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Vulvovajinal Kandidiyazis: Risk Faktörleri ve İnfeksiyon Etkenlerinin Dağılımı

Year 2024, Volume: 14 Issue: 1, 66 - 70, 16.01.2024
https://doi.org/10.33631/sabd.1359836

Abstract

Amaç: Dünyada yaygın görülen, milyonlarca kadının hayatını etkileyen ve anormal vajinal akıntının sık nedenlerinden olan vulvovajinal kandidiyazis (VVC)’in en önemli etkeni günümüze kadar Candida albicans iken, son yıllarda Non-albicans Candida (NAC) türlerinin sıklığı artmıştır. VVC’ da, birçok risk faktörünün de infeksiyon gelişimi ve tekrarlamasını etkilediği belirlenmiştir. Bu çalışmada; anormal vajinal akıntı yakınması olan hastalarda VVC sıklığı ve etkenlerinin belirlenerek, infeksiyon ile ilişkili risk faktörlerinin araştırılması amaçlanmıştır.
Gereç ve Yöntemler: Anormal vajinal akıntı şikayeti olan 87 hastaya, sosyo-demografik özellikleri ve risk faktörleri olarak tanımlanan bağımsız değişkenleri içeren 26 soruluk anket uygulanmıştır. Toplanan vajinal sürüntü örneklerinin kültür ve mikroskopik incelemesi yapılarak, izolatlar klasik ve biyokimyasal testle identifiye edilmiştir.
Bulgular: Hastaların %18,4’ünde Candida cinsi mantar üremesi saptanırken, gebelerde bu oran %60 olarak bulunmuştur. İnfeksiyon etkeni olarak izole edilen Candida’lardan %43,7 C. albicans, %37,5 C. glabrata, %12,5 C. krusei ve %6,3 C. parapsilosis olarak tanımlanmıştır. Hastaların %68,7’i tekrarlayan infeksiyon geçirdiğini bildirmiştir. Çalışmada VVC üremesini etkileyen tek faktör gebelik olarak saptanmış (p=0,041); VVC’i etkilemesi beklenen diğer bağımsız faktörler arasında anlamlı fark saptanmamıştır (p>0,05).
Sonuç: Çalışmamız; VVC etiyolojisinde NAC türlerinin öneminin arttığını ve saptanan yüksek rekürrens oranları ile ilişkili olabileceğini göstermektedir. Bu bulgu VVC hastalarında ve özellikle de çalışmamızda risk faktörü olarak saptanmış gebelik döneminde, etkenlerin tür düzeyinde tanımlanmasının ve olası risk faktörlerinin bilinerek, kontrol altında tutulmasının önemini ortaya koymaktadır.

Project Number

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References

  • Gonçalves B, Ferreira C, Alves CT, Henriques M, Azeredo J, Silva S. Vulvovaginal candidiasis: Epidemiology, microbiology and risk factors. Crit Rev Microbiol. 2016; 42(6): 905-27.
  • Rodriguez-Cerdeira C, Gregorio MC, Molares-Vila A, Lopez-Barcenas A, Fabbrocini G, Bardhi B, et al. Biofilms and vulvovaginal candidiasis. Colloids Surf B Biointerfaces. 2019; 174: 110-125.
  • Göker A. Vulvovajinal Kandidiyazis. Çetin ÇB, editör. Kandida Enfeksiyonları. 1. Baskı Ankara: Türkiye Klinikleri; 2019. Online ISBN: 978-605-7650-33-7.
  • Sobel JD. Recurrent vulvovaginal candidiasis. Am J Obstet Gynecol. 2016; 214(1): 15-21.
  • Arechavala A, Negroni R, Santiso G, Depardo R, Bonvehi P. Chronic recurrent vulvovaginitis is not only due to Candida. Rev Iberoam Micol. 2021; 38(3): 132-7.
  • Farr A, Effendy I, Frey Tirri B, Hof H, Mayser P, Petricevic L, et al. Guideline: Vulvovaginal candidosis (AWMF 015/072, level S2k). Mycoses. 2021; 64(6): 583-602.
  • Makanjuola O, Bongomin F, Fayemiwo SA. An Update on the roles of non-albicans Candida species in vulvovaginitis. J Fungi (Basel). 2018; 4(4): 121.
  • Tressler AB, Markwei M, Fortin C, Yao M, Procop GW, Soper DE, Goje O. Risks for recurrent vulvovaginal candidiasis caused by non-albicans Candida versus Candida albicans. J Womens Health (Larchmt). 2021; 30(11): 1588-96.
  • Ghaddar N, El Roz A, Ghssein G, Ibrahim JN. Emergence of vulvovaginal candidiasis among lebanese pregnant women: prevalence, risk factors, and species distribution. Infect Dis Obstet Gynecol. 2019; 2019: 5016810.
  • Pereira LC, Correia AF, da Silva ZDL, de Resende CN, Brandão F, Almeida RM, et al. Vulvovaginal candidiasis and current perspectives: new risk factors and laboratory diagnosis by using MALDI TOF for identifying species in primary infection and recurrence. Eur J Clin Microbiol Infect Dis. 2021; 40(8): 1681-93.
  • Venugopal D, Husain K, Mustafa SA, Sabeen S. Epidemiology, risk factors and antimicrobial profile of Vulvovaginal Candidiasis (VVC): A study among women in the central region of Saudi Arabia. J Mycol Med. 2021; 31(2):101049
  • Yano J, Sobel JD, Nyirjesy P, Sobel R, Williams VL, Yu Q, et al. Current patient perspectives of vulvovaginal candidiasis: incidence, symptoms, management and post-treatment outcomes. BMC Womens Health. 2019; 19(1):48.
  • Dou N, Li W, Zhao E, Wang C, Xiao Z, Zhou H. Risk factors for candida infection of the genital tract in the tropics. Afr Health Sci. 2014; 14(4): 835-9.
  • Sasani E, Rafat Z, Ashrafi K, Salimi Y, Zandi M, Soltani S, et al. Vulvovaginal candidiasis in Iran: A systematic review and meta-analysis on the epidemiology, clinical manifestations, demographic characteristics, risk factors, etiologic agents and laboratory diagnosis. Microb Pathog. 2021; 154: 104802.
  • Donders GGG, Mertens I, Bellen G, Pelckmans S. Self-elimination of risk factors for recurrent vaginal candidosis. Mycoses. 2011; 54 (1): 39-45.
  • Yurttaş Akar ÇB. Bir aile sağlığı merkezi’ne kayıtlı 15-49 yaş kadınlar arasında vajinit prevalansı ve etkileyen faktörlerin belirlenmesi. Ebelik ve Sağlık Bilimleri Derg. 2020; 3(2): 100-14.

Vulvovaginal Candidiasis: Risk Factors and Distribution of Infectious Agents

Year 2024, Volume: 14 Issue: 1, 66 - 70, 16.01.2024
https://doi.org/10.33631/sabd.1359836

Abstract

Aim: C. albicans is the most important cause of vulvovaginal candidiasis(VVC), which is one of the most common causes of abnormal vaginal discharge, affecting the lives of millions of women worldwide. In recent years, there has been a shift with the increase of Non-albicans Candida (NAC) species. Some risk factors were known to be associated with the development and recurrence of VVC.Our study was aimed to determine the frequency of VVC in patients with abnormal vaginal discharge, define causative agents and investigate the risk factors for the development of infection.
Material and Methods: A questionnaire including a total of 26 questions regarding to socio-demographic characteristics and independent variables defined as risk factors was applied to 87 patients with abnormal vaginal discharge.Subsequently, culture and microscopic examination of the vaginal swab samples were performed and were identified by classical and biochemical test methods.
Results: Fungal growth was detected in 18.4% of the patients, while this rate was found to be 60% in pregnant women. Of the Candida isolated as an infectious agent, the isolates were; 43.7% C. albicans, 37.5% C. glabrata, 12.5% C. krusei and 6.3% C. parapsilosis. Of the patients, 68.7% reported to have recurrent infections. Only pregnancy was detected to be a risk factor for VVC (p=0.041).
Conclusion: Our results showed the importance of NAC species, in the etiology of VVC which may be associated with the detected high recurrence rates.This results reveals the importance of defining the isolates to the species level and control the possible risk factors in VVC patients, especially during the pregnancy.

Project Number

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References

  • Gonçalves B, Ferreira C, Alves CT, Henriques M, Azeredo J, Silva S. Vulvovaginal candidiasis: Epidemiology, microbiology and risk factors. Crit Rev Microbiol. 2016; 42(6): 905-27.
  • Rodriguez-Cerdeira C, Gregorio MC, Molares-Vila A, Lopez-Barcenas A, Fabbrocini G, Bardhi B, et al. Biofilms and vulvovaginal candidiasis. Colloids Surf B Biointerfaces. 2019; 174: 110-125.
  • Göker A. Vulvovajinal Kandidiyazis. Çetin ÇB, editör. Kandida Enfeksiyonları. 1. Baskı Ankara: Türkiye Klinikleri; 2019. Online ISBN: 978-605-7650-33-7.
  • Sobel JD. Recurrent vulvovaginal candidiasis. Am J Obstet Gynecol. 2016; 214(1): 15-21.
  • Arechavala A, Negroni R, Santiso G, Depardo R, Bonvehi P. Chronic recurrent vulvovaginitis is not only due to Candida. Rev Iberoam Micol. 2021; 38(3): 132-7.
  • Farr A, Effendy I, Frey Tirri B, Hof H, Mayser P, Petricevic L, et al. Guideline: Vulvovaginal candidosis (AWMF 015/072, level S2k). Mycoses. 2021; 64(6): 583-602.
  • Makanjuola O, Bongomin F, Fayemiwo SA. An Update on the roles of non-albicans Candida species in vulvovaginitis. J Fungi (Basel). 2018; 4(4): 121.
  • Tressler AB, Markwei M, Fortin C, Yao M, Procop GW, Soper DE, Goje O. Risks for recurrent vulvovaginal candidiasis caused by non-albicans Candida versus Candida albicans. J Womens Health (Larchmt). 2021; 30(11): 1588-96.
  • Ghaddar N, El Roz A, Ghssein G, Ibrahim JN. Emergence of vulvovaginal candidiasis among lebanese pregnant women: prevalence, risk factors, and species distribution. Infect Dis Obstet Gynecol. 2019; 2019: 5016810.
  • Pereira LC, Correia AF, da Silva ZDL, de Resende CN, Brandão F, Almeida RM, et al. Vulvovaginal candidiasis and current perspectives: new risk factors and laboratory diagnosis by using MALDI TOF for identifying species in primary infection and recurrence. Eur J Clin Microbiol Infect Dis. 2021; 40(8): 1681-93.
  • Venugopal D, Husain K, Mustafa SA, Sabeen S. Epidemiology, risk factors and antimicrobial profile of Vulvovaginal Candidiasis (VVC): A study among women in the central region of Saudi Arabia. J Mycol Med. 2021; 31(2):101049
  • Yano J, Sobel JD, Nyirjesy P, Sobel R, Williams VL, Yu Q, et al. Current patient perspectives of vulvovaginal candidiasis: incidence, symptoms, management and post-treatment outcomes. BMC Womens Health. 2019; 19(1):48.
  • Dou N, Li W, Zhao E, Wang C, Xiao Z, Zhou H. Risk factors for candida infection of the genital tract in the tropics. Afr Health Sci. 2014; 14(4): 835-9.
  • Sasani E, Rafat Z, Ashrafi K, Salimi Y, Zandi M, Soltani S, et al. Vulvovaginal candidiasis in Iran: A systematic review and meta-analysis on the epidemiology, clinical manifestations, demographic characteristics, risk factors, etiologic agents and laboratory diagnosis. Microb Pathog. 2021; 154: 104802.
  • Donders GGG, Mertens I, Bellen G, Pelckmans S. Self-elimination of risk factors for recurrent vaginal candidosis. Mycoses. 2011; 54 (1): 39-45.
  • Yurttaş Akar ÇB. Bir aile sağlığı merkezi’ne kayıtlı 15-49 yaş kadınlar arasında vajinit prevalansı ve etkileyen faktörlerin belirlenmesi. Ebelik ve Sağlık Bilimleri Derg. 2020; 3(2): 100-14.
There are 16 citations in total.

Details

Primary Language Turkish
Subjects Medical Microbiology (Other)
Journal Section Research Articles
Authors

Arzu Malak 0000-0002-3123-9626

Mine Aydın Kurç 0000-0002-5053-4276

Dumrul Gulen 0000-0002-8711-7820

Ayşe Demet Kaya 0000-0001-8224-8242

Nicel Taşdemir 0000-0003-2382-1082

Gamze Varol 0000-0002-3490-3406

Project Number -
Publication Date January 16, 2024
Submission Date September 13, 2023
Published in Issue Year 2024 Volume: 14 Issue: 1

Cite

Vancouver Malak A, Aydın Kurç M, Gulen D, Kaya AD, Taşdemir N, Varol G. Vulvovajinal Kandidiyazis: Risk Faktörleri ve İnfeksiyon Etkenlerinin Dağılımı. VHS. 2024;14(1):66-70.