Investigation of the relationship between different Candida species and some risk factors affecting the incidence of Vulvovaginal Candidiasis

Document Type : Original Article

Authors

1 Assistant Professor, Laboratory Sciences Research Center, Department of Laboratory Sciences, Faculty of Paramedicine, Golestan University of Medical Sciences, Gorgan, Iran.

2 Professor, Department of Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.

3 Assistant Professor, Laboratory Sciences Research center, Department of Laboratory Sciences, Faculty of Paramedicine, Golestan university of Medical sciences, Gorgan, Iran.

4 Professor, Gastrointestinal and Liver Research center, Department of Laboratory Sciences, Faculty of Paramedicine, Golestan University of Medical Sciences, Gorgan, Iran.

5 B.Sc. of Midwifery, School of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran.

6 M.Sc. Student in Midwifery Consuling, School of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran.

7 B.Sc. Student of Nursing, School of Nursing and Midwifery, Bandar Gaz Islamic Azad University, Bandar Gaz, Iran.

Abstract

Introduction: Vulvovaginal candidiasis (VVC) is a yeast infection and is one of the most common causes of women's referral to the physician. The aim of this study was to investigate the relationship between different Candida species and some risk factors affecting the incidence of vulvovaginal candidiasis.
Methods: This descriptive study was conducted during 2016-2018 on 404 samples of vaginal discharge with clinical symptoms of vulvovaginitis in Sayyad Shirazi Hospital as well as Medical and Obstetric Clinics in Gorgan for two years. Vaginal secretions were tested directly on CHROMagar Candida medium and 280 patients with Candidiasis were identified using RFLP-PCR. The demographic information and individual fertility data were collected using a questionnaire. Subsequently, the data were analyzed in SPSS software (version. 22) through the Chi-square and Fisher's exact tests. P-value less than 0.05 was considered statistically significant.
Results: According to the results, 62 (22%) patients had recurrent vulvovaginal; moreover, the incidence of the VVC correlated significantly with the age group of 26-35 years, the incidence of underlying diseases, pregnancy, and the use of contraceptive drugs, such as  LD, metronidazole, and fluconazole (P<0.05). However, no significant relationship was found between other symptoms (P>0.05). The most commonly identified species regarding the risk factors of vulvovaginal Candidiasis was Candida albicans.
Conclusion: Awareness on the type of yeast, the type of effective antifungal drugs, and effective risk factors, such as broad and long-term use of antibiotics contraceptives, including LD, and some underlying factors can pave the way on the prevalence of the disease and the factors affecting the incidence of vulvovaginal candidiasis for medical specialists and health authorities.

Keywords

References

  1. Khorsand I, Nehzag G, Ali M, Zarrinfar H, Fata A, Naseri A, et al. Frequency of variety of Candida species in women with Candida vaginitis referred to clinical centers of Mashhad, Iran. Iran J Obstet Gynecol Infertil 2015; 18(168):15-22. (Persian).
  2. Bagheri M, Mahmoudi Rad M, Mansouri A, Younespour S, Taheripanah R. A comparison between antifungal effect of Fumaria officinalis, Echinacea angustifolia, vinegar, and fluconazole against Candida albicans and Candida glabrata isolated from vagina candidiasis. Iran J Obstet Gynecol Infertil 2015; 17(136):1-9. (Persian).
  3. Didehdar M, Khansarinejad B, Amirrajab N, Shokohi T. Development of a high-resolution melting analysis assay for rapid and high-throughput identification of clinically important dermatophyte species. Mycoses 2016; 59(7):442-9.
  4. Shokohi T, Soteh MH, Pouri ZS, Hedayati MT, Mayahi S. Identification of Candida species using PCR-RFLP in cancer patients in Iran. Indian J Med Microbiol 2010; 28(2):147.
  5. Hasanvand S, Qomi HA, Kord M, Didehdar M. Molecular epidemiology and in vitro antifungal susceptibility of candida isolates from women with vulvovaginal candidiasis in northern cities of Khuzestan province, Iran. Jundishapur J Microbiol 2017; 10(8):e12804.
  6. Mohammadi-Ghalehbin B, Javanpour Heravi H, Arzanlou M, Sarvi MR. Prevalence and antibiotic resistance pattern of candida spp. isolated from pregnant women referred to health centers in Ardabil, Iran. J Ardabil Univ Med Sci 2017; 16(4):409-21. (Persian). 
  7. Kenechukwu FC, Attama AA, Ibezim EC, Nnaman PO, Umeyor CE, Uronnachi EM, et al. Surface-modified mucoadhesive microgels as a controlled release system for miconazole nitrate to improve localized treatment of vulvovaginal Candidiasis. Eur J Pharm Sci 2018; 111:358-75.
  8. Chew SY, Than LT. Vulvovaginal Candidosis: contemporary challenges and the future of prophylactic and therapeutic approaches. Mycoses 2016; 59(5):262-73.
  9. Diba K, Namaki A, Ayatolahi H, Hanifian H. Comparison of biochemical and molecular methods for the identification of candida species causing vulvovaginal candidiasis and recurring vulvovaginal candidiasis. Iran J Med Microbiol 2014; 8(3):45-50. (Persian).
  10. Swidsinski A, Guschin A, Tang Q, Dörffel Y, Verstraelen H, Tertychnyy A, et al. Vulvovaginal candidiasis: histologic lesions are primarily polymicrobial and invasive and do not contain biofilms. Am J Obstet Gynecol 2019; 220(1):91.e1-8.
  11. Aguin TJ, Sobel JD. Vulvovaginal candidiasis in pregnancy. Curr Infect Dis Rep 2015; 17(6):462.
  12. Sobel JD. Pathogenesis and treatment of recurrent vulvovaginal candidiasis. Clin Infect Dis 1992; 14(Suppl 1):S148-53.
  13. Hosseini SS, Ghaemi E, Koohsar F. Influence of ZnO nanoparticles on Candida albicans isolates biofilm formed on the urinary catheter. Iran J Microbiol 2018; 10:424-32.
  14. Mohammadi R, Mirhendi H, Rezaei-Matehkolaei A, Ghahri M, Shidfar MR, Jalalizand N, et al. Molecular identification and distribution profile of Candida species isolated from Iranian patients. Med Mycol 2013; 51(6):657-63.
  15. Baykushev R, Ouzounova-Raykova V, Stoykova V, Mitov I. Reliable microbiological diagnosis of vulvovaginal candidiasis. Akush Ginekol (Sofiia) 2014; 53(4):17-20.
  16. Monod M, Togni G, Hube B,Sanglard D. Multiplicity of gene encoding secreted aspartic proteinase in Candida species. J Mol Microbiol 2004; 13(2):357-68.
  17. Hosseini SS, Ghaemi E, Noroozi A, Niknejad F. Zinc Oxide nanoparticles inhibition of initial adhesion and ALS1 and ALS3 gene expression in Candida albicans strains from urinary tract infections. Mycopathologia 2019; 184(2):261-71.
  18. Yokoyama H, Nagao A, Watanabe S, Honjo J. Incidence and risk of vaginal candidiasis associated with sodium-glucose cotransporter 2 inhibitors in real‐world practice for women with type 2 diabetes. J Diabetes Investig 2019; 10(2):439-45.
  19. Kohler S, Zeller C, Iliev H, Kaspers S. Safety and tolerability of empagliflozin in patients with type 2 diabetes: pooled analysis of phase I-III clinical trials. Adv Ther 2017; 34(7):1707-26.
  20. Blostein F, Levin-Sparenberg E, Wagner J, Foxman B. Recurrent vulvovaginal candidiasis. Ann Epidemiol 2017; 27(9):575-82.
  21. Nazeri M, Mesdaghinia E, Moraveji A.R, Atabakhshiyan R, Soleymani F. Prevalence of Vulvovaginal Candidiasis and Frequency of Candida Species in Women. J Mazand Univ Med Sci 2012; 22(86): 255-262 (Persian).
  22. Ghahri M. Systemic fungal infections: Candidiasis-aspergillosis. Iran J Pathol 2009; 35:24-6. (Persian).
  23. Zeng X, Zhang Y, Zhang T, Xue Y, Xu H, An R. Risk factors of vulvovaginal Candidiasis among women of reproductive age in xi’an: a cross-sectional study. Biomed Res Int 2018; 2018:9703754.
  24. Ocan M, Tumushabe B, Nakawunde H, Droma J, Waiswa G, Kirya K, et al. Prevalence and antifungal susceptibility of vaginal candida albicans among pregnant women attending arua regional referral hospital, Westnile Region of Uganda. Acta Sci Microbiol 2018; 1(6):17-22.
  25. Kord Z, Fata A, Zarrinfar H. Molecular identification of Candida species isolated from patients with Candida vulvovaginitis for the first time in Mashhad. Iran J Obstet Gynecol Infertil 2017; 20(4):50-7.
  26. Bitew A, Abebaw Y. Vulvovaginal candidiasis: species distribution of Candida and their antifungal susceptibility pattern. BMC Womens Health 2018; 18(1):94.
  27. Nagi S, Diba K, Yosefzadeh R, Mansouri F. Interspecies differences of candida species causing recurrent vulvovaginal candidiasis in response to fluconazole treatment. Tehran Univ Med J (TUMJ) 2017 July;75(4):280-287.
  28. Ashrafinia M, Behdani R, Komijani Z. Single and multiple dose Fluconazole in the treatment of candidia vulvovaginitis: a prospective comparative study. Tehran Univ Med J 2007; 65(5):19-24. (Persion).
  29. Marchaim D, Lemanek L, Bheemreddy S, Kaye KS, Sobel JD. Fluconazole-resistant Candida albicans vulvovaginitis. Obstet Gynecol 2012; 120(6):1407-14.
  30. Lin XL, Li Z, Zuo XL. Study on the relationship between vaginal and intestinal candida in patients with vulvovaginal candidiasis. Zhonghua Fu Chan Ke Za Zhi. 2011 Jul;46(7):496-500.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 22, Issue 7
September 2019
Pages 13-22

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