Pathogeny And Epidemiology Research Of Candidal Vaginitis In Baicheng City

Candidal vaginitis is a ubiquitous genital system infection in almost all Caste’sreproductive life women and also a common disease in clinic which have chronic inflammatoryconnective tissue of female vagina mucosa and submucosa. With the20-25%possession ofvulvovaginitis which is the second one only to bacterial vaginitis. Clinical research showed thatthe healthy woman vagina have the function of defensing the harmful pathogens invasion andkeeping the body healthy. The Candidal vaginitis will occur When the endovaginalmicroenvironment changed which causing vulvovaginitis. C. albicans outbreaking who is themost frequent pathogen of candidal vaginitis.Candidal vaginitis often occurred in the women between puberty and menopause, mainlyin reproductive life. Long term and bulk use of antibiotic, use of oral contraceptive andspermicide,hormone replacement therapy, diabetes, wear Chemical fiber underpants, flushesthe vagina frequently or pay no attention to cleanly, tiredness, pregnancy and frequent vitasexualis would increase disease incidence. Candida sp. is a kind of normal presence microbialpopulation in vagina.When the endovaginal microenvironment changed, it causedvulvovaginitis. C.albicans is the most frequent pathogen of candidal vaginitis, with possess85-90%. Non-C.albicans infections mainly occurred in immunity impaired women. Recently,for the widespread use of antibiotics, candidal vaginitis caused by C.glabrata, C. krusei, C.tropicalis and C. parapsilosis increase gradually.Objective: To study the distribution and proportion of Candida vaginitis pathogen in theBaicheng city; To understand the paroxysmal age, high season and risk factors of Candidavaginitis by collecting epidemiological survey data; To explore the drug resistance of clinicalisolates to5-fluorocytosine, fluconazole, amphotericin B and itraconazole; To analysis the roleof ITS-SSCP in clinical yeast species identification.Methods: The specimens were collected from suspected Candida vaginitis patients, who came from Baicheng City Central Hospital, during July2012and July2013. Theepidemiological questionnaires which include general information and disease-relatedconditions were filled out by the patients. The specimens were examined by direct microscopyand Gram staining. After that, the identification were done by used CHROMagar medium andITS sequencing. The drug sensitivity of the clinical isolates were tested to5-FC, FCZ, AmBand ICZ, by microdilution method according to M27-A2. ITS-SSCP was used to observed theinterspecific differences and intraspecific similarities between main clinical Candida sp.Results:166cases of suspected Candida vaginitis samples were collected in Baicheng city.Among them,118strains of yeast were isolated and incubated, the positive isolation rate was71.1%. The results of the identification118strains yeast as followed: Candida albicans60strains, C. glabrata35strains, C. tropicalis18strains C. krusei1strain, C. parapsilosis1strain,Pichia kudriavzevii2strains. The epidemiology investigation showed that the paroxysmal agebetween21-39years old, high season was summer and autumn, times of pregnancy, abortion,sexual life frequency, taking birth control pills, wearing tight underwear, and frequently usedchemical cleaning liquid were the main predisposing factors. The sensitivity rate of116strains5species of Candida sp.(C. albicans, C. glabrata, C. tropicalis, C. krusei, C.parapsilosis) to5-FC, AmB, FCZ and ICZ were respectively97.4%,99.1%,96.6%, and82.8%.The approach of ITS-PCR-SSCP showed great interspecific differences and intraspecificsimilarities between C. albicans, C. glabrata, C. tropicalis, C. krusei, C. parapsilosis.Conclusion: It is demonstrated for the first time that the occurrence of vaginitis yeastCandida in Baicheng city and its predisposing factors, revealed the distribution of pathogen,analyzed the sensitivity of Candida sp. clinical isolates to main antifungal drugs, discussed theapplication of ITS-PCR-SSCP in identification of clinical yeast strains. This study providedexperimental basis for effective prevention, rational medication, and accurate identificationpathogens for Candida vaginitis.