Improved treatment of vulvovaginal candidiasis with fluconazole plus probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14.

AIMS: To determine the ability of probiotic lactobacilli to improve the treatment of vulvovaginal candidiasis (VVC) using a randomized, double-blind and placebo-controlled trial. METHODS AND RESULTS: Fifty-five women diagnosed with VVC by vaginal discharge positive for Candida spp. (according to culture method) associated with at least one of the symptoms (itching and burning vaginal feeling, dyspareunia and dysuria), were treated with single dose of fluconazole (150 mg) supplemented every morning for the following 4 weeks with two placebo or two probiotic capsules (containing Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14). At 4 weeks, the probiotic treated group showed significantly less vaginal discharge associated with any of the above mentioned symptoms (10.3%vs 34.6%; P = 0.03) and lower presence of yeast detected by culture (10.3%vs 38.5%; P = 0.014). CONCLUSION: This study has shown that probiotic lactobacilli can increase the effectiveness of an anti-fungal pharmaceutical agent in curing disease. SIGNIFICANCE AND IMPACT OF THE STUDY: This novel finding of probiotic lactobacilli augmenting the cure rate of yeast vaginitis, not only offers an alternative approach to a highly prevalent condition that adversely affects the quality of life of women around the world, but also raises the question of how this combination works.

[Enzyme typing of species of the genus Candida isolated from the oral cavity]. / Enzimotipagem de espécies do gênero Candida isoladas da cavidade bucal.

The production of phospholipase and proteinase exoenzymes was evaluated in seventy nine samples of Candida isolated from the oral cavity of patients with oral lesions characteristic of candidosis and from individuals presenting a clinically normal mouth, attended at the University of Dentistry of Ribeirão Preto USP. Among the strains of C. albicans isolated from oral lesions, the phospholipase and proteinase were detected in 83.3% and 66.7%, respectively. C. tropicalis and C. parapsilosis produced only proteinase. Regarding the isolated strains from niches without lesions, out of a total of 32 C. albicans, 71.9% presented phospholipase and 68.7% proteinase. C. tropicalis only presented the enzyme proteinase, C. glabrata, C. krusei, C. guilliermondii and Candida spp did not present any of the exoenzymes. Among the samples of C. albicans from both groups, the enzymotype 22 (positive phospholipase and proteinase weakly positive), was prevalent. Different enzymotypes of the same species were detected in samples collected from the same patient.

Capacity of denture plaque/biofilm removal and antimicrobial action of a new denture paste.

The efficacy of a paste for complete dentures was analyzed in terms of denture plaque/biofilm removal and antimicrobial action against specific microorganisms by determination of colony forming units of mutans group streptococci and yeast from 120 full denture wearers with a healthy palatine mucosa. The patients were given a questionnaire to evaluate the experimental product in terms of important characteristics. The paste was widely accepted by the patients, and effective in denture plaque removal and antimicrobial action. The species of yeasts most frequently isolated were C. albicans, C. tropicalis and C. glabrata. We conclude that it is possible for complete denture wearers to keep their dentures clean with the regular use of a paste-like hygienic product.

In vitro activity of antimycotic agents determined by E-test method against vaginal Candida species.

Vaginal candidiasis continues to be a common cause of vaginal discharge, pruritus and other local complaints in women worldwide. Although numerous antimycotic agents are available for the treatment of yeast vaginitis there is little comparative data on the in vitro activity of these drugs. The objectives of this study were to isolate and identify the Candida species in the vagina and anus of patients treated in a gynaecology clinic, as well as determine the susceptibility to azolic compounds measured by the E-test method. Vaginal and rectal swabs were collected from 80 adult non-pregnant patients, seen at a gynaecological clinic, aged 18-59 years, with sexual activity, with and without vaginitis. The swabs were processed by methods routinely used for the detection of pathogenic yeasts. The susceptibility of the isolates to fluconazole, ketoconazole and itraconazole, was measured by the agar diffusion method (E-test), using RPM1 1,640 medium with 2% glucose and phosphate buffer. Candida species (33) strains were isolated from 17 patients at similar proportions from both anatomical sites, and 12 patients harboured 24 strains of C. albicans in the vaginal and rectal tracts. Twenty one percent of the strains of C. albicans were resistant to ketoconazole, 54% were resistant to itraconazole and 0% were resistant to fluconazole. The sensitivity of strains isolated from the two sites were similar, indicating that these are strains of the same phenotype.

Candida albicans morphotypes from oral cavity in several families

Se estudiaron 108 personas provenientes de 22 familias compuestas de 3 a 8 miembros cada una, para la búsqueda de morfotipos de candida albicans de la cavidad bucal con o sin piezas dentarias. Por la técnica de phongpaichit et. al., morfotipos idénticos o diferentes fueron detectados en 7 grupos familiares. En 10 familias, c. albicans fue aislada de la familia y de protesis dentarias removibles de un mismo individuo. La franja discontinua, considerada como probable indicador de virulencia fue detectada en 9 (16,7 porciento) de las cepas de c. albicans de personas con dentición completa y de saliva de usuarios y no usuarios de prótesis. La franja continua fue verificada en 5 (83,3 porciento) de las cepas de c. albicans aisladas de un mismo sitio. El morfotipo es simple, fácil de ejecutar, puede servir para detectar infección cruzada y como un posible indicador de riesgo de candidosis. C. albicans fue la especie prevalente (86,4 porciento), detectándose a lo menos en 2 miembros de 14 familias

[The differentiation of Candida albicans strains by the killer system]. / Diferenciação de cepas de Candida albicans pelo sistema killer.

The authors studied the killer effect of nine standard strains of yeasts on 146 samples of Candida albicans isolated from the following clinical specimens: oral mucosa, feces, bronchial wash, sputum, vaginal secretion, urine, skin lesion, nail lesion and blood. Using this system it was possible to differentiate 23 biotypes of Candida albicans. The biotypes 211, 111 and 811 were most frequently isolated. Most of the samples of C. albicans (98.6%) were sensitive to at least one or more of the nine killer strains. Using the killer system it was possible to show that two patients harbored the same killer biotypes, 111 and 211, respectively, in different clinical specimens and another patient harbored the same biotype (211) in bloodcultures effected in different ocasions. The utilization of the killer system to differentiate types among species of pathogenic yeasts can be a useful method to establish the eventual source of infection, and it is a valuable tool to control and watch for nosocomial infections caused by yeasts.