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.

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.

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%.

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.

包头地区295例VVC分离株的菌种分布及药物敏感性分析

目的:探讨包头地区外阴阴道念珠菌病(vulvovaginal candidiasis,VVC)患者感染念珠菌菌种分布特点及对抗真菌药物的敏感性,为临床精准治疗提供参考。方法:收集2021年1月至12月295例VVC患者阴道分泌物进行分离培养,应用MALDI-TOFMS、PCR方法完成菌种鉴定,按照CLSI M27-S4标准采用微量肉汤稀释法进行9种药物体外药敏试验。结果:感染患者以31~35年龄段最多见(30.85%),其次是26~30年龄段(20.34%),21~40年龄段患者占82.04%,性生活、妊娠等易感因素在VVC中占比较大;共分离鉴定出非重复菌株295株,白念珠菌居首位占79.32%,光滑念珠菌次之占13.90%,尼瓦利亚、布加拉等少见念珠菌共7种各1株;白念珠菌对伊曲康唑的耐药率高于非白念珠菌(P<0.01),二者对氟康唑、伏立康唑和泊沙康唑耐药情况差异无统计学意义(P>0.05),非白念珠菌对卡泊芬净和5-氟胞嘧啶的耐药率高于白念珠菌(P<0.01);未发现制霉菌素耐药菌株,所有菌株对两性霉素B的敏感性均为100%,对特比奈芬的耐药率均很高。结论:包头地区VVC患者感染菌种多样,以白念珠菌多见,但不同菌种念珠菌对常用抗真菌药物敏感情况差异较大,应定期进行持续的耐药监测,以便指导妇科医生制订正确的诊疗方案,同时延缓耐药性的产生。

Growing importance of urogenital candidiasis in individuals with diabetes:A narrative review

Both diabetes and fungal infections contribute significantly to the global disease burden,with increasing trends seen in most developed and developing countries during recent decades.This is reflected in urogenital infections caused by Candida species that are becoming ever more pervasive in diabetic patients,particularly those that present with unsatisfactory glycemic control.In addition,a relatively new group of anti-hyperglycemic drugs,known as sodium glucose cotransporter 2 inhibitors,has been linked with an increased risk for colonization of the urogenital region with Candida spp.,which can subsequently lead to an infectious process.In this review paper,we have highlighted notable virulence factors of Candida species(with an emphasis on Candida albicans)and shown how the interplay of many pathophysiological factors can give rise to vulvovaginal candidiasis,potentially complicated with recurrences and dire pregnancy outcomes.We have also addressed an increased risk of candiduria and urinary tract infections caused by species of Candida in females and males with diabetes,further highlighting possible complications such as emphysematous cystitis as well as the risk for the development of balanitis and balanoposthitis in(primarily uncircumcised)males.With a steadily increasing global burden of diabetes,urogenital mycotic infections will undoubtedly become more prevalent in the future;hence,there is a need for an evidence-based approach from both clinical and public health perspectives.

Prevalence of Non-<i>Albicans Candida</i>Infections in Women with Recurrent Vulvovaginal Symptomatology

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.

Clinical Experience in the Treatment of Vulvovaginal Candida Disease with Integrated Traditional Chinese and Western Medicine

Summarizing two cases of vaginal candidiasis,cured by integrated traditional Chinese and western medicine in clinical work,it is found that the combination of traditional Chinese and western medicine has a significant effect on the treatment of this disease.The curative effect is outstanding,and the recurrence rate is significantly reduced,which can be used as a reference for gynecological medical workers.

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.

Patient Preferences in the Treatment of Vaginal Candidiasis

Vulvovaginal candidiasis (VVC) is one of the most frequent problems facing women and their healthcare professionals (HCP). It is difficult for providers to understand the prevalence of VVC because effective over the counter treatments (OTC), are available. It is expected that there are a great many more episodes of VVC in our patient population, as the frequency of self-treatment, success and satisfaction for those that use OTC products prior to seeing a women’s health care provider is unknown. In this study;healthcare providers were given OTC miconazole/tioconazole units for free distribution to patients for whom they diagnosed VVC by exam in their offices. Surveys for both HCP and patients were also distributed to determine the initial or recurrent nature of their symptoms and their satisfaction with their treatments. 1265 OBGYNs and 1821 NP/CNM/PAs reported on over 19,000 patients receiving a single complete treatment. Among HCPs, treatment efficacy was the primary reason for recommending miconazole/tioconazole. However, rapid onset of symptom relief, safety vs. fluconazole, patient preference for the less messy ovule, avoidance with drugs metabolized by the liver, and resistance to, or failure on, fluconazole were additional reasons noted for topical preference. Overall, patient satisfaction (n = 317) was high at 95%, with 97% of patients reporting that they would use miconazole again. Importantly, 100% of first time sufferers (n = 95) would use miconazole again. The few patients dissatisfied with miconazole (2%), reported no symptom relief, burning after use, an “allergic reaction”, pain from the applicator or a messy discharge. Most patients using the external symptom relief products were satisfied with the external cream (93%) and wipes (96%). Almost all patients reported their yeast infection was cured (91%) and that they experienced quick symptom relief (94%), despite the prevalence of recurrent vs first time VVA sufferers that presented to offices in this trial. Most patients were cured and satisfied with their treatment, therefore supporting the use of topical miconazole/tioconazole as first line therapy for vulvovaginal candidiasis patients presenting to a healthcare office.

白头翁汤调控PI3K/AKT-HIF-1α通路治疗VVC小鼠的研究

目的基于磷脂酰肌醇-3激酶(Phosphoinositide 3-kinase,PI3K)/蛋白激酶B(Protein kinase B,AKT)-缺氧诱导因子-1α(Hypoxia-inducible factor-1α,HIF-1α)通路探究白头翁汤对外阴阴道假丝酵母菌病(Vulvovaginal candidiasis,VVC)小鼠的作用机制。方法雌性SPF级昆明种小鼠采用苯甲酸雌二醇皮下注射联合白色念珠菌混悬液阴道接种建立VVC小鼠模型。造模成功小鼠随机分为模型组,白头翁汤高、中、低剂量组(23.4、11.7、5.85 g·kg^(-1)),氟康唑组(0.02 g·kg^(-1)),每组20只。另取20只小鼠只注射苯甲酸雌二醇作为空白组。模型成功后次日给药,连续14 d。末次给药2 h后,巴氏染色法观测阴道灌洗液内中性粒细胞数量;HE染色法观察阴道组织形态;ELISA法测定阴道组织中烟酰胺腺嘌呤二核苷酸磷酸氧化酶2(Nicotinamide adenine dinucleo-tide phosphate oxidase 2,NOX2)、超氧化物歧化酶(Superoxide dismutase,SOD)活性及活性氧(Reactive oxygen species,ROS)、丙二醛(Malondialdehyde,MDA)水平;qPCR检测阴道组织PI3K、AKT、HIF-1α的mRNA表达;Western blot检测阴道组织p-PI3K、PI3K、p-AKT、AKT、HIF-1α蛋白表达。结果与空白组小鼠相比,模型组小鼠阴道灌洗液含有大量中性粒细胞(P<0.001);阴道黏膜层脱落严重,大量炎细胞浸润;阴道组织ROS、MDA水平升高(P<0.001),NOX2活性提高(P<0.001),SOD活性降低(P<0.001),PI3K、AKT、HIF-1αmRNA表达降低(P<0.001),p-PI3K/PI3K和p-AKT/AKT的比值、HIF-1α蛋白表达降低(P<0.001)。与模型组小鼠相比,白头翁汤高、中剂量组阴道灌洗液内中性粒细胞数量降低明显(P<0.01,P<0.001);阴道组织黏膜状况呈现不同程度的改善;阴道组织ROS、MDA水平有所降低(P<0.05,P<0.01,P<0.001),NOX2活性降低(P<0.01,P<0.001),SOD活性升高(P<0.01,P<0.001);白头翁汤高剂量组阴道组织PI3K、AKT、HIF-1αmRNA表达升高(P<0.001),p-PI3K/PI3K和p-AKT/AKT的比值、HIF-1α蛋白表达升高(P<0.001)。结论白头翁汤可通过调控PI3K/AKT-HIF-1α信号通路发挥对VVC的治疗作用。

白头翁汤正丁醇提取物对白念珠菌VVC临床株黏附作用的影响

目的探讨白头翁汤正丁醇提取物(Butyl alcohol extract of Bai Tou Weng decoction,BAEB)对外阴阴道念珠菌病(Vulvovaginal Candidiasis,VVC)白念珠菌临床分离株黏附作用的影响。方法平板法检测与BAEB共培养2 h、4 h时白念珠菌的CFU;XTT还原法检测与BAEB共培养2 h、4 h的白念珠菌代谢活性;试管法检测白念珠菌絮凝能力;水-烃两相法检测白念珠菌细胞表面疏水性(cell surface hydrophobicity,CSH);荧光显微镜观察菌体活力;扫描电镜观察白念珠菌细胞形态;qRT-PCR法检测黏附相关基因ALS1、CSH1、HWP1、ALS5、ALA1、INT1、MNT2与ALS3的表达。结果 512、1 024μg/m L BAEB可显著抑制黏附2 h、4 h时的白念珠菌的CFU及代谢活性;肉眼和倒置显微镜下观察发现512、1 024μg/m L BAEB可明显延缓絮凝产生的时间;256、512、1 024μg/m L的BAEB均能够显著减少白念珠菌的细胞表面疏水性;qRT-PCR检测表明1 024μg/m L的BAEB作用后,ALS1、CSH1、ALA1、ALS3、INT1、HWP1分别下调18.7%、36%、37.8%、29.6%、19.9%、21.6%,ALS5与MNT2未产生明显变化。结论 BAEB可能通过调节黏附相关基因抑制白念珠菌VVC临床株的黏附作用。

非妊娠期妇女BV和VVC发病状况及相关危险因素分析

目的：探讨细菌性阴道病（bacterial vaginosis,BV）和外阴阴道假丝酵母菌病（vulvovaginal candidiasis,VVC）在非妊娠期妇女的发病情况及其危险因素。方法：随机选取800例非妊娠期妇女,通过阴道分泌物检查、需氧菌及假丝酵母菌培养,了解BV和VVC患病情况,并结合问卷对可能的危险因素行单因素多变量非条件Logistic回归分析。结果：BV和VVC在受试人群的患病率分别为8.9%和8.1%。BV的危险因素为：阴道冲洗每周≥2次（OR2.438,95%CI1.285-4.626）和丈夫经常出差（OR1.946,95%CI1.046-3.620）;VVC的危险因素为：小学以下文化程度（OR3.217,95%CI1.326-7.805）。细菌培养结果以检出率表示,BV组与对照组比较,加德纳菌显著增加（70.4% vs 13.1%,P〈0.01）,乳杆菌显著减少（18.3% vs 65.4%,P〈0.01）;VVC组与对照组比较,白色假丝酵母菌（52.3% vs 3.1%,P〈0.01）和光滑假丝酵母菌（20.0% vs 3.7%,P〈0.01）均显著增加,乳杆菌减少（53.8% vs 65.4%,P〈0.05）。结论：BV和VVC均与阴道菌群失调有关,BV病原体以加德纳菌为主,阴道冲洗过频和丈夫经常出差是其危险因素;VVC病原体以白色假丝酵母菌和光滑假丝酵母菌为主,低学历是其危险因素;而BV和VVC与性行为的关系尚需进一步研究。

白头翁汤正丁醇提取物对白念珠菌VVC临床株体外生物膜形成的抑制作用

目的探讨白头翁汤正丁醇提取物（Butyl alcohol extract of Bai Tou Weng decoction,BAEB）对分离自外阴阴道念珠菌病（vulvovaginal candidiasis,VVC）的白念珠菌临床分离株（以下简称VVC临床株）生物膜形成的影响。方法采用微量稀释法测定BAEB对白念珠菌的最低抑菌浓度（Minimal Inhibitory Concentration,MIC）;甲基四氮盐（XTT）还原法测定BAEB对白念珠菌生物膜代谢活性的影响,Time-kill法检测BAEB对白念珠菌活菌数的影响;结晶紫染色法测定BAEB对白念珠菌生物膜生物量（Biomass）的影响;扫描电镜（SEM）观察BAEB对白念珠菌生物膜形态结构的影响;激光共聚焦显微镜（CLSM）检测BAEB对白念珠菌生物膜荧光信号强度的影响;实时荧光定量PCR（qRT-PCR）检测生物膜相关基因UME6、PES1和HSP90的转录水平变化。结果 BAEB对12株白念珠菌的MIC在64~256μg/mL之间,对白念珠菌生物膜的SMIC80（抑制80%生物膜形成的最低药物浓度）为1 024μg/mL或以上;Time-Kill曲线显示在12h之后,512、1 024μg/mL浓度的BAEB对白念珠菌均具良好的杀伤作用;结晶紫染色法表明512、1 024μg/mLBAEB能够减少其生物膜生物量;SEM观察到1 024μg/mL BAEB能够有效抑制白念珠菌在不同黏附介质上生物膜的完整度;CLSM显示512、1 024μg/mL的BAEB可以明显降低生物膜荧光信号强度;qRT-PCR检测显示在256、512、1 024μg/mL的BAEB作用下,UME6转录水平分别下调了72%、71%、77%,在512、1 024μg/mL的BAEB下HSP90转录水平上调了2.23和3.31倍,而PES1未有明显变化。结论 BAEB可以抑制白念珠菌VVC临床株体外生物膜的形成。

乌鲁木齐维吾尔族非妊娠女性BV和VVC危险因素及局部免疫研究

目的探讨乌鲁木齐维吾尔族非妊娠女性细菌性阴道病(BV)和外阴阴道假丝酵母菌病(VVC)的危险因素以及局部免疫情况。方法随机选取210例非妊娠期维吾尔族女性进行阴道分泌物检查,并进行常规细菌和真菌培养,同时留取阴道盥洗液,上清进行细胞因子浓度检测,细胞进行荧光定量PCR检测干扰素-γ(IFN-γ)、白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、白细胞介素-10(IL-10)mRNA水平,结合调查问卷对危险因素进行回归分析。结果 BV与年龄、居住地、文化程度和阴道冲洗因素有关。VVC与文化程度、职业、阴道冲洗因素有关。BV和VVC组阴道局部细胞因子IFN-γ下降,IL-10升高。结论 BV和VVC与阴道菌群失调有关,BV患者乳酸杆菌降低,加德纳菌增加,与年龄、居住地、文化程度和阴道冲洗因素有关。VVC病原体以白色假丝酵母菌为主,与文化程度、职业、阴道冲洗因素有关。BV和VVC患者阴道局部免疫以Th2免疫为主。

RVVC患者与VVC患者的流行病学研究

目的了解中国妇科/计划生育门诊中外阴阴道念珠菌病(VVC)及复发性VVC(RVVC)的发病情况及两者发病相关因素、既往用药和本次用药治疗的比较。方法对全国14家医院妇产科同天就诊的3590名患者进行阴道分泌物真菌学镜检,对VVC患者及RVVC患者进行调查登记和分析。结果(1)3590名患者当中,VVC、RVVC的发病率分别为11.60%和0.58%。(2)RVVC患者与普通VVC患者相比,在卫生习惯或应用激素、抗生素、避孕药、激素替代治疗等方面均无明显的特殊性,它的发生可能与局部的免疫异常有一定关系。(3)在既往的用药中,RVVC患者与普通VVC患者在应用局部药物方面无明显差异,但使用口服抗真菌药的几率要高于普通VVC患者。结论VVC尤其是RVVC对妇女身心健康有很大影响。RVVC的发生可能与局部的免疫异常有一定关系,应该对RVVC的患者尽可能选用敏感的抗真菌药物治疗,并一定要长疗程巩固治疗。

龙胆泻肝汤氯仿提取物对白念珠菌VVC临床株菌丝抑制作用研究

目的 观察龙胆泻肝汤氯仿提取物（chloroform extracts of Longdan xiegan decoction,CELX）对白念珠菌菌丝形成的影响,探讨其可能的作用机制。方法 采用微量稀释法测定龙胆泻肝汤不同溶剂提取物对15株VVC临床株的最低抑菌浓度（minimal inhibitory concentration,MIC）;采用固体培养基和半固体培养基观测菌落形态及菌丝侵袭能力;XTT还原法评价白念珠菌菌丝活性;平板法计数6h内药物对白念珠菌CFU的影响;荧光显微镜下观察菌丝代谢活力;采用实时荧光定量PCR（qRT-PCR）检测其菌丝相关基因：ALS3、SSA1、SUN41、HWP1、UME6和ECE1的表达量。结果 CELX对15株VVC临床株MIC介于32~64mg/L之间,效果优于总提物、石油醚提取物、乙酸乙酯提取物、正丁醇提取物和水提取物的MIC;256mg/L的CELX能显著抑制菌丝的形成;256mg/L的CELX在固体培养基中可抑制菌落褶皱,在半固体培养基中可抑制菌丝侵袭;qRT-PCR结果显示256 mg/L CELX可使菌丝相关基因ALS3、SSA1、SUN41、HWP1、UME6和ECE1分别下调81.6%、60.2%、69.8%、73.7%、49.5%、52.8%。结论 龙胆泻肝汤氯仿提取物（CELX）可通过影响菌丝相关基因的表达来抑制菌丝的形成,从而降低白念珠菌对机体的侵袭力。

农村地区RVVC病人阴道内所分离的假丝酵母菌分型和药敏分析

目的了解农村地区复发性假丝酵母菌外阴阴道炎(RVVC)病人假丝酵母菌菌型分布情况及其对常见抗真菌药物的敏感性。方法对农村地区RVVC患者阴道内分离到的菌株分别采用科玛嘉显色培养基和ATBFungul药敏试剂盒进行分型鉴定和药敏分析。结果所得30个菌株中白假丝酵母菌、光滑假丝酵母菌、热带假丝酵母菌、中间假丝酵母菌的构成比分别为1333%、3333%、2667%、1000%;菌株对5-FC、AMB、NYS、MIC、KET、ECO6种药物的敏感性分别为52%、48%、64%、16%、16%、16%。结论农村地区RVVC病人假丝酵母菌呈明显非白念化趋势,菌株对常见抗真菌药物敏感性降低,而且不同菌型有不同的药敏谱。

基于夏桂成改邪养正观探讨重建RVVC患者阴道微生态的辨治思路与方法

复发性外阴阴道假丝酵母菌病(RVVC)较难治愈,常反复发作,病程缠绵。国医大师夏桂成教授团队基于改邪养正学术观点,以分消走泄为基本治法,调理阴道整体内环境为立足点,重建阴道微生态为基础,扶植优势菌群如乳酸杆菌等的恢复,从而纠正局部免疫微环境的失调,发挥治愈疾病的目的,并研发了加味二妙颗粒用于临床治疗。

BV和VVC患者阴道灌洗液中相关细胞因子水平检测及意义

目的提高细菌性阴道病(BV)和外阴阴道假丝酵母菌病(VVC)诊疗水平。方法采集35例健康育龄妇女(对照组)、35例BV患者(BV组)、35例VVC患者(VVC组)阴道灌洗液,用ELISA法检测三组相关细胞因子(IL-2、IL-8、IFN-γ、IL-4、IL-13、IL-10、IgE)水平。结果与对照组比较,BV组IL-2显著降低,IL-13、IL-4、IL-10显著升高,IL-8、IFN-γ、IgE无明显变化;VVC组IFN-γ显著降低,IL-2、IL-13、IL-4、IgE显著升高,IL-8、IL-10无显著变化。讨论BV与VVC均存在Th1/Th2平衡失调,检测两种疾病局部细胞因子的变化有助于更好的控制感染。