The Relationship Between Symptomatic Vaginal Candidiasis and Lactobacillus Flora, Using Methenamine Silver Staining Method



Moghaddam NA^{1, 2} ; Rajabi P¹ Show Affiliations
Source: Rawal Medical Journal Published:2009

Abstract

Objective: To determine whether there is a relationship between the presence of Lactobacilli and the growth of Candida. Method: Out of 3762 vaginal smears examined cytologically in Al-Zahra Hospital, Isfahan from 2001 to 2006, 242 patients were diagnosed as having Candida. Among them, 215 satisfactory smears of patients who were normally menstruating, were subsequently selected for evaluation. For determining the flora type and maturation index, the vaginal parts of VCE smears were studied. The control group included 200 patients who had normal menstrual cycle, satisfactory smears and no infectious agents. Smears were stained with Methenamine silver staining method for determining Lactobacillus flora. Lactobacillus positive groups were classified into three types: Type 1: Lactobacillus overgrowth flora, Type 2: Lactobacillus flora, Type 3: mixed flora. To evaluate hormonal status, the cellular maturation index (CMI) was also determined. Data were analyzed by SPSS software using Chi-square and T-tests. Result: Lactobacilli prevalence rates in Candida positive and negative groups were 194 cases (90%) and 175 cases (87.5%), respectively (p=0.7). In Candida positive group, Lactobacillus flora types included: Type 1; (9%), type II; (84%) and type III; (7%) (p<0.0001). Superficial, intermediate and parabasal cells ratios were demonstrated in term of CMI. There were no significant differences in CMI between Candida positive and negative cases. Conclusions: These results suggest that Lactobacillus does not have a protective role against vaginal Candidiasis. Considering the maturation index pattern, we can conclude that progesterone plays an important role in Candida infections.