Diagnosis of vuvlovaginal candidiasis: Comparison of the informative value of clinical and laboratory findings


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Abstract

Objective. To compare the diagnostic characteristics of laboratory studies and clinical signs in the diagnosis of vulvovaginal candidiasis (VVC). Subjects and methods. The investigation enrolled 154 patients who had sought for gynecological advice for complaints of vaginal discharge and itching, burning, and hyperemia in the genital area. The patients’ examination involved microscopy, culture study, and polymerase chain reaction (PCR) quantifying five most important Candida species. Results. VVC was established in 47 (30.5%) patients. The diagnostic sensitivity and specificity of microscopy were 66 and 98%, those of culture were 98 and 89%, and those of PCR were 100 and 88%, respectively. Conclusion. PCR technique and culture demonstrated benefits, such as high sensitivity and specificity and possible quantification of the level of Candida spp. and its species identification. The time to obtain a result by PCR was similar to that by microscopic examination.

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About the authors

T. A Rumyantseva

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Welfare

Email: ivanovatatiana86@yandex.ru
researcher, Laboratory for molecular diagnostics and epidemiology of reproductive tract infections

Yu. A Savochkina

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Welfare

Email: savochkina@pcr.ru
PhD, senior researcher, Laboratory for molecular diagnostics and epidemiology of reproductive tract infections

T. V Dolgova

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Welfare

Email: tamara.dolgova89@gmail.com
junior researcer, Laboratory for molecular diagnostics and epidemiology of reproductive tract infections

S. V Zaitseva

Polyclinic One, Department for Presidential Affairs of the Russian Federation

Email: s.zaytseva@vipmed.ru
medical laboratory scientist, Department for laboratory diagnostics

M. A Kakherskaya

Polyclinic One, Department for Presidential Affairs of the Russian Federation

Email: m.kaherskaya@vipmed.ru
medical laboratory scientist, Department for laboratory diagnostics

L. V Kudryavtseva

Polyclinic One, Department for Presidential Affairs of the Russian Federation

Email: L.Kudryavceva@vipmed.ru
PhD, professor, chief of Department for laboratory diagnostics

A. E Gushchin

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Welfare

Email: aguschin@pcr.ru
PhD, chief of Laboratory for molecular diagnostics and epidemiology of reproductive tract infections

References

  1. Anderson M.R., Klink K., Cohrssen A. Evaluation of vaginal complaints. JAMA. 2004; 291: 1368-79.
  2. Sobel J.D., Faro S., Force R.W., Foxman B., Ledger W.J., Nyirjesy PR. et al. Vulvovaginal candidiasis: epidemiologic, diagnostic, and therapeutic considerations. Am. J. Obstet. Gynecol. 1998; 178(2): 203-11.
  3. Biggs W.S., Williams R.M. Common gynecologic infections. Prim. Care. 2009; 36(1): 33-51.
  4. Sherrard J., Donders G., White D., Jensen J.S.; European IUSTI. European (IUSTI/WHO) guideline on the management of vaginal discharge, 2011. Int. J. STD AIDS. 2011; 22(8): 421-9.
  5. Анкирская А.С., Муравьева В.В., Фурсова С.А., Миронова Т.Г., Королева Т.Е. Мониторинг видового состава и чувствительности к антимикотикам дрожжеподобных грибов, выделенных из влагалища женщин репродуктивного возраста. Клиническая микробиолология и антимикробная химиотерапия. 2006; 8(1): 87-95. [Ankirskaja A.S., Murav’eva V.V., Fursova S.A., Mironova T.G., Koroleva T.E. Monitoring of species composition and antifungal susceptibility of yeasts isolated from the vagina of women of reproductive age. Klinicheskaja mikrobiolologija i antimikrobnaja khimioterapija. 2006; 8(1): 87-95. (in Russian)]
  6. Weissenbacher T., Witkin S.S., Ledger W.J., Tolbert V., Gingelmaier A., Scholz C. et al. Relationship between clinical diagnosis of recurrent vulvovaginal candidiasis and detection of Candida species by culture and polymerase chain reaction. Arch. Gynecol. Obstet. 2009; 279(2): 125-9.
  7. Cartwright C.P., Lembke B.D., Ramachandran K., Body B.A., Nye M.B., Rivers C.A., Schwebke J.R. Comparison of nucleic acid amplification assays with BD affirm VPIII for diagnosis of vaginitis in symptomatic women. J. Clin. Microbiol. 2013; 51(11): 3694-9.
  8. Avni T., Leibovici L., Paul M. PCR diagnosis of invasive candidiasis: systematic review and meta-analysis. J. Clin. Microbiol. 2011; 49(2): 665-70.
  9. Engberts M.K., Korporaal H., Vinkers M., van Belkum A., van Binsbergen J., Lagro-Janssen T. et al. Vulvovaginal candidiasis: diagnostic and therapeutic approaches used by Dutch general practitioners. Eur. J. Gen. Pract. 2008; 14(1): 30-3. doi: 10.1080/13814780701814929.
  10. Emmerson J., Gunputrao A., Hawkswell J., Dexter A., Sykes R., Searle S. et al. Sampling for vaginal candidiasis: how good is it? Int. J. STD AIDS. 1994; 5(5): 356-8.
  11. Sonnex C., Lefort W. Microscopic features of vaginal candidiasis and their relation to symptomatology. Sex. Transm. Infect. 1999; 75(6): 417-9.
  12. Mårdh P.A., Rodrigues A.G., Genç M., Novikova N., Martinez-de-Oliveira J., Guaschino S. Facts and myths on recurrent vulvovaginal candidosis-- a review on epidemiology, clinical manifestations, diagnosis, pathogenesis and therapy. Int J. STD AIDS. 2002; 13(8): 522-39.
  13. Sudbery P., Gow N., Berman J. The distinct morphogenic states of Candida albicans. Trends Microbiol. 2004; 12(7): 317-24.
  14. Sudbery P.E. Growth of Candida albicans hyphae. Nat. Rev. Microbiol. 2011; 9(10): 737-48. doi: 10.1038/nrmicro2636.
  15. McClelland R.S., Richardson B.A., Hassan W.M., Graham S.M., Kiarie J., Baeten J.M. et al. Prospective study of vaginal bacterial flora and other risk factors for vulvovaginal candidiasis. J. Infect. Dis. 2009; 199(12): 1883-90. doi: 10.1086/599213.
  16. Odds F.C., Webster C.E., Mayuranathan P., Simmons P.D. Candida concentrations in the vagina and their association with signs and symptoms of vaginal candidosis. J. Med. Vet. Mycol. 1988; 26(5): 277-83.
  17. Albuquerque P., Casadevall A. Quorum sensing in fungi--a review. Med. Mycol. 2012; 50(4): 337-45. doi: 10.3109/13693786.2011.652201.
  18. Bertholf M.E. Symptom diagnosis of candida vaginitis. J. Fam. Pract. 1983; 17(5): 775, 777.
  19. Thompson D.S., Carlisle P.L., Kadosh D. Coevolution of morphology and virulence in Candida species. Eukaryot. Cell. 2011; 10(9): 1173-82. doi: 10.1128/EC.05085-11.
  20. Beigi R.H., Meyn L.A., Moore D.M., Krohn M.A., Hillier S.L. Vaginal yeast colonization in nonpregnant women: a longitudinal study. Obstet. Gynecol. 2004; 104(5, Pt 1): 926-30.
  21. Geiger A.M., Foxman B., Sobel J.D. Chronic vulvovaginal candidiasis: characteristics of women with Candida albicans, C glabrata and no candida. Genitourin. Med. 1995; 71(5): 304-7.
  22. Merson-Davies L.A., Odds F.C., Malet R., Young S., Riley V., Schober P., Fisk P.G. Quantification of Candida albicans morphology in vaginal smears. Eur. J. Obstet. Gynecol. Reprod. Biol. 1991; 42(1): 49-52.
  23. Fujita S.I., Senda Y., Nakaguchi S., Hashimoto T. Multiplex PCR using internal transcribed spacer 1 and 2 regions for rapid detection and identification of yeast strains. J. Clin. Microbiol. 2001; 39(10): 3617-22.
  24. Goldacre M.J., Watt B., Loudon N., Milne L.J., Loudon J.D., Vessey M.P. Vaginal microbial flora in normal young women. Br. Med. J. 1979; 1(6176): 1450-3.
  25. Spinillo A., Capuzzo E., Acciano S., De Santolo A., Zara F. Effect of antibiotic use on the prevalence of symptomatic vulvovaginal candidiasis. Am. J. Obstet. Gynecol. 1999; 180(1, Pt1): 14-7.
  26. Wilton L., Kollarova M., Heeley E., Shakir S. Relative risk of vaginal candidiasis after use of antibiotics compared with antidepressants in women: postmarketing surveillance data in England. Drug Saf. 2003; 26(8): 589-97.
  27. Pirotta M.V., Garland S.M. Genital Candida species detected in samples from women in Melbourne, Australia, before and after treatment with antibiotics. J. Clin. Microbiol. 2006; 44(9): 3213-7.

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