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Growing importance of urogenital candidiasis in individuals with diabetes:A narrative review

World Journal of Diabetes 2022年第10期13卷 809-821页

作者： Jasminka Talapko Tomislav Meštrović IvanaŠkrlec Laboratory for Microbiology Faculty of Dental Medicine and HealthJosip Juraj Strossmayer University of OsijekOsijek 31000Croatia University North University Centre VaraždinVaraždin 42000Croatia Institute for Health Metrics and Evaluation Department for Health Metrics SciencesUniversity of Washington School of MedicineSeattleWashington 98195United States Department of Biophysics Biologyand ChemistryFaculty of Dental Medicine and HealthJ.J.Strossmayer University of OsijekOsijek 31000Croatia

Both diabetes and fungal infections contribute significantly to the global disease burden,with increasing trends seen in most developed and developing countries during recent decades.This is reflected in urogenital infections caused by Candida species that are becoming ever more pervasive in diabetic patients,particularly those that present with unsatisfactory glycemic control.In addition,a relatively new group of anti-hyperglycemic drugs,known as sodium glucose cotransporter 2 inhibitors,has been linked with an increased risk for colonization of the urogenital region with Candida spp.,which can subsequently lead to an infectious process.In this review paper,we have highlighted notable virulence factors of Candida species(with an emphasis on Candida albicans)and shown how the interplay of many pathophysiological factors can give rise to vulvovaginal candidiasis,potentially complicated with recurrences and dire pregnancy outcomes.We have also addressed an increased risk of candiduria and urinary tract infections caused by species of Candida in females and males with diabetes,further highlighting possible complications such as emphysematous cystitis as well as the risk for the development of balanitis and balanoposthitis in(primarily uncircumcised)males.With a steadily increasing global burden of diabetes,urogenital mycotic infections will undoubtedly become more prevalent in the future;hence,there is a need for an evidence-based approach from both clinical and public health perspectives.

关键词： Balanitis Balanoposthitis Candida Candidiasis Diabetes Pregnancy Urogenital infections vulvovaginitis

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Clinical presentation, diagnosis and treatment of vulvovaginitis in girls: a current approach and review of the literature

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World Journal of Pediatrics 2017年第2期13卷 101-105页

作者： (I)lke Beyitler Salih Kavukcu Department of Pediatrics Near East University HospitalNicosiaNorth Cyprus Department of Pediatrics Division of NephrologyNear East University HospitalNicosiaNorth Cyprus

Background:vulvovaginitis is the most common cause of gynecological complaints in children and young girls.Some of the factors which cause vulvovaginitis include hypoestrogenism,the anatomical proximity of rectum and delicate vulvar skin and vaginal mucosa.Data sources:We made a literature search with Pubmed,Medline and Cochrane database from January 2002 to May 2015 in English language using the key words vulvovaginitis,children,clinical,diagnosis and treatment.Results:vulvovaginitis in girls is usually caused by non-specific factors and hygiene measures,bioyoghurt and avoidance of chemical irritants are generally useful.Weight control if necessary and prevention of voiding dysfunction are effective.Vaginal flora is important in girls and results should be interpreted with clinical features to decide whether an isolated microorganism is part of the normal microflora or is the cause of symptomatic vulvovaginitis.Specific treatment is generally considered in case of a detected pathogen microorganism.Isolation of a sexually transmitted organism requires further investigation.Persistent disease may not always indicate a foreign body but it must be taken into account.Girls and parents are encouraged psychologically in all steps of evaluation,diagnosis and treatment.Probiotics,nanotechnology and petroleum jelly are other important treatment options used in vulvovaginitis.Conclusions:In this review,we present current approach to the presentation and management of vulvovaginitis in childhood.This disorder requires a comprehensive evaluation in all steps of diagnosis,differential diagnosis and treatment.

关键词： children diagnosis treatment vulvovaginitis

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Clinical and microbiological features of vulvovaginitis in Mexican girls

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Open Journal of Obstetrics and Gynecology 2013年第2期3卷 243-248页

作者： Mario I.Ortiz Edna J.Arreola-Bautista Beatriz A.Sánchez-Reyes Georgina Romo-Hernández Marco A.Escamilla-Acosta Area Académica de Medicina del Instituto de Ciencias de la Salud de la Universidad Autónoma del Estado de Hidalgo PachucaHidalgoMexico Universidad del Futbol y Ciencias del Deporte San Agustín TlaxiacaHidalgoMexico Hospital del Nino DIF Hidalgo PachucaHidalgoMexico

Study Objective: To determine the prevalence of vulvovaginitis, predisposing factors, microbial etiology and therapy in patients treated at the Hospital del Nino DIF, Pachuca, Hidalgo, Mexico. Design. This was an observational and descriptive study from 2006 to 2009. Setting: Hospital del Nino DIF, Pachuca, Hidalgo, Mexico. Participants. Patients from 0 to 16 years, with vulvovaginitis and/or vaginal discharge were included. Interventions: None. Main Outcome Measures: Demographic data, etiology, clinical features, risk factors and therapy were analyzed. Results: Four hundred twenty seven patients with diagnosis of vulvovaginitis were included. The average prevalence to 4 years in the study period was 0.19%. The age group most affected was schoolchildren (225 cases: 52.69%). The main signs and symptoms presented were leucorrhea (99.3%), vaginal hyperemia (32.6%), vulvar itching (32.1%) and erythema (28.8%). Identified risk factors were poor hygiene (15.7%), urinary tract infection (14.7%), intestinal parasites (5.6%) and obesity or overweight (3.3%). The main microorganisms found in vaginal cultures were enterobacteriaceae (Escherichia coli, Klebsiella and Enterococcus faecalis), Staphylococcus spp, and Gardnerella vaginalis. Several inconsistent were found in the drug prescription of the patients. Conclusion: vulvovaginitis prevalence in Mexican girls is low and this was caused mainly by opportunist microorganisms. The initial treatment of vulvovaginitis must include hygienic measure and an antimicrobial according to the clinical features and microorganism found.

关键词： vulvovaginitis Prevalence Etiologic Microorganisms Mexican Children and Adolescents

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Change in Vaginal Flora as Indicated by Pap Smear (Schröder’s Classification) in Women Using Levonorgestrel-Releasing Intrauterine System “Mirena”—Prospective Cohort Study

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Open Journal of Obstetrics and Gynecology 2019年第5期9卷 631-642页

作者： Malames M. Faisal Magdy M. Abdel-Gawad Ragia A. Fahmy Mona S. Nour Marwa M. Shakweer Ahmed H. Abdel-Hakim Department of Obstetrics and Gynecology Faculty of Medicine Ain Shams University Cairo Egypt Early Cancer Detection Unit Faculty of Medicine Ain Shams University Cairo Egypt Department of Microbiology Faculty of Medicine Ain Shams University Cairo Egypt Department of Pathology Faculty of Medicine Ain Shams University Cairo Egypt

Background: The use of intrauterine device alters the normal balance between vaginal flora. It might change cervicovaginal environment, which was suggested to increase the risk for vulvovaginitis. It was found that up to 85% of levonorgestrel-releasing intrauterine system users become amenorrheic 4 months after insertion, or bleed only sporadically. It was hypothesized that this would have a beneficial effect on vaginal flora maintaining normal balance. Objectives: The aim of this study was to detect the effect of hormonal intrauterine system (“Mirena”: 20 microgram/24 hours intrauterine delivery system Levonorgestrel) on vaginal flora by using pap smear before and 6 months after insertion. Study design: A prospective cohort study was carried out in a university maternity hospital. 210 subjects were included with pap smear taken at time of insertion of IUS “Mirena” and another one taken 6 months later to detect percentage of incidence of infection in IUS users. Vaginal flora was studied, and lactobacilli were graded according to Schr?der’s classification. A comparison was made to allow detection of changes in vaginal flora caused by presence of hormonal IUS “Mirena”. Results: Over half of cases (57.2%) showed worse vaginal flora after hormonal IUS “Mirena” insertion than before. There was a highly statistically significant difference between Schr?der’s Grades before and after insertion (P value < 0.001) as 44.8% of cases presented by Grade I, 44.4% of cases presented by grade IIa, 38% of cases presented by grade IIb before insertion developed Grade III after insertion. Conclusion: Insertion of hormonal IUS “Mirena” results in significant change in microbial flora towards pathological bacteria.

关键词： IUD Bacterial Vaginosis Lactobacilli vulvovaginitis Mirena Contraception

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