دورية أكاديمية
Vaginal pH and microbiota during fluconazole maintenance treatment for recurrent vulvovaginal candidosis (RVVC).
| العنوان: | Vaginal pH and microbiota during fluconazole maintenance treatment for recurrent vulvovaginal candidosis (RVVC). |
|---|---|
| المؤلفون: | Donders GG; Femicare Clinical Research for Women, Tienen, Belgium; Regional Hospital H Hart, Tienen, Belgium; University Hospital Antwerp, Antwerpen, Belgium. Electronic address: Gilbert.Donders@femicare.net., Grinceviciene S; Femicare Clinical Research for Women, Tienen, Belgium; Department of Biothermodynamics and Drug Design, Institute of Biotechnology, Vilnius University, Vilnius, Lithuania., Ruban K; Femicare Clinical Research for Women, Tienen, Belgium., Bellen G; Femicare Clinical Research for Women, Tienen, Belgium. |
| المصدر: | Diagnostic microbiology and infectious disease [Diagn Microbiol Infect Dis] 2020 Jun; Vol. 97 (2), pp. 115024. Date of Electronic Publication: 2020 Feb 14. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Biomedical Country of Publication: United States NLM ID: 8305899 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-0070 (Electronic) Linking ISSN: 07328893 NLM ISO Abbreviation: Diagn Microbiol Infect Dis Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [New York, NY] : Elsevier Biomedical, [c1983- |
| مواضيع طبية MeSH: | Antifungal Agents/*therapeutic use , Candidiasis, Vulvovaginal/*prevention & control , Fluconazole/*therapeutic use , Microbiota/*drug effects , Vagina/*drug effects , Vagina/*microbiology, Acute Disease ; Adolescent ; Adult ; Bacteria/drug effects ; Candida/drug effects ; Candidiasis, Vulvovaginal/drug therapy ; Candidiasis, Vulvovaginal/microbiology ; Dysbiosis ; Female ; Humans ; Hydrogen-Ion Concentration ; Maintenance Chemotherapy ; Middle Aged ; Recurrence ; Vagina/chemistry ; Young Adult |
| مستخلص: | Background: It is commonly stated that Candida in the vagina prefers a low pH to develop infection. However, mixed infections of Candida with bacterial vaginosis (BV) and aerobic vaginitis (AV) are rather common and may challenge the rule that Candida should only be looked for in low vaginal pH settings. In this study we tested whether the vaginal pH in acute vaginal candidosis is lower than in women successfully treated to prevent Candida recurrences. Methods: Vaginal pH and microscopy findings of vaginal microbiota were recorded during 12 visits over 1.5 years in 117 patients medically monitored during a degressive fluconazole maintenance regimen for proven recurrent vulvovaginal candidosis (ReCiDiF trial). The fluctuation of the mean pH of and microscopic findings of the vaginal smears were studied before, during and after the treatment. Results: The mean vaginal pH of women with acute infection before or after ending maintenance treatment was (4.7±0.8 and 4.8 ±1.0, respectively, p>0.05). During maintenance treatment with fluconazole, the pH dropped significantly to 4.5±0.8 (p=0.01). Depression of Lactobacilli spp. (increased lactobacillary grades) was more frequent during the acute, pre-treatment period (30.0%) than during the treatment period (23.1%, p=0.03). Aerobic vaginitis type flora was also more prevalent pre-treatment than during treatment (30.0% vs 22.2%, OR=0.7 (95%CI 0.5-0.9), p=0.01). Discussion: In women with RVVC, acute vaginal Candida infection is associated with an increased pH, and disturbed vaginal bacterial microbiota. During fluconazole maintenance treatment, the pH drops to normal levels and the lactobacillary grade improves. Condensation: Acute Candida vulvovaginitis can be associated with a disturbance of the vaginal microbiota. In patients with recurrent vulvovaginal candidosis, decrease of pH, and increase of Lactobacilli spp. were observed during fluconazole maintenance treatment. This pH drop was seen in all response groups. This contradicts the common belief that active vaginal Candida infection is related to low pH. (Copyright © 2020. Published by Elsevier Inc.) |
| فهرسة مساهمة: | Keywords: Aerobic vaginitis; Bacterial vaginosis; Candida albicans; Candida non-albicans; Therapy; Vaginal dysbiosis; Vulvovaginitis |
| المشرفين على المادة: | 0 (Antifungal Agents) 8VZV102JFY (Fluconazole) |
| تواريخ الأحداث: | Date Created: 20200408 Date Completed: 20201127 Latest Revision: 20201127 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1016/j.diagmicrobio.2020.115024 |
| PMID: | 32253071 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1879-0070 |
|---|---|
| DOI: | 10.1016/j.diagmicrobio.2020.115024 |