Vestnik dermatologii i venerologiiVestnik dermatologii i venerologii0042-46092313-6294Rossijskoe Obschestvo Dermatovenerologov i Kosmetologov13210.25208/0042-4609-2015-91-2-122-129Vaginal candidal infection: clinical features of diagnostics methodsRakhmatuunaM. R.rahmatulina@cnikvi.ruGushchinA. YE.noemail@neicon.ruTsoiYE. G.noemail@neicon.ruFGBU State Research Center of Dermatovenereology and Cosmetology, Russian Health MinistryFGUN Central Research Institute of Epidemiology, Federal Service for Supervision of Consumer Rights Protection and Human Welfare (Rospotrebnadzor)Molecular Diagnostics Center, Central Research Institute of Epidemiology, Rospotrebnadzor2404201591212212924082017Copyright © 2015, Rakhmatuuna M.R., Gushchin A.Y., Tsoi Y.G.2015Goal. To study clinical features of the vaginal candidal infection and carry out a comparative analysis of the microscopy, cultural and real-time PCR methods for identifying Candida fungi. Materials and methods. The study involved 107 female subjects: Group 1: 56 women with Candida fungi found in their vaginal secrets by laboratory tests; Group 2: 51 women with absent clinical and laboratory signs of the urogenital infection. The laboratory test methods were as follows: microscopy, cultural and biomolecular (real-time PCR (RT PCR) - Florocenosis-Candida). Key findings. Pathologic vaginal secretion (76.8%) and hyperemia of vaginal and vulvar mucous tunic (41.1%) belong to the key clinical manifestations of the vaginal candidal infection. Caseous vaginal discharge was revealed in 33.9% of patients from Group 1, homogenous creamy discharge - in 42.9%, and homogenous mucous non-transparent vaginal discharge - in 23.2% of patients from Group 1. The patients had the following etiologic agents: C. albicans (94.6%), C. glabrata, (3.6%) and C. krusei (1.8%). Candida spp. identification results using the cultural and microscopy methods coincided in 78.6% of all cases, RT PCR and microscopy - in 66.1%, and RT PCR and cultural methods - in 87.5% of all cases. There were no reliable differences in the quantitative results for Candida fungi by the cultural and RT PCR methods: below 10<sup>2</sup> CFU/mL and below 10<sup>2</sup> GE/mL - 12.2 and 8.9%, respectively, 10<sup>3</sup>-10<sup>4</sup> CFU/mL and 10<sup>3</sup>-10<sup>4</sup> GE/mL - 44.9% and 33.9%, over 10<sup>4</sup> CFU/mL and over 104 GE/mL - 42.9 and 57.2%, respectively(p > 0.05). Conclusion. Candidal colonization of the vaginal mucous tunic was accompanied by specific clinical manifestations of urogenital candidosis in 76.8% of all cases; C. albicans was revealed in most of the subjects (94.6%). The real-time PCR method used for Candida spp. identification and quantitative determination demonstrated higher sensitivity and specificity vs. microscopy as well as sensitivity and specificity being comparable to the cultural diagnostics method.кандидозная инфекциягрибы рода Candidaдиагностикамолекулярно-биологические методыПЦР в режиме реального времениcandidal infectionCandida fungidiagnosticsbiomolecular methodsreal-time PCR[Прилепская В.Н., Байрамова Г.Р. Вульвовагинальный кандидоз. Клиника, диагностика, принципы терапии. M.: ГЭОТАР-Медиа; 2010][Иванова И.И., Степанян А.В., Джобава Э.М., Доброхотова Ю.Э. Опыт применения Ломексина (фентиконазола) в лечении кандидозного вульвовагинита. Гинекология 2012; (14): 72-75][Малова И.О., Рахматулина М.Р., Соколовский Е.В. Клинические рекомендации по ведению больных урогенитальным кандидозом. http://193.232.7.120/feml/clinical_ref/0001371160S/HTML/][Sherrard J., Donders G., White D. European (IUSTI/WHO) Guideline on the Management of Vaginal Discharge 2011. http://www.iusti.org/regions/Europe/pdf/2011/Euro_Guidelines_Vaginal_Discharge_2011.Intl_Jrev.pdf][Centers for Diseases Control and Prevention. Genital / vulvovaginal candidiasis. http://www.cdc.gov/fungal/diseases/candidiasis/genital/index.html][Сергеев А.Ю., Маликов В.Е., Жарикова Н.Е. Этиология вагинального кандидоза и проблема устойчивости к антимикотикам. Сибирский журнал дерматологии и венерологии 2001; (1): 25-28.][Sobel J. D., Zervos M., Reed B.D. et al. Fluconazole susceptibility of vaginal isolates obtained from woman with complicated Candida vaginitis: clinical implications. Antimicrob Agents Che-mother 2003; 47: 34-38.][Jurstrand M., Jensen J.S., Fredlund H., Falk L., Molling P. Detections of Mycoplasma genitalium in urogenital specimens by Real-Time PCR and by conventional PCR assay. J Med Microbiol 2005; 54: 23-29.][Просовецкая А.Л. Кандидозный вульвовагинит: этиопатогенез и клиническое течение заболевания. Венерология 2006; (9): 14-19.][Vitali B., Puqliese C., Biaqi E., Candela M., Turroni S., Bellen G., Donders G.G., Briqidi P. Dynamics of vaginal bacterial communities in woman developing bacterial vaginosis, candidiasis, or no infection, analyzed by PCR-denaturing gradient gel electrophoresis and real-time PCR. Appl Environ Microbiol 2007; 18: 5731-5741.]