Vaginal colonization by Candida spp. was compared in 117 women fitted with an intrauterine contraceptive device (IUCD users) and in 100 women not wearing an IUCD (control group). None of the subjects had factors currently assumed to predispose to yeast colonization or infection. Yeasts were present significantly more often in the IUCD users (20%) than in the control group (6%). In two of the 21 women with positive cultures the tail of the IUCD yielded substantially more colonies than the vaginal specimen and in seven, only the tail culture was positive. These findings strongly suggest that the IUCD is a predisposing factor in vaginal colonization by Candida strains. In half the women the presence of yeasts in the vagina was not associated with signs and symptoms of clinical infection. Of the 29 yeast strains isolated 17 were C. albicans, there was no difference in the prevalence of C. albicans between IUCD users and non-users or between symptomatic and asymptomatic women.
PIP: 217 women were investigated for the presence of genital candidiasis. 117 women had an IUD; the other 100 women did not. 23 IUD wearers and 6 of the non-wearers were found to harbor Candida in the vagina. 50% of the IUD wearers and 66% of the yeast-positive controls were asymptomatic. Pieces of IUD tails were snipped and cultured from 21 of the IUD wearers, and in 7 of them only the IUD tails yielded cultures. 59% of the yeasts were identified as Candida albicans and the rest as other strains of Candida. This study confirms the hypothesis that IUD use predisposes to colonization and infection by Candida albicans and other strains. The fact that the yeast organisms were more prevalent on the IUD tails than in the vaginal mucosa indicates that the IUD tail acts as a reservoir of infection.