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Objective To explore the effect of blue oxygen combined with Kennety in the treatment of recurrent vulvovaginal candidiasis. Methods 110 cases of patients with recurrent vulvovaginal candidiasis as subjects were randomly divided into single agent group and combination group, who were respectively treated with Kennety alone, Kennety combined with blue oxygen. The scores of pruritus, leucorrhea unusual? smell and leucorrhea character before and after treatment were compared, and the effectiveness was evaluated and the recurrence rates were statistically analyzed. Results After treatment, the scores of pruritus, bleucorrhea unusual? smell and leucorrhea character in the two groups were decreased compared with those before treatment, of which the scores in the combination group were lower than those in the single agent group, and there were significant differences between the 2 groups after treatment and before and after treatment (P＜0. 05). There were statistical differences in the effectiveness and total efficiency between the two groups (P＜0. 05), and the recurrence rate of the combination group was much lower than that of the single agent group (P＜0. 05). Conclusion For patients with recurrent vulvovaginal candidiasis, blue oxygen Fagafaga Kay Bnnie Dean therapy can relieve symptoms, improve curative effect, and significantly reduce the recurrence rate. It has high clinical value and is worthy of popularization and application.
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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.
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BACKGROUND: There are limited data regarding the antifungal susceptibility of Candida albicans causing recurrent vulvovaginal candidiasis. OBJECTIVE: The aim of the present study was to evaluate the effect of azoles susceptibilities on treatment failure and recurrence of vulvovaginal candidiasis. METHODS: Species identification was performed on 84 vaginal Candida isolates collected from October 2008 to June 2010 from 404 patients with suspected vulvovaginitis. MICs of C. albicans (26 isolates) to fluconazole, itraconazole, and voriconazole were tested by broth microdilution method of the Clinical and Laboratory Standards Institute (CLSI) M27-A2. RESULTS: C. albicans was the most frequently isolated (88.1%). All isolates were susceptible to fluconazole, itraconazole, and voriconazole. Trailing growth was found in treatment success group (10.0%) and treatment failure group (33.3%). CONCLUSIONS: The results of this study suggest the possibility that trailing growth have influence on treatment failure of vulvovaginal candidiasis.
Subject(s)
Humans , Azoles , Candida , Candida albicans , Candidiasis, Vulvovaginal , Danazol , Fluconazole , Itraconazole , Pyrimidines , Recurrence , Treatment Failure , Triazoles , VulvovaginitisABSTRACT
Objective:To investigate the pathogen flora of recurrent vulvovaginal candidiasis(RWC),and to discuss its treatment. Methods: Fungal culture and susceptibility tests of vaginal discharge from 108 RWC patients were performed. Sensitive drugs were selected for effective consolidating treatment for half year. Fungal smears were examined at the 3rd and 6th months after the treatment respectively. Results:①Among RWC patients,there were 81 cas es of Candida albicans(75.0%), 19 cases of C. Glabrata(17.6%), 4 cases of C. Parapsilosis(3.7%) ,2 cases of C.tropicalis (1.9%) and 2 cases of M. Krusei (1.9%). The drug susceptibility test showed that 80.6% of these 108 patients were sensitive to nystatin; 66.7% were sensitive to clotrimazole; 65.7% were sensitive to miconazole; 57.4% were sensitive to fluconazole;8.3% were sensitive to ketoconazole;6.5% were sensitive to itraconazole; 7.4% were resistant to all of the above drugs.②The score of symptom and sign was significantly improved compared with the first visit at the 3rd and 6th month after the treatment( P<0.0001). The negative rate was 76.2%(80/105) at the 3rd month after the treatment and 64.8%(68/105)at the 6th month after the treatment. Conclusions:①The rate of non Candida albicans is increased to 25% in RWC patients, and 17.60% is Candida glabrata.②During the treatment of RWC, the drugs should be selected according to fungal culture, results of susceptibility test, medication experience of patients,and attack character. The research of immune abnormality of the local vagina will be helpful to improve the cure rate of RWC.
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Objective To study the role of immunoregulation in patients with Recurrent vulvovaginal candidiasis(RVVC) that evaluate the efficacy of application with combining clotrimazole and rhIFN-? therapy.Methods Patients were divided randomly into two groups :treatment group(60) and control group(60). The patients in treatment group were scheduled to receive clotrimazole therapy, 400mg,pv,qd,and add to rhIFN-? 1000000u im,biw; control group only using clotrimazole therapy.Results The curative rate betweet two groups had significant difference (68.33 (41/60) vs. 35.0(21/60). The efficiency rate in control group was significantly higher than treatment group( (56.67(34/60)vs 26.67(16/60)),In treatment group ,the serum levels of IL-18(pg/ml)(before treatment (111.71?18.45),after treatment (189.18?28.17))and TNF-? (pg/ml)(before treatment (52.66?18.75),after treatment (124.25?43.77))were significantly increased (P0.05). Conclusion The application with combining clotrimazole and rhIFN-? can significant ameliorate the curative rate of RVVC,by regulate immune fanction in the patients that were induced the produce of IL-18 and TNF-?. rhIFN-?can improve cell-mediated immunity in patients with RVVC.
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Objective:To assess the efficacy of terbinafine combined with fluconazole in the treatment of recurrent vulvovaginal candidiasis(RVVC).Method:94 patients with recurrent vulvovaginal candidiasis were randomly divided into three groups.30 cases in the terbinafine monotherapy group were treated with an oral 250mg-dose of terbinafine once daily; 31 cases in the fluconazole monotherpy group were treated with an oral 150mg-dose of fluconazole once daily;33 cases in the combined therapy group were given terbinafine and fluconazole together,and the usage and dosage were the same as those of the monotherapy groups.The treatment period of the three groups was 7 days.The efficacy was evaluated in the second week,sixth month and twelfth month after the treatment.Result:In the second week or sixth month or twelfth month after the treatment,the clinical cure rate,clinical effective rate and fungous clearance rate of the combined therapy group were higher than those of the monotherapy groups,which had statistically significant difference.Conclusion:The combined therapy with terbinafine and fluconazole can effectively improve the clinical signs and symptoms of RVVC patients and eliminate candida,which is more effective than the monotherapy with terbinafine or fluconazole.