1887

Abstract

Vulvovaginal candidiasis (VVC) is one of the most common causes of vaginitis and affects about 75 % of women of reproductive age. In order to better understand the epidemiology and pathogenesis of this disease, we evaluated genetic relatedness among 62 clinical isolates of sequentially obtained from the anus and vagina of patients with sporadic and recurrent VVC. Evaluation of patients’ demographic and clinical data, direct examination, and colony forming units (c.f.u.) counts of vaginal and anal samples were also performed. The genotypes of strains were determined with ABC genotyping and Randomly Amplified Polymorphic DNA (RAPD). Genotype A was the most prevalent (93.6 %), followed by genotype C (6.4 %), whereas genotype B was not found. We found the maintenance of the same ABC genotype, regardless of the body site of each patient. Most of the vaginal strains suffered microevolution, whereas most of the anal strains were replaced during the period of study. Vaginal and anal isolates of obtained simultaneously from the same patient showed the same ABC genotype and high genetic similarity as determined by RAPD. Genotype A seemed to be dominant in both vaginal and anal isolates of patients with VVC. Our results corroborate the hypothesis that there are ‘substrains’ of the vaginal clone successfully established, which dominate in an apparently random manner over the course of time. It is suggested that the anal reservoir constitutes a possible source for vaginal infection in most of the cases.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.076604-0
2014-11-01
2019-11-13
Loading full text...

Full text loading...

/deliver/fulltext/jmm/63/11/1436.html?itemId=/content/journal/jmm/10.1099/jmm.0.076604-0&mimeType=html&fmt=ahah

References

  1. Amouri I., Sellami H., Abbes S., Hadrich I., Mahfoudh N., Makni H., Ayadi A.. ( 2012;). Microsatellite analysis of Candida isolates from recurrent vulvovaginal candidiasis. . J Med Microbiol 61:, 1091–1096. [CrossRef][PubMed]
    [Google Scholar]
  2. Ao J. H., Hao Z. F., Zhu H., Wen L., Yang R. Y.. ( 2014;). Environmental investigations and molecular typing of Aspergillus in a Chinese hospital. . Mycopathologia 177:, 51–57. [CrossRef][PubMed]
    [Google Scholar]
  3. Brilhante R. S. N., Ribeiro J. F., Lima R. A. C., Castelo-Branco D. S. C. M., Soares R. M., Mesquita J. R. L., Grangeiro T. B., de Camargo Z. P., Cordeiro R. A.. & other authors ( 2012;). Evaluation of the genetic diversity of Histoplasma capsulatum var. capsulatum isolates from north-eastern Brazil. . J Med Microbiol 61:, 1688–1695. [CrossRef][PubMed]
    [Google Scholar]
  4. Chong P. P., Abdul Hadi S. R., Lee Y. L., Phan C. L., Tan B. C., Ng K. P., Seow H. F.. ( 2007;). Genotyping and drug resistance profile of Candida spp. in recurrent and one-off vaginitis, and high association of non-albicans species with non-pregnant status. . Infect Genet Evol 7:, 449–456. [CrossRef][PubMed]
    [Google Scholar]
  5. da Costa K. R., Ferreira J. C., Lavrador M. A., Baruffi M. D., Candido R. C.. ( 2012;). Virulence attributes and genetic variability of oral Candida albicans and Candida tropicalis isolates. . Mycoses 55:, e97–e105. [CrossRef][PubMed]
    [Google Scholar]
  6. Dan M., Poch F., Levin D.. ( 2002;). High rate of vaginal infections caused by non-C. albicans Candida species among asymptomatic women. . Med Mycol 40:, 383–386. [CrossRef][PubMed]
    [Google Scholar]
  7. Emmanuel N. N., Romeo O., Mebi A. G., Mark O. O., Scordino F., Bessy E. I., Criseo G.. ( 2012;). Genotyping and fluconazole susceptibility of Candida albicans strains from patients with vulvovaginal candidiasis in Jos, Nigeria. . Asian Pac J Trop Dis 2:, 48–50. [CrossRef]
    [Google Scholar]
  8. Fan S. R., Bai F. Y., Liao Q. P., Liu Z. H., Li J., Liu X. P.. ( 2008;). Genotype distribution of Candida albicans strains associated with different conditions of vulvovaginal candidiasis, as revealed by microsatellite typing. . Sex Transm Infect 84:, 103–106. [CrossRef][PubMed]
    [Google Scholar]
  9. Ferrer J.. ( 2000;). Vaginal candidosis: epidemiological and etiological factors. . Int J Gynaecol Obstet 71: (Suppl 1), S21–S27. [CrossRef][PubMed]
    [Google Scholar]
  10. Fidel P. L. Jr, Sobel J. D.. ( 1996;). Immunopathogenesis of recurrent vulvovaginal candidiasis. . Clin Microbiol Rev 9:, 335–348.[PubMed]
    [Google Scholar]
  11. Ge S. H., Xie J., Xu J., Li J., Li D. M., Zong L. L., Zheng Y. C., Bai F. Y.. ( 2012;). Prevalence of specific and phylogenetically closely related genotypes in the population of Candida albicans associated with genital candidiasis in China. . Fungal Genet Biol 49:, 86–93. [CrossRef][PubMed]
    [Google Scholar]
  12. Giraldo P., von Nowaskonski A., Gomes F. A., Linhares I., Neves N. A., Witkin S. S.. ( 2000;). Vaginal colonization by Candida in asymptomatic women with and without a history of recurrent vulvovaginal candidiasis. . Obstet Gynecol 95:, 413–416. [CrossRef][PubMed]
    [Google Scholar]
  13. Holanda A. A. R., Fernandes A. C. S., Bezerra C. M., Ferreira M. A. F., Holanda M. R. R., Holanda J. C. P., Milan E. P.. ( 2007;). Candidíase vulvovaginal: sintomatologia, fatores de risco e colonização anal concomitante. . Rev Bras Ginecol Obstet 29:, 3–9. [CrossRef]
    [Google Scholar]
  14. Jacobsen M. D., Duncan A. D., Bain J., Johnson E. M., Naglik J. R., Shaw D. J., Gow N. A. R., Odds F. C.. ( 2008;). Mixed Candida albicans strain populations in colonized and infected mucosal tissues. . FEMS Yeast Res 8:, 1334–1338. [CrossRef][PubMed]
    [Google Scholar]
  15. Kent H. L.. ( 1991;). Epidemiology of vaginitis. . Am J Obstet Gynecol 165:, 1168–1176. [CrossRef][PubMed]
    [Google Scholar]
  16. Li J., Bai F. Y.. ( 2007;). Single-strand conformation polymorphism of microsatellite for rapid strain typing of Candida albicans.. Med Mycol 45:, 629–635. [CrossRef][PubMed]
    [Google Scholar]
  17. Li J., Fan S. R., Liu X. P., Li D. M., Nie Z. H., Li F., Lin H., Huang W. M., Zong L. L.. & other authors ( 2008;). Biased genotype distributions of Candida albicans strains associated with vulvovaginal candidosis and candidal balanoposthitis in China. . Clin Infect Dis 47:, 1119–1125. [CrossRef][PubMed]
    [Google Scholar]
  18. Lian C., Zhao J., Zhang Z., Liu W.. ( 2004;). Genotype of Candida species associated with different conditions of vulvovaginal candidosis. . Mycoses 47:, 495–502. [CrossRef][PubMed]
    [Google Scholar]
  19. Lockhart S. R., Reed B. D., Pierson C. L., Soll D. R.. ( 1996;). Most frequent scenario for recurrent Candida vaginitis is strain maintenance with “substrain shuffling”: demonstration by sequential DNA fingerprinting with probes Ca3, C1, and CARE2. . J Clin Microbiol 34:, 767–777.[PubMed]
    [Google Scholar]
  20. Lopes Consolaro M. E., Aline Albertoni T., Shizue Yoshida C., Mazucheli J., Peralta R. M., Estivalet Svidzinski T. I.. ( 2004;). Correlation of Candida species and symptoms among patients with vulvovaginal candidiasis in Maringá, Paraná, Brazil. . Rev Iberoam Micol 21:, 202–205.[PubMed]
    [Google Scholar]
  21. Mårdh P. A., Novikova N., Stukalova E.. ( 2003;). Colonisation of extragenital sites by Candida in women with recurrent vulvovaginal candiosis. . Br J Obstet Gynaecol 110:, 934–937. [CrossRef]
    [Google Scholar]
  22. McCullough M. J., Clemons K. V., Stevens D. A.. ( 1999;). Molecular and phenotypic characterization of genotypic Candida albicans subgroups and comparison with Candida dubliniensis and Candida stellatoidea.. J Clin Microbiol 37:, 417–421.[PubMed]
    [Google Scholar]
  23. Millar B. C., Moore J. E., Xu J., Walker M. J., Hedderwick S., McMullan R.. ( 2002;). Genotypic subgrouping of clinical isolates of Candida albicans and Candida dubliniensis by 25S intron analysis. . Lett Appl Microbiol 35:, 102–106. [CrossRef][PubMed]
    [Google Scholar]
  24. Muzny C. A., Rivers C. A., Parker C. J., Mena L. A., Austin E. L., Schwebke J. R.. ( 2014;). Lack of evidence for sexual transmission of genital Candida species among women who have sex with women: a mixed methods study. . Sex Transm Infect 90:, 165–170. [CrossRef][PubMed]
    [Google Scholar]
  25. Odds F. C., Davidson A. D., Jacobsen M. D., Tavanti A., Whyte J. A., Kibbler C. C., Ellis D. H., Maiden M. C. J., Shaw D. J., Gow N. A. R.. ( 2006;). Candida albicans strain maintenance, replacement, and microvariation demonstrated by multilocus sequence typing. . J Clin Microbiol 44:, 3647–3658. [CrossRef][PubMed]
    [Google Scholar]
  26. Odds F. C., Bougnoux M. E., Shaw D. J., Bain J. M., Davidson A. D., Diogo D., Jacobsen M. D., Lecomte M., Li S. Y.. & other authors ( 2007;). Molecular phylogenetics of Candida albicans.. Eukaryot Cell 6:, 1041–1052. [CrossRef][PubMed]
    [Google Scholar]
  27. Robles J. C., Koreen L., Park S., Perlin D. S.. ( 2004;). Multilocus sequence typing is a reliable alternative method to DNA fingerprinting for discriminating among strains of Candida albicans.. J Clin Microbiol 42:, 2480–2488. [CrossRef][PubMed]
    [Google Scholar]
  28. Sampaio P., Gusmão L., Alves C., Pina-Vaz C., Amorim A., Pais C.. ( 2003;). Highly polymorphic microsatellite for identification of Candida albicans strains. . J Clin Microbiol 41:, 552–557. [CrossRef][PubMed]
    [Google Scholar]
  29. Sampaio P., Gusmão L., Correia A., Alves C., Rodrigues A. G., Pina-Vaz C., Amorim A., Pais C.. ( 2005;). New microsatellite multiplex PCR for Candida albicans strain typing reveals microevolutionary changes. . J Clin Microbiol 43:, 3869–3876. [CrossRef][PubMed]
    [Google Scholar]
  30. Shi W. M., Mei X. Y., Gao F., Huo K. K., Shen L. L., Qin H. H., Wu Z. W., Zheng J.. ( 2007;). Analysis of genital Candida albicans infection by rapid microsatellite markers genotyping. . Chin Med J (Engl) 120:, 975–980.[PubMed]
    [Google Scholar]
  31. Shokri H.. ( 2014;). Genotypic variation and antifungal susceptibly of Candida zeylanoides clinical isolates. . J Mycol Med 24:, 179–184. [CrossRef][PubMed]
    [Google Scholar]
  32. Sobel J. D.. ( 1985;). Epidemiology and pathogenesis of recurrent vulvovaginal candidiasis. . Am J Obstet Gynecol 152:, 924–935. [CrossRef][PubMed]
    [Google Scholar]
  33. Sobel J. D.. ( 1988;). Pathogenesis and epidemiology of vulvovaginal candidiasis. . Ann N Y Acad Sci 544: (1 Antifungal Dr), 547–557. [CrossRef][PubMed]
    [Google Scholar]
  34. Sobel J. D.. ( 1992;). Pathogenesis and treatment of recurrent vulvovaginal candidiasis. . Clin Infect Dis 14: (Suppl 1), S148–S153. [CrossRef][PubMed]
    [Google Scholar]
  35. Soll D. R.. ( 2000;). The ins and outs of DNA fingerprinting the infectious fungi. . Clin Microbiol Rev 13:, 332–370. [CrossRef][PubMed]
    [Google Scholar]
  36. Tamura M., Watanabe K., Mikami Y., Yazawa K., Nishimura K.. ( 2001;). Molecular characterization of new clinical isolates of Candida albicans and C. dubliniensis in Japan: analysis reveals a new genotype of C. albicans with group I intron. . J Clin Microbiol 39:, 4309–4315. [CrossRef][PubMed]
    [Google Scholar]
  37. Yarrow D.. ( 1998;). Methods for the isolation, maintenance and identification of yeasts. . In The Yeasts, a Taxonomic Study, , 4th edn., pp. 77–100. Edited by Kurtzman C. P., Fell J. W... Amsterdam:: Elsevier Science B. V;. [CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.076604-0
Loading
/content/journal/jmm/10.1099/jmm.0.076604-0
Loading

Data & Media loading...

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