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Evaluation of overtime phenotypic variation of yeasts in chronic vulvovaginal candidosis cases
Medical Mycology ( IF 2.9 ) Pub Date : 2021-08-20 , DOI: 10.1093/mmy/myab048
Paula Faria-Gonçalves 1, 2, 3 , Carlos Gaspar 1, 2, 4 , Ana Sofia Oliveira 1, 2 , Rita Palmeira-de-Oliveira 1, 2, 4, 5 , Teresa Gonçalves 5, 6 , José Martinez-de-Oliveira 1 , Ana Palmeira-de-Oliveira 1, 2, 4 , Joana Rolo 1
Affiliation  

Chronic vulvovaginal candidosis results either from reinfection or from the ability of Candida spp. to persist in the vulva and/or vagina. Persistence is usually associated with increased antifungal (mainly azoles) resistance rates, which can explain treatment failure, and/or increased expression of virulence factors by Candida spp. The aim of this study was to assess the mechanisms leading to Candida spp persistence, by studying sequential isolates from women with chronic vulvovaginal candidosis, focusing on strains genotypes, azole resistance, and ability to form biofilms along the period of clinical evaluation. The strains were identified at species level by automated analysis of biochemical profiles and molecular typing evaluated by polymorphic DNA analysis. The capacity to form biofilm was assessed with a microtiter plate assay. Fluconazole susceptibility was determined by the microdilution broth assay at both pH 7 (following the recommended guideline) and pH 4.5 (as representative of vaginal pH). We studied samples from 17 clinically recurrent cases. In 53% of the chronic cases there were two or more isolates that had a phylogenetic relationship while the remaining (47%) were caused by different species. In those cases where related strains were involved in recurrence, we verified an increase in MIC at pH 7 and also an increased capacity to form biofilms over time. Significant correlation between these two parameters was observed only in cases caused by C. glabrata, evidencing the importance of these two factors to enhance persistence in the vaginal mucosa for this particular species.

中文翻译:

评估慢性外阴阴道念珠菌病病例中酵母菌的超时表型变异

慢性外阴阴道念珠菌病由再感染或念珠菌属的能力引起。坚持在外阴和/或阴道内。持久性通常与抗真菌药(主要是唑类)耐药率增加有关,这可以解释治疗失败,和/或念珠菌毒力因子表达增加。本研究的目的是通过研究慢性外阴阴道念珠菌病女性的连续分离株来评估导致念珠菌持续存在的机制,重点关注菌株基因型、唑类耐药性和在临床评估期间形成生物膜的能力。通过自动分析生化谱和通过多态性 DNA 分析评估的分子分型,在物种水平上鉴定了菌株。用微量滴定板测定评估形成生物膜的能力。氟康唑敏感性是通过微量稀释肉汤试验在 pH 7(遵循推荐的指南)和 pH 4.5(作为阴道 pH 的代表)下确定的。我们研究了 17 例临床复发病例的样本。在 53% 的慢性病例中,有两个或多个分离株具有系统发育关系,而其余 (47%) 是由不同物种引起的。在相关菌株参与复发的情况下,我们证实了 MIC 在 pH 7 时增加,并且随着时间的推移形成生物膜的能力也增加。这两个参数之间的显着相关性仅在由 C. glabrata 引起的情况下观察到,这证明了这两个因素对于增强该特定物种在阴道粘膜中的持久性的重要性。
更新日期:2021-08-20
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