Abstract
Objective: To determine whether there is a relationship between the presence of Lactobacilli and
the growth of Candida.
Material and Methods: Out of 3762 vaginal smears examined cytologically in Al-Zahra
Hospital, Isfahan from 2001 to 2006, 242 patients were diagnosed as having Candida. Among
them, 215 satisfactory smears of patients who were normally menstruating, were subsequently
selected for evaluation. For determining the flora type and maturation index, the vaginal parts of
VCE smears were studied. The control group included 200 patients who had normal menstrual
cycle, satisfactory smears and no infectious agents. Smears were stained with Methenamine
silver staining method for determining Lactobacillus flora. Lactobacillus positive groups were
classified into three types: Type 1: Lactobacillus overgrowth flora, Type 2: Lactobacillus flora,
Type 3: mixed flora. To evaluate hormonal status, the cellular maturation index (CMI) was also
determined. Data were analyzed by SPSS software using Chi-square and T-tests.
Result: Lactobacilli prevalence rates in Candida positive and negative groups were 194 cases
(90%) and 175 cases (87.5%), respectively (p=0.7). In Candida positive group, Lactobacillus
flora types included: Type I; (9%), type II; (84%) and type III; (7%) (p<0.0001). Superficial,
Vaginal Candidiasis & Lactobacillus flora
2
intermediate and parabasal cells ratios were demonstrated in term of CMI. There were no
significant differences in CMI between Candida positive and negative cases.
Conclusion: These results suggest that Lactobacillus does not have a protective role against
vaginal Candidiasis. Considering the maturation index pattern, we can conclude that
progesterone plays an important role in Candida infections. (Rawal Med J 2009;34:82-85).

Key words: Candida, lactobacillus, vaginal smears, methenamine silver.