The Vaginal Microbiome and Recurrent Vulvovaginal Candidiasis: A Narrative Review
DOI:
https://doi.org/10.31149/ijimm.v4i8.2970Keywords:
recurrent infection, fungal infection, candida, dysbiosis, lactobacillusAbstract
Recurrent vulvovaginal candidiasis affects approximately 140 million women annually, yet its pathogenesis remains incompletely understood. This narrative review synthesizes current evidence on the role of the vaginal microbiome in recurrent vulvovaginal candidiasis, emphasizing emerging paradigms that extend beyond candida centric models. Many metagenomic studies reveal that recurrent vulvovaginal candidiasis is associated with distinct vaginal microbiota signatures, notably characterized Lactobacillus iners dominance and increased abundance of an aerobics. Biofilm formation by Candida albicans isolates from recurrent vulvovaginal candidiasis patients demonstrates significantly higher biomass production, potentially contributing to treatment failure and relapse. The interkingdom interplay between bacterial communities and fungal pathogens, alongside host immune responses, appears central to disease persistence. Beyond standard antifungal therapy, novel therapeutic approaches including microbiome modulating strategies and selective inhibitors such as Oteseconazole show promise in extending recurrence free intervals. This integrated perspective on host, microbiome, and pathogen interactions may inform the development of personalized preventive and therapeutic strategies for this debilitating condition.
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