Features of vaginal smear microscopy in women with recurrent vulvovaginal candidiasis

Abstract

DOI: 10.52705/2788-6190-2024-02-13
УДК 618.15/.16-002:616.992.282-039:612.017.1

The objective: to determine the features of the vaginal microbiota in patients with recurrent
vulvovaginal candidiasis (RVVK).
Materials and methods. A prospective study and clinical and laboratory analysis of vaginal
microbiocenosis in women with RVVK were conducted. The main group (MG) consisted of 70
women of reproductive age with recurrent vulvovaginal candidiasis and 40 healthy women of
reproductive age who made up the control group (CG). The scope of the study - evaluation of the
microbiocenosis of the vagina according to the data of the smear microscopy, stained according
to Gram, cultural study of vaginal secretions
Results. It was established that 52 (72.8%) women were diagnosed with the classic variant
of vulvovaginal candidiasis (VVK), when yeast fungi grow against the background of normal
microflora, i.e. absolute dominance of lactobacilli. In 18 (25.7%) patients, a combination of VVK
and bacterial vaginosis (BV) was detected. Surface cells predominated among epithelial cells
(100.0% in 70 women), in 51 patients (72.8%) surface cells were combined with intermediate
cells. Parabasal epithelial cells were found in 2 patients (2.8%). Background microflora in patients
with VVK was homogeneous, lactobacilli morphotypes dominated, in women with a combined
form of VVK with BV, anaerobes and Gardnerella morphotypes prevailed. In patients with RVVK,
a moderate and pronounced leukocyte reaction prevailed, which was observed in 66 (94.2%)
cases, in 4 (5.7%) women, leukocytes were absent or were single in the preparation.
Conclusions. With RVVK, the total number of microorganisms in 19 (27.2%) patients was
moderate and ranged from ll to 102 microbial cells in the field of vision, in 33 (47.1%) – large –
102 – 103 microbial cells in the field of vision. In patients with a combined form of IVC, the number
of microorganisms exceeded 103 microbial cells in the field of view, moderate and pronounced
leukocyte reaction also prevailed, which was observed in 66 (94.2%) cases. The most frequent
causative agent of candidal infection is S. albicans (84.2%), followed by Candida glabrata (11.4%).
The research was carried out in accordance with the principles of the Helsinki Declaration. The
study protocol was approved by the Local Ethics Committee of the participating institution. The
informed consent of the patient was obtained for conducting the studies.