Relationship between clinical diagnosis of recurrent vulvovaginal candidiasis and detection of Candida species by culture and polymerase chain reaction.
BACKGROUND
Recurring vulvovaginal candidiasis (RVVC) is a common vaginal discharge affecting 75% of all women at least once in their life. In 5% of these women, infection is recurring. Aim of the study was to determine the sensitivity of detecting Candida species by culture and polymerase chain reaction (PCR) in women with a clinical diagnosis of RVVC.


METHODS
A total number of 104 patients referred with a clinical diagnosis of RVVC and therefore at least four episodes in the previous year were evaluated. In order to detect Candida, vaginal swabs were cultured on Sabouraud and chromagar. Furthermore, the supernatant from the vaginal lavage was examined for the presence of Candida by PCR.


RESULTS
When the culture was analyzed, only 31 (29.8%) of the 104 patients diagnosed with RVVC were positive for Candida species in their vagina. Candida albicans was identified in 25 women and six were positive for Candida glabrata. When analyzed by PCR, 44 (42.3%) patients were positive for Candida species. In 13 women (12.5%) only the PCR was positive, while in 31 patients both culture and PCR were positive.


CONCLUSIONS
The diagnostic method of PCR is more sensitive than culture in detecting Candida species in the vagina. The results also suggest further investigation to verify the complaints of the negative tested patients.
Weissenbacher
T
T
First Department of Obstetrics and Gynecology, Klinikum Innenstadt, Ludwig-Maximilians-University, Maistrasse 11, Munich, Germany.
Witkin
S S
SS
Ledger
W J
WJ
Tolbert
V
V
Gingelmaier
A
A
Scholz
C
C
Weissenbacher
E R
ER
Friese
K
K
Mylonas
I
I
D002175:Candida / Q000235:genetics / Q000302:isolation & purification*; D002176:Candida albicans / Q000302:isolation & purification; D041221:Candida glabrata / Q000302:isolation & purification; D002181:Candidiasis, Vulvovaginal / Q000175:diagnosis* / Q000382:microbiology*; D046508:Culture Techniques; D004271:DNA, Fungal / Q000032:analysis; D005260:Female; D006801:Humans; D016133:Polymerase Chain Reaction; D012008:Recurrence; D007507:Therapeutic Irrigation; D014621:Vagina / Q000382:microbiology
D004271:DNA, Fungal