An Update on the Roles of Non-albicans Candida Species in Vulvovaginitis
Open accessAbstract
Candida species are one of the commonest causes of vaginitis in healthy women of reproductive age. Vulvovaginal candidiasis (VVC) is characterized by vulvovaginal itching, redness and discharge. Candida albicans, which is a common genito-urinary tract commensal, has been the prominent species and remains the most common fungal agent isolated from clinical samples of patients diagnosed with VVC. In recent times, however, there has been a notable shift in the etiology of candidiasis with non-albicans Candida (NAC) species gaining prominence. The NAC species now account for approximately 10% to as high as 45% of VVC cases in some studies. This is associated with treatment challenges and a slightly different clinical picture. NAC species vaginitis is milder in presentation, often occur in patients with underlying chronic medical conditions and symptoms tend to be more recurrent or chronic compared with C. albicans vaginitis. C. glabrata is the most common cause of NAC-VVC. C. tropicalis, C. krusei, C. parapsilosis, and C. guilliermondii are the other commonly implicated species. Treatment failure is common in NAC-VVC, since some of these species are intrinsically resistant or show low susceptibilities to commonly used antifungal agents. This article reviews the etiology, pathogenesis, clinical features, diagnosis, and management of NAC vulvovaginitis.
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Given increased accessibility of over-the-counter antifungal therapy, some strains of Candida that were previously susceptible have become resistant.
“Given the increased accessibility of over-the-counter (OTC) antifungal therapy, some strains of Candida that were previously susceptible have become resistant, 12”
From Clinical challenges in diagnosis and treatment of recurrent vulvovaginal candidiasis (2022) · cites this paper as [12]
The prevalence of infection with non-albicans Candida (NAC) species is increasing.
“the prevalence of infection with non-albicans Candida (NAC) species is increasing.”
From Clinical challenges in diagnosis and treatment of recurrent vulvovaginal candidiasis (2022) · cites this paper as [12]
NAC species have been reported to be causative in approximately 10% of VVC cases, with some studies citing up to 45% of VVC cases.
“NAC species have been reported to be causative in approximately 10% of cases, with some studies citing up to 45% of VVC cases. 12”
From Clinical challenges in diagnosis and treatment of recurrent vulvovaginal candidiasis (2022) · cites this paper as [12]
Widespread use of broad-spectrum antibiotics coupled with increased availability of OTC and prescription antimycotic medications has fueled the shift toward NAC species.
“Widespread use of broad-spectrum antibiotics coupled with increased availability of OTC and prescription antimycotic medications has fueled this shift. 12”
From Clinical challenges in diagnosis and treatment of recurrent vulvovaginal candidiasis (2022) · cites this paper as [12]
Alternative treatment options are limited because the current armamentarium of antifungal agents active against NAC strains is limited.
“Alternative treatment options are limited because, as with azole-resistant strains, the current armamentarium of antifungal agents active against NAC strains is limited. 12”
From Clinical challenges in diagnosis and treatment of recurrent vulvovaginal candidiasis (2022) · cites this paper as [12]
The prevalence of non-albicans Candida species is rising.
“In addition, non-albicans Candida species are frequently dose-dependent susceptible or resistant to fluconazole and other azoles, and their prevalence is rising.”
From Management of recurrent vulvovaginal candidosis: Narrative review of the literature and European expert panel opinion (2022) · cites this paper as Makanjuola et al., 2018
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- Authors
- Makanjuola, O., Bongomin, F., & Fayemiwo, S.
- Affiliations
- University of Ibadan (NG)
- Gulu University (UG)
- Corresponding author
- Makanjuola, Olufunmilola
- Venue
- Journal of Fungi
- Publisher
- MDPI AG
- Published
- 2018-10-31
- Volume
- 4
- Issue
- 4
- Pages
- 121
- ISSN
- 2309-608X (ISSN-L)
- PMC
- PMC6309050
- OpenAlex
- W2899038225
- Cited by
- 182
- References
- 126
- Citations by year
- 2026: 23 · 2025: 27 · 2024: 26 · 2023: 21 · 2022: 31 · 2021: 33 · 2020: 14 · 2019: 6 · 2018: 1
- FWCI
- 1.98
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- Journal of Fungi (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Yeasts and Rust Fungi Studies
- Keywords
- non-albicans Candida, vaginal candidiasis, Candida glabrata, Candida tropicalis, Candida krusei, Candida parapsilosis, Candida guilliermondii, Candida albicans, antifungal resistance, recurrent vulvovaginal candidiasis, pathogenesis, diagnosis, treatment
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