Abstract
Objective: Our laboratory previously demonstrated that asymptomatic vaginal colonization during pregnancy is a factor predisposing patients to subsequent symptomatic vulvovaginal candidiasis. It is unknown whether symptoms result from strain replacement or a change in host relationship to the original colonizing strain. This study was undertaken to determine whether Candida albicans isolates from asymptomatic women could be responsible for subsequent symptomatic vaginitis. Methods: We retained isolates of C. albicans from women followed longitudinally through pregnancy, and identified six pairs of cultures from women who were colonized without symptoms and who later became symptomatic (average time 14 weeks). We used a random amplification of polymorphic DNA (RAPD) analysis to determine whether isolates from our study patients were genetically similar or dissimilar. Results: Analysis of these pairs of yeast strains by RAPD revealed that five of the six women had symptoms apparently due to the same yeast strain that was found initially as a commensal strain. To increase the power of these observations, we also performed RAPD analysis on six randomly selected yeast strains from other women in this study who had not become symptomatic to determine whether any of these unrelated strains matched strains from those women who became symptomatic. Conclusion: Symptomatic yeast vaginitis is usually due to strains of C. albicans already carried in the lower genital tract, underscoring the need to understand regulation of growth and virulence of the organism in vivo.
Highlights
Candida albicans is recognized both as normal flora in the female genital tract and as the causative agent of vulvovaginal candidiasis
What is not clear is whether the vaginal commensal organism increases its virulence to cause candidiasis, the host becomes more permissive toward proliferation of the organism resulting in symptoms, or whether another, possibly more virulent, strain supplants the normal flora organism
Byrd Health Sciences Center and its outreach clinics were the source of vaginal specimens, which were plated onto BIGGY agar in an effort to identify colonization by C. albicans
Summary
Candida albicans is recognized both as normal flora in the female genital tract and as the causative agent of vulvovaginal candidiasis. What is not clear is whether the vaginal commensal organism increases its virulence to cause candidiasis, the host becomes more permissive toward proliferation of the organism resulting in symptoms, or whether another, possibly more virulent, strain supplants the normal flora organism. The availability of methods of DNA analysis that distinguish between different strains makes it possible to obtain insight into this question
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
