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Emergence of Candida glabrata in vulvovaginal candidiasis should be attributed to selective pressure or virulence ability?

  • General Gynecology
  • Published:
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Abstract

Purpose

Vulvovaginal candidiasis (VVC) is one of the most frequent female genital disorders and Candida glabrata is the second most common agent. Current study was aimed to study the susceptibility to antifungal agents of C. glabrata isolated from vaginal samples and some virulence attributes in order to better understand why this species is emerging as the main VVC agents.

Methods

A total of 60 C. glabrata vaginal isolates were included in this study. Firstly they were screened by susceptibility tests to antifungal agents. The isolates that showed sensitivity or resistance to fluconazole were evaluated for their virulence potential, including ability to adhere to polystyrene and vaginal ring, cell surface hydrophobicity (CSH) and capacity to form biofilm.

Results

Candida glabrata isolates varied significantly in adherence capacity, biofilm formation and CSH. However, it was possible to observe that isolates resistant to fluconazole adhered more efficiently to the vaginal ring and were statistically more able to form biofilm.

Conclusion

These results allow hypothesizing that C. glabrata is an emergent agent in VVC probably because the treatment with fluconazole selects this species. But once adhered, yeasts remain on biotic or abiotic surfaces causing colonization or VVC symptomatology.

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Acknowledgements

The authors would like to thank Programa Nacional de Cooperação Acadêmica (CAPES/PNPD) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (Cnpq) by financial support.

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Authors and Affiliations

  1. Division of Medical Mycology, Teaching and Research Laboratory in Clinical Analyses, Department of Clinical Analysis, State University of Maringá, Av. Colombo, 5790, bloco T20 sala 203, Maringá, Paraná, 87020-900, Brazil

    Sandra Sayuri Nakamura-Vasconcelos, Patrícia de Souza Bonfim-Mendonça, Janine Ribeiro Godoy & Terezinha Inez Estivalet Svidzinski

  2. Federal University of Paraná (UFPR), Palotina, Paraná, Brazil

    Adriana Fiorini

  3. Clinical Cytology Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá, Paraná, Brazil

    Pamela Delvas Zanni & Marcia Edilaine Lopes Consolaro

  4. Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil

    Adriana Araújo Almeida-Apolonio

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  1. Sandra Sayuri Nakamura-Vasconcelos
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Contributions

SSNV: project development, data collection, manuscript writing and editing. AF: project development, data collection and management, manuscript editing. PDZ: project development, data analysis, manuscript editing. PSBM: project development, data collection. JRG: project development, data collection. AA: project development, data collection. MELC: project design, data analysis, financial support. TIES: project design and management, data analysis, financial support, manuscript writing and editing.

Corresponding author

Correspondence to Terezinha Inez Estivalet Svidzinski.

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Funding

This study was funded by Programa Nacional de Cooperação Acadêmica (CAPES/PNPD) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (Cnpq).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional (Committee of the State University of Maringá—number 185/2007) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Nakamura-Vasconcelos, S.S., Fiorini, A., Zanni, P.D. et al. Emergence of Candida glabrata in vulvovaginal candidiasis should be attributed to selective pressure or virulence ability?. Arch Gynecol Obstet 296, 519–526 (2017). https://doi.org/10.1007/s00404-017-4465-y

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