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The objective of this study was to determine the effect of medroxyprogesterone acetate (DMPA) on the development and maintenance of Candida albicans in the vagina of oophorectomized Wistar rats. The animals were divided into negative control groups (NCG), which received injections of sterile saline; positive control groups (PCG), which were given injections of estradiol valerate; and progesterone groups (PG), which were given injections of Depo-Provera®. After one week of hormonal induction, vaginal infection by C. albicans was induced in all the groups and detected by vaginal yeast culture and Papanicolaou smear. In addition, scanning and transmission electron microscopy images were obtained to confirm the vaginal infection by yeast in PG. A difference in progesterone levels in PG was observed between the basal level and after hormonal induction (P<0.0001). In this group, 100 percent of the rats acquired vaginal infection in the first week, but did not maintain it until the third week. The pharmaceutical brand of DMPA was effective for inducing the metestrus or diestrus phase of the estrous cycle in rats, similar to the use of pure progesterone. In contrast to estrogen treatment, progesterone alone could not support an experimental vaginal infection by C. albicans for any significant period of time.

O objetivo do presente estudo foi determinar os efeitos do acetato de depomedroxyprogesterona (ADMP) no desenvolvimento e manutenção de Candida albicans na vagina de ratas Wistar ooferectomizadas. Os animais foram divididos em grupos controle negativos (GCN), que receberam injeções de salina estéril; grupos controle positivos (GCP), que receberam injeções de valerato de estradiol; e grupos progesterona (GP), nos quais foram feitas injeções de Depo-Provera®. Após uma semana da aplicação hormonal, foi induzida a infecção vaginal por C. albicans em todos os grupos, detectada por cultura para leveduras vaginais e esfregaço de Papanicolaou. Foram feitas ainda imagens por microscopia eletrônica de varredura e transmissão para confirmar a infecção pela levedura no GP. Foram observados diferentes níveis de progesterona em GP, entre os valores basais e após a indução hormonal (P<0,0001). Neste grupo, 100,0 por cento das ratas contraíram a infecção vaginal na primeira semana, mas não a mantiveram até a terceira semana. A forma farmacêutica de ADMP foi efetiva em induzir as fases de metaestro e diestro do ciclo estral das ratas, da mesma forma que usando progesterona pura. Em contraste com o que ocorre no tratamento com estrógeno, a progesterona não pôde manter a infecção vaginal experimental por C. albicans por um período significativo de tempo.

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The adhesion of Candida albicans to the genital epithelium has not been fully investigated in vivo. The objective of this study was to evaluate the ultrastructural aspects of C. albicans adhesion in the lower genital system of female Wistar rats through scanning and transmission electron microscopy. The genital infection persisted until the end of the experiment, and all rats showed the same adhesion aspects. Various associated yeast/hyphae were observed in the lumen and adhered both at the vaginal and endocervical levels where the fungal filamentation process occurred. In the vaginal epithelium, closely adhered yeasts were observed as stretched strands bridging between yeasts and the epithelium surface. Different stages of the adhesion, where yeasts internalized into the epithelial cell inside a cytoplasmic vacuole, resembling endocytosis, and a wide fibrillar-floccular, glycocalyx-like layer on the yeasts were observed. On the endocervix, the adhesion occurred between the cilia. In the uterine body, only a yeast-like form was observed with superficial contact. This study reached the initial goal of demonstrating an experimental model for in vivo studies. Continuation of this line of research is important for studies of vulvovaginal candidiasis.

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OBJECTIVES: To determine the prevalence of Candida sp. by cervical-vaginal cytology in patients from the Brazilian Public Health System (SUS) and from the Private Network (RP). METHODS: A retrospective study on the results of cytology exams from the Souza Anatomy Laboratory of Maringá, Paraná state, Brazil, from 2004 to 2006. RESULTS: A total of 94,203 reports of cytology were evaluated, with a prevalence of Candida sp. of 4.94% (n = 4,655), with no significant variation in the two populations or among the 3 years studied (P > 0.05). Candida sp. predominated in both populations, aged between 20 and 39 years (P < 0.0001). The bacterial flora linked to Candida sp. was of lactobacilli (P < 0.05). CONCLUSIONS: With the results obtained, it was noticed that the socio-economical level does not seem to influence the epidemiology of the Candida sp. and pointed to a balance in terms of numbers of this agent in Maringá, Paraná, Brazil.

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The purpose of this work was to evaluate the efficacy of oncotic colpocytology stained with Harris-Shorr in the identification of the cervicovaginal microflora and infectious agents. Results of microbiologic evaluation carried out in colpocytology exams, bacterioscopy (Gram), and direct exams of 2,017 women aged from 13 to 80 years were compared. Of these, 83.1% agreed between cytology and Gram, 3.6% partially agreed, and 12.8% disagreed. The predominant microflora was of lactobacilli (63.3%), followed by mixed flora (32.1%). The results of sensitivity to lactobacilli were 96.1% and to mixed flora 88.0%; the specificity values were 91.2 and 92.0%, respectively. Colpocytology detected all the instances of trichomoniasis observed at direct exam (0.6%). The most frequent infectious agents were of candidiasis (14.8%, sensitivity 80.3%) and bacterial vaginosis (11.9%, sensitivity 68.1%). Thus, Harris-Shorr stained cytology was shown to be an excellent diagnostic method for T. vaginalis, lactobacilli, mixed flora, and candidiasis.

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