Skip to main content
SpringerLink
Log in

Genotyping and Persistence of Candida albicans from Pregnant Women with Vulvovaginal Candidiasis

  • Published:
Mycopathologia Aims and scope Submit manuscript

Abstract

Objective

To study Candida albicans genotypes using RAPD and their susceptibility to fluconazole in healthy pregnant women and in vulvovaginal candidiasis (VVC) patients after topical treatment with clotrimazole.

Methods

Vaginal swabs were collected at t = 0 and t = 1 (1 month later) in pregnant women (control group, n = 33), and before (t = 0), at 1 month (t = 1) and at 2 months (t = 2) after clotrimazole treatment in pregnant women with VVC.

Results

Candida albicans was isolated in 30% of healthy pregnant women and 80% of patients with VVC. A high genetic heterogeneity was observed in C. albicans genotypes between individuals. In patients with VVC, topical antifungal treatment with clotrimazole was clinically effective, but only in a 62% C. albicans was eradicated. In patients in which C. albicans was not eradicated, this microorganism persisted for 1 or 2 months after the antifungal treatment. The persistent colonies were not associated with a specific genotype, but they were associated with higher MICs in comparison with colonies isolated from the control group.

Conclusions

Therapy with topical clotrimazole, despite a good clinical outcome, could not eradicate completely C. albicans allowing the persistence of genotypes, with higher MICs to fluconazole. More studies with higher number of patients are needed to validate this preliminary finding.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Sobel JD. Vulvovaginal candidosis. Lancet (Lond Engl). 2007;369:1961–71.

    Article  Google Scholar 

  2. Pfaller MA, Messer SA, Woosley LN, Jones RN, Castanheira M. Echinocandin and triazole antifungal susceptibility profiles for clinical opportunistic yeast and mold isolates collected from 2010 to 2011: application of new CLSI clinical breakpoints and epidemiological cutoff values for characterization of geographic. J Clin Microbiol. 2013;51:2571–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Lischewski A, Ruhnke M, Tennagen I, Schönian G, Morschhäuser J, Hacker J. Molecular epidemiology of Candida isolates from AIDS patients showing different fluconazole resistance profiles. J Clin Microbiol. 1995;33:769–71.

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Samaranayake YH, Samaranayake LP, Dassanayake RS, Yau JYY, Tsang WK, Cheung BPK, et al. “Genotypic shuffling” of sequential clones of Candida albicans in HIV-infected individuals with and without symptomatic oral candidiasis. J Med Microbiol. 2003;52:349–59.

    Article  CAS  PubMed  Google Scholar 

  5. Shin JH, Park M-R, Song JW, Shin DH, Jung S-I, Cho D, et al. Microevolution of Candida albicans strains during catheter-related candidemia. J Clin Microbiol. 2004;42:4025–31.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Lockhart SR, Reed BD, Pierson CL, Soll DR. 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. 1996;34:767–77.

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Chong PP, Lee YL, Tan BC, Ng KP. Genetic relatedness of Candida strains isolated from women with vaginal candidiasis in Malaysia. J Med Microbiol. 2003;52:657–66.

    Article  CAS  PubMed  Google Scholar 

  8. Sobel JD, Faro S, Force RW, Foxman B, Ledger WJ, Nyirjesy PR, et al. Vulvovaginal candidiasis: epidemiologic, diagnostic, and therapeutic considerations. Am J Obstet Gynecol. 1998;178:203–11.

    Article  CAS  PubMed  Google Scholar 

  9. Ghannoum MA, Rice LB. Antifungal agents: mode of action, mechanisms of resistance, and correlation of these mechanisms with bacterial resistance. Clin Microbiol Rev. 1999;12:501–17.

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Jaeger M, Plantinga TS, Joosten LAB, Kullberg B-J, Netea MG. Genetic basis for recurrent vulvo-vaginal candidiasis. Curr Infect Dis Rep. 2013;15:136–42.

    Article  PubMed  Google Scholar 

  11. Martínez-Suárez JV. Rodríguez-Tudela JL [Antifungal resistance in opportunistic pathogenic fungi (II). Imidazoles and triazoles]. Enferm Infecc Microbiol Clín. 1996;14:490–8.

    PubMed  Google Scholar 

  12. Cowen LE, Anderson JB, Kohn LM. Evolution of drug resistance in Candida albicans. Annu Rev Microbiol. 2002;56:139–65.

    Article  CAS  PubMed  Google Scholar 

  13. Anderson JB. Evolution of antifungal-drug resistance: mechanisms and pathogen fitness. Nat Rev Microbiol. 2005;3:547–56.

    Article  CAS  PubMed  Google Scholar 

  14. Aguin TJ, Sobel JD. Vulvovaginal candidiasis in pregnancy. Curr Infect Dis Rep. 2015;17:462.

    Article  CAS  PubMed  Google Scholar 

  15. Pradenas M. InfeccIones cérvIco vagInales y embarazo. Rev Med Clin Condes. 2014;25:925–35.

    Google Scholar 

  16. Felton T, Troke PF, Hope WW. Tissue penetration of antifungal agents. Clin Microbiol Rev. 2014;27:68–88.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Dice LR. Measures of the amount of ecologic association between species. Ecology. 1945;26:297.

    Article  Google Scholar 

  18. Stoddart JA, Taylor JF. Genotypic diversity: estimation and prediction in samples. Genetics. 1988;118:705–11.

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Soll DR. The ins and outs of DNA fingerprinting the infectious fungi. Clin Microbiol Rev. 2000;13:332–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Cross EW, Park S, Perlin DS. Cross-resistance of clinical isolates of Candida albicans and Candida glabrata to over-the-counter azoles used in the treatment of vaginitis. Microb Drug Resist (Larchmt NY). 2000;6:155–61.

    Article  CAS  Google Scholar 

  21. Subcommittee on Antifungal Susceptibility Testing (AFST) of the ESCMID European Committee for Antimicrobial Susceptibility Testing (EUCAST). EUCAST definitive document EDef 7.1: method for the determination of broth dilution MICs of antifungal agents for fermentative yeasts. Clin Microbiol Infect. 2008;14:398–405.

  22. Bauters TGN, Dhont MA, Temmerman MIL, Nelis HJ. Prevalence of vulvovaginal candidiasis and susceptibility to fluconazole in women. Am J Obstet Gynecol. 2002;187:569–74.

    Article  CAS  PubMed  Google Scholar 

  23. Sautter RL, Brown WJ. Sequential vaginal cultures from normal young women. J Clin Microbiol. 1980;11:479–84.

    CAS  PubMed  PubMed Central  Google Scholar 

  24. Pirotta MV, Garland SM. Genital Candida species detected in samples from women in Melbourne, Australia, before and after treatment with antibiotics. J Clin Microbiol. 2006;44:3213–7.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Beigi RH, Meyn LA, Moore DM, Krohn MA, Hillier SL. Vaginal yeast colonization in nonpregnant women: a longitudinal study. Obstet Gynecol. 2004;104:926–30.

    Article  PubMed  Google Scholar 

  26. Farkas Z, Kocsubé S, Tóth M, Vágvölgyi C, Kucsera J, Varga J, et al. Genetic variability of Candida albicans isolates in a university hospital in Hungary. Mycoses. 2009;52:318–25.

    Article  CAS  PubMed  Google Scholar 

  27. Sun J, Qi C, Lafleur MD, Qi Q. Fluconazole susceptibility and genotypic heterogeneity of oral Candida albicans colonies from the patients with cancer receiving chemotherapy in China. Int J Oral Sci. 2009;1:156–62.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Ben Abdeljelil J, Saghrouni F, Emira N, Valentin-Gomez E, Chatti N, Boukadida J, et al. Molecular typing of Candida albicans isolates from patients and health care workers in a neonatal intensive care unit. J Appl Microbiol. 2011;111:1235–49.

    Article  CAS  PubMed  Google Scholar 

  29. Jewtuchowicz VM, Mujica MT, Malzone MC, Cuesta A, Nastri ML, Iovannitti CA, et al. Genetic relatedness of subgingival and buccal Candida dubliniensis isolates in immunocompetent subjects assessed by RAPD-PCR. J Oral Microbiol. 2009;1. doi:10.3402/jom.v1i0.2003.

  30. Brillowska-Dabrowska A, Bergmann O, Jensen IM, Jarløv JO, Arendrup MC. Typing of Candida isolates from patients with invasive infection and concomitant colonization. Scand J Infect Dis. 2010;42:109–13.

    Article  CAS  PubMed  Google Scholar 

  31. Noumi E, Snoussi M, Saghrouni F, Ben Said M, Del Castillo L, Valentin E, et al. Molecular typing of clinical Candida strains using random amplified polymorphic DNA and contour-clamped homogenous electric fields electrophoresis. J Appl Microbiol. 2009;107:1991–2000.

    Article  CAS  PubMed  Google Scholar 

  32. Tay ST, Na SL, Chong J. Molecular differentiation and antifungal susceptibilities of Candida parapsilosis isolated from patients with bloodstream infections. J Med Microbiol. 2009;58:185–91.

    Article  CAS  PubMed  Google Scholar 

  33. Fidel PL. History and update on host defense against vaginal candidiasis. Am J Reprod Immunol. 2007;57:2–12.

    Article  PubMed  Google Scholar 

  34. Pfaller MA. Antifungal drug resistance: mechanisms, epidemiology, and consequences for treatment. Am J Med. 2012;125:S3–13.

    Article  CAS  PubMed  Google Scholar 

  35. Arendrup MC, Cuenca-Estrella M, Lass-Flörl C, Hope WW. Breakpoints for antifungal agents: an update from EUCAST focussing on echinocandins against Candida spp. and triazoles against Aspergillus spp. Drug Resist Updates Rev Comment Antimicrob Anticancer Chemother. 2013;16:81–95.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Programa de Microbiología y Micología, ICBM, Facultad de Medicina, Universidad de Chile, Santiago, Chile

    Cecilia V. Tapia, Germán Hermosilla, Paula Fortes, María Cristina Díaz & Fabien Magne

  2. Laboratorio Clínica Dávila, Santiago, Chile

    Cecilia V. Tapia

  3. Escuela de Tecnología Médica, Universidad Mayor, Santiago, Chile

    Claudio Alburquenque

  4. Departamento de Ciencias Biológicas Animales, Facultad de Ciencias Veterinarias y Pecuarias, Centro Biotecnológico Biovetec, Universidad de Chile, Santiago, Chile

    Sergio Bucarey

  5. Departamento de Obstetricia y Ginecología, Hospital Clínico, Universidad de Chile, Santiago, Chile

    Hugo Salinas

  6. Center for Integrative Medicine and Innovative Science, Facultad de Medicina, Universidad Andrés Bello, Santiago, Chile

    Paula I. Rodas

  7. Laboratoire de Biologie, Conservatoire National des Arts et Métiers, Paris, Île-de-France, France

    Fabien Magne

Authors
  1. Cecilia V. Tapia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Germán Hermosilla
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paula Fortes
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Claudio Alburquenque
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sergio Bucarey
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hugo Salinas
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Paula I. Rodas
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. María Cristina Díaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Fabien Magne
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Cecilia V. Tapia or Fabien Magne.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tapia, C.V., Hermosilla, G., Fortes, P. et al. Genotyping and Persistence of Candida albicans from Pregnant Women with Vulvovaginal Candidiasis. Mycopathologia 182, 339–347 (2017). https://doi.org/10.1007/s11046-016-0095-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11046-016-0095-3

Keywords

Search

Navigation