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Vaginal Candida parapsilosis: pathogen or bystander?

Paul Nyirjesy1, Alynn B Alexander, M Velma Weitz

  • 1Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, PA, USA. pn35@drexel.edu

Infectious Diseases in Obstetrics and Gynecology
|July 26, 2005
PubMed
Summary

Candida parapsilosis vaginal infections are uncommon but can cause symptoms. Most cases respond well to various antifungal treatments, suggesting it may be a transient colonizer.

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Area of Science:

  • Medical Mycology
  • Vaginal Microbiome Research
  • Infectious Diseases

Background:

  • Candida parapsilosis is rarely identified in vaginal cultures.
  • Its role in causing vaginal conditions is not well understood.
  • Previous studies have not focused on its clinical significance or treatment outcomes.

Purpose of the Study:

  • To investigate the clinical significance of Candida parapsilosis vaginal isolates.
  • To evaluate the response of C. parapsilosis vaginal infections to antifungal therapy.
  • To characterize patient demographics and clinical presentation associated with C. parapsilosis.

Main Methods:

  • Retrospective chart review of women with positive vaginal cultures for C. parapsilosis (February 2001-August 2002).
  • Analysis of patient demographics, clinical symptoms, and treatment responses.

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  • Determination of mycological cure (negative fungal culture) and clinical cure (symptom resolution).

    • Main Results:

    • Candida parapsilosis accounted for 8.5% of positive fungal isolates (54/635).
    • Antifungal treatment achieved mycological cure with fluconazole (17/19), butoconazole (7/7), boric acid (6/6), and miconazole (1/1).
    • Spontaneous mycological cure occurred in 6/7 patients, and 64.9% of those with mycological cure also achieved clinical cure.

    Conclusions:

    • Candida parapsilosis can cause vaginal symptoms.
    • It appears to be susceptible to a range of antifungal agents.
    • The yeast may act as a transient vaginal colonizer rather than a persistent pathogen.