Fule S R, Das D, Fule R P
Department of Microbiology , Jawaharlal Nehru Medical College, Sawangi, Meghe, Wardha, Maharashtra, India.
Indian J Med Microbiol. 2015 Jan-Mar;33(1):92-5. doi: 10.4103/0255-0857.148392.
Vulvovaginal candidiasis (VVC) is most common accounting for 17 to 39% of symptomatic women. Both Candida albicans and non albicans Candida species are involved in VVC. Amongst various virulence factors proposed for Candida, extracellular phospholipases is one of the virulence factor implicated in its pathogenicity. With this background the present study was carried out to find the prevalence of different Candida species and to detect phospholipase producing strains isolated from symptomatic women with VVC.
At least two vaginal swabs from 156 women of reproductive age with abnormal vaginal discharge were collected. Direct microscopy and Gram's stained smear examined for presence of budding yeast and pseudo mycelia followed by isolation and identification of Candida species. Extracellular phospholipase activity was studied by inoculating all isolates on Sabouraud's dextrose egg yolk agar (SDA) medium.
Of the 156 women with curdy white discharge alone or in combination with other signs, 59 (37.82%) women showed laboratory evidence of VVC. A total of 31 (52.54%) women had curdy white discharge followed by 12 (20.33%) with other signs and symptoms. C. albicans (62.59%) and non albicans Candida (37.28%) in a ratio of 1.68:1 were isolated. Of the 37 strains of C. albians 30 (81.08%) showed the enzyme activity. Seventeen (56.66%) strains showed higher Pz value of < 0.70 (++++).
Although there may be typical clinical presentation of Candidiasis. all the patients did not show laboratory evidence of infection. Pregnancy was found to be major risk factor for development of VVC. C. albicans was prevalent species but non albicans species were also frequently isolated. Extracellular phospholipase activity was seen in C. albicans and not in non albicans Candida isolates.
外阴阴道念珠菌病(VVC)最为常见,占出现症状女性的17%至39%。白色念珠菌和非白色念珠菌均与VVC有关。在提出的念珠菌各种毒力因子中,细胞外磷脂酶是涉及其致病性的毒力因子之一。在此背景下,开展了本研究以确定不同念珠菌种类的患病率,并检测从有症状的VVC女性中分离出的产磷脂酶菌株。
收集了156名有异常阴道分泌物的育龄女性的至少两份阴道拭子。进行直接显微镜检查和革兰氏染色涂片,检查是否存在芽生酵母和假菌丝,随后分离并鉴定念珠菌种类。通过将所有分离株接种在沙保弱葡萄糖蛋黄琼脂(SDA)培养基上来研究细胞外磷脂酶活性。
在156名仅有凝乳状白带或伴有其他体征的女性中,59名(37.82%)女性有VVC的实验室证据。共有31名(52.54%)女性有凝乳状白带,其次是12名(20.33%)有其他体征和症状。分离出白色念珠菌(62.59%)和非白色念珠菌(37.28%),比例为1.68:1。在37株白色念珠菌中,30株(81.08%)显示出酶活性。17株(56.66%)菌株显示出较低的Pz值<0.70(++++)。
尽管念珠菌病可能有典型的临床表现,但并非所有患者都有感染的实验室证据。发现妊娠是VVC发生的主要危险因素。白色念珠菌是优势菌种,但非白色念珠菌也经常被分离出来。在白色念珠菌中可见细胞外磷脂酶活性,而在非白色念珠菌分离株中未见。