Genital candidiasis in prepubertal and pubertal girls

Abstract number: P1807

Baka S., Antonopoulou S., Genimata V., Salomidou P., Petropoulou F., Plati E., Logothetis E., Gerolymatos K., Kouskouni E.

Objectives: Vulvovaginal candidiasis is a frequent infection in women, especially of reproductive age. Although insufficiently studied in children, its prevalence is lower in children of prepubertal or pubertal age. High estrogen levels were associated with the presence of yeasts in vaginal samples of symptomatic women while low estrogen levels during childhood result in a lower incidence in prepubertal girls. This study was conducted in order to determine the prevalence of culture-positive candida infection in children with genital symptoms in our hospital.

Methods: We obtained and cultured 439 vaginal samples from an equal number of Virgo girls aged from 1 to 18 years old presenting to our hospital from May 2005 to October 2007 with signs and symptoms of vulvovaginitis. In order to isolate Candida spp., all samples were cultured on Sabouraud Dextrose Agar (Conda, Madrid, Spain) for 24–48 hours at 37°C. Candida spp. were identified on the basis of the macroscopic appearance of colonies, direct microscopy of wet mount and Gram-stained specimens. Finally, the identification to the species level was completed using the API System ID 32 C (BioMerieux, France).

Results: Out of the 439 vaginal samples studied, 40 samples yielded Candida spp., which represent the 9.1% of the samples. In particular, we isolated 27 C. albicans (67.5%), 7 C. glabrata (17.5%), 5 C. tropicalis (12.5%) and 1 C. sake (2.5%). When we attempted to sort the 40 cases with Candida by age groups, in the 1–5 years age group we included 2 samples (5.0%), in the 6–10 years group 1 sample (2.5%), in the 11–15 years group 7 samples (17.5%) and in the 16–18 years group 30 samples (75.0%).

Conclusion: In girls less than 11 years old we observed a low prevalence of Candida spp. In contrast, in pubertal girls a higher incidence of Candida spp. was noted, probably because of the rise in estrogen levels. Candida albicans was the most frequently isolated yeast from vulvovaginal candidiasis in our study group.