الفهرس 
Candida
Conclusions, recommendationsOnly 14 pages are availabe for public view
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Abstract
Vulvovaginal Candidiasis (VVC) is a female genital system
infection that occurs due to Candida species. There are many risk factors
for development of vulvovaginal candidiasis like advanced reproductive
age, pregnancy, diabetes, hormonal contraception, recent antibiotic use.
Elevated serum glucose may lead to impaired neutrophil and monocyte
adherence, chemotaxis, phagocytosis, pathogen killing, and respiratory
burst. Also elevated glucose level in infected tissue increase candidia
adherence and invasion.
Several characteristics of Candida have been shown to be
important for its pathogenicity, especially adherence to host surfaces and
medical devices, Reversible morphogenetic transitions between yeast and
filamentous growth, secreted hydrolytic enzymes as aspartyl proteinases,
phospholipases. So we conducted this study to determine the prevalence
of vaginal carriage of Candida, species level and its phospholipase
activity among diabetic and non diabetic women, at Fayoum University
Hospital by conventional microbiological methods and on molecular
basis.
Vaginal samples were collected from 80 diabetics and 100 non
diabetics. It is found that the prevalence of vaginal candidiasis among
diabetics was 40 (50%) against 20 (20%) in non diabetics. Species
detection by API system revealed that C. albicans was the predominant
species among both diabetics and non diabetics. The prevalence of C.
albicans was as follows: 11(55%) in symptomatic diabetics, 11 (40%) in
non symptomatic diabetics and 15 (75%) in non diabetics.
Phenotypic screening for phospholipase enzyme detection by
measuring PZ value on egg yolk media found that 100 % of Candida was
phospholipase producers. C. glabrata in diabetics was more
phospholipase producer than in non diabetics. PZ value of 3 (15.8%) C. glabrata in diabetics was (+ +) against 2 (50%) in non diabetics. 11
(57.9%) against 1 (25%) C. glabrata had PZ value of (+ + +) in diabetics
and non diabetics respectively. Among diabetics PZ value of 5 (26.3%)
C. glabrata was (+ + + +) versus 0% in non diabetic patients.
Molecular analysis revealed that; the prevalence of gene encoding
phospholipase among diabetic patients was as follows: 19 (95%)
symptomatic diabetic patients, 17 (85%) non symptomatic diabetic
patients and 19 (95%) non diabetics had PLB1 gene. PLB2 gene was
found in 3 (15%) symptomatic diabetics, 3 (15%) non symptomatic
diabetic patients and in 7 (35%) non diabetics.
ACT1gene which used for identification of Candida cell wall actin
was found in 10 (50%) of symptomatic diabetics but in non symptomatic
diabetics it was found in 4 (20%). 9 (45%) non diabetics were ACT1
positive.
We recommended detection of species by CHROM agar media
which is simple and any microbiology laboratory can use it. We also
recommended phenotypic and genotypic detection of other secreted
enzymes.
Finally, the results imply that vaginal candidiasis is present in
alarming prevalence in diabetic patients. This requires blood glucose
level control, improving hygienic habits and regular detection of
causative species.