Vulvovaginal candidiasis among symptomatic women of childbearing age attended at a Medical Analysis Laboratory in Franceville,Gabon

BackgroundVulvovaginal candidiasis (VVC) is one of the most common lower genital tract infections in women; this unpleasant and extremely embarrassing pathology is one of the main reasons for gynaecological consultation. In Gabon, the prevalence of VVC remains poorly described even though VVC is known to be the leading gynaecological condition in several countries. This retrospective cross-sectional study sought to assess the prevalence of VVC among symptomatic women in southeastern Gabon.MethodsClinical samples were collected from patients suspected to have VVC during a 2-year period (from January 2016 to December 2017). Gram staining of vaginal smears provided indications of vaginal flora and confirmed the presence of yeast. Sabouraud-chloramphenicol and chromID Candida media were used to isolate yeast, and species identification was performed using morphological tests and the Vitek 2 Compact automated system.ResultsFor the 873 patients included in this study, the prevalence of VVC was 28.52%. Eleven Candida species were identified, with greater representation of Candida albicans (82.73%) than of Non C. albicans candida (NCAC) (17.27%), which were distributed as follows: Candida famata (4.02%), Candida spp. (3.61%), Candida rugosa (3.21%), Candida lipolytica (1.61%), Candida parapsilosis (1.61%), Candida glabrata (1.21%), Candida tropicalis (0.80%), Candida krusei (0.40%), Candida dubliniensis (0.40%), and Candida sphaerica (0.40%).ConclusionThis study offers the first estimation of VVC among Gabonese women in childbearing age with the symptoms. It showed that VVC is very common in Gabon. C. albicans as the most commonly represented species.     

成都地区女性生殖道感染研究

目的:了解成都地区女性生殖道感染的基本状况。方法:随机调查5598例在我院就诊的妇科、产科和计划生育科病人,通过阴道分泌物检查了解滴虫性阴道炎(TV)、假丝酵母菌外阴阴道炎(VVC)、细菌性阴道病(BV)及淋病的感染率。结果:BV、VVC、TV及淋病的感染率依次为17·1%、12·9%、2·7%、0·3%;合并感染率中,BV合并VVC感染率为10·2%,显著高于其它合并感染率(P<0·05)。结论:BV是女性生殖道最常见的感染性疾病,且易于与VVC合并感染,应引起临床医生的高度重视。     

消炎痛对白色念珠菌菌丝形成的影响

目的:探讨环氧化酶抑制剂消炎痛对白色念珠菌形态发育的影响。方法:分别用含不同浓度消炎痛的RPM I1 640加10%小牛血清的液体培养基和玉米-吐温80固体培养基培养3株白色念珠菌,观察白色念珠菌形态发育变化。结果:消炎痛对白色念珠菌芽管和菌丝形成的抑制作用与其剂量相关。在液体培养基中,消炎痛浓度为0.75 mM时可抑制50%芽管形成,浓度为2.0mM时可完全抑制芽管和菌丝形成;而在固体培养基中,消炎痛浓度为1.0mM时可抑制菌丝和厚壁孢子的形成,浓度为2.0 mM时,几乎没有菌丝形成。结论:消炎痛可以抑制白色念珠菌芽管、菌丝的形成,阴道内给予消炎痛将有助于治疗念珠菌性阴道炎。     

妊娠期外阴阴道念珠菌病的发病分析

目的:了解妊娠期外阴阴道念珠菌病(VVC)的发病情况以及影响因素。方法:回顾性调查2005年1月1日至2005年6月20日在北京大学第一医院分娩的1119例孕妇孕前及孕期VVC的发病情况。结果:1119例孕妇中,孕前曾患VVC共212例(18·95%),孕前9个月内曾患VVC的孕妇较未感染者孕期VVC发生率明显升高(P<0·01)。1119例孕妇中孕期VVC感染102例(9·12%),明显高于孕前9个月内发生率(P<0.01),其中,妊娠早期22例,中期39例,晚期41例;血糖正常孕妇VVC发生率与血糖异常孕妇发生率比较,差异无显著性(P>0.05)。结论:妊娠中、晚期VVC发病率高于早期。妊娠前9个月内曾患有VVC是孕期VVC的高危因素,妊娠期糖代谢异常者孕期VVC的发生率未见明显增加。     

In vitro activity of ibrexafungerp and comparators against Candida albicans genotypes from vaginal samples and blood cultures

ObjectivesEmergence of azole resistance may contribute to recurrences of vulvovaginal candidiasis. Thus, new drugs are needed to improve the therapeutic options. We studied the in vitro activity of ibrexafungerp and comparators against Candida albicans isolates from vaginal samples and blood cultures. Furthermore, isolates were genotyped to study compartmentalization of genotypes and the relationship between genotype and antifungal susceptibility.MethodsCandida albicans unique patient isolates (n = 144) from patients with clinical suspicion of vulvovaginal candidiasis (n = 72 isolates) and from patients with candidaemia (n = 72) were studied. Antifungal susceptibility to amphotericin B, fluconazole, voriconazole, posaconazole, isavuconazole, clotrimazole, miconazole, micafungin, anidulafungin and ibrexafungerp was tested (EUCAST 7.3.2). Mutations in the erg11 gene were analysed and isolates genotyped.ResultsIbrexafungerp showed high activity (MICs from 0.03 mg/L to 0.25 mg/L) against the isolates, including those with reduced azole susceptibility, and regardless of their clinical source. Fluconazole resistance rate was 7% (n = 5/72) and 1.4% (n = 1/72) in vaginal and blood isolates, respectively. Some amino acid substitutions in the Erg11 protein were observed exclusively in phenotypically fluconazole non-wild type. Population structure analysis suggested two genotype populations, one mostly involving isolates from blood samples (66.3%) and the mostly from vaginal samples (69.8%). The latter group hosted all fluconazole non-wild-type isolates.DiscussionIbrexafungerp shows good in vitro activity against Candida albicans from vaginal samples including phenotypically fluconazole non-wild-type isolates. Furthermore, we found a certain population structure where some genotypes show reduced susceptibility to fluconazole.     

Genitourinary syndrome of menopause: New terminology for vulvovaginal atrophy from the International Society for the Study of Women's Sexual Health and The North American Menopause Society

Background

In 2012, the Board of Directors of the International Society for the Study of Women's Sexual Health (ISSWSH) and the Board of Trustees of The North American Menopause Society (NAMS) acknowledged the need to review current terminology associated with genitourinary tract symptoms related to menopause.

Methods

The 2 societies cosponsored a terminology consensus conference, which was held in May 2013.

Results and conclusion

Members of the consensus conference agreed that the term genitourinary syndrome of menopause (GSM) is a medically more accurate, all-encompassing, and publicly acceptable term than vulvovaginal atrophy. GSM is defined as a collection of symptoms and signs associated with a decrease in estrogen and other sex steroids involving changes to the labia majora/minora, clitoris, vestibule/introitus, vagina, urethra and bladder. The syndrome may include but is not limited to genital symptoms of dryness, burning, and irritation; sexual symptoms of lack of lubrication, discomfort or pain, and impaired function; and urinary symptoms of urgency, dysuria and recurrent urinary tract infections. Women may present with some or all of the signs and symptoms, which must be bothersome and should not be better accounted for by another diagnosis. The term was presented and discussed at the annual meeting of each society. The respective Boards of NAMS and ISSWSH formally endorsed the new terminology—genitourinary syndrome of menopause (GSM)—in 2014.     

念珠菌性外阴阴道炎阴道分泌物中IL-10和IFN-γ的表达水平测定

目的:测定念珠菌性阴道炎阴道分泌物中白细胞介素-10(IL-10)、干扰素-γ(IFN-γ)的表达水平,探讨不同类型细胞因子的表达水平与念珠菌性阴道炎发病的关系。方法:ELISA法检测初发组和复发组念珠菌性阴道炎的妇女阴道分泌物中IL-10I、FN-γ的表达水平,以健康体检妇女为对照组。结果:初发和复发念珠菌性阴道炎的阴道分泌物中IL-10的表达水平均显著高于健康对照组,复发组较初发组的表达水平也有显著性差异(P<0.05);初发和复发念珠菌性阴道炎的阴道分泌物中IFN-γ的表达水平无显著性差异(P>0.05),但均高于健康对照组(P<0.05)。结论:Th1型和Th2型细胞因子的表达异常可能与念珠菌性阴道炎发病和复发有关。