Skip to main content
Top
Published in: Current Infectious Disease Reports 6/2015

01-06-2015 | Genitourinary Infections (J Sobel, Section Editor)

The Role of PCR in the Diagnosis of Candida Vulvovaginitis—a New Gold Standard?

Authors: J. D. Sobel, Robert A. Akins

Published in: Current Infectious Disease Reports | Issue 6/2015

Login to get access

Abstract

PCR is recognized as a reliable technique for detection of all types of microorganisms. Being highly objective and reproducible also sensitive and specific, PCR is now widely used for sexually transmitted infection (STI) diagnosis. Potential, however, exists for detecting non-pathogens, and not identifying a pathogenic state decreases specificity or clinical significance. PCR Candida tests of vaginal specimens are now widely available and frequently used offering a modest to moderate increase in sensitivity and are likely to replace traditional culture and DNA homology testing. Nevertheless, there remain considerable gaps in our knowledge regarding the usefulness and applications of these expensive tests.
Literature
2.
3.
go back to reference Liu XP, Fan SR, Peng YT, Zhang HP. Species distribution and susceptibility of Candida isolates from patient with vulvovaginal candidiasis in Southern China from 2003 to 2012. J Med Mycol. 2014;24:106–11. Liu XP, Fan SR, Peng YT, Zhang HP. Species distribution and susceptibility of Candida isolates from patient with vulvovaginal candidiasis in Southern China from 2003 to 2012. J Med Mycol. 2014;24:106–11.
4.
go back to reference Senterre JM, Carpentier M, Foidart JM. [Vulvovaginal candidiasis: prevalence of different Candida species in the Liege region]. Rev Med Liege. 2005;60:882–4.PubMed Senterre JM, Carpentier M, Foidart JM. [Vulvovaginal candidiasis: prevalence of different Candida species in the Liege region]. Rev Med Liege. 2005;60:882–4.PubMed
5.
go back to reference Vermitsky JP, Self MJ, Chadwick SG, Trama JP, Adelson ME, Mordechai E, et al. Survey of vaginal-flora Candida species isolates from women of different age groups by use of species-specific PCR detection. J Clin Microbiol. 2008;46:1501–3.CrossRefPubMedCentralPubMed Vermitsky JP, Self MJ, Chadwick SG, Trama JP, Adelson ME, Mordechai E, et al. Survey of vaginal-flora Candida species isolates from women of different age groups by use of species-specific PCR detection. J Clin Microbiol. 2008;46:1501–3.CrossRefPubMedCentralPubMed
6.
go back to reference Zhang JY, Liu JH, Liu FD, Xia YH, Wang J, Liu X, Huang XT, et al. Vulvovaginal candidiasis: species distribution, fluconazole resistance and drug efflux pump gene overexpression. Mycoses. 2014;57:584-91. Zhang JY, Liu JH, Liu FD, Xia YH, Wang J, Liu X, Huang XT, et al. Vulvovaginal candidiasis: species distribution, fluconazole resistance and drug efflux pump gene overexpression. Mycoses. 2014;57:584-91.
8.
go back to reference Lowe NK, Neal JL, Ryan-Wenger NA. Accuracy of the clinical diagnosis of vaginitis compared with a DNA probe laboratory standard. Obstet Gynecol. 2009;113:89–95.CrossRefPubMedCentralPubMed Lowe NK, Neal JL, Ryan-Wenger NA. Accuracy of the clinical diagnosis of vaginitis compared with a DNA probe laboratory standard. Obstet Gynecol. 2009;113:89–95.CrossRefPubMedCentralPubMed
9.
go back to reference Odds FC, Bernaerts R. CHROMagar Candida, a new differential isolation medium for presumptive identification of clinically important Candida species. J Clin Microbiol. 1994;32:1923–9.PubMedCentralPubMed Odds FC, Bernaerts R. CHROMagar Candida, a new differential isolation medium for presumptive identification of clinically important Candida species. J Clin Microbiol. 1994;32:1923–9.PubMedCentralPubMed
10.
go back to reference Gultekin B, Yazici V, Aydin N. Distribution of Candida species in vaginal specimens and evaluation of CHROMagar Candida medium. Mikrobiyol Bul. 2005;39:319–24.PubMed Gultekin B, Yazici V, Aydin N. Distribution of Candida species in vaginal specimens and evaluation of CHROMagar Candida medium. Mikrobiyol Bul. 2005;39:319–24.PubMed
11.
go back to reference Guzel AB, Ilkit M, Akar T, Burgut R, Demir SC. Evaluation of risk factors in patients with vulvovaginal candidiasis and the value of chromID Candida agar versus CHROMagar Candida for recovery and presumptive identification of vaginal yeast species. Med Mycol. 2011;49:16–25.CrossRefPubMed Guzel AB, Ilkit M, Akar T, Burgut R, Demir SC. Evaluation of risk factors in patients with vulvovaginal candidiasis and the value of chromID Candida agar versus CHROMagar Candida for recovery and presumptive identification of vaginal yeast species. Med Mycol. 2011;49:16–25.CrossRefPubMed
12.
13.
go back to reference Ozcan K, Ilkit M, Ates A, Turac-Bicer A, Demirhindi H. Performance of Chromogenic Candida agar and CHROMagar Candida in recovery and presumptive identification of monofungal and polyfungal vaginal isolates. Med Mycol. 2010;48:29–34.CrossRefPubMed Ozcan K, Ilkit M, Ates A, Turac-Bicer A, Demirhindi H. Performance of Chromogenic Candida agar and CHROMagar Candida in recovery and presumptive identification of monofungal and polyfungal vaginal isolates. Med Mycol. 2010;48:29–34.CrossRefPubMed
14.
go back to reference Gorton RL, Ramnarain P, Barker K, Stone N, Rattenbury S, McHugh TD, et al. Comparative analysis of Gram’s stain, PNA-FISH and Sepsityper with MALDI-TOF MS for the identification of yeast direct from positive blood cultures. Mycoses. 2014;57:592–601.CrossRefPubMed Gorton RL, Ramnarain P, Barker K, Stone N, Rattenbury S, McHugh TD, et al. Comparative analysis of Gram’s stain, PNA-FISH and Sepsityper with MALDI-TOF MS for the identification of yeast direct from positive blood cultures. Mycoses. 2014;57:592–601.CrossRefPubMed
15.
go back to reference Stone NR, Gorton RL, Barker K, Ramnarain P, Kibbler CC. Evaluation of PNA-FISH yeast traffic light for rapid identification of yeast directly from positive blood cultures and assessment of clinical impact. J Clin Microbiol. 2013;51:1301–2.CrossRefPubMedCentralPubMed Stone NR, Gorton RL, Barker K, Ramnarain P, Kibbler CC. Evaluation of PNA-FISH yeast traffic light for rapid identification of yeast directly from positive blood cultures and assessment of clinical impact. J Clin Microbiol. 2013;51:1301–2.CrossRefPubMedCentralPubMed
16.
go back to reference Crampin AC, Matthews RC. Application of the polymerase chain reaction to the diagnosis of candidosis by amplification of an HSP 90 gene fragment. J Med Microbiol. 1993;39:233–8.CrossRefPubMed Crampin AC, Matthews RC. Application of the polymerase chain reaction to the diagnosis of candidosis by amplification of an HSP 90 gene fragment. J Med Microbiol. 1993;39:233–8.CrossRefPubMed
17.
go back to reference Chen YC, Eisner JD, Kattar MM, Rassoulian-Barrett SL, LaFe K, Yarfitz SL, et al. Identification of medically important yeasts using PCR-based detection of DNA sequence polymorphisms in the internal transcribed spacer 2 region of the rRNA genes. J Clin Microbiol. 2000;38:2302–10.PubMedCentralPubMed Chen YC, Eisner JD, Kattar MM, Rassoulian-Barrett SL, LaFe K, Yarfitz SL, et al. Identification of medically important yeasts using PCR-based detection of DNA sequence polymorphisms in the internal transcribed spacer 2 region of the rRNA genes. J Clin Microbiol. 2000;38:2302–10.PubMedCentralPubMed
18.
19.
go back to reference Landlinger C, Preuner S, Willinger B, Haberpursch B, Racil Z, Mayer J, et al. Species-specific identification of a wide range of clinically relevant fungal pathogens by use of Luminex xMAP technology. J Clin Microbiol. 2009;47:1063–73.CrossRefPubMedCentralPubMed Landlinger C, Preuner S, Willinger B, Haberpursch B, Racil Z, Mayer J, et al. Species-specific identification of a wide range of clinically relevant fungal pathogens by use of Luminex xMAP technology. J Clin Microbiol. 2009;47:1063–73.CrossRefPubMedCentralPubMed
20.
go back to reference Preuner S, Lion T. Species-specific identification of a wide range of clinically relevant fungal pathogens by the Luminex(®) xMAP technology. Methods Mol Biol. 2013;968:119–39.PubMed Preuner S, Lion T. Species-specific identification of a wide range of clinically relevant fungal pathogens by the Luminex(®) xMAP technology. Methods Mol Biol. 2013;968:119–39.PubMed
21.
go back to reference Baskova L, Landlinger C, Preuner S, Lion T. The Pan-AC assay: a single-reaction real-time PCR test for quantitative detection of a broad range of Aspergillus and Candida species. J Med Microbiol. 2007;56:1167–73.CrossRefPubMed Baskova L, Landlinger C, Preuner S, Lion T. The Pan-AC assay: a single-reaction real-time PCR test for quantitative detection of a broad range of Aspergillus and Candida species. J Med Microbiol. 2007;56:1167–73.CrossRefPubMed
22.
go back to reference Elie CM, Lott TJ, Reiss E, Morrison CJ. Rapid identification of Candida species with species-specific DNA probes. J Clin Microbiol. 1998;36:3260–5.PubMedCentralPubMed Elie CM, Lott TJ, Reiss E, Morrison CJ. Rapid identification of Candida species with species-specific DNA probes. J Clin Microbiol. 1998;36:3260–5.PubMedCentralPubMed
23.
go back to reference Jordan JA. PCR identification of four medically important Candida species by using a single primer pair. J Clin Microbiol. 1994;32:2962–7.PubMedCentralPubMed Jordan JA. PCR identification of four medically important Candida species by using a single primer pair. J Clin Microbiol. 1994;32:2962–7.PubMedCentralPubMed
24.
go back to reference Klingspor L, Jalal S. Molecular detection and identification of Candida and Aspergillus spp. from clinical samples using real-time PCR. Clin Microbiol Infect. 2006;12:745–53.CrossRefPubMed Klingspor L, Jalal S. Molecular detection and identification of Candida and Aspergillus spp. from clinical samples using real-time PCR. Clin Microbiol Infect. 2006;12:745–53.CrossRefPubMed
25.
go back to reference Maaroufi Y, Heymans C, De Bruyne JM, Duchateau V, Rodriguez-Villalobos H, Aoun M, et al. Rapid detection of Candida albicans in clinical blood samples by using a TaqMan-based PCR assay. J Clin Microbiol. 2003;41:3293–8.CrossRefPubMedCentralPubMed Maaroufi Y, Heymans C, De Bruyne JM, Duchateau V, Rodriguez-Villalobos H, Aoun M, et al. Rapid detection of Candida albicans in clinical blood samples by using a TaqMan-based PCR assay. J Clin Microbiol. 2003;41:3293–8.CrossRefPubMedCentralPubMed
26.
go back to reference Martin C, Roberts D, van Der Weide M, Rossau R, Jannes G, Smith T, et al. Development of a PCR-based line probe assay for identification of fungal pathogens. J Clin Microbiol. 2000;38:3735–42.PubMedCentralPubMed Martin C, Roberts D, van Der Weide M, Rossau R, Jannes G, Smith T, et al. Development of a PCR-based line probe assay for identification of fungal pathogens. J Clin Microbiol. 2000;38:3735–42.PubMedCentralPubMed
27.
go back to reference Posteraro B, Sanguinetti M, Masucci L, Romano L, Morace G, Fadda G. Reverse cross blot hybridization assay for rapid detection of PCR-amplified DNA from Candida species, Cryptococcus neoformans, and Saccharomyces cerevisiae in clinical samples. J Clin Microbiol. 2000;38:1609–14.PubMedCentralPubMed Posteraro B, Sanguinetti M, Masucci L, Romano L, Morace G, Fadda G. Reverse cross blot hybridization assay for rapid detection of PCR-amplified DNA from Candida species, Cryptococcus neoformans, and Saccharomyces cerevisiae in clinical samples. J Clin Microbiol. 2000;38:1609–14.PubMedCentralPubMed
28.
go back to reference Shin JH, Nolte FS, Morrison CJ. Rapid identification of Candida species in blood cultures by a clinically useful PCR method. J Clin Microbiol. 1997;35:1454–9.PubMedCentralPubMed Shin JH, Nolte FS, Morrison CJ. Rapid identification of Candida species in blood cultures by a clinically useful PCR method. J Clin Microbiol. 1997;35:1454–9.PubMedCentralPubMed
29.
go back to reference Wahyuningsih R, Freisleben HJ, Sonntag HG, Schnitzler P. Simple and rapid detection of Candida albicans DNA in serum by PCR for diagnosis of invasive candidiasis. J Clin Microbiol. 2000;38:3016–21.PubMedCentralPubMed Wahyuningsih R, Freisleben HJ, Sonntag HG, Schnitzler P. Simple and rapid detection of Candida albicans DNA in serum by PCR for diagnosis of invasive candidiasis. J Clin Microbiol. 2000;38:3016–21.PubMedCentralPubMed
30.
go back to reference Xiang H, Xiong L, Liu X, Tu Z. Rapid simultaneous detection and identification of six species Candida using polymerase chain reaction and reverse line hybridization assay. J Microbiol Methods. 2007;69:282–7.CrossRefPubMed Xiang H, Xiong L, Liu X, Tu Z. Rapid simultaneous detection and identification of six species Candida using polymerase chain reaction and reverse line hybridization assay. J Microbiol Methods. 2007;69:282–7.CrossRefPubMed
31.
go back to reference Arancia S, Sandini S, De Bernardis F, Fortini D. Rapid, simple, and low-cost identification of Candida species using high-resolution melting analysis. Diagn Microbiol Infect Dis. 2011;69:283–5.CrossRefPubMed Arancia S, Sandini S, De Bernardis F, Fortini D. Rapid, simple, and low-cost identification of Candida species using high-resolution melting analysis. Diagn Microbiol Infect Dis. 2011;69:283–5.CrossRefPubMed
32.
go back to reference Dunyach C, Bertout S, Phelipeau C, Drakulovski P, Reynes J, Mallie M. Detection and identification of Candida spp. in human serum by LightCycler real-time polymerase chain reaction. Diagn Microbiol Infect Dis. 2008;60:263–71.CrossRefPubMed Dunyach C, Bertout S, Phelipeau C, Drakulovski P, Reynes J, Mallie M. Detection and identification of Candida spp. in human serum by LightCycler real-time polymerase chain reaction. Diagn Microbiol Infect Dis. 2008;60:263–71.CrossRefPubMed
33.
go back to reference Khan Z, Mustafa AS, Alam FF. Real-time LightCycler polymerase chain reaction and melting temperature analysis for identification of clinically important Candida spp. J Microbiol Immunol Infect. 2009;42:290–5.PubMed Khan Z, Mustafa AS, Alam FF. Real-time LightCycler polymerase chain reaction and melting temperature analysis for identification of clinically important Candida spp. J Microbiol Immunol Infect. 2009;42:290–5.PubMed
34.
go back to reference Mandviwala T, Shinde R, Kalra A, Sobel JD, Akins RA. High-throughput identification and quantification of Candida species using high resolution derivative melt analysis of panfungal amplicons. J Mol Diagn. 2010;12:91–101.CrossRefPubMedCentralPubMed Mandviwala T, Shinde R, Kalra A, Sobel JD, Akins RA. High-throughput identification and quantification of Candida species using high resolution derivative melt analysis of panfungal amplicons. J Mol Diagn. 2010;12:91–101.CrossRefPubMedCentralPubMed
35.
go back to reference Trama JP, Mordechai E, Adelson ME. Detection and identification of Candida species associated with Candida vaginitis by real-time PCR and pyrosequencing. Mol Cell Probes. 2005;19:145–52.CrossRefPubMed Trama JP, Mordechai E, Adelson ME. Detection and identification of Candida species associated with Candida vaginitis by real-time PCR and pyrosequencing. Mol Cell Probes. 2005;19:145–52.CrossRefPubMed
36.
go back to reference Giraldo P, von Nowaskonski A, Gomes FA, Linhares I, Neves NA, Witkin SS. Vaginal colonization by Candida in asymptomatic women with and without a history of recurrent vulvovaginal candidiasis. Obstet Gynecol. 2000;95:413–6.CrossRefPubMed Giraldo P, von Nowaskonski A, Gomes FA, Linhares I, Neves NA, Witkin SS. Vaginal colonization by Candida in asymptomatic women with and without a history of recurrent vulvovaginal candidiasis. Obstet Gynecol. 2000;95:413–6.CrossRefPubMed
37.
go back to reference Weissenbacher T, Witkin SS, Ledger WJ, Tolbert V, Gingelmaier A, Scholz C, Mylonas I, et al. Relationship between clinical diagnosis of recurrent vulvovaginal candidiasis and detection of Candida species by culture and polymerase chain reaction. Arch Gynecol Obstet. 2009;279:125–129. Weissenbacher T, Witkin SS, Ledger WJ, Tolbert V, Gingelmaier A, Scholz C, Mylonas I, et al. Relationship between clinical diagnosis of recurrent vulvovaginal candidiasis and detection of Candida species by culture and polymerase chain reaction. Arch Gynecol Obstet. 2009;279:125–129.
38.•
go back to reference Cartwright CP, Lembke BD, Ramachandran K, Body BA, Nye MB, Rivers CA, et al. Comparison of nucleic acid amplification assays with BD Affirm VPIII for diagnosis of vaginitis in symptomatic women. J Clin Microbiol. 2013;51:3694–9. This large review compares PCR with the widely used BD Affirm VPIII test, finding the latter wanting. Cartwright CP, Lembke BD, Ramachandran K, Body BA, Nye MB, Rivers CA, et al. Comparison of nucleic acid amplification assays with BD Affirm VPIII for diagnosis of vaginitis in symptomatic women. J Clin Microbiol. 2013;51:3694–9. This large review compares PCR with the widely used BD Affirm VPIII test, finding the latter wanting.
39.
go back to reference Mardh PA, Novikova N, Witkin SS, Korneeva I, Rodriques AR. Detection of candida by polymerase chain reaction vs microscopy and culture in women diagnosed as recurrent vulvovaginal cases. Int J STD AIDS. 2003;14:753–6.CrossRefPubMed Mardh PA, Novikova N, Witkin SS, Korneeva I, Rodriques AR. Detection of candida by polymerase chain reaction vs microscopy and culture in women diagnosed as recurrent vulvovaginal cases. Int J STD AIDS. 2003;14:753–6.CrossRefPubMed
40.
go back to reference Lopez-Monteon A, Gomez-Figueroa FS, Ramos-Poceros G, Guzman-Gomez D, & Ramos-Ligonio A. Codetection of Trichomonas vaginalis and Candida albicans by PCR in urine samples in a low-risk population attended in a clinic first level in central Veracruz, Mexico. Biomed Res Int. 2013;2013:281892. Lopez-Monteon A, Gomez-Figueroa FS, Ramos-Poceros G, Guzman-Gomez D, & Ramos-Ligonio A. Codetection of Trichomonas vaginalis and Candida albicans by PCR in urine samples in a low-risk population attended in a clinic first level in central Veracruz, Mexico. Biomed Res Int. 2013;2013:281892.
Metadata
Title
The Role of PCR in the Diagnosis of Candida Vulvovaginitis—a New Gold Standard?
Authors
J. D. Sobel
Robert A. Akins
Publication date
01-06-2015
Publisher
Springer US
Published in
Current Infectious Disease Reports / Issue 6/2015
Print ISSN: 1523-3847
Electronic ISSN: 1534-3146
DOI
https://doi.org/10.1007/s11908-015-0488-3

Other articles of this Issue 6/2015

Current Infectious Disease Reports 6/2015 Go to the issue

Healthcare Associated Infections (G Bearman and D Morgan, Section Editors)

The Pros, Cons, and Unknowns of Search and Destroy for Carbapenem-Resistant Enterobacteriaceae

Genitourinary Infections (J Sobel, Section Editor)

Vulvovaginal Candidiasis in Pregnancy

Transplant and Oncology (M Ison and N Theodoropoulos, Section Editors)

The Swiss Transplant Cohort Study: Lessons from the First 6 Years

Intra-abdominal Infections, Hepatitis, and Gastroenteritis (T Steiner, Section Editor)

Epidemiology and Treatment of Trichomoniasis

Transplant and Oncology (M Ison and N Theodoropoulos, Section Editors)

Sepsis in the Severely Immunocompromised Patient

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.