Recurrent Vulvovaginal Candidosis and Cluster Analysis of Clinical Signs and Symptoms: A Laboratory-Based Investigation

Abstract

Recurrent vulvovaginal candidosis (RVVC) represents a major health problem that significantly affects a patient’s quality of life (QoL). This infection presents with a plethora of clinical manifestation, and this is the first study that carries out a cluster analysis of these signs and symptoms (SS). The goals are to evaluate the distribution of species causing RVVC, their in-vitro susceptibility to antifungals, and the patient’s QoL. Additionally, the clinical characteristics are analyzed using cluster analysis. Prospective analysis of data was performed for women diagnosed with RVVC in the period from January 2016 to December 2019 based on the analysis of data from a single-center’s records. The standard mycological methods and antifungal susceptibility testing were done. Clinical characteristics and QoL were examined by appropriate questions. The cluster analysis was used to identify clusters of SS. A total of 320 women were diagnosed. The dominant species was Candida (C.) albicans. Non-albicans Candida (NAC) yeast was found in 24.4%, and the most common was C. glabrata. Interestingly, Saccharomyces (S.) cerevisiae was detected in 2%. All of the isolated species, except C. parapsilosis and C. kefyr, demonstrated reduced susceptibility to antifungals. We confirmed the emergence of the NAC species and S. cerevisiae with reduced susceptibility to antifungals. Cluster analysis represented by a dendrogram revealed three SS clusters: irritation, uncommon, and discharge, but further studies are needed to examine the relationship between clusters, Candida strains, and outcomes.

Clinical Presentations, Cluster Analysis and Laboratory-Based Investigation of Aspergillus Otomycosis—A Single Center Experience

“…Although some A. flavus strains are found to be able to produce melanin [ 14 ], possibly leading to darker colored colonies, in this research we did not encounter one. Attempts to determine the phenotype of a particular disease by statistical methods, like in our previously conducted examination, showed that, in a certain percentage of patients, it is impossible to determine the cause without laboratory examination [ 15 ].…”

Management of recurrent vulvovaginal candidosis: Narrative review of the literature and European expert panel opinion

“…In line with this, epidemiological data confirm that almost all women diagnosed with resistant C. albicans strains had previously been exposed to fluconazole (Marchaim et al, 2012). In contrast to C. albicans, non-albicans Candida species frequently show reduced susceptibility, meaning that higher doses are required to achieve antifungal effects or are resistant to fluconazole and other azoles (Sobel and Sobel, 2018;Ignjatovic et al, 2020). Currently, available therapeutic options to treat fluconazole-resistant Candida species are limited (Sobel and Sobel, 2018;Farr et al, 2021a;Van Riel et al, 2021).…”

“…In a retrospective polymerase chain reaction (PCR)-assisted analysis of 93,775 cervicovaginal smears, of all positive samples, the prevalence of C. albicans was 89%, whereas C. glabrata represented 7.9% of cases (Vermitsky et al, 2008). C. albicans accounts for the majority of all documented RVVC cases (74%), followed by the non-albicans species, including C. glabrata and C. krusei found in about 14% and 6% of RVVC cases, respectively (Ignjatovic et al, 2020).…”

Detection of Candida Spp. That Causes Vulvovaginitis in Women That Use Contraceptive Methods

“…to spread and grow [24]. In other reports, Ghaddar et al [25] and Ignjatovi et al [26] looked into women with VV symptoms and found that C. albicans were high numbers among Candida spp. In this study, the species distribution was affected by the low number of non-albicans species caused by antifungals [27].…”