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Candida and parasitic infection: Helminths, trichomoniasis, lice, scabies, and malaria
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Although the diagnosis of Candida infection is generally suspected on the basis of physical findings, confirmation should be obtained. The use of saline or potassium hydroxide (KOH) wet mounts of the vaginal secretions is the most rapid and least expensive confirmatory test. If a saline preparation is used, dark-field or phase-contrast microscopy may aid in visualization of the fungal elements. Potassium hydroxide (10–20% solution) lyses the epithelial cells, allowing the Candida to be seen more easily. Wet-mount analysis is highly specific, but sensitivity is poor (as low as 20%) (11). Other microscopic methods of Candida detection include Gram stain of smears or touch preps and Papanicolaou smears. If microscopic analysis is negative despite persistent symptoms following therapy, culture should be performed prior to further treatment. Infected secretions are inoculated into tubes of candida culture media [Sabouraud’s dextrose slants or Nickerson’s medium have the highest sensitivity (90%) and specificity (70%) for Candida strains] (12) and incubated at 25°C to 37°C (3). Candida grows quickly, often within 24 hours. Isolates from sterile sources should be subcultured and identified to the species level, but vaginal specimens need only categorization to either albicans or non-albicans. Species differentiation is based on subculture characteristics. C. albicans exhibits both germ tube and chlamydospore growth (3). C. parapsilosis, tropicalis, and glabrata produce neither.
DRCOG OSCE for Circuit A Answers
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Overgrowth of Candida has been associated with diabetes mellitus, immunosuppression, pregnancy and recent antibiotic therapy. Gardnerella is a Gram-negative rod and a frequent member of the normal flora of the vagina. Excessive douching or indulging in bubble baths has been associated with the overgrowth of Gardnerella and anaerobes, resulting in a frothy, grayish discharge and the distinctive 'fishy' vaginal odour when alkalinized with potassium hydroxide. IUD users are also at increased risk. The pH of the discharge is > 4.6.
Sexually transmitted infections
Published in Suzanne Everett, Handbook of Contraception and Sexual Health, 2020
Candida is caused by Candida albicans and is not sexually transmitted. It causes vulval itching and soreness; discharge is white and thick like ‘cottage cheese’. Diagnosis is through a vaginal swab for microbiology or through microscopy. Treatment first line is clotrimazole 500 mg pessary per vagina or fluconazole 150 mg, if not pregnant 150 mg stat orally. It is good practice to perform urinalysis to exclude diabetes mellitus and a full STI screen. You should also warn your client that treatment for candida may cause condoms to break.
Bacterial vaginosis, vulvovaginal candidiasis, and trichomonal vaginitis in reproductive-age women in Yunnan, China: a descriptive study
Published in Journal of Obstetrics and Gynaecology, 2022
Ting Zhao, Xiao Xiao, Li Xiao, Xiao-Mei Wu, Tao Yuan
Similar to our study, which showed a low prevalence of VVC (18.65%) among reproductive-age women, a previous study conducted on a European population reported that approximately 44% of patients had an episode of VVC within a year (Corsello et al. 2003). Approximately 75% of women are affected by VVC at some point in their lifetime, with pregnancy being a predisposing factor. In our study, several risk factors for this condition, including an age of 30–39 years (OR = 2.12, 95% CI: 1.03–4.38; p = .038), were most strongly associated with VVC in Yunnan Province. We explored the relationship between two identified risk factors for these infections: douching and pregnancy. Pregnancy plays a major role in colonisation and infection. Leli et al. (2013) demonstrated frequent Candida spp. colonisation in the vagina of pregnant women than in the vagina of non-pregnant women. This is due to the high concentration of oestrogen during pregnancy, which provides a favourable environment for the growth of Candida spp. Our results also found that women with a history of miscarriage are more likely to develop VVC, which is associated with numerous adverse outcomes, including predisposition to vaginal infections such as BV and VVC (Xu et al. 2019). However, we did not find any significant association between douching and the occurrence of any of these three infections in our study population, despite the reported links.
Existing and emerging therapies for the treatment of invasive candidiasis and candidemia
Published in Expert Opinion on Emerging Drugs, 2022
David De Bels, Evelyne Maillart, Françoise Van Bambeke, Sebastien Redant, Patrick M. Honoré
Candida infection is a frequent healthcare-associated disease. It comprises invasive candidiasis and noninvasive candidiasis including cutaneous, oropharyngeal, and vulvovaginal infections [1]. Invasive candidiasis covers two subsets of infections: deep-seated candidiasis and candidemia. Deep-seated candidiasis mainly originates from direct inoculation or hematogenous dissemination and is probably the most common fungal disease in our hospitals. Candidemia is considered as the fourth most frequent cause of blood stream infections in the United States [2] and the seventh one in Europe [3,4]. A recent epidemiological survey estimated the global number of patients with invasive candidiasis to 750,000 [5]. This infection remains associated with a high morbidity and even mortality from 15% to 40% [1]. The incidence rate of invasive candidiasis is about 15 cases per 100,000 patient-years [6]. Risk factors for invasive candidiasis are shown in Table 1.
Lactobacillus casei reduces the extracellular matrix components of fluconazole-susceptible Candida albicans biofilms
Published in Biofouling, 2021
Beatriz H. D. Panariello, Marlise Inez Klein, Luana Mendonça Dias, Amanda Bellini, Vitoria Bonan Costa, Paula Aboud Barbugli, Ana Claudia Pavarina
Understanding the interaction between Lactobacillus spp. and C. albicans biofilms is important to develop anti-Candida approaches. The constant maintenance of the intestinal and oral microbiota can prevent the development and prevalence of diseases caused by Candida spp. (Hatakka et al. 2007; Dos Santos et al. 2009; Mendonça et al. 2012). It has been shown that several species of the genus Lactobacillus have anti-Candida activity, possibly by direct inhibition, competition for adhesion sites, or production of secondary metabolites with antimicrobial activity (Ribeiro et al. 2020). However, the effect of these probiotics on the extracellular matrix of C. albicans biofilms has not yet been fully elucidated. Thus, this study investigated whether the interaction with Lactobacillus interferes with the extracellular matrix of biofilm of fluconazole-susceptible and -resistant C. albicans dual-species biofilms.