Gebelerde Candida Vajinitinin Epidemiyolojisi

KARA, ERTAN; Sucu, Mete; Karakoyun, Ayşe Sultan; Ünal, Nevzat; chaabaawi, ahmed

doi:10.54453/TMCD.2022.82621

Gebelerde Candida Vajinitinin Epidemiyolojisi

ahmed chaabaawi, (Çukurova Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, Mikoloji Bilim Dalı, Adana, Türkiye)

Mete SUCU, (Çukurova Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, Adana, Türkiye)

Ayşe Sultan KARAKOYUN, (Çukurova Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, Mikoloji Bilim Dalı, Adana, Türkiye)

Nevzat ÜNAL, (Sağlık Bilimleri Üniversitesi, Adana Şehir Eğitim ve Araştırma Hastanesi, Mikrobiyoloji Laboratuvarı, Adana, Türkiye)

Ertan KARA (Çukurova Üniversitesi Tıp Fakültesi, Halk Sağlığı Anabilim Dalı, Adana, Türkiye)

Türk Mikrobiyoloji Cemiyeti Dergisi

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Yıl: 2022 Cilt: 52 Sayı: 2 Sayfa Aralığı: 109 - 118 Metin Dili: Türkçe DOI: 10.54453/TMCD.2022.82621 İndeks Tarihi: 02-11-2022

Gebelerde Candida Vajinitinin Epidemiyolojisi

Öz:

Amaç: Her dört kadından üçünün yaşamları boyunca en az bir kez maruz kaldığı Candida vajiniti (CV)’nin en önemli risk faktörlerinden birisi de gebeliktir. Sunulan çalışmada, rutin gebelik takibi yapılan kadınlarda CV’nin prevalansı, trimesterlere göre dağılımı, etken mantar türlerinin belirlenmesi ve identifikasyon yöntemlerinin karşılaştırılması amaçlandı. Yöntem: Nisan 2021–Haziran 2021 tarihleri arasında hastanemize başvuran rastgele seçilmiş 250 gebeden posterior forniks sürüntü örneği alındı. Klinik örnekler, doğrudan mikroskop incelemesi, Gram boyaması, mantar kültürleri (CHROMagar Candida [CAC] ve Sabouraud glikoz agar) ile değerlendirildi. İzole edilen maya mantarları germ-tüp testi, mısır unlu–tween 80 agarda yapısal özelliklerinin değerlendirilmesi, CAC’da üreme özellikleri ve MALDI-TOF MS yöntemi ile identifiye edildi. Bulgular: Mantar vajinitlerinin prevalansı %43.2 idi. Mantar vajinitli 108 olgunun 22’si (%20.4) rekürren vajinit atakları tarif etti ve olguların %82.4’ü ikinci ve üçüncü trimesterde idi (p>.05). En sık izole edilen mantar türü Candida albicans (%49.6) olup, diğer türler C. glabrata (%35.3), C. krusei (%7.5), C. kefyr (%3.4), C. tropicalis (%1.7), Saccharomyces cerevisiae (%1.7) ve C. dubliniensis (%0.8) idi. Polifungal popülasyon 10 olguda (%9.3) görüldü ve en sık C. albicans + C. glabrata (%60) birlikteliği bulundu. Sonuç: Geçtiğimiz 10 yıl içerisinde, hastanemizde vajinit etkeni olarak belirlenen C. albicans oranı azalma eğiliminde iken, C. glabrata ve C. kruseideki artış endişe vericidir.

Anahtar Kelime:

Epidemiology of Candida Vaginitis in Pregnant Women

Öz:

Objective: Candida vaginitis (CV), which involves three in four women at least once in their lifetimes, poses a significant risk to pregnancy. This study aimed to determine the prevalence of CV in women undergoing followup routine pregnancy examinations, its distribution by trimester, and the most common causative species and to compare identification methods. Methods: Posterior fornix swab samples were taken from 250 randomly selected pregnant women presenting to our hospital between April and June 2021. The samples were evaluated by direct microscopic examinations, Gram staining, and fungal cultures (CHROMagar Candida [CAC] and Sabouraud glucose agar). Yeast isolates were identified by germ-tube tests, micromorphology on corn meal–Tween 80 agar, colony appearance on CAC, and the MALDI-TOF MS. Results: The prevalence of fungal vaginitis was 43.2%. Of the 108 diagnosed patients with fungal vaginitis, 20.4% experienced recurrent vaginitis, and 82.4% were in the second or third trimester (p>.05). The most common fungal species were Candida albicans (49.6%), followed by C. glabrata (35.3%), C. krusei (7.5%), C. kefyr (3.4%), C. tropicalis (1.7%), Saccharomyces cerevisiae (1.7%), and C. dubliniensis (0.8%). Polyfungal populations were present in 10 cases (9.3%), in which C. albicans + C. glabrata (60%) was the most common coexistence. Conclusion: While the rate of C. albicans identified as the causative agent of vaginitis in our hospital has declined in the last decade, the increase in C. glabrata and C. krusei is alarming.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

Seyedmousavi S, İlkit M, Durdu M, et al. Candida ve kandidoz: Epidemiyoloji, tanı, tedavi, antifungal ilaç direnci ve konağın genetik yatkınlığında güncel durum. Turk Mikrobiyol Cemiy Derg. 2015;45(1):1-11. https://doi.org/10.5222/TMCD.2015.001
Sobel JD. Vulvovaginal candidosis. Lancet. 2007;369(9577):1961-71. https://doi.org/10.1016/S0140-6736(07)60917-9.
Denning DW, Kneale M, Sobel JD, Rautemaa-Richardson R. Global burden of recurrent vulvovaginal candidiasis: A systematic review. Lancet Infect Dis. 2018;18(11):e339-47. https://doi.org/10.1016/S1473-3099(18)30103-8
4. Sustr V, Foessleitner P, Kiss H, Farr A. Vulvovaginal candidosis: Current concepts, challenges and perspectives. J Fungi (Basel). 2020;6(4):267. https://doi.org/10.3390/jof6040267
5. Gonçalves B, Ferreira C, Alves CT, Henriques M, Azeredo J, Silva S. Vulvovaginal candidiasis: Epidemiology, microbiology and risk factors. Crit Rev Microbiol. 2016;42(6):905-27.
https://doi.org/10.3109/1040841X.2015.1091805 6. Hilmioğlu-Polat S, Seyedmousavi S, Ilkit M, et al. Estimated burden of serious human fungal diseases in Turkey. Mycoses. 2019;62(1):22-31. https://doi.org/10.1111/myc.12842
7. Aguin TJ, Sobel JD. Vulvovaginal candidiasis in pregnancy. Curr Infect Dis Rep 2015;17(6):462. https://doi.org/10.1007/s11908-015-0462-0
8. Ilkit M, Guzel AB. The epidemiology, pathogenesis, and diagnosis of vulvovaginal candidosis: A mycological perspective. Crit Rev Microbiol. 2011;37(3):250-61. https://doi.org/10.3109/1040841X.2011.576332
9. Maki Y, Fujisaki M, Sato Y, Sameshima H. Candida chorioamnionitis leads to preterm birth and adverse fetal-neonatal outcome. Infect Dis Obstet Gynecol. 2017;2017:9060138. https://doi.org/10.1155/2017/9060138
10. Guzel AB, Ilkit M, Akar T, Burgut R, Demir SC. Evaluation of risk factors in patients with vulvovaginal candidiasis and the value of chromID Candida agar versus CHROMagar Candida for recovery and presumptive identification of vaginal yeast species. Med Mycol. 2011;49(1):16-25. https://doi.org/10.3109/13693786.2010.497972
11. Ozcan K, Ilkit M, Ates A, Turac-Bicer A, Demirhindi H. Performance of Chromogenic Candida agar and CHROMagar Candida in recovery and presumptive identification of monofungal and polyfungal vaginal isolates. Med Mycol. 2010;48(1):29-34. https://doi.org/10.3109/13693780802713224
12. Pincus DH, Orenga S, Chatellier S. Yeast identification– past, present, and future methods. Med Mycol. 2007;45(2):97-121. https://doi.org/10.1080/13693780601059936
13. Guzel AB, Ilkit M, Burgut R, Urunsak IF, Ozgunen FT. An evaluation of risk factors in pregnant women with Candida vaginitis and the diagnostic value of simultaneous vaginal and rectal sampling. Mycopathologia. 2011;172(1):25-36. https://doi.org/10.1007/s11046-011-9392-z
14. Walsh TH, Hayden TH, Larone DH. Larone’s Medically Important Fungi: A Guide to Identification. 6th ed. Washington DC: ASM Press, 2018.
15. Marklein G, Josten M, Klanke U, et al. Matrixassisted laser desorption ionization-time of flight mass spectrometry for fast and reliable identification of clinical yeast isolates. J Clin Microbiol. 2009;47(9):2912-7. https://doi.org/10.1128/JCM.00389-09
16. Yang L, Su MQ, Ma YY, et al. Epidemiology, species distribution, antifungal susceptibility, and ERG11 mutations of Candida species isolated from pregnant Chinese Han women. Genet Mol Res. 2016;15(2):gmr7168. https://doi.org/10.4238/gmr.15027168
17. 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. https://doi.org/10.1186/s12884-020-02963-3
18. Fardiazar Z, Ronaci F, Torab R, Goldust M. Vulvovaginitis candidiasis recurrence during pregnancy. Pak J Biol Sci. 2012;15(8):399-402. https://doi.org/10.3923/pjbs.2012.399.402
19. Leli C, Mencacci A, Meucci M, et al. Association of pregnancy and Candida vaginal colonization in women with or without symptoms of vulvovaginitis. Minerva Ginecol. 2013;65(3):303-9. PMID: 23689173.
20. Siddiqui R. Clinical patterns and risk factors of vulvovaginal candidiasis among women of reproductive age attending a tertiary Hospitalin Central India. Stam J Microbiol. 2020;9(1):27-31. https://doi.org/10.3329/sjm.v9i1.45655
21. Sampson T, George AP. Evaluating the risk of Candida albicans associated with gestation amongst women in Port Harcourt, River State, Nigeria. IJPR. 2020;3(3- 4):1-7. https://doi.org/10.9734/IJPR/2019/v3i430098
22. Wokem GN, Ndukwu CB. Albicans candidiasis among women and infants at two health facilities in Port Harcourt, Rivers State, Nigeria. Nigerian J Parasitol. 2015;36(1):55-60.
23. Dias LB, de Souza Carvalho Melhem M, Szeszs MW, Filho JM, Hahn RC. Vulvovaginal candidiasis in Mato Grosso, Brazil: Pregnancy status, causative species and drugs tests. Braz J Microbiol. 2011;42(4):1300-7. https://doi.org/10.1590/S1517-83822011000400009
24. 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):783-9. https://doi.org/10.1099/jmm.0.000740
Mushi MF, Mmole A, Mshana SE. Candida vaginitis among symptomatic pregnant women attending antenatal clinics in Mwanza, Tanzania. BMC Res Notes. 2019;12(1):775. https://doi.org/10.1186/s13104-019-4793-z
Ghaddar N, Anastasiadis E, Halimeh R, et al. Prevalence and antifungal susceptibility of Candida albicans causing vaginal discharge among pregnant women in Lebanon. BMC Infect Dis. 2020;20(1):32. https://doi.org/10.1186/s12879-019-4736-2
Abdelaziz ZA, Ibrahim ME, Bilal NE, Hamid ME. Vaginal infections among pregnant women at Omdurman Maternity Hospital in Khartoum, Sudan. J Infect Dev Ctries. 2014;8(4):490-7. https://doi.org/10.3855/jidc.3197
Mylonas I, Bergauer F. Diagnosis of vaginal discharge by wet mount microscopy: A simple and underrated method. Obstet Gynecol Surv. 2011;66(6):359-68. https://doi.org/10.1097/OGX.0b013e31822bdf31
Makanjuola O, Bongomin F, Fayemiwo SA. An update on the roles of non-albicans Candida species in vulvovaginitis. J Fungi (Basel). 2018;4(4):121. https://doi.org/10.3390/jof4040121
Cetin M, Ocak S, Gungoren A, Hakverdi AU. Distribution of Candida species in women with vulvovaginal symptoms and their association with different ages and contraceptive methods. Scand J Infect Dis. 2007;39(6-7):584-8. https://doi.org/10.1080/00365540601148491
Güzel AB, Aydın M, Meral M, Kalkancı A, Ilkit M. Clinical characteristics of Turkish women with Candida krusei vaginitis and antifungal susceptibility of the C. krusei isolates. Infect Dis Obstet Gynecol. 2013;2013:698736. https://doi.org/10.1155/2013/698736
Hazirolan G, Altun HU, Gumral R, Gursoy NC, Otlu B, Sancak B. Prevalence of Candida africana and Candida dubliniensis, in vulvovaginal candidiasis: First Turkish Candida africana isolates from vulvovaginal candidiasis. J Mycol Med. 2017;27(3):376-81. https://doi.org/10.1016/j.mycmed.2017.04.106
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. https://doi.org/10.1007/s10096-021-04199-1
Erdem H, Erganiş S, Evren E, Aksakal FN, Çağlar K, Kalkancı A. Candida cinsi mayaların tür düzeyinde tanımlanmasında kullanılan yöntemlerin karşılaştırmalı analizi. Turk Mikrobiyol Cemiy Derg. 2017;47(3):114-24. https://doi.org/10.5222/TMCD.2017.114
Dhiman N, Hall L, Wohlfiel SL, Buckwalter SP, Wengenack NL. Performance and cost analysis of matrix-assisted laser desorption ionization-time of flight mass spectrometry for routine identification of yeast. J Clin Microbiol. 2011;49(4):1614-6. https://doi.org/10.1128/JCM.02381-10
Quintilla R, Kolecka A, Casaregola S, et al. MALDI-TOF MS as a tool to identify foodborne yeasts and yeast-like fungi. Int J Food Microbiol. 2018;266:109-118. https://doi.org/10.1016/j.ijfoodmicro.2017.11.016

APA	chaabaawi a, Sucu M, Karakoyun A, Ünal N, KARA E (2022). Gebelerde Candida Vajinitinin Epidemiyolojisi. , 109 - 118. 10.54453/TMCD.2022.82621
Chicago	chaabaawi ahmed,Sucu Mete,Karakoyun Ayşe Sultan,Ünal Nevzat,KARA ERTAN Gebelerde Candida Vajinitinin Epidemiyolojisi. (2022): 109 - 118. 10.54453/TMCD.2022.82621
MLA	chaabaawi ahmed,Sucu Mete,Karakoyun Ayşe Sultan,Ünal Nevzat,KARA ERTAN Gebelerde Candida Vajinitinin Epidemiyolojisi. , 2022, ss.109 - 118. 10.54453/TMCD.2022.82621
AMA	chaabaawi a,Sucu M,Karakoyun A,Ünal N,KARA E Gebelerde Candida Vajinitinin Epidemiyolojisi. . 2022; 109 - 118. 10.54453/TMCD.2022.82621
Vancouver	chaabaawi a,Sucu M,Karakoyun A,Ünal N,KARA E Gebelerde Candida Vajinitinin Epidemiyolojisi. . 2022; 109 - 118. 10.54453/TMCD.2022.82621
IEEE	chaabaawi a,Sucu M,Karakoyun A,Ünal N,KARA E "Gebelerde Candida Vajinitinin Epidemiyolojisi." , ss.109 - 118, 2022. 10.54453/TMCD.2022.82621
ISNAD	chaabaawi, ahmed vd. "Gebelerde Candida Vajinitinin Epidemiyolojisi". (2022), 109-118. https://doi.org/10.54453/TMCD.2022.82621

APA	chaabaawi a, Sucu M, Karakoyun A, Ünal N, KARA E (2022). Gebelerde Candida Vajinitinin Epidemiyolojisi. Türk Mikrobiyoloji Cemiyeti Dergisi, 52(2), 109 - 118. 10.54453/TMCD.2022.82621
Chicago	chaabaawi ahmed,Sucu Mete,Karakoyun Ayşe Sultan,Ünal Nevzat,KARA ERTAN Gebelerde Candida Vajinitinin Epidemiyolojisi. Türk Mikrobiyoloji Cemiyeti Dergisi 52, no.2 (2022): 109 - 118. 10.54453/TMCD.2022.82621
MLA	chaabaawi ahmed,Sucu Mete,Karakoyun Ayşe Sultan,Ünal Nevzat,KARA ERTAN Gebelerde Candida Vajinitinin Epidemiyolojisi. Türk Mikrobiyoloji Cemiyeti Dergisi, vol.52, no.2, 2022, ss.109 - 118. 10.54453/TMCD.2022.82621
AMA	chaabaawi a,Sucu M,Karakoyun A,Ünal N,KARA E Gebelerde Candida Vajinitinin Epidemiyolojisi. Türk Mikrobiyoloji Cemiyeti Dergisi. 2022; 52(2): 109 - 118. 10.54453/TMCD.2022.82621
Vancouver	chaabaawi a,Sucu M,Karakoyun A,Ünal N,KARA E Gebelerde Candida Vajinitinin Epidemiyolojisi. Türk Mikrobiyoloji Cemiyeti Dergisi. 2022; 52(2): 109 - 118. 10.54453/TMCD.2022.82621
IEEE	chaabaawi a,Sucu M,Karakoyun A,Ünal N,KARA E "Gebelerde Candida Vajinitinin Epidemiyolojisi." Türk Mikrobiyoloji Cemiyeti Dergisi, 52, ss.109 - 118, 2022. 10.54453/TMCD.2022.82621
ISNAD	chaabaawi, ahmed vd. "Gebelerde Candida Vajinitinin Epidemiyolojisi". Türk Mikrobiyoloji Cemiyeti Dergisi 52/2 (2022), 109-118. https://doi.org/10.54453/TMCD.2022.82621