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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 positive tests. While Candida albicans was most common, many other yeast species were also identified, some of which are resistant to common antifungal medications. Using advanced laboratory techniques (MALDI-TOF MS), researchers found more accurate identification was possible, which is important since different yeasts require different treatments, especially during pregnancy when some medications can harm the baby.

Background

Candida is present in approximately 50% of women of reproductive age and can cause chronic or recurrent infections during pregnancy. Beyond Candida albicans, non-albicans Candida and non-Candida yeast species play important roles in vulvovaginal infections. Precise local epidemiological data on yeast species prevalence in pregnant women has been lacking in Serbia.

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 for species identification. Secondary aims included comparing the accuracy of biochemical versus proteomic identification methods and updating species nomenclature based on current taxonomy.

Results

Laboratory positivity was 48.3% (n=1,035), with prevalence of Candida albicans 74%, non-albicans Candida 23%, and non-Candida yeast 3%. Seven yeast genera were identified including Candida, Pichia, Clavispora, Nakaseomyces, Loddermyces, Kluyveromyces, and Saccharomyces. MALDI-TOF MS showed 100% concordance with biochemical methods for some species but revealed misidentifications in others, highlighting the importance of proteomic identification.

Conclusion

The prevalence of non-albicans Candida and non-Candida yeast species is increasing but remains underestimated in Serbia. Accurate species identification using MALDI-TOF MS is crucial for guiding appropriate antifungal treatment and improving outcomes. The authors recommend updating disease terminology from vulvovaginal candidiosis to vulvovaginal yeast infection and implementing new laboratory diagnostic guidelines.
  • Published in:Mycopathologia,
  • Study Type:Prospective Cohort Study,
  • Source: PMID: 40952531, DOI: 10.1007/s11046-025-00989-9
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