Epidemiological survey of vulvovaginal candidosis in Sfax, Tunisia

Abstract

Vulvovaginal candidosis (VVC) is a common infection of the female genital tract affecting 75% women at least once in their lifetime. The aim of this study was to determine the incidence and potential risk factors associated with VVC and recurrent vulvovaginal candidosis (RVVC). A prospective study of women with vaginitis symptoms was conducted over 2 years in the regional clinic of population and family education in Sfax. A discriminant analysis was used to evaluate the association between the incidence of Candida vaginitis and potential risk factors. Sporadic and recurrent VVC were documented respectively in 48% and 6.1%. The most frequent factors associated with positive Candida culture were employed women, uncontrolled diabetes, history of genital infection and intrauterine device contraception. Increased episode numbers of VVC and condom/spermicidal contraception were positively associated with recurrences. Candida albicans was the predominantly isolated species (76.3%) followed by Candida glabrata (19.3%). Infection with C. glabrata occurred in 34% and 17.5% of patients with RVVC and VVC respectively. The discriminant investigation had provided further insights into the basis for prevention and control of RVVC. Increased prevalence of C. glabrata in patients with RVVC and observed risk factors should be taken into consideration to achieve success in the management of this infection.

Microsatellite analysis of Candida isolates from recurrent vulvovaginal candidiasis

“…This genetic diversity of C. glabrata isolates has many consequences for the epidemiology of RVVC. In a previous epidemiological study, we reported that C. glabrata isolates were significantly predominant in cases of RVVC (34 %) versus sporadic VVC (17.5 %) (Amouri et al, 2011). These findings implied that strains with dominant genotypes may be more virulent than others causing sporadic VVC.…”

“…This suggests that recurrent strains (group I and II) do not possess any significant difference in their genotypes from strains that cause one-off episode of vaginitis (group III). The lack of genetic differentiation of the C. albicans population isolated from RVVC patients is in accordance with the fact that the pathogenesis of RVVC can be due to a myriad of risk factors such as previous history of VVC, intrauterine device contraception and non-compliance with therapy (Amouri et al, 2011;Richter et al, 2005). On the other hand, recurrent C. glabrata isolates were genetically divergent (H50.65).…”

“…However, it was estimated that a second episode follows the first occurrence in approximately 50 % of cases (Sobel, 2007). In a prospective survey of VVC, 69 % of the patients returned with a second symptomatic episode of VVC and the increased number of previous VVC episodes was significantly associated to RVVC (Amouri et al, 2011).…”

Interactions between copy number and expression level of genes involved in fluconazole resistance in Candida glabrata

“…The population of Candida glabrata clinical isolates included in the present study were recovered during an epidemiological survey of antifungal resistance conducted at the Habib Bourguiba University Hospital in Sfax from January 2005 to December 2007 as previously described (Abbes et al, 2011, 2012; Amouri et al, 2011; Sellami et al, 2011). The specimens were isolated from 30 patients with urinary tract infection, vaginal infection or systemic infections.…”

Highly-cited estimates of the cumulative incidence and recurrence of vulvovaginal candidiasis are inadequately documented

“…•50% of initially infected women will experience at least a second episode [5,6,8,10,11,13-15,18,20],[22-25,27,29-33,36-40,44,46,50,51],[53], and…”