Article

Genital Candida species detected in samples from women in Melbourne, Australia, before and after treatment with antibiotics

Department of General Practice, University of Melbourne, 200 Berkeley Street, Carlton, Victoria 3053, Australia.
Journal of Clinical Microbiology (Impact Factor: 4.23). 10/2006; 44(9):3213-7. DOI: 10.1128/JCM.00218-06
Source: PubMed

ABSTRACT Vulvovaginal candidiasis (VVC) remains a common cause of morbidity, with three-quarters of women affected during their lifetimes. Use of antibiotics is an acknowledged trigger for VVC, which adversely affects women's physical and emotional health. Knowledge of patterns of genital Candida species-level identification is important for management, as Candida species other than Candida albicans often fail first-line treatment. A community sample of women with no vaginal symptoms, and who were prescribed antibiotics, was recruited into this study, where the incidence of genital colonization by various Candida species was documented, as well as symptoms of VVC plus relevant associations, before and after treatment with antibiotics. Self-collected low vaginal swabs were taken prior to and 8 days after completion of antibiotic treatment, and data on various potential risk factors for VVC were collected simultaneously, with complete data being available for 233 participants. Baseline Candida species colonization was present in 21% of women (95% confidence intervals [CI], 17% to 27%), rising to 37% (95% CI, 31% to 44%) after antibiotic treatment. The primary species detected for either period was C. albicans (73%), with Candida glabrata detected in around 20%. Self-assessed proneness to VVC after antibiotic treatment and baseline colonization with Candida spp. were significantly associated with symptomatic VVC after antibiotic treatment. For microbiologically proven candidiasis, VVC symptoms had a sensitivity of 57% and a specificity of 91%. When physicians prescribe antibiotics, the history of risk of VVC is one issue that physicians should discuss with women, particularly those who are self-identified as being prone to VVC. Furthermore, we recommend that definitive microbiological diagnoses be made for women with recurrent symptoms or those failing initial treatment, to guide appropriate therapy.

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    • "Widespread antibiotic therapy used to treat throat infections could also affect the mammary gland microbiota and lead to mastitis. Conversely, broad range antibiotics to treat mastitis are linked to a variety of adverse effects, including urinary infections and vaginal candidiasis [32]. Microbial habitats in the human body, including the skin, constitute a network of interrelated communities [33]. "
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    ABSTRACT: Background The purpose of this study was to identify potential predisposing factors associated with human infectious mastitis. Methods We conducted a case–control study among breastfeeding women, with 368 cases (women with mastitis) and 148 controls. Data were collected by a questionnaire designed to obtain retrospective information about several factors related to medical history of mother and infant, different aspects of pregnancy, delivery and postpartum, and breastfeeding practices that could be involved in mastitis. Bivariate analyses and multivariate logistic regression model were used to examine the relationship between mastitis and these factors. Results The variables significantly- and independently-associated with mastitis were cracked nipples (P < 0.0001), oral antibiotics during breastfeeding (P < 0.0001), breast pumps (P < 0.0001), topical antifungal medication during breastfeeding (P = 0.0009), mastitis in previous lactations (P = 0.0014), breast milk coming in later than 24 h postpartum (P = 0.0016), history of mastitis in the family (P = 0.0028), mother-infant separation longer than 24 h (P = 0.0027), cream on nipples (P = 0.0228) and throat infection (P = 0.0224). Conclusions Valuable factors related to an increased risk of infectious mastitis have been identified. This knowledge will allow practitioners to provide appropriate management advice about modifiable risk factors, such as the use of pumps or inappropriate medication. They also could identify before delivery those women at an increased risk of developing mastitis, such as those having a familial history of mastitis, and thus develop strategies to prevent this condition.
    BMC Pregnancy and Childbirth 06/2014; 14(1):195. DOI:10.1186/1471-2393-14-195 · 2.15 Impact Factor
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    • "Beigi et.al., (2004) found that within a group of women repeatedly screened over 12 months, 30% were never colonized, 70% were colonized on at least one occasion, and 4% were persistently colonized. Higher rates of vaginal carriage have been found in pregnant women, women colonized by Lactobacillus spp (Beigi et al., 2004; Hamad et al., 2006), type I diabetics (de Leon et al., 2002), and post-antibiotic treatment (Pirotta and Garland, 2006). Table 2 gives a brief summary of risk factors for localized and systemic candidiasis in general. "
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    • "Beigi et.al., (2004) found that within a group of women repeatedly screened over 12 months, 30% were never colonized, 70% were colonized on at least one occasion, and 4% were persistently colonized. Higher rates of vaginal carriage have been found in pregnant women, women colonized by Lactobacillus spp (Beigi et al., 2004; Hamad et al., 2006), type I diabetics (de Leon et al., 2002), and post-antibiotic treatment (Pirotta and Garland, 2006). Table 2 gives a brief summary of risk factors for localized and systemic candidiasis in general. "
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    ABSTRACT: Abstract In recent decades, many fungal species have emerged as major causes of human disease. While invasive candidiasis, aspergillosis, and cryptococcosis remain very common, rates of infection by other opportunistic fungal pathogens such as Histoplasma capsulatum, Coccidioides immitis, Fusarium spp. and other yeasts and molds are on the rise. Adding to this bleak picture is the fact that treatment and control measures currently available to us are hardly able to keep up with current trends of morbidity and mortality that associate with common and emerging fungal infections. It is interesting to note the likelihood of emerging fungal pathogens exhibiting significant resistance to standard antifungal therapy is real. Hence, invasive infections due to previously rare fungi such as Acremonium, Scedosporium, Paecilomyces, and Trichoderma species are proving difficult to treat. The ever increasing number of hosts with compromised immunity, increased volume of surgeries and invasive medical procedures, limited repertoire of and increased resistance to available antifungals, and better diagnosis and pathogen identification procedures are largely to blame for these alarming trends. Improvements in managing patients with cancer, AIDS, diabetes, and transplantation that are significantly improving patient survival rates are also generously contributing to the pool of patients with compromised immunity. In this article, we review the changing spectrum of invasive mycosis, risk-factors for infections and susceptibility to available antifungals. Keywords: Aspergillus, Antifungal Drugs, Candida, Compromised Immunity, Cryptococcus, Histoplasma, Invasive Mycosis. * Corresponding author e-mail: salma@hu.edu.jo 1. Introduction The incidence of invasive fungal infections (IFIs) and rates of morbidity and mortality due to such infections have all been on the rise over the last three decades (Binder et al., 2011; Low et al., 2011). Although Candida albicans, Aspergillus fumigatus and Cryptococcus neoformans are the most common causes of IFIs (Pfaller and Diekema, 2004a), the incidence of infection by Candida spp. other than C. albicans, Aspergillus spp. other than A. fumigatus, opportunistic yeast-like fungi (Trichosporon spp., Rhodotorula spp. and Geotrichum capitatum [Blastoschizomyces capitatus]), zygomycetes; hyaline molds (Fusarium, Acremonium, Scedosporium, Paecilomyces, and Trichoderma spp), and a wide variety of dematiaceous fungi are all on the rise (table 1). The emergence of organisms such as Fusarium spp., Histoplasma capsulatum, Coccidioides immitis as significant pathogens has important implications for diagnosis and management. On the one hand, the clinical presentation of infections caused by such pathogens can mimic more common diseases (e.g. aspergillosis). On the other hand, these emerging pathogens are resistant to conventional antifungals making infection management difficult to say the least (Fleming et al., 2002;
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