title: Pathogenicity of non-albicans yeasts in the vagina.
abstract: OBJECTIVE
  It is hypothesized that vaginal non-albicans yeasts (NAYs) do not require treatment. The objective was to determine whether women (presenting with a range of vulvovaginal complaints) found to be harboring NAY, which is left untreated (no antifungals), have similar clinical outcomes to women with comparable presentations but who do not harbor NAY.
  
  
  METHODS
  This is a case-control study design comparing patient outcomes between women with untreated non-albicans Candida on vaginal swab cultures and those who were swab culture-negative.
  
  
  METHODS
  A Melbourne metropolitan, private gynecologic and obstetric practice.
  
  
  METHODS
  Women presenting with vulvovaginal symptoms or management of pregnancy, who attended the above practice between 2001 and 2006.
  
  
  METHODS
  Fifty-two women were found to have NAY on culture of their vaginal swabs. They were prospectively studied to determine the effect of leaving the NAY untreated (no antifungals) but with appropriate attention to their other diagnoses. Seventy-eight symptomatic women with negative swab cultures were used as the comparison group, and descriptive statistics was computed to compare patient outcomes between the groups. A subanalysis was also carried out, only looking at women who presented with pruritus.
  
  
  METHODS
  Proportion of patients self-reporting improvement in symptoms.
  
  
  RESULTS
  Of the 44 women with NAY who presented with symptoms, 86% reported experiencing improvement. Approximately 77% of the women in the comparative group reported improvement.
  
  
  CONCLUSIONS
  Non-albicans yeasts found on culture of a vaginal swab can probably be ignored. The clinician's efforts should be concentrated on making a correct diagnosis without assuming that NAY are pathogenic.
authors.affiliation: Western Health Sunshine Hospital, Melbourne, Australia. gragrazdenn@smartchat.net.au
authors.forename: Graeme J
authors.initials: GJ
authors.lastname: Dennerstein
authors.forename: David H
authors.initials: DH
authors.lastname: Ellis
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Reed
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Bennett
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D001315:Australia; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy* / Q000382:microbiology*; D011247:Pregnancy; D016896:Treatment Outcome; D014848:Vulvovaginitis / Q000188:drug therapy* / Q000382:microbiology*; D015003:Yeasts / Q000302:isolation & purification* / Q000472:pathogenicity*