1887

Abstract

spp. may cause opportunistic infections called vulvovaginal candidiasis (VVC), which is estimated to be the second most common cause of vaginitis worldwide.

Under various circumstances, VVC could compromise pregnancy outcomes. Emerging data suggests that VVC during pregnancy may be associated with increased risk of complications and congenital cutaneous candidiasis.

To assess the prevalence of spp. in asymptomatic pregnant women and determine the susceptibility of the isolates to antifungal drugs.

In a prospective cohort, 65 high vaginal swab samples of consented pregnant women. isolates were identified using both microbiological and molecular tools and drug susceptibilities were profiled.

The prevalence of VVC among our study participants was 37 %, 24 of the 65 asymptomatic pregnant women show spp. colonization. was the most common species 61 %, followed by 39 %. In addition, a significant fraction of the isolated colonies showed resistance to Fluconazole, with a ratio of 63 % for isolates and 16 % for isolates. Moreover, relative quantification of genes related to resistance to fluconazole, CDR1, ERG11 as well as HWP1, showed a significant change compared to controls.

Monitoring of vaginal olonization before the third trimester of pregnancy, that could reduce congenital colonization and risk of pregnancy complications.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.001589
2022-09-20
2024-11-10
Loading full text...

Full text loading...

References

  1. Lopez JEM. Candidal (vulvovaginitis). BMJ Clin Evid 2015815
    [Google Scholar]
  2. Stock I. Fungal diseases of vulva and vagina caused by Candida species. Med Monatsschr Pharm 2010; 33(9):324–333
    [Google Scholar]
  3. Mendling W, Niemann D, Tintelnot K. Vaginal colonisation with Candida species with special focus on Candida dubliniensis. a prospective study. Geburtsh Frauenheilk 2007; 67:1132–1137 [View Article]
    [Google Scholar]
  4. Aguin TJ, Sobel JD. Vulvovaginal candidiasis in pregnancy. Curr Infect Dis Rep 2015; 17:462 [View Article]
    [Google Scholar]
  5. Sobel JD. Vulvovaginal candidosis. Lancet 2007; 369:1961–1971 [View Article]
    [Google Scholar]
  6. Farr A, Kiss H, Holzer I, Husslein P, Hagmann M et al. Effect of asymptomatic vaginal colonization with Candida albicans on pregnancy outcome. Acta Obstet Gynecol Scand 2015; 94:989–996 [View Article]
    [Google Scholar]
  7. Ilkit M, Guzel AB. The epidemiology, pathogenesis, and diagnosis of vulvovaginal candidosis: a mycological perspective. Crit Rev Microbiol 2011; 37:250–261 [View Article]
    [Google Scholar]
  8. Mazor M, Chaim W, Shinwell ES, Glezerman M. Asymptomatic amniotic fluid invasion with Ccandida albicans in preterm premature rupture of membranes: implications for obstetric and neonatal management. Acta Obstet Gynecol Scand 1993; 72:52–54 [View Article]
    [Google Scholar]
  9. Payne MS, Ireland DJ, Watts R, Nathan EA, Furfaro LL et al. Ureaplasma parvum genotype, combined vaginal colonisation with Candida albicans, and spontaneous preterm birth in an Australian cohort of pregnant women. BMC Pregnancy Childbirth 2016; 16:1–13 [View Article]
    [Google Scholar]
  10. Blaschke‐Hellmessen RJM. Subpartale Übertragung von Candida und ihre Konsequenzen: subpartal transmission of Candida and its consequences. In Mycoses 1998 pp 31–36 [View Article]
    [Google Scholar]
  11. Roberts CL, Rickard K, Kotsiou G, Morris JM. Treatment of asymptomatic vaginal candidiasis in pregnancy to prevent preterm birth: an open-label pilot randomized controlled trial. BMC Pregnancy Childbirth 2011; 11:1–6 [View Article]
    [Google Scholar]
  12. Czeizel AE, Fladung B, Vargha P. Preterm birth reduction after clotrimazole treatment during pregnancy. Eur J Obstet Gynecol Reprod Biol 2004; 116:157–163 [View Article]
    [Google Scholar]
  13. Mendling W, Brasch J. Guideline vulvovaginal candidosis (2010) of the german society for gynecology and obstetrics, the working group for infections and infectimmunology in gynecology and obstetrics, the german society of dermatology, the board of german dermatologists and the german speaking mycological society. Mycoses 2012; 55 Suppl 3:1–13 [View Article]
    [Google Scholar]
  14. Elefant E, Vauzelle C, Beghin DJT. Le entre de référence sur les agents tératogènes (CRAT): une structure pionnière. Therapies 2014; 69:39–45 [View Article]
    [Google Scholar]
  15. Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA et al. Clinical practice guideline for the management of candidiasis: 2016 update by the infectious diseases society of America. Clin Infect Dis 2016; 62:e1–50 [View Article]
    [Google Scholar]
  16. Pfeiffer CD, Samsa GP, Schell WA, Reller LB, Perfect JR et al. Quantitation of Candida CFU in initial positive blood cultures. J Clin Microbiol 2011; 49:2879–2883 [View Article]
    [Google Scholar]
  17. Sanglard D, Ischer F, Koymans L, Bille J. Amino acid substitutions in the cytochrome P-450 lanosterol 14alpha-demethylase (CYP51A1) from azole-resistant Candida albicans clinical isolates contribute to resistance to azole antifungal agents. Antimicrob Agents Chemother 1998; 42:241–253 [View Article]
    [Google Scholar]
  18. Sherry L, Rajendran R, Lappin DF, Borghi E, Perdoni F et al. Biofilms formed by Candida albicans bloodstream isolates display phenotypic and transcriptional heterogeneity that are associated with resistance and pathogenicity. BMC Microbiol 2014; 14:1–14 [View Article]
    [Google Scholar]
  19. Nagayoshi Y, Miyazaki T, Shimamura S, Nakayama H, Minematsu A et al. Unexpected effects of azole transporter inhibitors on antifungal susceptibility in Candida glabrata and other pathogenic Candida species. PLoS One 2017; 12:e0180990 [View Article]
    [Google Scholar]
  20. Cavalheiro M, Costa C, Silva-Dias A, Miranda IM, Wang C et al. A transcriptomics approach to unveiling the mechanisms of In Vitro evolution towards Fluconazole resistance of a Candida glabrata clinical isolate. Antimicrob Agents Chemother 2019; 63:e00995-18 [View Article]
    [Google Scholar]
  21. Mendling W, Brasch J. Guideline vulvovaginal candidosis (2010) of the german society for gynecology and obstetrics, the working group for infections and infectimmunology in gynecology and obstetrics, the german society of dermatology, the board of german dermatologists and the german speaking mycological society. Mycoses 2012; 55 Suppl 3:1–13 [View Article]
    [Google Scholar]
  22. Madhavan P, Jamal F, Chong PP, Ng KP. Identification of local clinical Candida isolates using CHROMagar CandidaTM as a primary identification method for various Candida species. Trop Biomed 2011; 28:269–274
    [Google Scholar]
  23. Ouanes A, Kouais A, Marouen S, Sahnoun M, Jemli B et al. Apport du milieu chromogène CHROMagar ® Candida dans le diagnostic mycologique des levures. J Mycol Med 2013; 23:237–241 [View Article]
    [Google Scholar]
  24. Lõoke M, Kristjuhan K, Kristjuhan AJB. Extraction of genomic DNA from yeasts for PCR-based applications. Biotechniques 2011; 50:325–328 [View Article]
    [Google Scholar]
  25. Mirhendi H, Makimura K, Khoramizadeh M, Yamaguchi H. A one-enzyme PCR-RFLP assay for identification of six medically important Candida species. Nippon Ishinkin Gakkai Zasshi 2006; 47:225–229 [View Article]
    [Google Scholar]
  26. Reference method for broth dilution antifungal susceptibility testingof yeasts; Approved standard—second edition. In NCCLS Document M27-A2 vol 22 Pennsylvania: NCCLS; 2002
    [Google Scholar]
  27. Berkow EL, Lockhart SR, Ostrosky-Zeichner L. Antifungal susceptibility testing: current approaches. Clin Microbiol Rev 2020; 33:e00069-19 [View Article]
    [Google Scholar]
  28. Wang T, Shao J, Da W, Li Q, Shi G et al. Strong synergism of palmatine and Fluconazole/itraconazole against planktonic and biofilm cells of Candida species and efflux-associated antifungal mechanism. Front Microbiol 2018; 9:2892 [View Article]
    [Google Scholar]
  29. Xu Y, Sheng F, Zhao J, Chen L, Li C. ERG11 mutations and expression of resistance genes in fluconazole-resistant Candida albicans isolates. Arch Microbiol 2015; 197:1087–1093 [View Article]
    [Google Scholar]
  30. Livak KJ, Schmittgen TD. Analysis of relative gene expression data using real-time quantitative PCR and the 2(-Delta Delta C(T)) Method. Methods 2001; 25:402–408 [View Article]
    [Google Scholar]
  31. Abd-Alrahman EA, El-Mokhtar MA, Yassin AS, Thabit A, Manal A et al. Efflux pump mediated resistance to fluconazole in Candida glabrata in vulvovaginal candidiasis patients. Eur J Mol Clin Med 2020; 7:7224–7241
    [Google Scholar]
  32. Mtibaa L, Fakhfakh N, Kallel A, Belhadj S, Belhaj Salah N et al. Vulvovaginal candidiasis: etiology, symptomatology and risk factors. J Mycol Med 2017; 27:153–158 [View Article]
    [Google Scholar]
  33. Abu-Lubad MA, Helaly GF, Aqel AA, DaA J, Al-kharabsheh AM et al. Putative virulence factors of Candida species colonising asymptomatic pregnant Jordanian women; 2021; 7551–56
  34. Brandolt TM, Klafke GB, Gonçalves CV, Bitencourt LR, AMBd M et al. Prevalence of Candida spp. In In Cervical-Vaginal Samples and the in Vitro Susceptibility of Isolates vol 48 2017 pp 145–150 [View Article]
    [Google Scholar]
  35. Ranji N, Sharami SH, Golpour H, Koohpar ZK, Anvari M et al. Molecular Aspect of Drug Resistance in Candida albicans Isolates of Women with Vulvovaginal Candidiasis. Mol Genet Microbiol Virol 2020; 35:117–122 [View Article]
    [Google Scholar]
  36. Holmes AR, Lin Y-H, Niimi K, Lamping E, Keniya M et al. ABC transporter Cdr1p contributes more than Cdr2p does to fluconazole efflux in fluconazole-resistant Candida albicans clinical isolates. Antimicrob Agents Chemother 2008; 52:3851–3862 [View Article]
    [Google Scholar]
  37. Chen LM, Xu YH, Zhou CL, Zhao J, Li CY et al. Overexpression of CDR1 and CDR2 genes plays an important role in Fluconazole resistance in Candida albicans with G487T and T916C mutations. J Int Med Res 2010; 38:536–545 [View Article]
    [Google Scholar]
  38. Nailis H, Kucharíková S, Ricicová M, Van Dijck P, Deforce D et al. Real-time PCR expression profiling of genes encoding potential virulence factors in Candida albicans biofilms: identification of model-dependent and -independent gene expression. BMC Microbiol 2010; 10:1–11 [View Article]
    [Google Scholar]
  39. Manastır L, Ergon MC, Yücesoy MJM. Investigation of mutations in Erg11 gene of fluconazole resistant Candida albicans isolates from Turkish hospitals. Mycoses 2011; 54:99–104 [View Article]
    [Google Scholar]
  40. Alvarez-Rueda N, Fleury A, Logé C, Pagniez F, Robert E et al. The amino acid substitution N136Y in Candida albicans sterol 14alpha-demethylase is involved in fluconazole resistance. Med Mycol 2016; 54:764–775 [View Article]
    [Google Scholar]
  41. Caudle KE, Barker KS, Wiederhold NP, Xu L, Homayouni R et al. Genomewide expression profile analysis of the Candida glabrata Pdr1 regulon. Eukaryot Cell 2011; 10:373–383 [View Article]
    [Google Scholar]
  42. Galocha M, Pais P, Cavalheiro M, Pereira D, Viana R et al. Divergent approaches to virulence in C. albicans and C. glabrata: two sides of the same coin. IJMS 2019; 20:2345 [View Article]
    [Google Scholar]
  43. Hassan Y, Chew SY, Than LTL. Candida glabrata: Pathogenicity and Resistance Mechanisms for Adaptation and Survival. J Fungi 2021; 7:667 [View Article]
    [Google Scholar]
  44. Mundy RD, Cormack B. Expression of Candida glabrata adhesins after exposure to chemical preservatives. J Infect Dis 2009; 199:1891–1898 [View Article]
    [Google Scholar]
  45. Ni Q, Wang C, Tian Y, Dong D, Jiang C et al. CgPDR1 gain-of-function mutations lead to azole-resistance and increased adhesion in clinical Candida glabrata strains. Mycoses 2018; 61:430–440 [View Article]
    [Google Scholar]
  46. Vale-Silva LA, Moeckli B, Torelli R, Posteraro B, Sanguinetti M et al. Upregulation of the adhesin gene EPA1 mediated by PDR1 in Candida glabrata leads to enhanced host colonization. mSphere 2016; 1:e00065-15 [View Article]
    [Google Scholar]
/content/journal/jmm/10.1099/jmm.0.001589
Loading
/content/journal/jmm/10.1099/jmm.0.001589
Loading

Data & Media loading...

Supplements

Supplementary material 1

PDF
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error