Role of dual therapy on the repeated episode of vulvovaginal candidiasis
Keywords:pregnancy, vulvovaginal candidiasis, dual treatment
AbstractVulvovaginal candidiasis (VVC) is one of the most common infections of female genital tract and is mainly associated with Candida albicans, different types of Candida are found in 10–20% of healthy women of childbearing age in the genitourinary organs. Currentl, the factors that influence the evolution of yeast infection from colonization to clinical symptoms, including susceptibility, inflammatory reactions, and imbalance of vaginal microbiota, are being studied. 75% of women experience an repeated episode of VVC, and 5–10% of women experience recurrent vulvovaginal candidiasis. During pregnancy, candidiasis of the genitourinary organs occurs 2–3 times more often than in non-pregnant women.
Purpose — to conduct an analysis of the effectiveness of the dual therapy influence on the recurrent episode of vaginal candidiasis.
Patients and methods. We examined and treated 52 women who had a first episode of candidiasis during pregnancy (they received short-term treatment) and next episode in the first three months of the postpartum period. The cultural method and the microscopy of a vaginal smear, gram-stained, were performed, revealed the microflora which accompanies fungi, that influenced on the choice of rational aetiotropic therapy. In all 52 women we revealed different strains: C. albicans (92.3%), C. glabrata (3.8%), C. crusei (1.9%), C. dubliniensis (1.9%), as well as the presence of pathological flora, a significant reduction of lactobacilli levels.
Results. Given the potentially threatening effects of candidiasis on pregnancy and the fetus, it is essential to effectively treat the first acute episode of pregnancy during pregnancy, which is possible if adequate examination is made to select the drug correctly and to determine the duration of treatment.
Conclusions. Carrying out dual (combined vaginal tablets and multistrain probiotic) therapy with a compound action on mixed infection and maintaining its effectiveness with accompanying therapy has a proven patient satisfaction rate of 96.2%.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of this Institute. The informed consent of the patient was obtained for conducting the studies.
No conflict of interest were declared by the authors.
Ashraf R, Shah NP. (2014). Immune system stimulation by probiotic microorganisms. Crit Rev Food Sci Nutr. 54: 938—956. https://doi.org/10.1080/10408398.2011.619671; PMid:24499072
Atkinson MJ, Sinha A, Hass SL et al. (2004). Validation of a general measure of treatment satisfaction, the Treatment Satisfaction Questionnaire for Medication (TSQM), using a national panel study of chronic disease. Health Qual Life Outcomes. 2: 12.
Bienenstock J, Gibson G, Klaenhammer TR, Walker AW, Neish AS. (2013). New insights into probiotic mechanisms A harvest from functional and metagenomic studies. Gut Microbes. 4: 1—7. https://doi.org/10.4161/gmic.23283; PMid:23249742 PMCid:PMC3595083
Boirivant M, Strober W. (2007). The mechanism of action of probiotics. Curr Opin Gastroenterol. 23: 679—692. https://doi.org/10.1097/MOG.0b013e3282f0cffc; PMid:17906447
Borges S, Silva J, Teixeira P. (2014). The role of lactobacilli and probiotics in maintaining vaginal health. Arch Gynecol Obstet. 289: 479—489. https://doi.org/10.1007/s00404-013-3064-9; PMid:24170161
Choi SB, Lew LC, Yeo SK, Nair Parvathy S, Liong MT. (2015). Probiotics and the BSH-related cholesterol lowering mechanism: a Jekyll and Hyde scenario. Crit. Rev. Biotechnol. 35: 392—340. Rev. Biotechnol. 35: https://doi.org/10.3109/07388551.2014.889077; PMid:24575869
De Seta F, Parazzini F, De Leo R, Banco R, Maso GP, De Santo D et al. (2014). Lactobacillus plantarum P17630 for preventing Candida vaginitis recurrence: a retrospective comparative study. Eur J Obstet Gynecol Reprod Biol. 182: 136—139. https://doi.org/10.1016/j.ejogrb.2014.09.018; PMid:25305660
Dhanani AS, Bagchi T. (2013). The expression of adhesin EF-Tu in response to mucin and its role in Lactobacillus adhesion and competitive inhibition of enteropathogens to mucin. J. Appl. Microbiol. 115: 546—554. https://doi.org/10.1111/jam.12249; PMid:23663754
Dovnik A, Golle A, Novak D, Arko D, Takac I. (2015). Treatment of vulvovaginal candidiasis: a review of literature. Acta Dermatovenerol Alp Pannonica Adriat. 24: 5—7. https://doi.org/10.15570/actaapa.2015.2; PMid:25770305
Hill C, Guarner F, Reid G et al. (2014). Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 11: 506—514. https://doi.org/10.1038/nrgastro.2014.66; PMid:24912386
Kumar RN, Kirking DM, Hass SL, Vinokur AD, Taylor SD, Atkinson MJ, McKercher PL (2007). The association of consumer expectations, experiences and satisfaction with newly prescribed medications. Qual Life Res. 16 (7): 1127—1136. https://doi.org/10.1007/s11136-007-9222-4; PMid:17530445
Mendling W, Brasch J, Cornely OA, Effendy I, Friese K, Ginter-Hanselmayer G et al. (2015). Guideline: vulvovaginal candidosis (AWMF 015/072). S2k (excluding chronic mucocutaneous candidosis). Mycoses. 58: 1—15. https://doi.org/10.1111/myc.12292; PMid:25711406.
Murina F, Graziottin A, Felice R et al. (2011). The recurrent vulvovaginal candidiasis: proposal of a personalized therapeutic protocol. ISRN Obstet Gynecol: 806065. https://doi.org/10.5402/2011/806065; PMid:21845227 PMCid:PMC3153925.
Osset J, Garcia E, Bartolome RM et al. (2001). Role of Lactobacillus as protector against vaginal candidiasis. Med Clin. 117: 285—288. https://doi.org/10.1016/S0025-7753(01)72089-1
Peters BM, Yano J, Noverr MC, Fidel PL. (2014). Candida vaginitis: when opportunism knocks, the host responds. PLoS Pathog. 10: e1003965. https://doi.org/10.1371/journal.ppat.1003965; PMid:24699903 PMCid:PMC3974868
Strus M, Brzychczy-Wloch M, Kucharska A et al. (2005). Inhibitory activity of vaginal Lactobacillus bacteria on yeasts causing vulvovaginal candidiasis, Med Dosw Mikrobiol. 57: 7-17.
Zhiwei Z, Gerstein DR, Friedmann PD. (2008). Patient satisfaction and sustained outcomes of drug abuse treatment. J Health Psychol. 13: 388—400. https://doi.org/10.1177/1359105307088142; PMid:18420772 PMCid:PMC2796692
Jayashree S., Jayaraman K., Kalaichelvan G. (2010). Probiotic properties of the riboflavin producing Lactobacillus fermentum strain isolated from yoghurt sample. J. Ecobiotechnol. 2: 11-16.
Jayashree S., Pooja S., Pushpanathan M., Rajendhran J., Gunasekaran P. (2014). Identification and characterization of bile salt hydrolase genes from the genome of Lactobacillus fermentum MTCC 8711. Appl. Biochem. Biotechnol. 174: 855—866. https://doi.org/10.1007/s12010-014-1118-5; PMid:25099376
Jayashree S., Pooja S., Pushpanathan M., Vishnu U., Sankarasubramanian J., Rajendhran J., et al. (2013). Genome sequence of Lactobacillus fermentum strain MTCC 8711, a probiotic bacterium is lated from yogurt. Genome Announc. 1: e00770—13. https://doi.org/10.1128/genomeA.00770-13; PMid:24072868 PMCid:PMC3784788
Kumar H., Salminen S., Verhagen H., Rowland I., Heimbach J., Banares S., et al. (2015). Novel probiotics and prebiotics: road to the market. Curr. Opin. Biotechnol. 32: 99—103. https://doi.org/10.1016/j.copbio.2014.11.021; PMid:25499742
Jayashree S, Karthikeyan R, Nithyalakshmi S, Ranjani J, Gunasekaran P, Rajendhran J. (2018). Anti-adhesion Property of the Potential Probiotic Strain Lactobacillus fermentum 8711 Against Methicillin-Resistant Staphylococcus aureus (MRSA). Front Microbiol. 9: 411. https://doi.org/10.3389/fmicb.2018.00411; PMid:29568290 PMCid:PMC5852077
The policy of the Journal “Ukrainian Journal of Perinatology and Pediatrics” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license(СС BY-NC).
Authors transfer the copyright to the Journal “MODERN PEDIATRICS. UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.