<b><i>Candida glabrata</i></b> Chorioamnionitis following in vitro Fertilization: Review of the Literature

Abstract

Aim: To review all past reports of Candida glabrata chorioamnionitis in the literature while noting their correlation with in vitro fertilization (IVF). Methods: We checked MEDLINE, PubMed and Google scholar (January 1970 to December 2014) for articles using the search terms ‘Candida', ‘Torulopsis', ‘glabrata', ‘chorioamnionitis', ‘congenital', ‘perinatal' and ‘infection'. Case reports were included if they described a verified intrauterine infection with C. glabrata. The authors reviewed the articles and abstracted the data. 20 cases were compared, including a case reported from our institution shortly described in this article. Results: 13 of 20 cases (65%) involved pregnancies achieved by IVF; 3 patients underwent amniocentesis during their pregnancy. Of the 7 cases with no history of IVF, 2 involved a history of cerclage and 2 a history of intrauterine device use. Only 6 infants survived, delivered prematurely by cesarean section. Conclusions: Review of literature demonstrated a high prevalence of IVF-assisted pregnancies among the few C. glabrata chorioamnionitis cases previously described, typically occurring during the second trimester. Additional cases were notable for additional instrumentation/invasive procedure. The prognosis was mostly grim, entailing a high incidence of stillbirth or rapid neonatal death.

Epidemiology of Candida albicans and non-C.albicans of neonatal candidemia at a tertiary care hospital in western China

“…Globally, few studies have verified the association of ART and the outcome of neonatal candidemia. Most of the previous literature focused on the Candida species was associated with chorioamnionitis in in vitro fertilization (IVF) pregnancy [36]. It was reported that some types of uterine manipulation, such as IVF, may introduce the fungus at the time of embryo transfer [37].…”

Candida glabratachorioamnionitis in a twin pregnancy following in vitro fertilisation: a rare cause of septic miscarriage

“…C. glabrata is generally considered to be an innocuous vaginal commensal and rarely associated with pathogenicity in healthy, non-immunocompromised individuals 2. This reduced virulence is mainly due to the inability of C. glabrata to produce hyphae and its less adhesive capacity, thereby reducing its capability to invade across intact chorionic membranes 3 . C. glabrata chorioamnionitis is a rare entity; in a 2015 review, only 20 cases were identified in the literature 3.…”

“…This reduced virulence is mainly due to the inability of C. glabrata to produce hyphae and its less adhesive capacity, thereby reducing its capability to invade across intact chorionic membranes 3 . C. glabrata chorioamnionitis is a rare entity; in a 2015 review, only 20 cases were identified in the literature 3. There is, however, a strong link between C. glabrata chorioamnionitis and IVF and invasive uterine instrumentation,2 supporting a possible iatrogenic mechanism of pathogenesis, in which C. glabrata chorioamnionitis and subsequently sepsis are facilitated by direct uterine inoculation via antenatal instrumentation.…”

Candida Chorioamnionitis in Mothers with Gestational Diabetes Mellitus: A Report of Two Cases

“…In a case series by Maki et al (2017), they reported 0.3% of the deliveries had Candida chorioamnionitis [ 9 ]. The possible routes of infection include ascending infection from lower genital tract following premature rupture of membrane, the presence of a retained foreign body such as intrauterine contraceptive device or cervical cerclage, accidental introduction of contaminated material during amniocentesis, in vitro fertilisation or chorionic sampling, haematogenous, retrograde seeding from peritoneal cavity via fallopian tube, and systemic condition including diabetes mellitus [ 9 , 10 , 11 , 12 , 13 , 14 , 15 ].…”