Vaginal candidosis: epidemiological and etiological factors

Abstract

A review is presented of the emerging problem of candidal colonization regarding epidemiological and etiological factors. In recent years a change in epidemiological trends has been observed. Vaginal candidosis seems to show a higher frequency to recur and a significant increase in infections caused by non albicans species of candidas has been stated. The three stage mechanisms of adhesion, blastopore germination and epithelium invasion are emphasized. There is a balance between candidal organisms and vaginal defense factors (lactobacilli, cellular and humoral immunity) controlling and limiting fungal growth. Vaginitis appears because of an increased number or an enhanced virulence of candidas. In some other patients, a decreased vaginal defense mechanism is a determinant factor. There are still a number of factors involved in clinical candidal vulvovaginitis that need to be clarified.

Itraconazole-resistant Candida auris with phospholipase, proteinase and hemolysin activity from a case of vulvovaginitis

“…Previous studies on vulvovaginitis cases due to Candida spp have already documented the increasing prevalence of non-albicans Candida spp over C. albicans. Indiscriminate use of antifungal agents along with incorrect dosage schedules, prolonged hospitalization, poor immune status are some of the implicated factors behind the emergence of unusual species [8].…”

Detection of FUR1 Gene in 5-Flucytosine Resistant Candida Isolates in Vaginal Candidiasis Patients

“…Majority of VC cases are caused by C. albicans [2]. However, episodes caused by non-albicans Candida spp (NAC) are increasing [3].…”

Candidíase vulvovaginal: fatores predisponentes do hospedeiro e virulência das leveduras

“…Altos níveis de produção de hormônios femininos, especialmente a progesterona, aumentam a disponibilidade de glicogênio no ambiente vaginal, o qual serve como excelente fonte de carbono para o crescimento e a germinação das leveduras (57) . Raramente isola-se Candida na pré-menarca, fato que, associado à baixa prevalência CVV na menopausa, enfatiza a dependência hormonal da infecção (21) . Como muitas mulheres são portadoras assintomáticas de Candida em pequenas quantidades, nesse estado a levedura é considerada comensal, e as alterações no ambiente vaginal do hospedeiro são necessárias para que ela induza aos seus efeitos patológicos e a paciente desenvolva CVV (58) .…”