Candida cell wall mannan in the vagina and its association with the signs and symptoms of vaginal candidosis.

Measurement of Candida cell wall polysaccharide (mannan) with an enzyme-linked immunosorbent assay (ELISA) was evaluated as an alternative to viable counting for the enumeration of yeast cell numbers in the human vagina. A statistically significant association was found between mannan levels and the number of colony forming units in vaginal washings collected from 40 women infected with Candida albicans (r = 0.81), indicating the accuracy of mannan levels in reflecting yeast cell load in vulvo-vaginal candidosis. Subsequent comparisons revealed a significant association between mannan levels and clinical signs in the vagina, so reflecting the importance of vulvitis and vaginitis as clinical markers for determining the severity of infection. No association was found between yeast load and the clinical symptoms, indicating the high degree of patient subjectivity. Estimation of mannan levels could be developed and used for the rapid laboratory investigation of chronic vulvo-vaginal candidosis.