 publications

(3 citation statements)

References 9 publications

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“…While studies using oral nystatin did not result in a resolution of chronic VVC, 56,57 other studies of recurrent or chronic VVC have demonstrated that the Candida strain isolated from the patient's vagina and the strain from the rectum are identical in the majority of cases. 56,58 Therefore, until this issue is settled, the physician should not discount the possibility of gastrointestinal carriage as a contributing factor to the recurrence of VVC.…”

Section: Discussionmentioning

confidence: 99%

New treatments for vulvovaginal candidiasis

Faro

1996

Infect. Dis. Obstet. Gynecol.

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Vulvovaginal candidiasis; Candida; fluconazole ulvovaginal candidiasis (VVC) is probably the most common form of vaginal infection, although bacterial vaginosis is believed to be more frequent. 1,z Even though Candida assumes a role as a pathogen, it is an opportunistic organism causing systemic infections usually in patients who are immunosuppressed or critically ill on multiple antibiotics. However, several studies have demonstrated that C. albicans is a member of the host's endogenous vaginal and gastrointestinal microflora. Auger and Jolly 3 isolated Candida from approximately 70% of healthy women. Other investigators 4-6 have isolated C. albicans from the lower genital tracts of healthy, asymptomatic women with a frequency of 5-55%.It is estimated that 75% of all women will experience one episode of symptomatic VVC during their lifetime. 7,8 Unfortunately, 40-50% of women will have at least one recurrence of VVC and at least 5% will have chronic or repeated episodes of VVC.Perhaps this condition should be viewed as a disturbance in the vaginal ecosystem rather than a disease in view of the fact that Candida is part of the complex endogenous microflora of many individuals. Alterations in the vaginal ecosystem can be favorable to the growth of C. albicans and other species. Once the yeast becomes dominant, it may result in a symptomatic condition and even produce findings consistent with acute infection. No

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Section: Discussionmentioning

confidence: 99%

New treatments for vulvovaginal candidiasis

Faro

1996

Infect. Dis. Obstet. Gynecol.

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“…The GI tract has also been suggested as a potential endogenous source population. A study in 1979 that treated RVVC patients with oral nystatin with the goal of reducing a resident GI population found that it did not decrease the time to recurrence (39). Furthermore, studies that have looked at yeast colonization of the GI tract through feces or rectal swabs during an active infection find that not all participants are culture-positive (39)(40)(41)(42)(43)(44)(45).…”

Section: Introductionmentioning

confidence: 99%

“…A study in 1979 that treated RVVC patients with oral nystatin with the goal of reducing a resident GI population found that it did not decrease the time to recurrence (39). Furthermore, studies that have looked at yeast colonization of the GI tract through feces or rectal swabs during an active infection find that not all participants are culture-positive (39)(40)(41)(42)(43)(44)(45). However, this does not necessarily preclude that a small GI population is present in all individuals (below the culture detection limit in some), which could act as an endogenous reintroduction source under the right host conditions.…”

Section: Introductionmentioning

confidence: 99%

Migration and standing genetic variation in vaginal and rectal yeast populations in recurrent vulvovaginal candidiasis

Bukari,

Kukurudz-Gorowski,

de Graaf

et al. 2023

Preprint

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Vulvovaginal candidiasis is one of the most common vaginal and fungal infections. Many are successfully treated with antifungal drugs, but ~9% of cases will recur even with treatment (RVVC). We quantified the genotypic and phenotypic diversity of vaginal and rectal yeast isolates from four individuals with a history of recurrent vulvovaginal candidiasis during a symptomatic relapse. One participant had a Nakaseomyces glabrata infection while the other three had Candida albicans. We used whole genome sequencing to place the isolates into a global phylogenic context and precisely quantify standing genetic variation within RVVC yeast populations. The C. albicans isolates statistically clustered close together and closer than expected to other vaginal isolates in a subgroup of clade 1. In all participants, we found that vaginal and rectal isolates are monophyletic and phylogenetically overlapping, consistent with frequent migration between sites. We found very low levels of genotypic and phenotypic diversity and few phenotypic outliers, consistent with rapid population expansion. This provides a view of the within-host isolate variation that is inconsistent with a rectal source population for vaginal reinfection and a generally small effective population size over time in RVVC.

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Chronic recurrent vaginal candidosis: easy to treat, difficult to cure. Results of intermittent treatment with a new oral antifungant

Heusden¹,

Merkus²

1990

European Journal of Obstetrics & Gynecology and Reproductiv

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Effect of simultaneous oral and vaginal treatment on the rate of cure and relapse in vaginal candidosis.

Cited by 16 publications

References 9 publications

New treatments for vulvovaginal candidiasis

New treatments for vulvovaginal candidiasis

Migration and standing genetic variation in vaginal and rectal yeast populations in recurrent vulvovaginal candidiasis

Chronic recurrent vaginal candidosis: easy to treat, difficult to cure. Results of intermittent treatment with a new oral antifungant

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