Increased vulvovaginal candidiasis incidence risk in various gestational ages at a private midwifery practice in Surabaya, Indonesia
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HIGHLIGHTS
1. Hormonal changes during pregnancy lead to the presence of vulvovaginal candidiasis.
2. Increased incidence of vulvovaginal candidiasis in different pregnancy trimesters were analyzed.
3. Frequency of vulvovaginal candidiasis tends to increase along with the gestational age.
ABSTRACT
Objectives: This study aimed to analyze whether there was an increase in the incidence risk of vulvovaginal candidiasis at various gestational ages.
Materials and Methods: A study examined vaginal smears of pregnant women at a private midwifery practice Farida Hadjri, Surabaya, Indonesia. A total sample of 96 patients was taken by the consecutive sampling method, consisting of 32 patients each from the 1st, 2nd, and 3rd trimester of pregnancy.y The smear was examined using Gram stain at Balai Besar Laboratorium Kesehatan Daerah Jawa Timur to detect the presence of fungi elements. Data were analyzed using Chi-square test with 95% confidence interval to investigate whether there was an increased risk of vulvovaginal candidiasis and gestational age.
Results: There was an increased risk of vulvovaginal candidiasis and increased gestational age (p < 0.05). This result was related to the hormonal status of pregnant women. An increase in estrogen level during pregnancy leads to an increase in glycogen production by vaginal epithelial cells, which cause the vaginal environment to become more susceptible to fungal growth.
Conclusion: There was increased vulvovaginal candidiasis incidence risk along with gestational age. Pregnancy is one of the predisposing factors for candida infection.
Sardi JCO, Scorzoni L, Bernardi T, et al. Candida species: current epidemiology, pathogenicity, biofilm formation, natural antifungal products and new therapeutic options. J Med Microbiol. 2013;62(Pt 1):10-24. doi: 10.1099/jmm.0.045054-0. Epub 2012 Nov 22. PMID: 23180477.
Willems HME, Lowes DJ, Barker KS, et al. Comparative analysis of the capacity of the candida species to elicit vaginal immunopathology. Infect Immun. 2018;86(12):e00527-18. doi: 10.1128/IAI. 00527-18. PMID: 30249743; PMCID: PMC 6246903.
Aguin TJ, Sobel JD. Vulvovaginal candidiasis in pregnancy. Curr Infect Dis Rep. 2015;17(6):462. doi: 10.1007/s11908-015-0462-0. PMID: 25916994.
Sangaré I, Sirima C, Bamba S, et al. Prevalence of vulvovaginal candidiasis in pregnancy at three health centers in Burkina Faso. J Mycol Med. 2018;28(1):186-92. doi: 10.1016/j.mycmed.2017. 08.006. Epub 2017 Sep 20. PMID: 28939305.
Blostein F, Levin-Sparenberg E, Wagner J, et al. Recurrent vulvovaginal candidiasis. Ann Epidemiol. 2017;27(9):575-82.e3. doi: 10.1016/j. annepidem.2017.08.010. Epub 2017 Aug 15. PMID: 28927765.
Kumar M, Saadaoui M, Al Khodor S. Infections and pregnancy: effects on maternal and child health. Front Cell Infect Microbiol. 2022;12: 873253. doi: 10.3389/fcimb.2022.873253. PMID: 35755838; PMCID: PMC9217740.
Mtibaa L, Fakhfakh N, Kallel A, et al. Les candidoses vulvovaginales: étiologies, symptí´mes et facteurs de risque. Journal de Mycologie Medicale. 2017;27(2):153–8.
Venugopal D, Husain K, Mustafa SA, et al. Epidemiology, risk factors and antimicrobial profile of Vulvovaginal Candidiasis (VVC): A study among women in the central region of Saudi Arabia. J Mycol Med. 2021;31(2):101049. doi: 10.1016/j.mycmed.2020.101049. Epub 2020 Oct 15. PMID: 33153879.
Gonçalves B, Ferreira C, Alves CT, et al. Vulvovaginal candidiasis: Epidemiology, micro-biology and risk factors. Crit Rev Microbiol. 2016;42(6):905-27. doi: 10.3109/1040841X.2015. 1091805. Epub 2015 Dec 21. PMID: 26690853.
Pereira LC, Correia AF, da Silva ZDL, et al. Vulvovaginal candidiasis and current perspectives: new risk factors and laboratory diagnosis by using MALDI TOF for identifying species in primary infection and recurrence. Eur J Clin Microbiol Infect Dis. 2021;40(8):1681-93. doi: 10.1007/ s10096-021-04199-1. Epub 2021 Mar 13. PMID: 33713006; PMCID: PMC8295079.
Fardiazar Z, Ronaci F, Torab R, et al. Vulvovaginitis candidiasis recurrence during pregnancy. Pak J Biol Sci. 2012;15(8):399-402. doi: 10.3923/pjbs.2012.399.402. PMID: 24199471.
Waikhom SD, Afeke I, Kwawu GS, et al. Prevalence of vulvovaginal candidiasis among pregnant women in the Ho municipality, Ghana: species identification and antifungal susceptibility of Candida isolates. BMC Pregnancy Childbirth. 2020;20(1):266. doi: 10.1186/s12884-020-02963-3. PMID: 32375724; PMCID: PMC7201979.
Zisova LG, Chokoeva AA, Amaliev GI, et al Vulvovaginal Candidiasis in Pregnant Women and its Importance for Candida Colonization of Newborns. Folia Med (Plovdiv). 2016;58(2):108-14. doi: 10.1515/folmed-2016-0018. PMID: 27552787.
Olowe OA, Makanjuola OB, Olowe R, et al. Prevalence of vulvovaginal candidiasis, tricho-moniasis and bacterial vaginosis among pregnant women receiving antenatal care in Southwestern Nigeria. Eur J Microbiol Immunol (Bp). 2014; 4(4):193-7. doi: 10.1556/EUJMI-D-14-00027. Epub 2014 Dec 16. PMID: 25544891; PMCID: PMC4271815.
Verwijs MC, Agaba SK, Darby AC, et al. Impact of oral metronidazole treatment on the vaginal microbiota and correlates of treatment failure. Am J Obstet Gynecol. 2020;222(2):157.e1-157.e13. doi: 10.1016/j.ajog.2019.08.008. Epub 2019 Aug 9. PMID: 31404542; PMCID: PMC6995998.
Ghaddar N, El Roz A, Ghssein G, et al. Emergence of vulvovaginal candidiasis among Lebanese pregnant women: Prevalence, risk factors, and species distribution. Infect Dis Obstet Gynecol. 2019;2019:5016810. doi: 10.1155/2019/5016810. PMID: 31467477; PMCID: PMC6699268.
Denning DW, Kneale M, Sobel JD, et al. Global burden of recurrent vulvovaginal candidiasis: a systematic review. Lancet Infect Dis. 2018;18 (11):e339-e347. doi: 10.1016/S1473-3099(18) 30103-8. Epub 2018 Aug 2. PMID: 30078662.
Brandí£o LDS, Boniek D, Resende Stoianoff MA, et al. Prevalence and antifungal susceptibility of Candida species among pregnant women attending a school maternity at Natal, Brazil. Lett Appl Microbiol. 2018;67(3):285-291. doi: 10.1111/lam. 13034. Epub 2018 Jul 12. PMID: 29908032.
Zhai Y, Liu J, Zhou L, et al. Detection of Candida species in pregnant Chinese women with a molecular beacon method. J Med Microbiol. 2018;67(6):783-789. doi: 10.1099/jmm.0.000740. PMID: 29676728; PMCID: PMC6096925.
Maldonado I, Cataldi S, Garbasz C, et al.; Red de Micología de la Ciudad Autónoma de Buenos Aires (RMCABA), Argentina; Red de Micología de la Ciudad Autónoma de Buenos Aires:. Identificación de levaduras del género Candida: los métodos convencionales frente a MALDI-TOF MS [Identification of Candida yeasts: Conventional methods and MALDI-TOF MS]. Rev Iberoam Micol. 2018;35(3):151-4. Spanish. doi: 10.1016/j.riam.2018.02.002. Epub 2018 Aug 3. PMID: 30078526.
Farr A, Effendy I, Frey Tirri B, et al. Guideline: Vulvovaginal candidosis (AWMF 015/072, level S2k). Mycoses. 2021;64(6):583–602. doi: 10.1111/ myc.13248.
Mucci MJ, Cuestas ML, Landanburu MF, et al. Prevalence of Candida albicans, Candida dubliniensis and Candida africana in pregnant women suffering from vulvovaginal candidiasis in Argentina. Rev Iberoam Micol. 2017;34(2):72-6. doi: 10.1016/j.riam.2016.09.001. Epub 2017 Apr 3. PMID: 28385421.
Nicholls S, MacCallum DM, Kaffarnik FA, et al. Activation of the heat shock transcription factor Hsf1 is essential for the full virulence of the fungal pathogen Candida albicans. Fungal Genet Biol. 2011;48(3):297-305. doi: 10.1016/j.fgb.2010.08. 010. Epub 2010 Sep 9. PMID: 20817114; PMCID: PMC3032048.
van Schalkwyk J, Yudin MH; Infectious Disease Committee. Vulvovaginitis: screening for and management of trichomoniasis, vulvovaginal candi-diasis, and bacterial vaginosis. J Obstet Gynaecol Can. 2015;37(3):266-74. doi: 10.1016/ S1701-2163(15)30316-9. PMID: 26001874.
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