{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T18:50:09Z","timestamp":1787683809285,"version":"build-2784847793"},"reference-count":46,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,1,24]],"date-time":"2022-01-24T00:00:00Z","timestamp":1642982400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Candida vulvovaginitis is a frequent condition, and although several risk factors are known, its behavior is still enigmatic. The seasonal influence of climate conditions and living habits on its prevalence was studied. In a retrospective lab-based cohort over 10 years, we studied the prevalence of Candida in 12,941 vaginal cultures taken from women attending a vulvovaginitis clinic. The prevalence of non-albicans and albicans species were compared per month to detect differences in positivity rates in summer versus winter months. Chi-square and chi-square for trend were used. Of the 2109 (16.3%) Candida spp. positive swabs, 201 (1.0%) revealed non-albicans species, varying between 1.0% and 2.0% per month, but without significant monthly differences. Over the 10 years, compared to other months, vaginal Candida was more frequent in June (19.0%, p = 0.008) and less frequent in December (14.5%, p = 0.04). The Candida prevalence was 15.5% in summer (June\/July\/August) versus 14.0% in the winter (Dec\/Jan\/Feb, p = 0.04). Change in temperature, dietary habits, and bodily adaptations due to increased amount of sunlight were discussed as potential pathophysiological mechanisms to explain the excess of Candida in summertime. Further confirmatory research would be beneficial. Women at risk for Candida vulvovaginitis should pay more attention to living habits in summertime to avoid recurrences.<\/jats:p>","DOI":"10.3390\/jcm11030574","type":"journal-article","created":{"date-parts":[[2022,1,25]],"date-time":"2022-01-25T20:40:18Z","timestamp":1643143218000},"page":"574","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Lab-Based Retrospective 10-Year Analysis Shows Seasonal Variation of Vaginal Candida Infection Rates in Belgium"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9890-6254","authenticated-orcid":false,"given":"Gilbert G. G.","family":"Donders","sequence":"first","affiliation":[{"name":"Femicare, Clinical Research for Women, 3300 Tienen, Belgium"},{"name":"Department of Obstetrics & Gynecology, Regional Hospital Heilig Hart, Kliniekstraat 45, 3300 Tienen, Belgium"},{"name":"Department of Obstetrics and Gynecology, University Hospital Antwerpen, 2650 Edegem, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kateryna","family":"Ruban","sequence":"additional","affiliation":[{"name":"Femicare, Clinical Research for Women, 3300 Tienen, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0376-0067","authenticated-orcid":false,"given":"Francesca","family":"Donders","sequence":"additional","affiliation":[{"name":"Femicare, Clinical Research for Women, 3300 Tienen, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhilde","family":"Reybrouck","sequence":"additional","affiliation":[{"name":"Clinical Biochemistry, Regional Hospital Heilig Hart, 3300 Tienen, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,24]]},"reference":[{"key":"ref_1","first-page":"629","article-title":"Vaginitis in a gynecologic practice in Israel: Causes and risk factors","volume":"5","author":"Dan","year":"2003","journal-title":"Isr. Med. Assoc. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S21","DOI":"10.1016\/S0020-7292(00)00350-7","article-title":"Vaginal candidosis: Epidemiological and etiological factors","volume":"71","author":"Ferrer","year":"2000","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1056\/NEJMoa033114","article-title":"Maintenance fluconazole therapy for recurrent vulvovaginal candidiasis","volume":"351","author":"Sobel","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"613.e1","DOI":"10.1016\/j.ajog.2008.06.029","article-title":"Individualized decreasing-dose maintenance fluconazole regimen for recurrent vulvovaginal candidiasis (ReCiDiF trial)","volume":"199","author":"Donders","year":"2008","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1007\/s11046-014-9827-4","article-title":"Vaginal nystatin versus oral fluconazole for the treatment for recurrent vulvovaginal candidiasis","volume":"179","author":"Fan","year":"2015","journal-title":"Mycopathologia"},{"key":"ref_6","first-page":"883","article-title":"Sexual transmission of Candida","volume":"69","author":"Horowitz","year":"1987","journal-title":"Obstet. Gynecol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1111\/myc.12825","article-title":"Sexual behaviour and extra-genital colonisation in women treated for recurrent Candida vulvo-vaginitis","volume":"61","author":"Grinceviciene","year":"2018","journal-title":"Mycoses"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1111\/j.1471-0528.2003.01445.x","article-title":"Colonisation of extragenital sites by Candida in women with recurrent vulvovaginal candidosis","volume":"110","author":"Mardh","year":"2003","journal-title":"BJOG"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.diagmicrobio.2018.05.024","article-title":"Is multiple-site colonization with Candida spp. related to inadequate response to individualized fluconazole maintenance therapy in women with recurrent Candida vulvovaginitis?","volume":"92","author":"Donders","year":"2018","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1159\/000314022","article-title":"Management of recurrent vulvo-vaginal candidosis as a chronic illness","volume":"70","author":"Donders","year":"2010","journal-title":"Gynecol. Obstet. Investig."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/0732-8893(91)90001-V","article-title":"Use of rDNA restriction fragment length polymorphisms to differentiate strains of Candida albicans in women with vulvovaginal candidiasis","volume":"14","author":"Stein","year":"1991","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_12","first-page":"134","article-title":"Recurrent vulvovaginal candidiasis: Could it be related to cell-mediated immunity defect in response to candida antigen?","volume":"11","author":"Talaei","year":"2017","journal-title":"Int. J. Fertil. Steril."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1111\/j.1365-2249.2005.02891.x","article-title":"Association between atopy and recurrent vaginal candidiasis","volume":"142","author":"Neves","year":"2005","journal-title":"Clin. Exp. Immunol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1086\/377234","article-title":"Relation between recurrent vulvovaginal candidiasis, vaginal concentrations of mannose-binding lectin, and a mannose-binding lectin gene polymorphism in Latvian women","volume":"37","author":"Babula","year":"2003","journal-title":"Clin. Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1097\/01.AOG.0000260386.17555.a5","article-title":"Mannose-binding lectin gene polymorphism, vulvovaginal candidiasis, and bacterial vaginosis","volume":"109","author":"Giraldo","year":"2007","journal-title":"Obstet. Gynecol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1111\/j.1471-0528.2008.01830.x","article-title":"Mannose-binding lectin gene polymorphism and resistance to therapy in women with recurrent vulvovaginal candidiasis","volume":"115","author":"Donders","year":"2008","journal-title":"BJOG"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1007\/s11596-008-0423-z","article-title":"Local expression of vaginal Th1 and Th2 cytokines in murine vaginal candidiasis under different immunity conditions","volume":"28","author":"Chen","year":"2008","journal-title":"J. Huazhong Univ. Sci. Technol. Med. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1111\/j.1567-1364.2010.00620.x","article-title":"Protection against rat vaginal candidiasis by adoptive transfer of vaginal B lymphocytes","volume":"10","author":"Santoni","year":"2010","journal-title":"FEMS Yeast Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3297","DOI":"10.1128\/IAI.68.6.3297-3304.2000","article-title":"Local anticandidal immune responses in a rat model of vaginal infection by and protection against Candida albicans","volume":"68","author":"Santoni","year":"2000","journal-title":"Infect. Immun."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"4202","DOI":"10.1128\/iai.61.10.4202-4207.1993","article-title":"Candida-specific Th1-type responsiveness in mice with experimental vaginal candidiasis","volume":"61","author":"Fidel","year":"1993","journal-title":"Infect. Immun."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1007\/s11596-008-0329-9","article-title":"Local Th1\/Th2 cytokine expression in experimental murine vaginal candidiasis","volume":"28","author":"Ouyang","year":"2008","journal-title":"J. Huazhong Univ. Sci. Technol. Med. Sci."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1590\/1516-3180.2014.1322640","article-title":"Prevalence of Candida albicans and non-albicans isolates from vaginal secretions: Comparative evaluation of colonization, vaginal candidiasis and recurrent vaginal candidiasis in diabetic and non-diabetic women","volume":"132","author":"Gunther","year":"2014","journal-title":"Sao Paulo Med. J."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Akimoto-Gunther, L., de Souza Bonfim-Mendonca, P., Takahachi, G., Irie, M.M., Miyamoto, S., Consolaro, M.E., and Svidzinsk, T.I. (2016). Highlights regarding host predisposing factors to recurrent vulvovaginal candidiasis: Chronic stress and reduced antioxidant capacity. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0158870"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1007\/s11908-002-0042-y","article-title":"Lower genital tract infections in diabetic women","volume":"4","author":"Donders","year":"2002","journal-title":"Curr. Infect. Dis. Rep."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1067\/mob.2002.126285","article-title":"Impaired tolerance for glucose in women with recurrent vaginal candidiasis","volume":"187","author":"Donders","year":"2002","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1111\/myc.12626","article-title":"Non-response to fluconazole maintenance treatment (ReCiDiF regimen) for recurrent vulvovaginal candidosis is not related to impaired glucose metabolism","volume":"60","author":"Grinceviciene","year":"2017","journal-title":"Mycoses"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1111\/j.1439-0507.2009.01754.x","article-title":"Self-elimination of risk factors for recurrent vaginal candidosis","volume":"54","author":"Donders","year":"2011","journal-title":"Mycoses"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/S0301-2115(03)00096-4","article-title":"An epidemiological survey of vulvovaginal candidiasis in Italy","volume":"110","author":"Corsello","year":"2003","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_29","first-page":"107","article-title":"A comparison of three methods for detecting Candida albicans in patients with Sjogren\u2019s syndrome","volume":"29","author":"Rhodus","year":"1998","journal-title":"Quintessence Int."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1002\/jcla.20373","article-title":"Candida dubliniensis screening using the germ tube test in clinical yeast isolates and prevalence of C. dubliniensis in Korea","volume":"24","author":"Kim","year":"2010","journal-title":"J. Clin. Lab. Anal."},{"key":"ref_31","first-page":"433","article-title":"Relative and seasonal incidences of the sexually transmitted diseases. A two-year statistical review","volume":"54","author":"Wright","year":"1978","journal-title":"Br. J. Vener. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1128\/jcm.31.1.39-46.1993","article-title":"Genetic similarity of Candida albicans strains from vaginitis patients and their partners","volume":"31","author":"Schmid","year":"1993","journal-title":"J. Clin. Microbiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"905","DOI":"10.3109\/1040841X.2015.1091805","article-title":"Vulvovaginal candidiasis: Epidemiology, microbiology and risk factors","volume":"42","author":"Goncalves","year":"2016","journal-title":"Crit. Rev. Microbiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1093\/ajcn\/40.6.1352","article-title":"Seasonal variation in plasma glucose and hormone levels in adult men and women","volume":"40","author":"Behall","year":"1984","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_35","first-page":"3065","article-title":"Seasonal variation in lipoprotein lipase and plasma lipids in physically active, normal weight humans","volume":"85","author":"Donahoo","year":"2000","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1007\/BF00281300","article-title":"Seasonal variation in fasting plasma glucose levels in man","volume":"22","author":"Suarez","year":"1982","journal-title":"Diabetologia"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1038\/ejcn.2013.3","article-title":"Seasonal changes in vitamin D status among Danish adolescent girls and elderly women: The influence of sun exposure and vitamin D intake","volume":"67","author":"Andersen","year":"2013","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/BF02849996","article-title":"Effects of melatonin on Candida sepsis in an experimental rat model","volume":"24","author":"Yavuz","year":"2007","journal-title":"Adv. Ther."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1007\/s00360-004-0429-1","article-title":"Comparative study of the heterophil phagocytic function in young and old ring doves (Streptopelia risoria) and its relationship with melatonin levels","volume":"174","author":"Terron","year":"2004","journal-title":"J. Comp. Physiol. B"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/j.mycmed.2014.05.003","article-title":"Melatonin inhibits biofilm formation in Candida parapsilosis","volume":"24","author":"Yang","year":"2014","journal-title":"J. Mycol. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1093\/infdis\/jiq008","article-title":"1,25-dihydroxyvitamin D3 modulates cytokine production induced by Candida albicans: Impact of seasonal variation of immune responses","volume":"203","author":"Khoo","year":"2011","journal-title":"J. Infect. Dis."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1111\/j.1365-2249.2010.04315.x","article-title":"Regulation of cytokine responses by seasonality of vitamin D status in healthy individuals","volume":"164","author":"Khoo","year":"2011","journal-title":"Clin. Exp. Immunol."},{"key":"ref_43","first-page":"594","article-title":"Seasonal allergic vulvovaginitis caused by pollen","volume":"22","author":"Berman","year":"1964","journal-title":"Ann. Allergy"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Donders, G.G., Grinceviciene, S., Bellen, G., Jaeger, M., ten Oever, J., and Netea, M. (Am. J. Reprod. Immmunol., 2018). Is non-response to fluconazole maintenance therapy for recurrent Candida vaginitis related to sensitization to atopic reactions?, Am. J. Reprod. Immmunol., in press.","DOI":"10.1111\/aji.12811"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1067\/mai.2002.120555","article-title":"Downregulation of IFN-gamma production in patients with recurrent vaginal candidiasis","volume":"109","author":"Carvalho","year":"2002","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1097\/01.LGT.0000171664.63976.FB","article-title":"Successful treatment of refractory recurrent vaginal candidiasis with cetirizine plus fluconazole","volume":"9","author":"Neves","year":"2005","journal-title":"J. Low Genit. Tract. Dis."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/3\/574\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:06:28Z","timestamp":1760133988000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/3\/574"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,24]]},"references-count":46,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["jcm11030574"],"URL":"https:\/\/doi.org\/10.3390\/jcm11030574","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,24]]}}}