OBJECTIVE: A review of recurrent vulvovaginal candidiasis and the possibility of its treatment. SUBJECT: Original study. SETTING: Department of Obstetrics and Gynaecology, Medical Faculty Hradec Králové, Charles University, Prague. Department of Clinical Microbiology, Medical Faculty Hradec Králové, Charles University, Prague. Department of Biological and Medical Sciences, Faculty of Pharmacy Hradec Králové, Charles University, Prague. Department of Clinical Imunology and Allergology, Medical Faculty Hradec Králové, Charles University, Prague. Department of Psychiatry, Medical Faculty Olomouc, Palacky University, Olomouc. METHODS: Analysis and discussion focused especially on our results and experience in a long time followup of patients with confirmed recurrent vulvovaginal candidiasis. CONCLUSION: Owing to the multifactorial character of etiopathogenesis, the management of recurrent vulvovaginal candidiasis would be taken into consideration the complexity of the disease, not only the treatment of individual episodes with antimycotics.

• MeSH
• kandidóza vulvovaginální farmakoterapie   prevence a kontrola   terapie   MeSH
• lidé MeSH
• recidiva MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH

OBJECTIVE: A review of the role of yeasts in indigenous microbiota with the focus on urogenital tract. The yeast in vaginal environment and their relation to acute and recurrent form of vulvovaginal candidiasis. DESIGN: A review. SETTING: Department of Obstetrics and Gynecology, Department of Urology, Medical Faculty, Charles University, Hradec Králové. SUBJECT AND METHODS: Review of current literature data with the contribution on own experience. CONCLUSIONS: Vulvovaginal candidiasis is one of the most frequent complaints in patients attending gynecologist. Recurrent form of this disease is still an unsolved problem because the etiopathogenesis is unexplained and successful therapeutic management from the point of view of next attacks is very difficulty.

• MeSH
• Candida růst a vývoj   MeSH
• kandidóza vulvovaginální diagnóza   mikrobiologie   terapie   přenos   MeSH
• lidé MeSH
• močové ústrojí mikrobiologie   MeSH
• urogenitální systém mikrobiologie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

• MeSH
• kandidóza vulvovaginální * mikrobiologie   patofyziologie   přenos   MeSH
• lidé MeSH
• recidiva MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Vulvovaginal candidiasis remains one of the most frequently diagnosed inflammatory diseases of the vagina, which affects most sexually active women. In most patients, it is manifested as acute inflammation which is easy to diagnose and treat. However, in the susceptible population, it may be characterized by recurrent episodes, usually with an unknown cause or exacerbating moment. These facts complicate the diagnosis and therapy. This is highlighted by both non-specific symptoms shared with many other vaginal infections and paucity of reliable signs for diagnosis. Under these circumstances, it is difficult to associate vaginal complaints with yeasts and, vice versa, the presence of yeasts does not necessarily confirm fungal aetiology. Therefore, it is better to regard the condition as a syndrome and the chronic problems as vulvovaginal discomfort. It is a prerequisite for an unbiased diagnostic approach, increasing the probability of finding the real cause of the problem and the chances of treating or even curing the disease. The article is concerned with controversial and problematic aspects of diagnosis and treatment of vulvovaginal candidiasis with a focus on laboratory diagnosis, terminology, epidemiology and ecology of yeasts in relation to vaginal microbiota and, last but not least, on alternative therapeutic approaches.

• MeSH
• diferenciální diagnóza MeSH
• kandidóza vulvovaginální diagnóza   farmakoterapie   MeSH
• lidé MeSH
• recidiva MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH

OBJECTIVE: This study was undertaken to characterize systemic immunity in the patients with recurrent vulvovaginal candidiasis. SUBJECT: Original prospective study. SETTING: 1. Department of Biological and Medical sciences, Charles University in Prague, Faculty of Pharmacy, Hradec Kralove, 2. Department of Obstetrics and Gynaecology, Medical Faculty, Hradec Kralove, Charles University in Prague, 3. Department of Clinical Immunology and Allergology, University Hospital, Hradec Kralove, 4. Department of Clinical Microbiology, University Hospital, Hradec Kralove, Czech republic. SUBJECT AND METHOD: Basic immunological parameters in 44 patients with recurrent vulvovaginal candidiasis were investigated and analyzed in this longitudinal follow-up study. CONCLUSION: Although there is no fundamental disturbance in systemic immunity in patients with recurrent vulvovaginal candidiasis and the majority of systemic immunological parameters in the patients were within normal range, some subtle changes of a few parameters of humoral and cellular immunity in contrast to the controls were identified.

• MeSH
• dospělí MeSH
• kandidóza vulvovaginální imunologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• recidiva MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

OBJECTIVE: Phase I: A prospective evaluation of long-term systemic enzyme therapy (Wobenzym; WE) effects on the frequency of recurrent vulvovaginal candidiasis (RVVC) episodes. Phase II: A retrospective analysis of possible positive effects remaining in the next 3 years. TRIAL DESIGN: Original work - pilot project consisting of prospective phase I and retrospective phase II trials. METHODS: Composition of animal and plant proteo-lytic enzymes (WE) is a common component in the treatment of chronic or recurrent inflammatory diseases and has been also shown to have immunomodulatory effects. Project involving 7 gynecology practices has been started in 2005 - 2007 to evaluate the effectiveness of WE in the complex treatment of RVVC. The trial involved 62 women with at least 4 microscopically confirmed episodes of RVVC in the last 12 months (year 1; 4-9 episodes, mean 4.4 episodes per patient-year). From the beginning of the trial, participants took WE in the dose of 2× 8 tbl/day for 10 weeks and were monitored for 12 months (year +1). All infections of RVVC were treated according to usual practice of the particular gynecologist. The number of RVVC episodes during the year -1 was compared to the number of RVVC during the year +1. To evaluate possible long-term effects of the WE treatment, retrospective analysis of the data from 3 years following the phase I (year +2, +3, +4) was performed. Complete data for 54 women were collected (87.1% of the former group of patients). All data were processed with regular statistics methods. RESULTS: Mean number of RVVC in the year +1 has decreased from 4.4 to 0.5 per patient-year (i.e. by 88.5%; p < 0.001). All women experienced an improvement, 63% of them experienced no recurrence. The lower incidence of RVVC remained also for the phase II (year +2: 0.91; year +3: 0.57; year +4: 0.52 episodes of RVVC per patient-year). The difference, as compared to the mean incidence of RVVC before the treatment (year -1), remains significant (p < 0.001) although women, who became pregnant during the trial, were not excluded from the observed population. If only non-pregnant women were analyzed (41 women), the mean incidence of RVVC was even lower (year +2: 0.69; year +3: 0.39; year +4: 0.44 episodes of RVVC per patient-year). CONCLUSION: 10 weeks of systemic enzyme therapy (WE) in women with RVVC significantly reduced recurrence of this disease not only for the first year following the treatment, but also for the next 3 years. An explanation of the basis for this effect needs further research.

• MeSH
• enzymoterapie * MeSH
• kandidóza vulvovaginální farmakoterapie   epidemiologie   MeSH
• lidé MeSH
• prospektivní studie MeSH
• proteasy terapeutické užití   MeSH
• recidiva MeSH
• retrospektivní studie MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze II MeSH
• Názvy látek
• proteasy MeSH

OBJECTIVE: Analysis of the prevalence and species representation of pathogenic yeasts in patients with vulvovaginal candidiasis. Determination of in vitro susceptibility of yeast isolates to clinically used antimycotic agents. DESIGN: A retrospective clinical study of patients with positive vaginal cultures for the presence of pathogenic yeast species. SETTING: I. gynekologicko-pôrodnícka klinika LF UK a FN, Zochova 7,811 03 Bratislava, Slovenská republika. METHODS: Identification of yeast pathogens on the chromogenic medium CHROMagar CANDIDA and with API-CANDIDA identification system. In vitro susceptibility assays of clinical yeast isolates to antifungal agents using the plate dilution method, NCCLS method and ATB-FUNGUS test system. RESULTS: The highest prevalence of vulvovaginal candidasis was found in women aged between 20-30 years. Candida albicans was the most commonly identified species of pathogenic yeasts (87.4%). Of the non-albicans species, C. glabrata (6.3%) was the most prevalent species. C. glabrata and C. krusei clinical isolates were found to be generally less susceptible to several antifungals in vitro as compared to C. albicans strains. A minimal number of resistant yeast isolates was observed for econazole, clotrimazole and nystatin. A relatively high number of resistant strains was observed for some other azole antifungals (miconazole, ketoconazole, itraconazole, fluconazole). CONCLUSION: A successful treatment of vaginal mycotic infections requires the results of the microbiological analyses. They will bring evidence to a physician of the presence and fate of the pathogen, of its sensitivity to antifungals, both of which are essential for the rational and successful therapy of Candida vaginitis.

• MeSH
• antifungální látky farmakologie   MeSH
• Candida účinky léků   izolace a purifikace   MeSH
• dospělí MeSH
• fungální léková rezistence * MeSH
• kandidóza vulvovaginální mikrobiologie   MeSH
• lidé MeSH
• mikrobiální testy citlivosti MeSH
• retrospektivní studie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antifungální látky MeSH

OBJECTIVE: Aim of this study was to ascertain the prevalence of differrent candida strains and their sensitivity to different antimycotic treatment in women with vulvovaginal candidosis. DESIGN: Prospective study. SETTING: Department of Obstetrics and Gynecology, 1st Faculty of Medicine and the General Faculty Hospital, Charles University, Prague. UKLB, Clinical microbiology and ATB center, 1st Faculty of Medicine and the General Faculty Hospital, Charles University, Prague. Department of Obstetrics and Gynecology, Hospital Milosrdných bratrí, Brno. PATIENTS: 124 women with symptomatic vulvovaginal candidosis were included in the study between January and October 2003. After complete clinical exam, vaginal pH, wet prep, the cultures were taken for special fungal examination. RESULTS: In 92% of patient was confirmed infection with C. albicans, from topical antifugal agents were most sensitive to nystatin and pimaricin (100% cases), from oral antifugal agents to fluconasol, itraconasol and ketokonasol in 97-98% cases. C. nonalbicans strains were confirmed in 8% cases of vaginitis and there were similiar sensitivity to topical antifugal agents as in C. albicans strains. To oral antifugal agents there were in 10% resistance to fluconasol and in 20% to itraconasol. CONCLUSION: In this study we did not confirmed the higher prevalence of C. nonalbicans strains in vulvovaginal candidiasis, in literature the prevalence is 10-15%. We did not confirmed the increasing resistance to antifugal agents.

• MeSH
• antifungální látky farmakologie   MeSH
• Candida účinky léků   izolace a purifikace   MeSH
• dospělí MeSH
• fungální léková rezistence * MeSH
• kandidóza vulvovaginální mikrobiologie   MeSH
• lidé MeSH
• vagina mikrobiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antifungální látky MeSH

OBJECTIVE: To evaluate the microbiological findings in the patients with the recurrent vulvovaginal candidiasis (RVVC) with a focus on the establishment of fungal etiology and its in vitro antifungal susceptibility. DESIGN: Retrospective clinical and laboratory study. SETTING: Department of Obstetrics and Gynecology, Medical Faculty Hradec Králové, Charles University, Prague, Department of Clinical Microbiology, Medical Faculty Hradec Králové, Charles University, Prague, Department of Biological and Medical Sciences, Faculty of Pharmacy Hradec Králové, Charles University, Prague. METHODS: An analysis of clinical and anamnestic data in outpatients of the Dept. of Obstetrics and Gynecology and the laboratory data from the microbiological examinations performed in the Dept. of Clinical Microbiology from 1995 to 2002. RESULTS: Candida albicans accounted for 88.5% of the episodes of RVVC in the setting of 56 patients. Non-albicans Candida species were represented especially by C. glabrata (4.9%) and C. krusei (3.1%). There were no considerable differences between the spectrum of RVVC and acute vulvovaginal candidiasis with the exception of Saccharomyces cerevisiae (0.7% in RVVC vs. 3.7% in acute VVC). Mycological findings in 61 (20.5%) samples were accompanied by bacterial microbiota with the predominance of Streptococcus agalactiae (n = 15) and Gardnerella vaginalis (n = 9). Decreased antifungal susceptibility determined by the disk test was observed in the strains of C. glabrata, C. krusei and S. cerevisiae, the other yeast isolates being susceptible to all ten antifungal drugs tested. CONCLUSION: The microbiological examination was decisive for the establishment of the diagnosis of RVVC in most cases. The most frequent etiological agents responsible for the attacks of RVVC as well as for acute vulvovaginal candidiasis was C. albicans, which was generally susceptible to antifungal drugs.

• MeSH
• akutní nemoc MeSH
• antifungální látky farmakologie   MeSH
• Bacteria izolace a purifikace   MeSH
• Candida izolace a purifikace   MeSH
• kandidóza vulvovaginální mikrobiologie   MeSH
• lidé MeSH
• mikrobiální testy citlivosti MeSH
• recidiva MeSH
• Saccharomyces cerevisiae izolace a purifikace   MeSH
• vagina mikrobiologie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antifungální látky MeSH

• MeSH
• kandidóza vulvovaginální farmakoterapie   MeSH
• lidé MeSH
• nystatin terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• nystatin MeSH