ABSTRACT
Resumen OBJETIVO: determinar, mediante reacción en cadena de la polimerasa (PCR), si C. albicans y C. glabrata son causantes de las recurrencias de candidiasis vulvovaginal y si suelen colonizar la vagina de mujeres mexicanas asintomáticas en edad reproductiva. MATERIALES Y MÉTODOS: estudio analítico, transversal, prospectivo, experimental, de casos y controles, efectuado en mujeres de 18 a 45 años de edad, atendidas en el servicio de Ginecología del Centro Médico ABC de la Ciudad de México y el Cinvestav del Instituto Politécnico Nacional. Identificar C. albicans y C. glabrata en muestras vaginales por medio de reacción en cadena de la polimerasa con iniciadores específicos para cada especie. RESULTADOS: se estudiaron 93 pacientes: 46 casos y 47 controles. En los casos se encontraron: 2.17% con C. albicans, 80.4% con C. glabrata y 17.3% con coinfección por ambas especies. En los controles se encontraron: 61.7% con C. albicans, 4.2% con C. glabrata, 19.1% con coinfección por ambas especies y 14.8% con ausencia de Candida spp. CONCLUSIONES: el agente causal de la mayor parte de las candidiasis vulvovaginales recurrentes es C. glabrata. La colonización por esta especie y por C. albicans es común y no provoca síntoma alguno, por lo que para su identificación es importante utilizar métodos de diagnóstico como la reacción en cadena de la polimerasa.
Abstract BACKGROUND: 75% of women are affected with vulvovaginal candidiasis and 10% of them will have at least 4 episodes during one year. The most common etiological agents are C. albicans and C. glabrata, which is usually the responsible of the recurrent cases when the patients have received inadequate treatment. Up to 55% of asymptomatic women can have different species of Candida spp. as vaginal commensals, but there are no recent studies that identify this yeast through molecular techniques in healthy women and with history of vulvovaginal candidiasis. OBJECTIVE: Determine using polymerase chain reaction if C. albicans and C. glabrata are responsible of recurrent vulvovaginal candidiasis and if they usually colonize Mexican asymptomatic women in reproductive age. MATERIAL AND METHODS: An analytical, transversal, prospective, experimental, case control study was carried out in women age 18 to 45 in the Gynecology Service of ABC Medical Centre of México City and IPN Cinvestav. C. albicans and C. glabrata were identified in vaginal samples using polymerase chain reaction with specific primers for each specie. RESULTS: A total of 93 patients were studied, 46 cases and 47 controls. 2.17% of the case patients were positive C. albicans, 80.43% for C. glabrata, and 17.39% for both species. 61.70% of the control patients were positive for C. albicans, 4.20% for C. glabrata, 19.14% for both species, and 14.89% were negative for Candida. CONCLUSIONS: The main etiological agent of recurrent vulvovaginal candidiasis is C. glabrata. The vaginal colonization of this specie and C. albicans is common and causes no symptoms, thus, it is important to use diagnostic tools such as polymerase chain reaction to identify them. It is relevant to investigate the factors that help this yeast to cause a symptomatic infection and stop being just a vaginal commensal.