title: The dynamic changes of vaginal microecosystem in patients with recurrent vulvovaginal candidiasis: a retrospective study of 800 patients.
abstract: OBJECTIVE
  Vaginal microecological environment is an important factor of recurrent vulvovaginal candidiasis (RVVC). This study was undertaken to investigate dynamic changes of vaginal microecosystem in patients with RVVC.
  
  
  METHODS
  Four hundred patients with VVC and 400 healthy women of reproductive age who admitted to the hospital from January 2012 to December 2013 were evaluated retrospectively. Vaginal microecological factors were evaluated before and after treatment until no recurrence, including vaginal cleanliness, white blood cells, Lactobacillus, Lactobacillus classification, bacteria density, flora diversity, Nugent scores, etc. The grouping was done according to the recurrence of the disease. Every time after treatment, the relapsing patients were defined as case group and the cured patients without recurrence were defined as control group. The differences in the results between the case and the control groups were analyzed by t test.
  
  
  RESULTS
  With the development of RVVC, the ages of all case groups were lower than the corresponding control groups. In different stages of the disease, the bacteria density of the case groups and their corresponding control groups had no significant difference (P > 0.05). Most of the microecological indicators of the first occurring group were significantly different (P < 0.05) from that of the control group. In the recurrence groups, only a few indicators were significantly different from the control groups. The values of all vaginal microecological indicators (except Lactobacillus) of all case groups were higher than that of the control groups. The values of Lactobacillus of all RVVC case groups were lower than that of the RVVC control groups.
  
  
  CONCLUSIONS
  There were vaginal microecological imbalances in all developing stages of RVVC. As for vaginal flora, diverse sorts changed to normal Lactobacillus dominantly with the development of RVVC. In the first occurrence of RVVC, after antifungal treatment, Lactobacillus is suggested to be timely supplemented to restore vaginal microecological balance.
authors.affiliation: Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, No. 20, Section 3, Renmin Nanlu, Chengdu, 610041, Sichuan, China.
authors.forename: Xin-Ai
authors.initials: XA
authors.lastname: Yue
authors.affiliation: Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, No. 20, Section 3, Renmin Nanlu, Chengdu, 610041, Sichuan, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Chen
authors.affiliation: Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, No. 20, Section 3, Renmin Nanlu, Chengdu, 610041, Sichuan, China.
authors.forename: Yuanting
authors.initials: Y
authors.lastname: Tang
authors.affiliation: Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, No. 20, Section 3, Renmin Nanlu, Chengdu, 610041, Sichuan, China.
authors.forename: Xiuli
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, No. 20, Section 3, Renmin Nanlu, Chengdu, 610041, Sichuan, China. huzhengqiangm@163.com.
authors.forename: Zhengqiang
authors.initials: Z
authors.lastname: Hu
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use*; D002176:Candida albicans / Q000302:isolation & purification*; D002181:Candidiasis, Vulvovaginal / Q000382:microbiology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007778:Lactobacillus / Q000378:metabolism*; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014621:Vagina / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000935:Antifungal Agents
keywords: Dynamic change; Lactobacillus; Recurrent vulvovaginal candidiasis; Vaginal microecosystem