Background: Candida vulvovaginitis is one of the most frequently diagnosed conditions in women’s care practices. Historically, 90% of cultured yeast species were C. albicans. However, due to a variety of intervention...Background: Candida vulvovaginitis is one of the most frequently diagnosed conditions in women’s care practices. Historically, 90% of cultured yeast species were C. albicans. However, due to a variety of interventions, the proportion of non-albicans Candida (NAC) infections appears to be increasing. We sought to estimate the current prevalence of Candida vulvovaginitis and the species-specific distribution of such infections in recurrent cases. Methods: Women with recurrent vulvovaginal symptomatology referred to an Obstetrics and Gynecology practice were tested by genital fungus culture, Candida-specific polymerase chain reaction (PCR), or both between July 2010 and February 2013. Results: A total of 103 women were tested. Mean age was 45.6 years. Including only their most recent positive test result, 29.1% (30/103) of women tested positive for Candida by any of the above testing measures. Of those, 50% (15/30) tested positive for C. albicans and 50% (15/30) tested positive for a NAC species. Across all visits, 60% (18/30) tested positive for C. albicans, 56.7% (17/30) tested positive for NAC, and 16.7% (5/30) tested positive for both a C. albicans and a NAC species. Among all isolated NAC species, 28.6% (6/21) were determined to be C. glabrata, 23.8% (5/21) C. krusei, 23.8% (5/21) C. parapsilosis, and 23.8% (5/21) other Candida species. Conclusion: Approximately 30% of women with recurrent vulvovaginal symptomatology have detectable Candida strains and it appears that NAC species may cause half of all these infections. This is imperative because NAC infections are usually more difficult to diagnose and are resistant to most treatments.展开更多
Objective To investigate the features of vaginal bacteria community in women with recurrent vulvovaginal candidiasis （R VVC） and its etiological risk in vaginal health. Methods Totally 237 reproductive-aged women wi...Objective To investigate the features of vaginal bacteria community in women with recurrent vulvovaginal candidiasis （R VVC） and its etiological risk in vaginal health. Methods Totally 237 reproductive-aged women with RVVC in an acute episode were studied. Whereas 230 healthy reproductive-aged women were enrolled as the control. The vaginal pH was evaluated, while vaginal secretions were sampled for Gram＇s staining and oilmicroscopy. By Nugent score system, the composition of vaginal communities was determined, and other micro-ecological features were approached. To describe other features of vaginal microbiota, the community＇s bacteria density, species diversity and predominant species were evaluated at 1 000 X magnification. Results The vaginal pH （4.53 ~ 0.30） and Nugent score （4.31 ___＋ O. 73） in RVVC group were significantly increased compared with vaginal pH （4.11 __＋ 0.30） and Nugent score （1.32 _＋ 1.29） in control group （P〈O.05, respectively）. The density of Lactoba- cillus in RVVC group was significantly lower than that in control group （P〈O.05）, while the densities of Gardnerella vaginalis, Gram-positive cocci and other species were significantly higher respectively than those in control group （P〈O. 05）. Species diversity of women with RVVC significantly exceeded that of control group （P〈O.05）. More than half of vaginal communities in R VVC group lost Lactobacillus-dominating and were predominated by other bacteria such as Gardnerella vaginalis and Gram-positive cocci. The prevalence of Gardnerella vaginalis-dominating and Gram-positive cocci-domi- nating communities in RVVC group （37.55% and 19.83%） were significantly higher than those in control group （1.30% and 1.73%） （P〈0.05）. Conclusion The significant changes in vaginal bacterial community were observed in RVVC women. Such variations in community might relate to vaginal biological barrier compromising and increase the risk to the recurrence of VVC. It is still controversial whether probiotics can prevent recurrences of VVC, and more randomized, doubleblind, placebo-controlled trials with a larger sample size should be carried out, so as to clarify its effects for the prophylaxis of RVVC.展开更多
目的探究复发性外阴阴道假丝酵母菌病(RVVC)患者阴道菌群的动态变迁。方法不同时间点采集RVVC患者(6例)以及正常对照女性(5例)阴道分泌物,分别对每个样本进行细菌总基因组DNA提取、16S r RNA V4区基因扩增及采用Illumina高通量测序技术...目的探究复发性外阴阴道假丝酵母菌病(RVVC)患者阴道菌群的动态变迁。方法不同时间点采集RVVC患者(6例)以及正常对照女性(5例)阴道分泌物,分别对每个样本进行细菌总基因组DNA提取、16S r RNA V4区基因扩增及采用Illumina高通量测序技术对扩增的PCR产物进行测序等步骤,然后通过BIPES、TSC、GAST等程序,分析比较两组阴道菌群物种丰度和结构以及菌群动态变化。结果正常对照女性阴道菌群以乳酸杆菌为主,其中惰性乳杆菌和卷曲乳杆菌比例相当,同时存在少量加德纳菌属、普氏菌属和其它菌属;或者以加德纳菌属、普氏菌属、奇异菌属、纤毛菌属等为主要菌属;而RVVC患者阴道菌群丰富度明显降低,以惰性乳杆菌为优势菌属,卷曲乳杆菌含量明显减少。正常对照女性阴道菌群随月经周期的变化出现波动,其中在月经期的波动最为明显,其优势菌属在月经周期中呈现相互交替或保持绝对优势的变化模式;而RVVC患者阴道菌群的波动性减弱,不随月经周期的变化而变化,且在疾病发作期和间歇期的菌群结构相似。结论 RVVC患者阴道菌群结构不随月经周期发生变化,在疾病发作期和间歇期相似。诱导卷曲乳杆菌产生或抑制惰性乳杆菌定植,从而恢复阴道菌群比例,可能可以治愈RVVC。展开更多
文摘Background: Candida vulvovaginitis is one of the most frequently diagnosed conditions in women’s care practices. Historically, 90% of cultured yeast species were C. albicans. However, due to a variety of interventions, the proportion of non-albicans Candida (NAC) infections appears to be increasing. We sought to estimate the current prevalence of Candida vulvovaginitis and the species-specific distribution of such infections in recurrent cases. Methods: Women with recurrent vulvovaginal symptomatology referred to an Obstetrics and Gynecology practice were tested by genital fungus culture, Candida-specific polymerase chain reaction (PCR), or both between July 2010 and February 2013. Results: A total of 103 women were tested. Mean age was 45.6 years. Including only their most recent positive test result, 29.1% (30/103) of women tested positive for Candida by any of the above testing measures. Of those, 50% (15/30) tested positive for C. albicans and 50% (15/30) tested positive for a NAC species. Across all visits, 60% (18/30) tested positive for C. albicans, 56.7% (17/30) tested positive for NAC, and 16.7% (5/30) tested positive for both a C. albicans and a NAC species. Among all isolated NAC species, 28.6% (6/21) were determined to be C. glabrata, 23.8% (5/21) C. krusei, 23.8% (5/21) C. parapsilosis, and 23.8% (5/21) other Candida species. Conclusion: Approximately 30% of women with recurrent vulvovaginal symptomatology have detectable Candida strains and it appears that NAC species may cause half of all these infections. This is imperative because NAC infections are usually more difficult to diagnose and are resistant to most treatments.
文摘Objective To investigate the features of vaginal bacteria community in women with recurrent vulvovaginal candidiasis （R VVC） and its etiological risk in vaginal health. Methods Totally 237 reproductive-aged women with RVVC in an acute episode were studied. Whereas 230 healthy reproductive-aged women were enrolled as the control. The vaginal pH was evaluated, while vaginal secretions were sampled for Gram＇s staining and oilmicroscopy. By Nugent score system, the composition of vaginal communities was determined, and other micro-ecological features were approached. To describe other features of vaginal microbiota, the community＇s bacteria density, species diversity and predominant species were evaluated at 1 000 X magnification. Results The vaginal pH （4.53 ~ 0.30） and Nugent score （4.31 ___＋ O. 73） in RVVC group were significantly increased compared with vaginal pH （4.11 __＋ 0.30） and Nugent score （1.32 _＋ 1.29） in control group （P〈O.05, respectively）. The density of Lactoba- cillus in RVVC group was significantly lower than that in control group （P〈O.05）, while the densities of Gardnerella vaginalis, Gram-positive cocci and other species were significantly higher respectively than those in control group （P〈O. 05）. Species diversity of women with RVVC significantly exceeded that of control group （P〈O.05）. More than half of vaginal communities in R VVC group lost Lactobacillus-dominating and were predominated by other bacteria such as Gardnerella vaginalis and Gram-positive cocci. The prevalence of Gardnerella vaginalis-dominating and Gram-positive cocci-domi- nating communities in RVVC group （37.55% and 19.83%） were significantly higher than those in control group （1.30% and 1.73%） （P〈0.05）. Conclusion The significant changes in vaginal bacterial community were observed in RVVC women. Such variations in community might relate to vaginal biological barrier compromising and increase the risk to the recurrence of VVC. It is still controversial whether probiotics can prevent recurrences of VVC, and more randomized, doubleblind, placebo-controlled trials with a larger sample size should be carried out, so as to clarify its effects for the prophylaxis of RVVC.
文摘目的探究复发性外阴阴道假丝酵母菌病(RVVC)患者阴道菌群的动态变迁。方法不同时间点采集RVVC患者(6例)以及正常对照女性(5例)阴道分泌物,分别对每个样本进行细菌总基因组DNA提取、16S r RNA V4区基因扩增及采用Illumina高通量测序技术对扩增的PCR产物进行测序等步骤,然后通过BIPES、TSC、GAST等程序,分析比较两组阴道菌群物种丰度和结构以及菌群动态变化。结果正常对照女性阴道菌群以乳酸杆菌为主,其中惰性乳杆菌和卷曲乳杆菌比例相当,同时存在少量加德纳菌属、普氏菌属和其它菌属;或者以加德纳菌属、普氏菌属、奇异菌属、纤毛菌属等为主要菌属;而RVVC患者阴道菌群丰富度明显降低,以惰性乳杆菌为优势菌属,卷曲乳杆菌含量明显减少。正常对照女性阴道菌群随月经周期的变化出现波动,其中在月经期的波动最为明显,其优势菌属在月经周期中呈现相互交替或保持绝对优势的变化模式;而RVVC患者阴道菌群的波动性减弱,不随月经周期的变化而变化,且在疾病发作期和间歇期的菌群结构相似。结论 RVVC患者阴道菌群结构不随月经周期发生变化,在疾病发作期和间歇期相似。诱导卷曲乳杆菌产生或抑制惰性乳杆菌定植,从而恢复阴道菌群比例,可能可以治愈RVVC。
