{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T16:40:00Z","timestamp":1792255200459,"version":"4.4.0"},"reference-count":101,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100019690","name":"MRC Centre for Medical Mycology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100019690","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000737","name":"University of Exeter","doi-asserted-by":"publisher","award":["MR\/N006364\/2"],"award-info":[{"award-number":["MR\/N006364\/2"]}],"id":[{"id":"10.13039\/501100000737","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000737","name":"University of Exeter","doi-asserted-by":"publisher","award":["MR\/V033417\/1"],"award-info":[{"award-number":["MR\/V033417\/1"]}],"id":[{"id":"10.13039\/501100000737","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIHR Exeter Biomedical Research Centre","award":["NIHR203320"],"award-info":[{"award-number":["NIHR203320"]}]},{"DOI":"10.13039\/501100000276","name":"Department of Health and Social Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000276","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Vulvovaginal candidiasis is one of the most prevalent infections in women worldwide. Together with its recurrent form, it affects millions of women annually, causing significant symptoms and severely impacting quality of life. This review examines the pathophysiology, risk factors, microbiome interactions, clinical manifestations, and challenges in diagnosing and managing vulvovaginal candidiasis, with emphasis on recurrent vulvovaginal candidiasis. While Candida albicans is the primary cause, non-albicans species are increasingly common. Multiple factors contribute to both forms, including hormonal changes, diabetes, antibiotic use, immune dysfunction, and genetics. The vaginal microbiome plays a key role in maintaining homeostasis and preventing Candida overgrowth. Symptoms such as itching, discharge, and soreness overlap with other conditions, complicating the diagnosis. Standard treatment involves topical or systemic antifungals, but recurrence and resistance are frequent. Emerging strategies include novel antifungals, immunomodulators, and vaccines. Future approaches should focus on modulating host and environmental factors to prevent recurrence, reduce resistance, and improve outcomes.<\/jats:p>","DOI":"10.1093\/cid\/ciaf673","type":"journal-article","created":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T13:01:56Z","timestamp":1765026116000},"page":"371-382","source":"Crossref","is-referenced-by-count":18,"title":["State-of-the-Art Review: Managing Vulvovaginal Candidiasis"],"prefix":"10.1093","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1071-6040","authenticated-orcid":false,"given":"Riina","family":"Rautemaa-Richardson","sequence":"first","affiliation":[{"name":"Mycology Reference Centre Manchester and Department of Infectious Diseases, ECMM Centre of Excellence, Manchester Academic Health Science Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust , Manchester ,","place":["United Kingdom"]},{"name":"Division of Evolution, Infection and Genomics, Faculty of Biology, Medicine and Health, University of Manchester , Manchester ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5589-4609","authenticated-orcid":false,"given":"Jack D","family":"Sobel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Wayne State University School of Medicine , Detroit, Michigan ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6887-7947","authenticated-orcid":false,"given":"Neil","family":"Stone","sequence":"additional","affiliation":[{"name":"Hospital for Tropical Diseases\/University College London Hospitals Infection Division , London ,","place":["United Kingdom"]},{"name":"Centre for Clinical Microbiology, Division of Infection and Immunity, University College London , London ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"De Seta","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, IRCCS San Raffaele Scientific Institute , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0434-0761","authenticated-orcid":false,"given":"Antonio","family":"Cassone","sequence":"additional","affiliation":[{"name":"Polo d'Innovazione della Genomica, Genetica e Biologia , Siena ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Vieira-Baptista","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Gynecology-Obstetrics and Pediatrics, Universidade do Porto , Porto ,","place":["Portugal"]},{"name":"Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University , Ghent ,","place":["Belgium"]},{"name":"Department of Gynecology and Obstetrics, Hospital Lus\u00edadas Porto , Porto ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manola","family":"Comar","sequence":"additional","affiliation":[{"name":"Advanced Translational Microbiology, Institute for Maternal and Child Health-IRCCS Burlo Garofolo , Trieste ,","place":["Italy"]},{"name":"Department of Medicine, Surgery and Health Sciences, University of Trieste , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6586-3358","authenticated-orcid":false,"given":"Adilia","family":"Warris","sequence":"additional","affiliation":[{"name":"Department of Biosciences, Faculty of Health and Life Sciences, Medical Research Council Centre for Medical Mycology at the University of Exeter , Exeter ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3929-7502","authenticated-orcid":false,"given":"Elena","family":"Roselletti","sequence":"additional","affiliation":[{"name":"Department of Biosciences, Faculty of Health and Life Sciences, Medical Research Council Centre for Medical Mycology at the University of Exeter , Exeter ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"2026031620014122700_ciaf673-B1","doi-asserted-by":"crossref","first-page":"e339","DOI":"10.1016\/S1473-3099(18)30103-8","article-title":"Global burden of recurrent vulvovaginal candidiasis: a systematic review","volume":"18","author":"Denning","year":"2018","journal-title":"Lancet Infect Dis"},{"key":"2026031620014122700_ciaf673-B2","doi-asserted-by":"crossref","first-page":"20503121221115201","DOI":"10.1177\/20503121221115201","article-title":"Clinical challenges in diagnosis and treatment of recurrent vulvovaginal candidiasis","volume":"10","author":"Neal","year":"2022","journal-title":"SAGE Open Med"},{"key":"2026031620014122700_ciaf673-B3","author":"CDC"},{"key":"2026031620014122700_ciaf673-B4","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1097\/LGT.0b013e318273e8cf","article-title":"Prevalence of recurrent vulvovaginal candidiasis in 5 European countries and the United States: results from an internet panel survey","volume":"17","author":"Foxman","year":"2013","journal-title":"J Low Genit Tract Dis"},{"key":"2026031620014122700_ciaf673-B5","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.ajog.2015.06.067","article-title":"Recurrent vulvovaginal candidiasis","volume":"214","author":"Sobel","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"2026031620014122700_ciaf673-B6","doi-asserted-by":"crossref","first-page":"S162","DOI":"10.1093\/cid\/ciab1057","article-title":"Vulvovaginal candidiasis: a review of the evidence for the 2021 Centers for Disease Control and Prevention of sexually transmitted infections treatment guidelines","volume":"74","author":"Nyirjesy","year":"2022","journal-title":"Clin Infect Dis"},{"key":"2026031620014122700_ciaf673-B7","doi-asserted-by":"crossref","first-page":"1625952","DOI":"10.3389\/fmicb.2025.1625952","article-title":"New insights toward personalized therapies for vulvovaginal candidiasis and vaginal co-infections","volume":"16","author":"De Seta","year":"2025","journal-title":"Front Microbiol"},{"key":"2026031620014122700_ciaf673-B8","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.3390\/pharmaceutics16121555","article-title":"Fluconazole-resistant vulvovaginal candidosis: an update on current management","volume":"16","author":"Akinosoglou","year":"2024","journal-title":"Pharmaceutics"},{"key":"2026031620014122700_ciaf673-B9","doi-asserted-by":"crossref","first-page":"27","DOI":"10.3390\/jof6010027","article-title":"Vulvovaginal candidiasis: a current understanding and burning questions","volume":"6","author":"Willems","year":"2020","journal-title":"J Fungi (Basel)"},{"key":"2026031620014122700_ciaf673-B10","doi-asserted-by":"crossref","first-page":"312","DOI":"10.2337\/dc06-1469","article-title":"Prevalence of Candida glabrata and its response to boric acid vaginal suppositories in comparison with oral fluconazole in patients with diabetes and vulvovaginal candidiasis","volume":"30","author":"Ray","year":"2007","journal-title":"Diabetes Care"},{"key":"2026031620014122700_ciaf673-B11","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1186\/s12905-022-01741-x","article-title":"Survey of incidence, lifetime prevalence, and treatment of self-reported vulvovaginal candidiasis, United States, 2020","volume":"22","author":"Benedict","year":"2022","journal-title":"BMC Womens Health"},{"key":"2026031620014122700_ciaf673-B12","doi-asserted-by":"crossref","first-page":"924","DOI":"10.3390\/jof8090924","article-title":"Compliance with the updated BASHH recurrent vulvovaginal candidiasis guidelines improves patient outcomes","volume":"8","author":"Brown","year":"2022","journal-title":"J Fungi (Basel)"},{"key":"2026031620014122700_ciaf673-B13","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1186\/s12905-024-03063-6","article-title":"A mixed methods systematic literature review of barriers and facilitators to help-seeking among women with stigmatised pelvic health symptoms","volume":"24","author":"Jouanny","year":"2024","journal-title":"BMC Womens Health"},{"key":"2026031620014122700_ciaf673-B14","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1177\/13634593241271041","article-title":"Loss, shame and secrecy in women's experiences of a vulval skin condition: a qualitative study","volume":"29","author":"Rees","year":"2025","journal-title":"Health (London)"},{"key":"2026031620014122700_ciaf673-B15","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.1093\/jac\/dkt156","article-title":"Vaginal concentrations of lactic acid potently inactivate HIV","volume":"68","author":"Aldunate","year":"2013","journal-title":"J Antimicrob Chemother"},{"key":"2026031620014122700_ciaf673-B16","doi-asserted-by":"crossref","first-page":"1936","DOI":"10.3389\/fmicb.2016.01936","article-title":"Lactobacilli dominance and vaginal pH: why is the human vaginal microbiome unique?","volume":"7","author":"Miller","year":"2016","journal-title":"Front Microbiol"},{"key":"2026031620014122700_ciaf673-B17","doi-asserted-by":"crossref","first-page":"3265","DOI":"10.3389\/fmicb.2018.03265","article-title":"Effect of acetic acid and lactic acid at low pH in growth and azole resistance of Candida albicans and Candida glabrata","volume":"9","author":"Lourenco","year":"2018","journal-title":"Front Microbiol"},{"key":"2026031620014122700_ciaf673-B18","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1080\/21505594.2016.1237332","article-title":"The vaginal mycobiome: a contemporary perspective on fungi in women's health and diseases","volume":"8","author":"Bradford","year":"2017","journal-title":"Virulence"},{"key":"2026031620014122700_ciaf673-B19","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1016\/j.resmic.2017.02.005","article-title":"Candida and its dual lifestyle as a commensal and a pathogen","volume":"168","author":"Cauchie","year":"2017","journal-title":"Res Microbiol"},{"key":"2026031620014122700_ciaf673-B20","doi-asserted-by":"crossref","first-page":"631972","DOI":"10.3389\/fcimb.2021.631972","article-title":"The female vaginal microbiome in health and bacterial vaginosis","volume":"11","author":"Chen","year":"2021","journal-title":"Front Cell Infect Microbiol"},{"key":"2026031620014122700_ciaf673-B21","doi-asserted-by":"crossref","first-page":"103599","DOI":"10.1016\/j.micpath.2019.103599","article-title":"Vaginal microbiota of asymptomatic bacterial vaginosis and vulvovaginal candidiasis: are they different from normal microbiota?","volume":"134","author":"Pramanick","year":"2019","journal-title":"Microb Pathog"},{"key":"2026031620014122700_ciaf673-B22","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1007\/s11908-013-0325-5","article-title":"Mixed vaginitis-more than coinfection and with therapeutic implications","volume":"15","author":"Sobel","year":"2013","journal-title":"Curr Infect Dis Rep"},{"key":"2026031620014122700_ciaf673-B23","doi-asserted-by":"crossref","first-page":"108","DOI":"10.3390\/microorganisms12010108","article-title":"Bacterial vaginosis and vulvovaginal candidiasis pathophysiologic interrelationship","volume":"12","author":"Sobel","year":"2024","journal-title":"Microorganisms"},{"key":"2026031620014122700_ciaf673-B24","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.3390\/microorganisms11051211","article-title":"The interplay between Candida albicans, vaginal mucosa, host immunity and resident microbiota in health and disease: an overview and future perspectives","volume":"11","author":"Gaziano","year":"2023","journal-title":"Microorganisms"},{"key":"2026031620014122700_ciaf673-B25","doi-asserted-by":"crossref","first-page":"119","DOI":"10.4161\/viru.22913","article-title":"Candida albicans pathogenicity mechanisms","volume":"4","author":"Mayer","year":"2013","journal-title":"Virulence"},{"key":"2026031620014122700_ciaf673-B26","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s00294-023-01263-5","article-title":"Morphogenic plasticity: the pathogenic attribute of Candida albicans","volume":"69","author":"Prasad","year":"2023","journal-title":"Curr Genet"},{"key":"2026031620014122700_ciaf673-B27","doi-asserted-by":"crossref","first-page":"2669","DOI":"10.3389\/fmicb.2019.02669","article-title":"A role for yeast\/pseudohyphal cells of Candida albicans in the correlated expression of NLRP3 inflammasome inducers in women with acute vulvovaginal candidiasis","volume":"10","author":"Roselletti","year":"2019","journal-title":"Front Microbiol"},{"key":"2026031620014122700_ciaf673-B28","doi-asserted-by":"crossref","first-page":"eadi3363","DOI":"10.1126\/scitranslmed.adi3363","article-title":"Zinc prevents vaginal candidiasis by inhibiting expression of an inflammatory fungal protein","volume":"15","author":"Roselletti","year":"2023","journal-title":"Sci Transl Med"},{"key":"2026031620014122700_ciaf673-B29","doi-asserted-by":"crossref","first-page":"iqae010","DOI":"10.1093\/oxfimm\/iqae010","article-title":"Inflammatory cytokine signalling in vulvovaginal candidiasis: a hot mess driving immunopathology","volume":"5","author":"Cheng","year":"2024","journal-title":"Oxf Open Immunol"},{"key":"2026031620014122700_ciaf673-B30","doi-asserted-by":"crossref","first-page":"a004952","DOI":"10.1101\/cshperspect.a004952","article-title":"Heparan sulfate proteoglycans","volume":"3","author":"Sarrazin","year":"2011","journal-title":"Cold Spring Harb Perspect Biol"},{"key":"2026031620014122700_ciaf673-B31","doi-asserted-by":"crossref","first-page":"e00211-17","DOI":"10.1128\/mBio.00211-17","article-title":"Vaginal heparan sulfate linked to neutrophil dysfunction in the acute inflammatory response associated with experimental vulvovaginal candidiasis","volume":"8","author":"Yano","year":"2017","journal-title":"mBio"},{"key":"2026031620014122700_ciaf673-B32","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1128\/IAI.00861-13","article-title":"Vaginal epithelial cell-derived S100 alarmins induced by Candida albicans via pattern recognition receptor interactions are sufficient but not necessary for the acute neutrophil response during experimental vaginal candidiasis","volume":"82","author":"Yano","year":"2014","journal-title":"Infect Immun"},{"key":"2026031620014122700_ciaf673-B33","doi-asserted-by":"crossref","first-page":"225","DOI":"10.3390\/jof6040225","article-title":"Perinuclear anti-neutrophil cytoplasmic antibodies (pANCA) impair neutrophil candidacidal activity and are increased in the cellular fraction of vaginal samples from women with vulvovaginal candidiasis","volume":"6","author":"Ardizzoni","year":"2020","journal-title":"J Fungi (Basel)"},{"key":"2026031620014122700_ciaf673-B34","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1177\/0956462420943034","article-title":"British Association for Sexual Health and HIV national guideline for the management of vulvovaginal candidiasis (2019)","volume":"31","author":"Saxon Lead Author, Guideline Development Group Cara","year":"2020","journal-title":"Int J STD AIDS"},{"key":"2026031620014122700_ciaf673-B35","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1016\/S0140-6736(07)60917-9","article-title":"Vulvovaginal candidosis","volume":"369","author":"Sobel","year":"2007","journal-title":"Lancet"},{"key":"2026031620014122700_ciaf673-B36","doi-asserted-by":"crossref","first-page":"130","DOI":"10.14715\/cmb\/2021.67.4.15","article-title":"Comparison of copper IUDs and hormonal IUDs in prevalence of Candida species in cervicovaginal smears","volume":"67","author":"Wei","year":"2022","journal-title":"Cell Mol Biol (Noisy-le-grand)"},{"key":"2026031620014122700_ciaf673-B37","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1099\/jmm.0.000657","article-title":"Short- and long-term influence of the levonorgestrel-releasing intrauterine system (Mirena(R)) on vaginal microbiota and Candida","volume":"67","author":"Donders","year":"2018","journal-title":"J Med Microbiol"},{"key":"2026031620014122700_ciaf673-B38","doi-asserted-by":"crossref","first-page":"387070","DOI":"10.1155\/2014\/387070","article-title":"Determinants of symptomatic vulvovaginal candidiasis among human immunodeficiency virus type 1 infected women in rural KwaZulu-Natal, South Africa","volume":"2014","author":"Apalata","year":"2014","journal-title":"Infect Dis Obstet Gynecol"},{"key":"2026031620014122700_ciaf673-B39","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1086\/317936","article-title":"The evolution of Candida species and fluconazole susceptibility among oral and vaginal isolates recovered from human immunodeficiency virus (HIV)-seropositive and at-risk HIV-seronegative women","volume":"183","author":"Sobel","year":"2001","journal-title":"J Infect Dis"},{"key":"2026031620014122700_ciaf673-B40","first-page":"CD008739","article-title":"Interventions for prevention and treatment of vulvovaginal candidiasis in women with HIV infection","author":"Ray","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"2026031620014122700_ciaf673-B41","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1053\/jinf.2000.0723","article-title":"Species-specific prevalence of vaginal candidiasis among patients with diabetes mellitus and its relation to their glycaemic status","volume":"41","author":"Goswami","year":"2000","journal-title":"J Infect"},{"key":"2026031620014122700_ciaf673-B42","doi-asserted-by":"crossref","first-page":"458","DOI":"10.2337\/cd23-0011","article-title":"Diabetes and vulvovaginal conditions","volume":"41","author":"O'Laughlin","year":"2023","journal-title":"Clin Diabetes"},{"key":"2026031620014122700_ciaf673-B43","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/0010-7824(95)00079-P","article-title":"The impact of oral contraception on vulvovaginal candidiasis","volume":"51","author":"Spinillo","year":"1995","journal-title":"Contraception"},{"key":"2026031620014122700_ciaf673-B44","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1128\/CMR.00029-06","article-title":"Epidemiology of invasive candidiasis: a persistent public health problem","volume":"20","author":"Pfaller","year":"2007","journal-title":"Clin Microbiol Rev"},{"key":"2026031620014122700_ciaf673-B45","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/S0025-6196(11)60839-2","article-title":"Fungal infections complicating tumor necrosis factor alpha blockade therapy","volume":"83","author":"Tsiodras","year":"2008","journal-title":"Mayo Clin Proc"},{"key":"2026031620014122700_ciaf673-B46","first-page":"e85","article-title":"Use of Dermasilk briefs in recurrent vulvovaginal candidosis: safety and effectiveness","volume":"55","author":"D'Antuono","year":"2012","journal-title":"Mycoses"},{"key":"2026031620014122700_ciaf673-B47","first-page":"509","article-title":"The association between dietary intake and reported history of Candida vulvovaginitis","volume":"29","author":"Reed","year":"1989","journal-title":"J Fam Pract"},{"key":"2026031620014122700_ciaf673-B48","first-page":"e30510","article-title":"Consuming an all-meat ketogenic diet for the long-term management of Candida vulvovaginitis and vaginal hidradenitis suppurativa: a 47-month follow-up case report","volume":"14","author":"Yar","year":"2022","journal-title":"Cureus"},{"key":"2026031620014122700_ciaf673-B49","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1038\/s41430-019-0517-7","article-title":"Sunlight exposure, consumption of vitamin D-rich foods and vulvovaginal candidiasis in an African population: a prevalence case-control study","volume":"74","author":"Amegah","year":"2020","journal-title":"Eur J Clin Nutr"},{"key":"2026031620014122700_ciaf673-B50","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1186\/s12879-023-08120-3","article-title":"Association between bacterial vaginosis and 25-hydroxy vitamin D: a case-control study","volume":"23","author":"Mojtahedi","year":"2023","journal-title":"BMC Infect Dis"},{"key":"2026031620014122700_ciaf673-B51","doi-asserted-by":"crossref","first-page":"329","DOI":"10.2105\/AJPH.80.3.329","article-title":"The epidemiology of vulvovaginal candidiasis: risk factors","volume":"80","author":"Foxman","year":"1990","journal-title":"Am J Public Health"},{"key":"2026031620014122700_ciaf673-B52","doi-asserted-by":"crossref","first-page":"e280","DOI":"10.1016\/S1473-3099(24)00749-7","article-title":"Global guideline for the diagnosis and management of candidiasis: an initiative of the ECMM in cooperation with ISHAM and ASM","volume":"25","author":"Cornely","year":"2025","journal-title":"Lancet Infect Dis"},{"key":"2026031620014122700_ciaf673-B53","doi-asserted-by":"crossref","first-page":"e1011684","DOI":"10.1371\/journal.ppat.1011684","article-title":"Insights and advances in recurrent vulvovaginal candidiasis","volume":"19","author":"San Juan Gal\u00e1n","year":"2023","journal-title":"PLoS Pathog"},{"key":"2026031620014122700_ciaf673-B54","doi-asserted-by":"crossref","first-page":"17877","DOI":"10.1038\/s41598-017-17649-8","article-title":"NLRP3 inflammasome is a key player in human vulvovaginal disease caused by Candida albicans","volume":"7","author":"Roselletti","year":"2017","journal-title":"Sci Rep"},{"key":"2026031620014122700_ciaf673-B55","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1007\/s10096-016-2600-5","article-title":"Association of a variable number tandem repeat in the NLRP3 gene in women with susceptibility to RVVC","volume":"35","author":"Jaeger","year":"2016","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"2026031620014122700_ciaf673-B56","doi-asserted-by":"crossref","first-page":"eaar3558","DOI":"10.1126\/scitranslmed.aar3558","article-title":"A systems genomics approach identifies SIGLEC15 as a susceptibility factor in recurrent vulvovaginal candidiasis","volume":"11","author":"Jaeger","year":"2019","journal-title":"Sci Transl Med"},{"key":"2026031620014122700_ciaf673-B57","doi-asserted-by":"crossref","first-page":"12149","DOI":"10.1038\/s41598-025-95772-7","article-title":"Genetic susceptibility to recurrent vulvovaginal candidiasis in an African population from Nairobi, Kenya","volume":"15","author":"Omosa-Manyonyi","year":"2025","journal-title":"Sci Rep"},{"key":"2026031620014122700_ciaf673-B58","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1097\/01.qco.0000160897.74492.a3","article-title":"Immunity in vaginal candidiasis","volume":"18","author":"Fidel","year":"2005","journal-title":"Curr Opin Infect Dis"},{"key":"2026031620014122700_ciaf673-B59","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1111\/j.1600-0897.2006.00450.x","article-title":"History and update on host defense against vaginal candidiasis","volume":"57","author":"Fidel","year":"2007","journal-title":"Am J Reprod Immunol"},{"key":"2026031620014122700_ciaf673-B60","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1097\/LGT.0000000000000643","article-title":"The vaginal microbiome: I. research development, lexicon, defining \u201cnormal\u201d and the dynamics throughout women's lives","volume":"26","author":"Verstraelen","year":"2022","journal-title":"J Low Genit Tract Dis"},{"key":"2026031620014122700_ciaf673-B61","doi-asserted-by":"crossref","first-page":"4680","DOI":"10.1073\/pnas.1002611107","article-title":"Vaginal microbiome of reproductive-age women","volume":"108 Suppl 1","author":"Ravel","year":"2011","journal-title":"Proc Natl Acad Sci U S A"},{"key":"2026031620014122700_ciaf673-B62","doi-asserted-by":"crossref","first-page":"2431","DOI":"10.1038\/ismej.2014.90","article-title":"Primate vaginal microbiomes exhibit species specificity without universal Lactobacillus dominance","volume":"8","author":"Yildirim","year":"2014","journal-title":"ISME J"},{"key":"2026031620014122700_ciaf673-B63","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1038\/s42003-022-03955-z","article-title":"Integrative functional analysis uncovers metabolic differences between Candida species","volume":"5","author":"Begum","year":"2022","journal-title":"Commun Biol"},{"key":"2026031620014122700_ciaf673-B64","doi-asserted-by":"crossref","first-page":"2451165","DOI":"10.1080\/21505594.2025.2451165","article-title":"Lactic acid in the vaginal milieu modulates the Candida-host interaction","volume":"16","author":"Rosati","year":"2025","journal-title":"Virulence"},{"key":"2026031620014122700_ciaf673-B65","doi-asserted-by":"crossref","first-page":"273","DOI":"10.4103\/0366-6999.198927","article-title":"Lactobacillus crispatus modulates vaginal epithelial cell innate response to Candida albicans","volume":"130","author":"Niu","year":"2017","journal-title":"Chin Med J (Engl)"},{"key":"2026031620014122700_ciaf673-B66","doi-asserted-by":"crossref","first-page":"6151","DOI":"10.1038\/s41467-021-26390-w","article-title":"A small molecule produced by Lactobacillus species blocks Candida albicans filamentation by inhibiting a DYRK1-family kinase","volume":"12","author":"MacAlpine","year":"2021","journal-title":"Nat Commun"},{"key":"2026031620014122700_ciaf673-B67","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/cid\/civ933","article-title":"Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America","volume":"62","author":"Pappas","year":"2016","journal-title":"Clin Infect Dis"},{"key":"2026031620014122700_ciaf673-B68","doi-asserted-by":"crossref","first-page":"2497","DOI":"10.1128\/jcm.34.10.2497-2499.1996","article-title":"Vaginal microbiology of women with acute recurrent vulvovaginal candidiasis","volume":"34","author":"Sobel","year":"1996","journal-title":"J Clin Microbiol"},{"key":"2026031620014122700_ciaf673-B69","first-page":"7148","article-title":"Associations between bacterial vaginosis, candida vaginitis, trichomonas vaginalis, and vaginal pathogenic community in Chinese women","volume":"13","author":"Yuan","year":"2021","journal-title":"Am J Transl Res"},{"key":"2026031620014122700_ciaf673-B70","doi-asserted-by":"crossref","first-page":"foz008","DOI":"10.1093\/femsyr\/foz008","article-title":"Anti-Candida activity of beneficial vaginal lactobacilli in in vitro assays and in a murine experimental model","volume":"19","author":"De Gregorio","year":"2019","journal-title":"FEMS Yeast Res"},{"key":"2026031620014122700_ciaf673-B71","doi-asserted-by":"crossref","first-page":"14095","DOI":"10.1038\/s41598-019-50410-x","article-title":"Diversity of vaginal microbiome and metabolome during genital infections","volume":"9","author":"Ceccarani","year":"2019","journal-title":"Sci Rep"},{"key":"2026031620014122700_ciaf673-B72","doi-asserted-by":"crossref","first-page":"e0062221","DOI":"10.1128\/msystems.00622-21","article-title":"Recurrent vulvovaginal candidiasis: a dynamic interkingdom biofilm disease of Candida and Lactobacillus","volume":"6","author":"McKloud","year":"2021","journal-title":"mSystems"},{"key":"2026031620014122700_ciaf673-B73","doi-asserted-by":"crossref","first-page":"e0152124","DOI":"10.1128\/spectrum.01521-24","article-title":"Highlight signatures of vaginal microbiota and metabolome contributed to the occurrence and recurrence of vulvovaginal candidiasis","volume":"12","author":"Liang","year":"2024","journal-title":"Microbiol Spectr"},{"key":"2026031620014122700_ciaf673-B74","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1007\/s11908-019-0700-y","article-title":"Vulvovaginitis caused by Candida species following antibiotic exposure","volume":"21","author":"Shukla","year":"2019","journal-title":"Curr Infect Dis Rep"},{"key":"2026031620014122700_ciaf673-B75","author":"Vieira-Baptista"},{"key":"2026031620014122700_ciaf673-B76","first-page":"CD009151","article-title":"Treatment for recurrent vulvovaginal candidiasis (thrush)","volume":"1","author":"Cooke","year":"2022","journal-title":"Cochrane Database Syst Rev"},{"key":"2026031620014122700_ciaf673-B77","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1016\/0272-0590(85)90172-1","article-title":"Chronic toxicity and carcinogenicity studies of gentian violet in mice","volume":"5","author":"Littlefield","year":"1985","journal-title":"Fundam Appl Toxicol"},{"key":"2026031620014122700_ciaf673-B78","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1111\/exd.12257","article-title":"Gentian violet: a 19th century drug re-emerges in the 21st century","volume":"22","author":"Maley","year":"2013","journal-title":"Exp Dermatol"},{"key":"2026031620014122700_ciaf673-B79","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/myc.12292","article-title":"Guideline: vulvovaginal candidosis (AWMF 015\/072), S2k (excluding chronic mucocutaneous candidosis)","volume":"58 Suppl 1","author":"Mendling","year":"2015","journal-title":"Mycoses"},{"key":"2026031620014122700_ciaf673-B80","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1097\/LGT.0b013e318287aced","article-title":"Vulvovaginal candidiasis as a chronic disease: diagnostic criteria and definition","volume":"18","author":"Hong","year":"2014","journal-title":"J Low Genit Tract Dis"},{"key":"2026031620014122700_ciaf673-B81","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.clinmicnews.2006.05.004","article-title":"Recurrent vulvovaginal candidiasis","volume":"28","author":"Ventolini","year":"2006","journal-title":"Clin Microbiol Newsl"},{"key":"2026031620014122700_ciaf673-B82","doi-asserted-by":"crossref","first-page":"43","DOI":"10.5694\/j.1326-5377.2003.tb05418.x","article-title":"\u201cNot thrush again!\u201d Women's experience of post-antibiotic vulvovaginitis","volume":"179","author":"Pirotta","year":"2003","journal-title":"Med J Aust"},{"key":"2026031620014122700_ciaf673-B83","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1080\/14787210.2024.2347953","article-title":"Treatment of vaginitis caused by non-albicans Candida species","volume":"22","author":"Sobel","year":"2024","journal-title":"Expert Rev Anti Infect Ther"},{"key":"2026031620014122700_ciaf673-B84","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1007\/s15010-024-02233-w","article-title":"Efficacy and safety of oral ibrexafungerp in Chinese patients with vulvovaginal candidiasis: a phase III, randomized, double-blind study","volume":"52","author":"Wang","year":"2024","journal-title":"Infection"},{"key":"2026031620014122700_ciaf673-B85","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1089\/jwh.2022.0132","article-title":"Oral ibrexafungerp for vulvovaginal candidiasis treatment: an analysis of VANISH 303 and VANISH 306","volume":"32","author":"Goje","year":"2023","journal-title":"J Womens Health (Larchmt)"},{"key":"2026031620014122700_ciaf673-B86","doi-asserted-by":"crossref","first-page":"363","DOI":"10.2147\/DDDT.S339349","article-title":"Ibrexafungerp for the treatment of vulvovaginal candidiasis: design, development and place in therapy","volume":"17","author":"Phillips","year":"2023","journal-title":"Drug Des Devel Ther"},{"key":"2026031620014122700_ciaf673-B87","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1093\/cid\/ciad002","article-title":"New antifungals for vulvovaginal candidiasis: what is their role?","volume":"76","author":"Sobel","year":"2023","journal-title":"Clin Infect Dis"},{"key":"2026031620014122700_ciaf673-B88","doi-asserted-by":"crossref","first-page":"857","DOI":"10.3390\/jof8080857","article-title":"Pharmacodynamics, mechanisms of action and resistance, and spectrum of activity of new antifungal agents","volume":"8","author":"Wiederhold","year":"2022","journal-title":"J Fungi (Basel)"},{"key":"2026031620014122700_ciaf673-B89","doi-asserted-by":"crossref","first-page":"3243","DOI":"10.1016\/j.bmcl.2017.06.037","article-title":"Design and optimization of highly-selective, broad spectrum fungal CYP51 inhibitors","volume":"27","author":"Yates","year":"2017","journal-title":"Bioorg Med Chem Lett"},{"key":"2026031620014122700_ciaf673-B90","doi-asserted-by":"crossref","first-page":"e1518","DOI":"10.1093\/cid\/ciaa1204","article-title":"A randomized phase 2 study of VT-1161 for the treatment of acute vulvovaginal candidiasis","volume":"73","author":"Brand","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2026031620014122700_ciaf673-B91","doi-asserted-by":"crossref","first-page":"880.e1","DOI":"10.1016\/j.ajog.2022.07.023","article-title":"Phase 3 study evaluating the safety and efficacy of oteseconazole in the treatment of recurrent vulvovaginal candidiasis and acute vulvovaginal candidiasis infections","volume":"227","author":"Martens","year":"2022","journal-title":"Am J Obstet Gynecol"},{"key":"2026031620014122700_ciaf673-B92","doi-asserted-by":"crossref","first-page":"e0077823","DOI":"10.1128\/aac.00778-23","article-title":"Oteseconazole versus fluconazole for the treatment of severe vulvovaginal candidiasis: a multicenter, randomized, double-blinded, phase 3 trial","volume":"68","author":"Wang","year":"2024","journal-title":"Antimicrob Agents Chemother"},{"key":"2026031620014122700_ciaf673-B93","doi-asserted-by":"crossref","first-page":"EVIDoa2100055","DOI":"10.1056\/EVIDoa2100055","article-title":"Efficacy and safety of oteseconazole in recurrent vulvovaginal candidiasis","volume":"1","author":"Sobel","year":"2022","journal-title":"NEJM Evid"},{"key":"2026031620014122700_ciaf673-B94","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1177\/10600280231195649","article-title":"Oteseconazole for the treatment of recurrent vulvovaginal candidiasis: a drug review","volume":"58","author":"Lanier","year":"2024","journal-title":"Ann Pharmacother"},{"key":"2026031620014122700_ciaf673-B95","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.ejogrb.2024.09.040","article-title":"Maintenance pharmacological therapy of recurrent vulvovaginal candidiasis. A Bayesian network meta-analysis of randomized studies","volume":"302","author":"Gardella","year":"2024","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2026031620014122700_ciaf673-B96","doi-asserted-by":"crossref","first-page":"e1002777","DOI":"10.1371\/journal.ppat.1002777","article-title":"Candida albicans scavenges host zinc via Pra1 during endothelial invasion","volume":"8","author":"Citiulo","year":"2012","journal-title":"PLoS Pathog"},{"key":"2026031620014122700_ciaf673-B97","doi-asserted-by":"crossref","first-page":"1654","DOI":"10.1016\/j.chom.2024.08.018","article-title":"Host-microbe interaction paradigms in acute and recurrent vulvovaginal candidiasis","volume":"32","author":"MacAlpine","year":"2024","journal-title":"Cell Host Microbe"},{"key":"2026031620014122700_ciaf673-B98","doi-asserted-by":"crossref","first-page":"e0340923","DOI":"10.1128\/mbio.03409-23","article-title":"Nanobody-mediated neutralization of candidalysin prevents epithelial damage and inflammatory responses that drive vulvovaginal candidiasis pathogenesis","volume":"15","author":"Valentine","year":"2024","journal-title":"mBio"},{"key":"2026031620014122700_ciaf673-B99","doi-asserted-by":"crossref","first-page":"e00724","DOI":"10.1128\/mBio.00724-15","article-title":"Secretory aspartyl proteinases cause vaginitis and can mediate vaginitis caused by Candida albicans in mice","volume":"6","author":"Pericolini","year":"2015","journal-title":"mBio"},{"key":"2026031620014122700_ciaf673-B100","doi-asserted-by":"crossref","first-page":"1928","DOI":"10.1093\/cid\/ciy185","article-title":"A fungal immunotherapeutic vaccine (NDV-3A) for treatment of recurrent vulvovaginal candidiasis-A phase 2 randomized, double-blind, placebo-controlled trial","volume":"66","author":"Edwards","year":"2018","journal-title":"Clin Infect Dis"},{"key":"2026031620014122700_ciaf673-B101","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.3389\/fimmu.2018.01349","article-title":"Human anti-Als3p antibodies are surrogate markers of NDV-3A vaccine efficacy against recurrent vulvovaginal candidiasis","volume":"9","author":"Uppuluri","year":"2018","journal-title":"Front Immunol"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/82\/3\/371\/67372114\/ciaf673.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/82\/3\/371\/67372114\/ciaf673.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:02:04Z","timestamp":1773705724000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/82\/3\/371\/8525096"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,15]]},"references-count":101,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3,17]]},"published-print":{"date-parts":[[2026,3,17]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciaf673","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3,15]]},"published":{"date-parts":[[2026,3,15]]}}}