A Prospective study of vaginal bacterial flora and other risk factors for vulvovaginal candidiasis
Date
2009-06Author
McClelland, R. S.
Richardson, B. A.
Hassan, W. M.
Graham, S. M.
Baeten, J. M.
Mandaliya, K.
Jaoko Walter G.
Ndinya-Achola JO.
Holmes, K. K.
Kiarie, James Njogu
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
Background. It has been suggested that vaginal colonization with lactobacilli may reduce the risk of vulvovaginal
candidiasis (VVC), but supporting data are limited. Our objective was to determine the relationship between vaginal
bacterial flora and VVC.
Methods. We conducted a prospective cohort analysis that involved 151 Kenyan sex workers. At monthly
follow-up visits, VVC was defined as the presence of yeast buds, pseudohyphae, or both on a wet preparation (includ-
ing potassium hydroxide preparation) of vaginal secretions. Generalized estimating equations were used to identify
correlates of VVC.
Results. Participants returned for a median of 12 visits (interquartile range, 11–12 visits). VVC was identified at
162 visits, including 26 involving symptomatic VVC. Bacterial vaginosis was associated with fewer episodes of VVC
(adjusted odds ratio [aOR], 0.29 [95% confidence interval {CI}, 0.16 – 0.50]). After excluding women with concurrent
bacterial vaginosis, another possible cause of vaginal symptoms, the likelihood of symptomatic VVC was higher
among those who had had yeast identified on wet preparation of vaginal secretions during the past 60 days (aOR, 4.06
[95% CI, 1.12–14.74]) and those with concurrent vaginal Lactobacillus colonization (aOR, 3.75 [95% CI, 1.30 –
10.83]).
Conclusions. Contrary to the commonly posited hypothesis that vaginal Lactobacillus colonization has a protec-
tive effect, we found that such colonization was associated with a nearly 4-fold increase in the likelihood of symptom-
atic VVC.
URI
http://www.ncbi.nlm.nih.gov/pubmed/19456235http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/15397
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2743896/
Citation
J Infect Dis.Publisher
Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya
Collections
- Faculty of Health Sciences (FHS) [10378]