Determinants of different Candida species infections of the genital tract in women

Objective: We have analyzed the differences in the epidemiological characte ristics of women with different Candida low female genital tract infection. Study design: Eligible for the study were 4228 women aged 18-70 years with symptomatic low gynecological tract infection and clinical findings sugges tive for Candida infection consecutively attending during the study period first level outpatients gynecological services-in Italy. CHROMagar Candida method was used to identify albicans and non-albicans species and among non -albicans ones Candida glabrata, tropicalis and krusei. Result: Out of the 4228 women who entered the study, Candida infection was confirmed by CHROMa gar test in 3351 cases (79.3%): Candida albicans was identified in 1431 cas es (43%) and non-albicans in 1920. Among the 1920 women with non-albicans i nfection, Candida glabrata was identified in 1207 women, Candida krusei in 290, Candida tropicalis in 404 (in 19 cases other species or non-specified species were involved). Candida albicans infection was more frequently repo rted than non-albicans ones in diabetic women (Odds Ratio, OR=1.7, 95%, Con fidence Interval, CI 1.1-2.7). Current oral contraceptive users tended more frequently to be infected with Candida albicans than non-albicans, however the estimated OR was only slightly above unity and of borderline statistic al significance (OR 1.3, 9.5%, CI 1.1-1.5). Women reporting previous treatm ent with topic antimicotic reported more frequently non-albicans infection, than Candida albicans ones. However the association was limited and of bor derline statistical significance (OR albicans vs. non albicans 0.7, 95% CI 0.5-1.0). Albicans infection was more frequently identified in women whose partner reported symptomatology for Candida infection (OR 1.7, 95% C.I. 1.4 -2.0). Conclusions: This study shows that in this Italian population with s ymptomatic Candida infection of low female genital tract, there are some di fferences in the epidemiological characteristics of women with albicans and non-albicans infection. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.