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Prevalence of Candida and Other Yeasts in Vulvovaginal Infections during Pregnancy: A 10-Year Serbian Survey

Summary

This study examined yeast infections in pregnant Serbian women over 10 years, finding that nearly half had vulvovaginal yeast infections. While Candida albicans remained the most common cause, other yeast species are increasingly found and can be harder to treat. The research emphasizes the importance of accurate laboratory identification of yeast species to guide proper antifungal treatment and prevent serious complications for both mother and newborn.

Background

Candida is a common component of vaginal microbiota present in approximately 50% of women of reproductive age. During pregnancy, Candida can cause chronic or recurrent infections with potential for vertical transmission leading to life-threatening neonatal infections. Timely identification of causative yeast species is critical for appropriate treatment and prevention of adverse outcomes.

Objective

To determine the 10-year prevalence of Candida albicans, non-albicans Candida species, and non-Candida yeasts in symptomatic pregnant women in Serbia using MALDI-TOF MS for species identification. The study aimed to compare identification accuracy between traditional biochemical methods and proteomic MALDI-TOF MS methods.

Results

Laboratory positivity was 48.3% (n=1,035). Prevalence of Candida albicans, non-albicans Candida, and non-Candida yeasts were 74%, 23%, and 3% respectively. MALDI-TOF MS identified seven yeast genera including Candida, Saccharomyces, Pichia, Clavispora, Nakaseomyces, Loddermyces, and Kluyveromyces. Perfect concordance (100%) was observed between methods for C. albicans and several NAC species.

Conclusion

The prevalence of emerging non-albicans Candida and non-Candida yeast species in pregnant women is increasing but remains underestimated. New laboratory diagnostic guidelines incorporating MALDI-TOF MS identification are needed to enable accurate species identification and guide appropriate antifungal therapy. The study supports reconsidering disease terminology from vulvovaginal candidiosis to vulvovaginal yeast infection.
  • Published in:Mycopathologia,
  • Study Type:Cross-sectional/Epidemiological Survey,
  • Source: PMID: 40952531, DOI: 10.1007/s11046-025-00989-9
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