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Vol. 15. Issue 3.
Pages 239-244 (May - June 2011)
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Vol. 15. Issue 3.
Pages 239-244 (May - June 2011)
Open Access
Candida species isolated from the vaginal mucosa of HIV-infected women in Salvador, Bahia, Brazil
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Paula Matos Oliveira1, Rita Elizabeth Mascarenhas2, Claire Lacroix3, Suzana Ramos Ferrer2, Rone Peterson C. Oliveira4, Elaine Andrade Cravo5, André P. Ribeiro Alves5, Maria Fernanda Rios Grassi6,
Corresponding author
grassi@bahia.fiocruz.br

Rua Waldemar Falcão, 121, Candeal - Salvador (BA) Brazil, 40296-710, Phone: +55 71 3176-2200, Fax: +55 71 3176-2327.
1 Obstetrics and Gynecology Specialist; PhD student of Postgraduate Program on Medicine and Human Health, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Bahia, Brazil
2 Professor of Microbiology, EBMSP, Salvador, Bahia, Brazil
3 Laboratoire de Mycologie-Parasitologie, Paris, France
4 Gynecology Assitant Professor, EBMSP, Salvador, Bahia, Brazil
5 Scientific initiation student, EBMSP, Salvador, Bahia, Brazil
6 Chief of Laboratório Avançado de Saúde Pública, FIOCRUZ, Bahia, Brazi
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Abstract
Background

Vulvovaginal candidiasis (VVC) is the second most common vaginal infection. HIV-infection is a risk factor for this infection.

Objective

To determine the frequency of VVC and to describe the main Candida species isolated and their susceptibility to antifungal drugs in HIV-infected patients, compared to HIV-uninfected women in Salvador, Brazil.

Methods

Cross-sectional study including a group of 64 HIV-infected women and 76 uninfected women, followed up at the AIDS reference center and at the Gynecological Clinic of Escola Bahiana de Medicina e Saúde Pública (Salvador, Bahia, Brazil).

Results

Frequency of Candida spp. was higher in HIV-infected women (29.7%) than in HIV-uninfected controls (14.5%) (p=0.02). The odds ratio value for vulvovaginal candidiasis in HIV-infected patients was 2.6 (95% CI: 1.07 − 6.32 p=0.03). Candida albicans was the most commonly isolated species in both HIV-infected (52.3%) and uninfected women (85.7%), followed by C. parapsolis in 17.6% and 14.3%, respectively. In HIV-infected women, C. glabrata, C. parapsilosis, and a coinfection of C. albicans and C. glabrata were also identified. There was no significant difference between Candida species isolated from the vaginal mucosa of women with VVC and colonization of the vaginal mucosa of HIV-infected and HIV-uninfected women. One C. glabrata isolate from an HIV-infected patient was resistant to fluconazole and other two isolates exhibited a dose-dependent susceptibility.

Conclusion

Our results confirm a higher frequency of Candida spp. isolated from the vaginal mucosa of HIV-infected women and a broader spectrum of species involved. Only Candida glabrata isolates showed decreased susceptibility to fluconazole.

Keywords:
HIV
Candida
candidiasis
vulvovaginal
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References
[1.]
J.D. Sobel, S. Faro, R.W. Force, et al.
Vulvovaginal candidiasis: epidemiologic, diagnostic and therapeutic considerations.
Am J Obstet Gynecol., 178 (1998), pp. 203-211
[2.]
B. Foxman, R. Barlow, H. D’Arcy, B. Gillespie, J.D. Sobel.
Candida vaginitis: self-reported incidence and associated costs.
Sex Transm Dis., 27 (2000), pp. 230-235
[3.]
P.A. Mardh, A.G. Rodrigues, M. Genc, et al.
Facts and myths on recurrent vulvovaginal candidosis-a review on epidemiology, clinical manifestations, diagnosis, pathogenesis and therapy.
Int J STD AIDS, 13 (2002), pp. 522-539
[4.]
M. Schaller.
Candida albicans-interactions with the mucosa and the immune system.
J Dtsch Dermatol Ges., 4 (2006), pp. 328-336
[5.]
W. Mendling, C. Seebacher.
Guideline vulvovaginal candidosis: guideline of the German Dermatological Society, the German Speaking Mycological Society and the Working Group for Infections and Infectimmunology of the German Society for Gynecology and Obstetrics.
Mycoses, 46 (2003), pp. 365-369
[6.]
L.M. Linhares, S.S. Witkin, S.D. Miranda, et al.
Differentiation between women with vulvovaginal symptoms who are positive or negative for Candida species by culture.
Infect Dis Obstet Gynecol., 9 (2001), pp. 221-225
[7.]
M.I. Rosa, D. Rumel.
Fatores Associados à Candidíase Vulvovaginal: Estudo Exploratório.
Rev Bras Ginecol Obstet., 26 (2004), pp. 65-70
[8.]
Z. Barrenetxea.
Vulvovaginitis candidiásica.
Rev Iberoam Micol., 19 (2002), pp. 22-24
[9.]
M.H. Sebitloane.
Gynecological H.I.V. infections.
Best Pract Res Clin Obstet Gynaecol., 19 (2005), pp. 231-241
[10.]
A. Beltrame, A. Matteelli, A.C. Carvalho, et al.
Vaginal colonization with Candida spp. in human immunodeficiency virus-infected women: a cohort study.
Int J STD AIDS, 17 (2006), pp. 260-266
[11.]
J.D. Sobel, S.E. Ohmit, P. Schuman, et al.
The evolution of Candida spp. and fluconazole susceptibility among oral and vaginal isolates recovered from human immunodeficiency virus (HIV)-seropositive and at-risk HIV-seronegative women.
J Infect Dis, 183 (2001), pp. 286-293
[12.]
A. Spinillo, F. Zara, B. Gardella, et al.
The effect of vaginal candidiasis on the shedding of human immunodeficiency virus in cervicovaginal secretions.
Am J Obstet Gynecol., 192 (2005), pp. 774-779
[13.]
E. Shifrin, D. Matityahu, J. Feldman, H. Minkoff.
Determinants of incident vulvovaginal candidiasis in human immunodeficiency virus-positive women.
Infect Dis Obstet Gynecol., 8 (2000), pp. 176-180
[14.]
S.E. Gygax, J.P. Vermitsky, S.G. Chadwick, et al.
Antifungal resistance of Candida glabrata vaginal isolates and development of a quantitative reverse transcription-PCR-based azole susceptibility assay.
Antimicrob Agents Chemother., 52 (2008), pp. 3424-3426
[15.]
B. Grinsztejn, F.I. Bastos, V.G. Veloso, et al.
Assessing sexually transmitted infections in a cohort of women living with HIV/AIDS, in Rio de Janeiro, Brazil.
Int J STD AIDS, 17 (2006), pp. 473-478
[16.]
A. Duerr, C.M. Heilig, S.F. Meikle, et al.
Incident and persistent vulvovaginal candidiasis among human immunodeficiency virus-infected women: Risk factors and severity.
Obstet Gynecol., 101 (2003), pp. 548-556
[17.]
A. Duerr, M.F. Sierra, J. Feldman, et al.
Immune compromise and prevalence of Candida vulvovaginitis in human immunodeficiency virus-infected women.
Obstet Gynecol., 90 (1997), pp. 252-256
[18.]
A. Williams, S. Andrews, K. Tashima, J. Mezger, C. Yu.
Factors associated with vaginal yeast infections in HIV-positive women.
J Assoc Nurses AIDS Care, 9 (1998), pp. 47-52
[19.]
A. Holanda, A. Fernandes, C. Bezerra, et al.
Candidíase vulvovaginal: sintomatologia, fatores de risco e colonização anal concomitante.
Rev Bras Ginecol Obstet., 29 (2007), pp. 3-9
[20.]
M.E. Lopes Consolaro, T. Aline Albertoni, C. Shizue Yoshida, et al.
Correlation of Candida species and symptoms among patients with vulvovaginal candidiasis in Maringa, Parana.
Brazil. Rev Iberoam Micol., 21 (2004), pp. 202-205
[21.]
N. Novikova, A. Rodrigues, P.A. Mardh.
Can the diagnosis of recurrent vulvovaginal candidosis be improved by use of vaginal lavage samples and cultures on chromogenic agar?.
Infect Dis Obstet Gynecol., 10 (2002), pp. 89-92
[22.]
S. Corsello, A. Spinillo, G. Osnengo, et al.
An epidemiological survey of vulvovaginal candidiasis in Italy.
Eur J Obstet Gynecol Reprod Biol., 110 (2003), pp. 66-72
[23.]
E. Ringdahl.
Treatment of recurrent vulvovaginal candidiasis.
Fam Physician., 61 (2000), pp. 3306-3312
[24.]
J. Sobel.
Vulvovaginitis due to Candida glabrata An emerging problem.
Mycoses, 41 (1998), pp. 18-22
[25.]
S.S. Richter, R.P. Galask, S.A. Messer, et al.
Antifungal susceptibilities of Candida species causing vulvovaginitis and epidemiology of recurrent cases.
J Clin Microbiol, 43 (2005), pp. 2155-2162
[26.]
N. Hettiarachchi, H.R. Ashbee, J.D. Wilson.
Prevalence and management of non-albicans vaginal candidiasis.
Sex Transm Infect, 86 (2010), pp. 99-100
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