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

Summary

This 10-year study from Serbia examined vaginal yeast infections in nearly 2,200 pregnant women. Researchers found that yeast infections occurred in about 48% of symptomatic pregnant women, with Candida albicans being the most common cause. Importantly, the study discovered that other yeast species are increasingly important in these infections, and new identification methods (MALDI-TOF MS) revealed these species are often misidentified by traditional laboratory methods. The findings suggest that accurate yeast identification is essential for choosing the right treatment during pregnancy.

Background

Candida is a common vaginal microbiota component present in approximately 50% of women of reproductive age. During pregnancy, Candida may cause chronic or recurrent infections with significant impact on quality of life and potential for life-threatening vertical transmission to newborns. Accurate identification of causative agents is critical for optimal patient outcomes.

Objective

To determine the 10-year prevalence of Candida albicans, non-albicans Candida, and non-Candida yeast species in symptomatic pregnant women in Serbia using MALDI-TOF MS identification. Secondary aim was to compare accuracy of species identification between traditional biochemical methods and proteomic MALDI-TOF MS methods.

Results

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

Conclusion

The prevalence of emerging non-albicans Candida and non-Candida yeast species is increasing but remains underestimated. Implementation of MALDI-TOF MS enables accurate species identification and supports reconsidering terminology from vulvovaginal candidiosis to vulvovaginal yeast infection. New laboratory diagnostic guidelines are needed for timely and accurate identification to guide appropriate treatment.
  • Published in:Mycopathologia,
  • Study Type:Prospective Cohort Study,
  • Source: PMID: 40952531, DOI: 10.1007/s11046-025-00989-9
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