Investigating microorganisms present in vulvovaginal candidiasis v1
Research type
Research Study
Full title
Evaluating vaginal biofilms and their impact in recurrent candidiasis infections.
IRAS ID
208268
Contact name
Gordon Ramage
Contact email
Sponsor organisation
R&D Office, NHS Greater Glasgow & Clyde
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
Fungal infections play a surprisingly substantial yet unrecognised health burden on the global population. Vulvovaginal candidiasis (VVC), commonly known as vaginal thrush, is one example of these, where it is estimated to be the most common fungal infection in a number of countries worldwide. Up to 75% of women are affected by VVC at least once in their lifetime, with the yeast Candida albicans reported to be the organism accounting for >90% of infections. Such cases are effectively treated, however, approximately 138 million women worldwide complain of >4 episodes of VVC per year due to treatment failure. This is clinically defined as recurrent VVC (RVVC) and the reasons to why this happens can be attributed to a number of factors.
1) Unknown species: there are increasing reports of a shift in yeast epidemiology, with a move towards non-C. albicans species (NCAS). This includes organisms that are insensitive to current antifungals used, making treatment of such infections even more challenging.
2) Strain characteristics: Candida species are able to form aggregates on host mucosa, known as biofilms. Cells within a biofilm continue to grow in multiple layers contained within a self-produced slime. This protective structure is highly resistance to antimicrobial therapy and the host immune response, making biofilm infections difficult to resolve. Whether biofilms form in the vagina has been an area of contention, with recent studies showing they do in animal models.
Therefore, in an effort to fully understand RVVC clinically, we aim to conduct a surveillance study whereby the causative organism is identified. In addition, samples from the vaginal mucosa will be obtained and assessed for the ability to form biofilms, using standard culture and molecular methods. The findings of this study will guide future antifungal therapy more appropriately for VVC, reducing patient morbidity and ultimately mitigate healthcare costs.
REC name
Yorkshire & The Humber - Sheffield Research Ethics Committee
REC reference
16/YH/0310
Date of REC Opinion
19 Aug 2016
REC opinion
Further Information Favourable Opinion