Baykushev R, Ouzounova-Raykova V, Stoykova V, Mitov I
Akush Ginekol (Sofiia). 2014;53(4):17-20.
Vulvovaginal candidiasis is common infection among those affecting the vulva and vagina. Is caused by the perpesentatives from the genus Candida, in most cases C. albicans (85-90%). An increase in the percentage of the so-called non-albicans agents is seen and these pathgogens are often resistant to the most commonly used in the practice antifungals. Faulty diagnosis, incorrect use of azoles, and self-treatment lead to selection of resistant strains and recurrent infections.
Identification of Candida species associated with vulvovaginal candidiasis by conventional and PCR techniques.
For six months a total number of 213 vaginal secretions were tested applying Gram stain and cultivation on ChromAgar. API Candida fermentation tests and API 20CAUX assimilation tests were performed for the identification of the bacteria. Extraction of DNA of all the smears with subsequent PCR detection of different Candida species were done.
80.7% materials showed presence of blastospores and/or hyphae. Positive culture results were detected in 60 (28.2%) samples. The species specific identification revealed presence of C. albicans in 51 (85%) smears, C. glabrata--in 8 (13.3%), C. krusei--in 2 (3.3%), and S. cervisie--in 1 (2.1%). The PCR technique confirmed the results of the conventional methods. It is worth to mention that 51 of the tested smears were positive for G. vaginalis using additional PCR.
The correct diagnosis of the cause of vulvovaginal candidiasis helps in the correct choice of appropriate antifungal therapy and prevents development of recurrent infections and consequences. The PCR based method is rapid, specific and sensitive. It perfectly correlates with the results from the conventional diagnostic tests so it could be selected as a method of choice for the diagnosis of vulvovaginal candidiasis.
外阴阴道念珠菌病是一种常见的影响外阴和阴道的感染。它由念珠菌属的代表菌株引起,在大多数情况下是白色念珠菌(85 - 90%)。所谓非白色念珠菌病原体的比例有所增加,并且这些病原体通常对实践中最常用的抗真菌药物耐药。错误的诊断、唑类药物的不当使用以及自我治疗导致耐药菌株的产生和反复感染。
通过传统方法和聚合酶链反应(PCR)技术鉴定与外阴阴道念珠菌病相关的念珠菌种类。
在六个月的时间里,共检测了213份阴道分泌物,采用革兰氏染色和在显色培养基上培养的方法。进行了API念珠菌发酵试验和API 20CAUX同化试验以鉴定细菌。对所有涂片进行DNA提取,随后进行不同念珠菌种类的PCR检测。
80.7%的样本显示存在芽生孢子和/或菌丝。在60份(28.2%)样本中检测到阳性培养结果。种属特异性鉴定显示,51份(85%)涂片中有白色念珠菌,8份(13.3%)中有光滑念珠菌,2份(3.3%)中有克柔念珠菌,1份(2.1%)中有近平滑念珠菌。PCR技术证实了传统方法的结果。值得一提的是,使用额外的PCR检测,51份检测涂片中有阴道加德纳菌呈阳性。
正确诊断外阴阴道念珠菌病的病因有助于正确选择合适的抗真菌治疗,并预防反复感染及其后果的发生。基于PCR的方法快速、特异且灵敏。它与传统诊断试验的结果完美相关,因此可被选为诊断外阴阴道念珠菌病的首选方法。