Application of Biotyping and DNA Typing of Candida albicans to the Epidemiology of Recurrent Vulvovaginal Candidiasis

Abstract

One-hundred and five Candida albicans isolates from various anatomic sites of 28 patients, obtained at the onset of two consecutive episodes of well-documented recurrent vulvovaginitis, were typed by methods relying on physiologic or genomic markers. The isolates represented a wide variety of types, and neither a single biotype nor genotype was associated with recurrent vaginitis or a particular body site. Patients generally carried similar strains at various anatomic sites that persisted over time. Genomic methods indicated an 86% rate of relapse, which suggested that most recurrent vaginal infections are of endogenous origin. A similar evaluation with biotyping methods was inconclusive because of a lack of reproducibility, resulting from clonal variation or switching, and difficulties in establishing the number of phenotypic tests necessary to distinguish between identical and different strains. Therefore, Southern hybridization was considered the ideal reference method to study the epidemiology of C. albicans infections.

Genetic relatedness of Candida strains isolated from women with vaginal candidiasis in Malaysia

“…Vazquez et al (1994) found that eight of ten patients maintained a single strain of C. albicans through sequential infectious episodes but, in two patients, the strain had undergone replacement by another strain. In a similar study, Mercure et al (1993) demonstrated that the majority of patients had maintenance of a single strain, whereas a few patients had strain replacement. These studies were focused only on C. albicans, whereas patients with non-albicans infections were excluded.…”

“…Nonetheless, Lockhart et al (1996) did not find any instances of strain replacement among the sequential isolates of 18 patients studied by using DNA fingerprinting probes. Mercure et al (1993) found that 14 % of recurrent cases were due to colonization by a different strain, by using a Southern hybridization method. By using karyotyping resolved by PFGE, Vazquez et al (1994) found that as many as 20 % of sequential isolates involved strain replacement.…”

“…About 75 % of women will have at least one episode of vaginal infection during their lifetime (Lanchares & Hernandez, 2000); 15-20 % of women without any specific predisposing factor will experience repeated infections within 3 months of treatment (Mercure et al, 1993). Candida albicans is the dominant species that causes vaginitis, with a prevalence of 70-90 % in various reports; other Candida species, such as Candida glabrata (approx.…”

The Ins and Outs of DNA Fingerprinting the Infectious Fungi

“…Furthermore, DNA fingerprinting with Ca3 fulfills the general requirements set forth in a previous section of this review for effective fingerprinting methods (288). Ca3 and 27A have been used in a number of epidemiological studies of C. albicans and the highly related species C. dubliniensis (see, e.g., references 6,80,137,164,168,192,196,216,218,227,246,265,FIG. 4.…”

Candida albicansStrain Maintenance, Replacement, and Microvariation Demonstrated by Multilocus Sequence Typing

“…Most longitudinal and/or multiple-site epidemiological work demonstrating strain maintenance in C. albicans has been done with superficial isolates, particularly with cultures from the oral cavities of human immunodeficiency virus (HIV)-infected patients (2,3,6,19,31,48,51,61,71,72,90,96), with vaginal isolates (1,37,49,64,65,73,76,91), with other sources of superficial isolates (4,17,74,97), or with superficial surveillance cultures from hospitalized patients (60,81,89). Some surveys of oral isolates have shown the same strain persisting for months to years (4,17).…”