Treatment of Vulvovaginal Candidiasis with A Strategy Based on Phototherapy (M.A.C.® Scar Acceleration Method)

Candidiasis, also known as candidiasis vulvovaginitis, is an infection caused by different types of Candida fungi, the most frequent being Candida albicans. The present study reports an effective strategy, which opens new avenues for the treatment of this public health problem. The MAC® Methodology, conventional laser light-emitting (LLLT)/LED) methods are based on the biphasic response demonstrated many times in LLLT research and as with other forms of drugs, a “drug” (irradiation parameters) and a “dose” (irradiation times) and the “Arndt-Schulz Law” is often cited as a suitable model to describe the dose-dependent effects of LLLT. This method uses photopharmaceuticals, cell markers and the use of correct parameters for each case to induce the acceleration of tissue repair. The present study shows a case of a 32-year-old patient diagnosed with recurrent candidiasis 4 years ago. Eighteen sessions were performed (every other day) using a photoactivated component (Methylene blue 1% + Clotrimazole 1%) and LED phototherapy (red, blue and violet) with emission times of 60 - 260 seconds for each applicator, according to the dose recommendations of the scar acceleration method (MAC®). At the sixth treatment session there was a noticeable decrease in the itching sensation reported by the patient. In session 11 she reported feeling a great improvement, indicating that she no longer felt itching in any area after 18 sessions. The present case demonstrates new methodologies to treat common problems in the population that have a positive impact on the quality of life. This methodology has a promising future because it is non-invasive and requires a great biological transformation for inflammatory, fungal and viral control.

Study of the Frequency of Superficial Candidiasis at the Fann National Hospital: Search for Candida auris

Background: Superficial candidiasis is a very frequent opportunistic disease caused by yeasts of the genus Candida. Among Candida types, some, such as Candida auris, have developed resistance to several antifungal agents. The objective of this study was to determine the hospital frequency of superficial candidiasis diagnosed at the CHU Fann and to investigate the presence of C. auris among the identified Candida strains. Methods: A cross-sectional study was conducted from February to June 2019. It involved all patients received at the Parasitology-Mycology laboratory of the CHU of Fann for suspected superficial candidiasis. Nails, skin, and vaginal specimens were subjected to direct examination and culture to identify yeasts of the genus Candida. The Candida strains were then tested by molecular biology targeting the specific C. auris ITS2 region. Results: A total of 1196 patients were examined. One thousand two hundred and five specimens (1205) were collected, including 1042 vaginal specimens, 92 nail specimens, and 71 skin specimens. Superficial candidiasis was diagnosed in 408 patients (37%). Women (34.52%) and patients under 30 years of age (39.60%) were the most affected. Yeasts of the genus Candida were found in 411 specimens (349 vaginal swabs, 36 nail fragments, and 26 skin flakes) by routine mycological techniques. The Candida albicans complex (C. albicans, C. dubliniensis, and C. africana) represented 75.91% of the Candida strains isolated. Molecular biology did not identify C. auris. Conclusion: Superficial candidiasis remains very common in hospitals in Senegal. Candida auris was not found in our study. Due to its rapid spread, surveillance is necessary to prevent epidemics in our hospitals.

Prevalence and clinical risk factors for esophageal candidiasis in non-human immunodeficiency virus patients:A multicenter retrospective case-control study

BACKGROUND Although esophageal candidiasis(EC)may manifest in immunocompetent individuals,there is a lack of consensus in the current literature about predisposing conditions that increase the risk of infection.AIM To determine the prevalence of EC in patients without human immunodeficiency virus(HIV)and identify risk factors for infection.METHODS We retrospectively reviewed inpatient and outpatient encounters from 5 regional hospitals within the United States(US)from 2015 to 2020.International Classification of Diseases,Ninth and Tenth Revisions were used to identify patients with endoscopic biopsies of the esophagus and EC.Patients with HIV were excluded.Adults with EC were compared to age,gender,and encounter-matched controls without EC.Patient demographics,symptoms,diagnoses,medications,and laboratory data were obtained from chart extraction.Differences in medians for continuous variables were compared using the Kruskal-Wallis test and categorical variables using chi-square analyses.Multivariable logistic regression was used to identify independent risk factors for EC,after adjusting for potential confounding factors.RESULTS Of the 1969 patients who had endoscopic biopsies of the esophagus performed from 2015 to 2020,295 patients had the diagnosis of EC.177 of 1969 patients(8.99%)had pathology confirming the diagnosis of EC and were included in the study for data collection and further analysis.In comparison to controls,patients with EC had significantly higher rates of gastroesophageal reflux disease(40.10%vs 27.50%;P=0.006),prior organ transplant(10.70%vs 2%;P<0.001),immunosuppressive medication(18.10%vs 8.10%;P=0.002),proton pump inhibitor(48%vs 30%;P<0.001),corticosteroid(35%vs 17%;P<0.001),Tylenol(25.40%vs 16.20%;P=0.019),and aspirin use(39%vs 27.50%;P=0.013).On multivariable logistic regression analysis,patients with a prior organ transplant had increased odds of EC(OR=5.81;P=0.009),as did patients taking a proton pump inhibitor(OR=1.66;P=0.03)or corticosteroids(OR=2.05;P=0.007).Patients with gastroesophageal reflux disease or medication use,including immunosuppressive medications,Tylenol,and aspirin,did not have a significantly increased odds of EC.CONCLUSION Prevalence of EC in non-HIV patients was approximately 9%in the US from 2015-2020.Prior organ transplant,proton pump inhibitors,and corticosteroids were identified as independent risk factors for EC.

Candidiasis Treatment Should Pay Attention to the Immune Changing Patients

The guideline of the Infectious Diseases Society of America (IDSA) about candidiasis is a key standard for clinical doctors to treat patients, and textbook to teach medical students. However, in the progress of clinical treatment and documents checking, the immune changing patients, who suffered candidiasis, may be mismatched to the clinical treatment guidelines. The opinion could be shown by the literature of gastrointestinal system, and respiratory system, which suffered severely fungal infection mostly, mainly connected with the outside world and inside organ systems of the human body. They could show some patients have been excess treatment, and we should pay attention to the immune changing patients.

Alpha Defensins Genes and Vulvovaginal Candidiasis:A Study of Cases

Objective: To evaluate the alpha-defensin (α-DF) genes polymorphism in women with vulvovaginal candidiasis and recurrence. Methods: This observational study included clinical vaginal secretion samples collected over four years from 88 women, ranging in age from 18 to 65 years, from medical centers of Sao Paulo and Mogi das Cruzes, Brazil. Thirty-six of these women were asymptomatic (control group) and 52 presented clinical condition compatible with vulvovaginitis (38 primary or episodic as non-recurrent forms, and 14 recurrent vulvovaginal candidiasis). A portion of each sample was plated on Sabouraud dextrose agar with chloramphenicol and grown on CHROMagar Candida for presumptive characterization. The identification of the species was obtained by sequencing of the ITS1 region of rDNA. α-DF genes were amplified for subsequent evaluation of polymorphisms by endonuclease restriction assay. Results: From 88 samples were isolated 60 Candida albicans and 28 non-albicans Candida spp. Resistant C. albicans strains and non-albicans Candida spp. were more prevalent in recurrence. In all groups, the number of resistant non-albicans Candida spp. was most high than susceptible strains. α-DF1, α-DF3 and α-DF1/α-DF3 genotypes were found in 32 (36.4%), 17 (19.3%), 6 (6.8%) vaginal samples, respectively. About 33 samples were not amplified. Recurrence and severe disease were more observed in homozygous population. Conclusions: Non-albicans Candida spp. and homozygotic α-DF genotipes (α-DF1 and α-DF3) were more related with severe clinical signs and recurrence. Further studies about vulvovaginal candidiasis and α-DF genes are necessary to access the more comprehensive role of defensins in clinical manifestations.

Local IL-23 Expression in Murine Vaginal Candidiasis and Its Relationship with Infection and Immune Status

To investigate the expression of vaginal IL-23 and its role in experimental murine vaginal candidiasis and its relationship with infection and immune status, immuno-competent （group A） and immuno-suppressed （group B） murine models of vaginal candidiasis were established in estrogentreated mice. Non-estrogen-treated mice were used as controls （group C）. The level of IL-23 p19 mRNA in murine vaginal tissue was determined by RT-PCR. Significantly increased levels of IL- 23p19mRNA were observed on the 4th, the 7th and 14th day after inoculation in immuno-competent group when compared with that in control group （P〈0.01, P〈0.05）, However, significant increase of IL-23 p19mRNA were only observed on the 7th day and the 14th day after inoculatuon in immuno-suppressed groups （P〈0. 05）. On the 4th and 7th day, the levels of IL-23 p19mRNA were significantly increased in immuno-competent group than those in immuno-suppressed group （P 〈0.05）. Local IL-23 may play a role in the pathogenesis of murine vaginal candidiasis and has a protective function during infection. Low vaginal IL-23 level may correlate with the increased susceptibility to Candida albicans in immuno-suppressed group.

Susceptibility to Vaginal Candidiasis under Different Conditions in Mice

In order to study the susceptibility of murine vaginal mucosa to Candida albicans under different conditions, vaginal lavage fluid and vaginal tissue of mice were observed and compared between murine models with normal immune system （estrogen-treated mice） and immunosuppressed murine model, and between primary infection model of vaginal candidiasis and secondary infection one. The average level of colony forming unit （CFU） from the immuosuppressed group was higher than that from estrogen-treated group at each time point and the peak time was delayed. The differences between the two groups were statistically significant （P〈0.05） from the fourth day after inoculation. A significant difference existed in the average level of CFU between the control group and the estrogen-treated group （P〈0.05）, and between the control group and the immuosuppressed group （P〈0.01）. It was concluded that the vaginal mucosa from the immunosuppressed mice is more susceptible to Candida albicans and no difference is found in susceptibility between mice with primary infection and secondary infection.

Clinical significance of isolated biliary candidiasis in patients with unresectable cholangiocarcinoma

BACKGROUND: The frequency of isolated biliary candidiasis is increasing in cancer patients. The clinical signiifcance of isolated biliary candidiasis remains unclear. We analyzed the risk factors of biliary candidiasis and outcomes of the patients with unresectable cholangiocarcinoma after percutaneous transhepatic biliary drainage (PTBD). METHODS: Among 430 patients who underwent PTBD between January 2012 and March 2015, 121 patients had unresectable cholangiocarcinoma. Bile and blood samples were collected for consecutive fungal culture. RESULTS: The study cohort included 49 women and 72 men with a median age of 71 years. Multivariate analysis showed that cancer progression (P=0.013), concurrent presence of another microorganism (P=0.010), and previous long-term (>7 days) antibiotic use (P=0.011) were potential risk factors of biliary candidiasis. Chemotherapy was not associated with overall biliary candidiasis (P=0.196), but was signiifcantly related to repeated biliary candidiasis (P=0.011). Patients with isolated biliary candidiasis showed remarkably reduced survival compared with those without (median overall sur-vival (OS): 32 vs 62 days,P=0.011)Subgroup analysis was also performed. Patients with repeated candidiasis had markedly decreased survival compared with those with transient candi-diasis (median OS: 30 vs 49 days,P=0.046). Biliary candidiasis was identiifed as a poor prognostic factor by univariate and multivariate analyses (P=0.033). Four cases of repeated can-didiasis (4/19, 21%) showedCandida species in consecutive blood culture until the end of the study, but others showed no candidemia. CONCLUSIONS: Isolated biliary candidiasis may be associ-ated with poor prognosis in patients with unresectable chol-angiocarcinoma. Especially, repeated biliary candidiasis may have the possibility of progression to candidemia. We suggest that biliary dilatation treatment or antifungal agents might be helpful for patients with biliary candidiasis.

Protective Effects of cis-2-Dodecenoic Acid in an Experimental Mouse Model of Vaginal Candidiasis

Objective To evaluate the efficacy of cis-2-dodecenoic acid(BDSF) in the treatment and prevention of vaginal candidiasis in vivo. Methods The activities of different concentrations of BDSF against the virulence factors of Candida albicans(C. albicans) were determined in vitro. An experimental mouse model of Candida vaginitis was treated with 250 μmol/L BDSF. Treatment efficiency was evaluated in accordance with vaginal fungal burden and inflammation symptoms. Results In vitro experiments indicated that BDSF attenuated the adhesion and damage of C. albicans to epithelial cells by decreasing phospholipase secretion and blocking filament formation. Treatment with 30 μmol/L BDSF reduced the adhesion and damage of C. albicans to epithelial cells by 36.9% and 42.3%, respectively. Treatment with 200 μmol/L BDSF completely inhibited phospholipase activity. In vivo mouse experiments demonstrated that BDSF could effectively eliminate vaginal infection and relieve inflammatory symptoms. Four days of treatment with 250 μmol/L BDSF reduced vaginal fungal loads by 6-fold and depressed inflammation. Moreover, BDSF treatment decreased the expression levels of the inflammatory chemokine-associated genes MCP-1 and IGFBP3 by 2.5-and 2-fold, respectively. Conclusion BDSF is a novel alternative drug that can efficiently control vaginal candidiasis by inhibiting the virulence factors of C. albicans.

Treatment of chronic vulvovaginal candidiasis with posaconazole and ciclopiroxolamine

Therapy of chronic recurrent vulvovaginal can- didiasis (VVC) caused by Candida glabrata is still rare in comparison to C. albicans infection, but therapy remains more difficult. Combination therapy with topical antifungals may improve therapy outcome, but still standard agents as fluconazole or itraconazole often fail. Posaconazole is a new systemic triazole with a wide antifungal spectrum including rare Candida species. Up to now, no clinical trials with posa- conazole in chronic recurrent VVC have been undertaken. Here, first results of the application of a new therapy regimen consisting of oral posaconazole in combination with topical ciclopiroxolamine are presented. 15 patients with chronic recurrent VVC caused by C. glabrata have been treated. 14 of these patients experienced successful therapy, clinical and mycological cure 30 days after begin of therapy has been observed. Long-term results are promising, as in 4 patients clinical and mycologic cure persists for more than 1 year up to now.

Prospective observational multicenter study to define a diagnostic algorithm for biliary candidiasis

AIM:To develop an algorithm to improve the diagnosis and treatment of patients with biliary candidiasis.METHODS:We performed a prospective study of 127patients who underwent endoscopic retrograde cholangiopancreatography,for various biliary disorders,at 3 tertiary referral centers in Germany from July 2011through July 2012(ClinicalTrials.gov:NCT01109550).Bile,buccal,and stool samples were collected.When indicated,endoscopic transpapillary bile duct biopsies were performed to clarify the etiology of bile duct strictures and to prove invasive fungal infections.RESULTS:Candida species were detected in 38 of the 127 bile samples(29.9%).By multivariate analysis patients’age and previous endoscopic sphincterotomy were independent risk factors for biliary candidiasis(P<0.05).Patients with immunosuppression(P=0.058)and recent long-term antibiotic therapy(>7 d)(P=0.089)tend to be at risk for biliary candidiasis.One patient was negative in mycological culture of bile fluid but invasive biliary candidiasis was diagnosed histologically.Of Candida subspecies detected,36.7%were azole-resistant,such as C glabrata.Eight patients received anti-mycotic therapy,based on our algorithm.Of these,3 had cancer with biliary tract involvement,2had secondary sclerosing cholangitis,1 had retroperitoneal fibrosis,and 5 had septicemia.In all patients contamination was ruled out by smears of the endoscope channel.CONCLUSION:Gastroenterologists should be aware of frequent candida colonization in patients with cholangitis and biliary disorders.Our suggested algorithm facilitates the further clinical management.

Analysis of Clinical Characteristics and Diagnostic Value of Fungal Serology in Patients with Invasive Candidiasis

Objective: To evaluate the diagnostic value of (1 - 3)-β-D glucan and mannan assay for invasive candidiasis. Methods: A retrospective study was conducted on 32 cases in the disease group (18 proven invasive candidiasis and 14 probable invasive candidiasis) and 48 cases in the control group. The subjects were recruited from January 2018 to March 2019 in Clinical Laboratory of Hainan General Hospital. All subjects were detected by (1 - 3)-β-D glucan and mannan assay. Results: The mean concentration of (1 - 3)-β-D glucan in the disease group was 97.45 (43.23, 224.35) pg/ml and it was significantly higher than the mean concentration of the control group which was 49.85(41.91, 56.07) pg/ml (P = 0.005). The mean concentration of mannan in the disease group and the control group were 161.36 (34.96, 224.49) pg/ml and 25.80 (25.00, 29.31) pg/ml, respectively, which were significantly different (P < 0.001). The sensitivity, specificity, positive predictive value and negative predictive value of (1 - 3)-β-D glucan assay were 59.38%, 89.58%, 79.17%, 76.79%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of mannan assay were 65.63%, 95.83%, 91.30%, 80.70%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of combination of two types of assays were 81.25%, 85.42%, 78.79% and 87.23%, respectively. Conclusions: Combination of (1 - 3)-β-D glucan and mannan assay can improve diagnostic specificity and it has essential clinical diagnostic value for invasive candidiasis.

A Ten-year Retrospective Study of Invasive Candidiasis in a Tertiary Hospital in Beijing

Objective This study aimed to evaluate the epidemiological,clinical and mycological characteristics of invasive candidiasis(IC)in China.Methods A ten-year retrospective study including 183 IC episodes was conducted in a tertiary hospital in Beijing,China.Results The overall incidence of IC from 2010–2019 was 0.261 episodes per 1,000 discharges.Candidemia(71.0%)was the major infective pattern;70.3%of the patients tested positive for Candida spp.colonization before IC and the median time to develop an invasive infection after colonization was13.5 days(interquartile range:4.5–37.0 days).Candida albicans(45.8%)was the most prevalent species,followed by Candida parapsilosis(19.5%),Candida glabrata(14.2%)and Candida tropicalis(13.7%).C.non-albicans IC was more common in patients with severe anemia(P=0.018),long-term hospitalization(P=0.015),hematologic malignancies(P=0.002),continuous administration of broad-spectrum antibiotics(P<0.001)and mechanical ventilation(P=0.012).In vitro resistance testing showed that11.0%of the Candida isolates were resistant/non-wild type(non-WT)to fluconazole,followed by voriconazole(9.6%),micafungin(3.8%),and caspofungin(2.9%).Fluconazole was the most commonly used drug to initiate antifungal therapy both before and after the proven diagnosis(52.6%and 54.6%,respectively).The 30-day and 90-day all-cause mortality rates were 24.5%and 32.7%,respectively.Conclusion The incidence of IC has declined in the recent five years.C.non-albicans contributed to more than half of the IC cases.Fluconazole can be used as first-line therapy if resistant strains are not prevalent.Prospective,multi-center surveillance of the clinical and mycological characteristics of IC is required.

Study on The Role of Interleukin-4 in Experimental Murine Systemic Candidiasis

In order to investigate the role of interleukin 4 in experimental murine systemic Candidiasis, we created the intact and dexamethasone induced immunosuppressed murine systemic Candidiasis models. In these models, two site ELISA and RT PCR were applied to determine the level of IL 4 protein and mRNA expression in spleens respectively, clone forming units of infected kidneys were determined with the plating dilution method, and mean survival time of the mice was recorded. The results showed that, when compared with the controls, protein level of IL 4 increased in both intact mice infected with lethal doses of yeast (day 3, P <0.05; day 7, P <0 001) and immunosuppressed mice infected with sublethal doses of yeast (day 3, P >0.05; day 7, P <0.05). Furthermore, the level of IL 4 was higher on day 7 than on day 3 after infection ( P <0 001 and P <0.05 respectively in two groups). The tendency of IL 4mRNA expression was similar with that of IL 4 protein. As for fungal loads in kidneys, CFUs were significantly higher on day 7 than on day 3 after infection . Mice in both groups succumbed to infection within several days. It was suggested that IL 4 might play a promoting role in the development of murine systemic Candidiasis.

Relationship between Host Survival and the Type of Immune Response in Different Organs during Disseminated Candidiasis

Summary: To examine the relationship between host survival and the type of immune response in different organs during disseminated candidiasis, the murine model of disseminated candidiasis was established by injection with Candida albicans via tail vein. The survival time was observed for up to 60 days. And the expression levels of cytokines in the spleen and kidney, including IFN-γ and IL-4, were determined with RT-PCR. Our results showed that in the spleen, both non-fatal and fatal inoculum caused a type Ⅱimmune response with steady expression levels of IFN-γ and the obviously increased levels of IL-4. While in the kidney, non-fatal inoculum induced a typeⅠimmune response with the obviously increased levels of IFN-γ and the steady expression levels of IL-4. However, fatal inoculum induced a type Ⅱ immune response with a constant expression of IFN-γ and the evidently increased levels of IL-4. It is concluded that in disseminated candidiasis, host survival is associated with the type of immune responses in the kidney, but not in the spleen.

Expression of Candida Albicans Secreted Aspartyl Proteinase in Acute Vaginal Candidiasis

In order to analyze the in vivo expression of Candida albicans secreted aspartyl pro- teinases (SAP) in human vaginal infection, the vaginal secretion from 29 human subjects was col- lected by vaginal swab, and the expression of SAP1–SAP6 was detected by reverse-transcriptase po- lymerase chain reaction using specific primer sets. It was found that Sap2 and Sap5 were the most common genes expressed during infection; Sap3 and Sap4 were detected in all subjects and all 6 SAP genes were simultaneously expressed in some patients with vaginal candidiasis. It was suggested that the SAP family is expressed by Candida albicans during infection in human and that Candida albi- cans infection is associated with the differential expression of individual SAP genes which may be involved in the pathogenesis of vaginal candidiasis.

Oral Candidiasis in Sjgoren's Syndrome：Prevalence，Clinical Features，and Treatment

This paper reports the diagnosis of 65 patients with Sjogren′s Syndrome. Among these patients, 20 patients(30.77%) were complicated with oral candidiasis. The twenty patients were treated by topical nystatin smearing, 2% sodium bicarbonate solution rinsing, and transfer factor injecting for about 2 months. The soreness, erythema, unpleasant feeling, angular cheilitis in mouths significantly diminished or completely disappeared, following two months treatments. The good results have been kept 6 months after follow up. However, dry mouth and atrophic changes, though showed no furture development, the therapeutic response was not significant.

Polyhexamethylene Biguanide in Vaginal Solution Is Effective in the Treatment of Vulvovaginal Candidiasis: A Pilot Study

Vaginitis is one of the most recurrent conditions that afflict women and require medical care. Vulvovaginal candidiasis (VVC) is frequently related to vaginal carriage of Candida albicans, an opportunistic polymorphic fungus, which colonizes the human skin, the mucosa and the reproductive tract. Actually, standard treatments to counteract vaginitis include several topical and oral treatments. The aim of this study was to evaluate the efficacy of a new biguanide compound, polyhexamethylene biguanide (PHMB) in avaginal solution, in women affected by vaginal candidiasis. For this reason, 40 women showing the symptoms previously ascribed to vaginal candidiasis were recruited and treated with a single PHMB dose of vaginal solution. After a single dose of treatment, 80% of them had a complete resolution of the fungal infection;furthermore, all of them reported clinical benefits, statistically significant reduction in both clinical signs and symptoms of candidiasis and a score’s reduction of 50%.

Pharmacokinetics of Micafungin in Adult Patients with Invasive Candidiasis and Candidemia

Micafungin is an efficacious and well-tolerated echinocandin with in vitro and in vivo activity against a broad range of Candida species. The objective of this randomized, double-blind study was to examine the pharmacokinetic parameters of micafungin and its metabolites in a subset of adult patients with invasive candidiasis or candidemia. The study was conducted at 27 sites in four countries, including eight in Europe. Micafungin 100 mg/day or liposomal amphotericin B 3 mg/kg/day were administered once daily as a 1-hour infusion in a blinded manner. The minimum duration of therapy was 14 days. To define plasma analyte (micafungin and metabolites) concentration-time profiles, serial blood samples were collected after the first dose (Day 1), and at the end of therapy (EOT). For patients who received treatment for longer than 2 weeks, an additional profile was obtained during Week 2. To determine plasma trough analyte concentrations, blood samples were collected immediately prior to dosing on Day 2, Week 2, and EOT. In 20 evaluable, micafungin-treated patients, plasma micafungin concentrations peaked at completion of the 1-hour infusion and then declined biexponentially. Plasma concentrations of the micafungin metabolites (M-1, M-2, and M-5) remained low (<1 μg/mL) throughout the study. The mean half-life and clearance of micafungin were largely unchanged with repeated dosing up to 28 days, and no evidence of micafungin accumulation was observed. These data provide further support for the predictability of micafungin pharmacokinetics in adult patients with invasive candidiasis and candidemia.

Prevalence of Vaginal Candidiasis and Determination of the Occurrence of Candida Species in Pregnant Women Attending the Antenatal Clinic of Thika District Hospital, Kenya

Epidemiological monitoring of vaginal candidiasis infections associated with preterm delivery and death of the infant is highly desirable especially in pregnant women. The objectives were to determine the prevalence of vaginal candidiasis and the occurrence of Candida species in pregnant women attending the antenatal clinic of Thika District Hospital, Kenya. Vaginal swabs were collected from 104 pregnant women between the months of June and August 2010. The Candida species were identified by standard mycological and biochemical methods and the prevalence was determined by?, where: O is the number of individuals with the disease and P is the total number of individuals in the population involved in the study. Out of 104 samples obtained from the pregnant women with symptoms of vaginal candidiasis, 94 (90.38%) patients were tested positive and 10 (9.62%) were tested negative for vaginal candidiasis. The percentage distribution of vaginal candidiasis within age group was highest in the age brackets 26 - 35 years with 56(60%) patients and in the 3rd trimester of pregnancy with 64(68.09%) patients. The percentage occurrence of vaginal Candida species showed that Candida albicans was the most isolated species with 60(63.83%) isolates. The results indicated a high prevalence of vaginal candidiasis: 42.7%. The women at great risk were those between 26 - 35 years and in their 3rd trimester. Candida albicans was the most prevalent vaginal Candida species across all age groups and trimesters.