Candida albicans and non-albicans species as etiological agent of vaginitis in pregnant and non-pregnant women

Abstract

Pregnancy represents a risk factor in the occurrence of vaginal candidosis. The objectives of our study were: to make determination of the microscopic findings of vaginal swab, frequency of Candida species in the culture of pregnant women and patients who are not pregnant, determine the Candida species in all cultures, and to determine the frequency and differences in the frequency of C. albicans and other non-albicans species. In one year study performed during 2006 year, we tested patients of Gynaecology and Obstetrics clinic of the Clinical Centre in Sarajevo and Gynaecology department of the General hospital in Sarajevo. 447 woman included in the study were separated in two groups: 203 pregnant (in the last trimester of pregnancy), and 244 non-pregnant woman in period of fertility. Each vaginal swab was examined microscopically. The yeast, number of colonies, and the species of Candida were determined on Sabouraud dextrose agar with presence of antibiotics. For determination of Candida species, we used germ tube test for detection of C. albicans, and cultivation on the selective medium and assimilation tests for detection of non-albicans species. The results indicated positive microscopic findings in the test group (40,9%), as well as greater number of positive cultures (46,8%). The most commonly detected species for both groups was C. albicans ( test group 40.9% and control group 23,0%). The most commonly detected non-albicans species for the test group were C. glabrata (4,2 %) and C. krusei (3,2%), and for the control group were C. glabrata (3,2%) and C. parapsilosis (3,2%). The microscopic findings correlated with the number of colonies in positive cultures. In the test group, we found an increased number of yeasts (64,3%), and the pseudopyphae and blastopores by microscopic examination as an indication of infection. In the control group, we found a small number of yeasts (64,6%) , in the form of blastopores, as an indication of the candida colonisation. Our results indicate that gravidity, as the risc factor for incidence of infection, has the significant role in the incidence of vaginal candidosis.

FIGURE 1

Positive microscopic findings blastopores in vaginal smear (methylene blue 100 x)

FIGURE 2

Positive microscopic findings pseudopyphae and blastopores in vaginal smear (methylene blue 100x)

GRAPH 1

Microscopic examination findings, vaginal smear control (n=244) and test (n=203) groups

FIGURE 3

Positive culture of yeast on Sabouraud’s agar

GRAPH 2

Positive and negative cultures in test (n=203) and control groups (n=244)

FIGURE 4

Positive germ tube test (Candida albicans]

GRAPH 3

Results of germ tube test in relation to the total number of samples (determination of C. albicans) for test (n=203) and control groups (n=244)

FIGURE 5

Determination of Candida species on Chrom agar medium

GRAPH 4

Correlation the results of Candida species and microscopic examination of test group

GRAPH 5

Correlation the results of Candida spp. and microscopic examination of control group