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PubMedID: 21599498 Vulvovaginal candidosis (VVC) is the second most common cause of vaginitis after bacterial vaginosis, and it is diagnosed in up to 40% of women with vaginal complaints in the primary care setting. Reliable diagnosis of VVC requires a correlation of clinical features with mycological evidence. The mycological methods used for diagnosis include microscopic examination, fungal culture, and antigen tests. Fungal culture can reveal the species of organism(s) responsible for the infection and provide epidemiological data. This report reviews current knowledge about the available diagnostic methods and tests that accurately diagnose VVC, and highlights the importance of fungal culture. © 2011 Informa Healthcare USA, Inc.

PubMedID: 21293929 In this study, we investigated the epidemiological characteristics of VVC among pregnant women. We conducted a prospective survey among 372 pregnant women to investigate the prevalence, clinical forms, etiological agents, and predisposing factors of VVC. In addition, we determined the relationship between vaginal and rectal flora by simultaneously obtaining one high vaginal swab and one rectal swab from each patient using sterile cotton-tipped swabs. Furthermore, we compared the recovery and identification performances of chromID Candida agar to Sabouraud dextrose agar with gentamicin and chloramphenicol. Clinically and mycologically confirmed cases of VVC were detected in 139 (37. 4%) and vaginal colonization described in 42 (11. 3%) of 372 pregnant women. Rectal cultures were also positive in 98 of the 139 (70. 5%) VVC cases. Candida albicans and C. glabrata were identified in vaginal samples in 58. 0 versus 19. 0% and from rectal samples in 49. 0 versus 13. 5%, respectively. Increases in gestational week and gravidae were identified to be statistically significant in patients with acute VVC (AVVC) and symptomatic recurrent VVC (RVVC), and asymptomatic RVVC (P = 0. 04 and P = 0. 03, respectively). In the laboratory diagnosis of VVC, specifically tailored chromogenic media are reliable tools for both the recovery and rapid identification of common Candida spp., particularly C. albicans, as well as for the detection of polyfungal populations in vaginal samples (P > 0. 05). In addition, rectal colonization is a common finding in cases of AVVC and symptomatic-RVVC cases and corresponds well with the presence of the same yeast species in the vagina. © 2011 Springer Science+Business Media B.V. TF2010BAP1 Acknowledgments This study was supported by the Research Fund of Cukurova University (Project No: TF2010BAP1). We gratefully acknowledge all of the patients who agreed to participate in this study. We also greatly appreciate to Selim Mısırlıoglu, MD; Erdem Akter, MD; Enver Naci Tuncer, MD; and Tuba Yuksel, MSc for their kind assistance in the laboratory workup.

Vulvovaginal candidiasis (VVC), particularly the recurrent form, remains an intractable problem for clinicians, microbiologists, and patients. It is essential to confi rm the clinical diagnosis by mycological methods and avoid empirical therapy. The recovery of yeast in fungal culture, such as on Sabouraud dextrose agar, remains the gold standard for diagnosis. In this investigation, we examined 474 participants, including 122 (25.7%) with acute VVC cases, 249 (52.5%) who had recurrent VVC (RVVC) cases, and 103 (21.7%) healthy controls. We also administered a questionnaire to obtain information on patient lifestyle and medical, gynecological, and sexual history. In addition, we compared the performance of chromID Candida agar (CAN2) to CHROMagar Candida (CAC) and Sabouraud dextrose agar with gentamicin and chloramphenicol (SGC2). The yeasts were identifi ed by conventional methods including the germ tube test, microscopic morphology on cornmeal–Tween 80 agar, and the commercial API 20C AUX system. We detected yeasts in 60 of 122 (49.2%) patients with acute VVC cases, 110 of 249 (44.2%) with RVVC cases, and in 35 of 103 (34%) healthy controls ( P 0.07). A total of 205 samples were found to be positive for fungi (43.2%), of which 176 (85.9%) were monofungal, and 29 (14.1%) were polyfungal. In addition, 198 of these samples (96.6%) were positive on CAN2, 195 (95.1%) on CAC, 189 (92.2%) on SGC2, and 183 (89.3%) samples on all three ( P 0.17). The 234 yeast isolates recovered were C. albicans ( n 118), C. glabrata ( n 82), C. kefyr ( n 11), C. krusei ( n 9), C. lipolytica ( n 3), C. colliculosa ( n 2), C. parapsilosis ( n 2), C. pelliculosa ( n 2), C. tropicalis ( n 2), and other species of Candida ( n 3). Of the 29 polyfungal populations, 28 (96.6%) were detected in CAN2, 25 in (86.2%) CAC, and 25 (86.2%) on both ( P 0.35). Notably, we detected the high predominance of C. albicansC. glabrata (86.2%) in polyfungal populations. Briefl y, the detection of C. albicans after 24 h of incubation was easier on CAN2 (64.4%) than on CAC (25.4%). This study showed that CAN2 is a rapid and reliable medium for immediate identifi cation of C. albicans and for detecting polyfungal populations in vaginal specimens. We observed that the use of antibiotics, intrauterine devices, as well as, perineal laceration, short anovaginal distance ( 3 cm), and genital epilation in common areas are predisposing factors for RVVC ( P 0.001). In addition, we detected that the use of menstrual pad, using an (IUD), and having a history of childbirth increased the risk of both acute and recurrent VVC ( P 0.01), whereas the use of a daily pad and walking daily signifi cantly decreased the risk of both acute and recurrent VVC ( P 0.01).