title: Does removal of CU-IUD in patients with biofilm forming candida really maintain regression of clinical symptoms?
abstract: OBJECTIVE
  To evaluate whether symptoms and recurrence would differ with and without Cu-IUD removal in patients with concomitant biofilm forming Candida spp.
  
  
  METHODS
  The data of 270 consecutive patients wearing TCu380A Cu-IUD were evaluated. Among these patients, 100/270 were found to have Candida spp. isolated from the tail of Cu-IUD or vaginal samples. These patients were investigated in four groups: Group 1 (n = 24; Biofilm (+), Cu-IUD removed), Group 2 (n = 14; Biofilm (+), Cu-IUD not removed), Group 3 (n = 29; Biofilm (-), Cu-IUD removed), Group 4 (n = 33; Biofilm (-), Cu-IUD not removed). Patients in each group were followed for clinical signs and symptoms for 8-16 months and compared to each other.
  
  
  RESULTS
  Symptoms, physical findings and candida positivity have decreased statistically significantly in Group 1 one year after removal of Cu-IUD (95.8% vs. 4.2%, p < 0.01; 95.8% vs. 4.2%, p < 0.01; 100% vs. 8.3%, p < 0.01 respectively). In Group 2, symptoms, physical findings and candida positivity have decreased after follow-up, but without a statistical significance. In Group 3, all the parameters have decreased, but only decrease in candida positivity has reached statistical significance (100% vs. 48.3%, p < 0.01). In Group 4 - as in Group 1- symptoms, physical findings and candida positivity have decreased statistically significantly (48.5% vs. 18.2%, p = 0.01; 72.7% vs. 48.5%, p = 0.05; 100% vs. 51.5%, p < 0.01 respectively).
  
  
  CONCLUSIONS
  Biofilm forming microorganisms should be considered in the management of vaginal infections or symptoms for safer use of intrauterine devices.
authors.affiliation: a Department of Obstetrics and Gynecology , School of Medicine, Kocaeli University , Kocaeli , Turkey.
authors.forename: Y
authors.initials: Y
authors.lastname: Cakiroglu
authors.affiliation: b Department of Clinical Microbiology , Sakarya University Education and Research Hospital , Sakarya , Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Caliskan
authors.affiliation: a Department of Obstetrics and Gynecology , School of Medicine, Kocaeli University , Kocaeli , Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Doger
authors.affiliation: c Department of Clinical Microbiology , Kocaeli University , Kocaeli , Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Ozcan
authors.affiliation: a Department of Obstetrics and Gynecology , School of Medicine, Kocaeli University , Kocaeli , Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Caliskan
mesh_terms: D000328:Adult; D018441:Biofilms / Q000254:growth & development*; D002175:Candida / Q000254:growth & development* / Q000302:isolation & purification; D002181:Candidiasis, Vulvovaginal / Q000628:therapy*; D005260:Female; D006801:Humans; D007435:Intrauterine Devices, Copper / Q000009:adverse effects / Q000382:microbiology*; D008875:Middle Aged; D012008:Recurrence
keywords: Biofilm; fertility control; general obstetrics; intrauterine device; vulvovaginal candidiasis