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Cited by 7Reproductive tract infections researchAntifungal resistance and susceptibilityYeasts and Rust Fungi Studies

Quantitative system for diagnosis of vulvovaginal candidiasis

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Dermendzhiev, T, Pehlivanov, B, Petrova, A, Stanev, S., Murdjeva, M.·2022·Journal of Medical Mycology
DOI 10.1016/j.mycmed.2022.101302
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Abstract

INTRODUCTION: Vaginal infections are one of the most common reason for gynecological consultations. Many of them are the result of overgrowth of resident microorganisms. The clinical symptoms of vulvovaginal candidiasis are nonspecific and an accurate diagnosis is a problem that often leads to inadequate treatment or delays in treatment. The lack of an exact and practical diagnostic method is a common cause of misdiagnosis. AIM: To create a complex, quantitative method for the diagnosis of vulvovaginal candidiasis which to enables differentiation from vaginal fungal colonization. MATERIAL AND METHODS: A total of 2306 vaginal samples were examined. Clinical, microbiological, epidemiological methods and statistical models are used. RESULTS AND DISCUSSION: The proposed score system is a specific, sensitive and inexpensive method to routinely diagnose vulvovaginal candidiasis. Statistical processing of the obtained data shows the impact of the individual components on which the method is based: the presence of vaginal discharge, pruritus, direct microscopy and assessment of the fungal growth. The data analysis reveals good sensitivity (71%) and high specificity (98%) of the method. This allows accurate interpretation of the result of the clinical and microbiological examination of each patient. CONCLUSION: The system for diagnosing vulvovaginal candidiasis is complex and based on quantitative indicators. The method can be used to differentiate vulvovaginal candidiasis from vaginal fungal colonization (the cut-off value is 5.5 points) and to more accurately interpret a Candida positive result from quantitative real-time PCR in asymptomatic patients or in women with mixed vaginal infection.

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  • VVC diagnosis often relies on clinical symptoms, leading to 50% diagnostic imprecision, which can result in inappropriate antifungal prescriptions and increased resistance.

    “Consequently, diagnosis often relies on clinical symptoms, which can be imprecise and have low specificity, leading to a 50% rate of diagnostic imprecision [62]. This empirical approach can result in inappropriate antifungal prescriptions, contributing to increased resistance and recurrent [63].”

    From Statins as Antifungal Agents: A Review on Drug Repurposing and Nanotechnology-Driven Delivery Strategies (2025) · cites this paper as [62]

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Authors
Dermendzhiev, T., Pehlivanov, B., Petrova, A., Stanev, S., & Murdjeva, M.
Affiliations
Medical University Plovdiv (BG)
Corresponding author
Petrova, A
ORCID
Venue
Journal of Medical Mycology
Publisher
Elsevier BV
Published
2022-11
Volume
32
Issue
4
Pages
101302
ISSN
1156-5233 (ISSN-L)
DOI
10.1016/j.mycmed.2022.101302
OpenAlex
W4283211860
Cited by
7
References
22
Citations by year
2026: 2 · 2025: 2 · 2024: 2 · 2023: 1
FWCI
0.78
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal de Mycologie Médicale (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Yeasts and Rust Fungi Studies
Keywords
vaginal candidiasis, Candida, quantitative real-time PCR, vaginal discharge, pruritus, direct microscopy, mixed vaginal infections, sensitivity and specificity
MeSH terms
Candida, Candidiasis, Vulvovaginal, Female, Humans, Vagina

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