Genotyping Of Candida Albicans Research Articles

Genotyping of Candida albicans and Comparison of its Antifungal Resistance Pattern in the South Indian Region

Recent studies have documented an increase in the incidence of antifungal resistance in newly emerging species closely related to C. albicans, and the coexistence of genotypic variants. Hence, an application of PCR-based molecular typing is crucial in identifying these fungi. Our study used molecular methods to characterize the latest genotypic subgroups of C. albicans and analysed if there was a relationship between the genotypes and the antifungal resistance pattern. The study was conducted in JSS Hospital, Mysuru, Karnataka between July 2018 and December 2020. A total of 1427 Candida species were isolated from clinical samples. Candida albicans were isolated and confirmed using Germ tube test, ID VITEK 2 and PCR (ITS primer). DNA extraction was done using the Hi-Media Yeast DNA Extraction Kit. The amplified products were analysed using Agarose gel electrophoresis (2%). Among 1427 Candida species, 282 were Candida albicans. The following resistance was exhibited to major antifungals – Caspofungin (3.5%), Amphotericin B (1.4%), flucytosine (2.8%) Fluconazole (6%) Micafungin (2.8%) Voriconazole (3.1%) and all were sensitive to miconazole. ABC genotyping showed Genotype A (450 bp) predominant (87.58%) followed by genotype B (840bp) (9.92 %) and genotype C (450bp and 840 bp) (0.2%). Genotype D and E were not observed. Our study showed the growing antifungal resistance in clinical isolates. Genotype A was predominant in South Karnataka region followed by Genotype B and C. There was no correlation between genotyping and antifungal resistance. However, a study with greater number of samples from diverse geographical locations may give more insight.

Prevalence, Molecular Identification, and Genotyping of Candida Species Recovered from Oral Cavity among Patients with Diabetes Mellitus from Tehran, Iran.

Background:Oral candidiasis (OC) has been noticed as a common mucous membrane infection in immunocompromised patients such as that diabetes. This study, focused on the genotyping of Candida albicans and enzymatic activities of Candida species recovered from oral mucosa among diabetes patients and healthy individuals.Materials and Methods:Specimens were obtained from oral mucosa of One-hundred and sixty patients with type 2 diabetic and 108 healthy individuals. All isolates were definitely identified by ribosomal DNA (rDNA) gene sequencinghHydrophobicity, hemolytic activities of Candida species and genotypes of C. albicans were determined through polymerase chain reaction (CA-INT).Results:, Eighty eight (55%) samples out of 160, were positive for Candida species in diabetic patients. Moreover, 79.5% (70/88) and 20.5% (18/88) isolates belonged to the C. albicans and non-albicans Candida species respectively. Three genotypes of C. albicans have recovered in diabetic patients: genotype A (71.42%), B (21.42%), and C (7.14%). In healthy individuals, 42.6% (46/102) Candida species recovered from oral cavity, with the highest prevalence of genotype A (76.6% of C. albicans). Additionally, hydrophobicity and hemolytic activities from Candida species were significantly greater in diabetes patients than healthy nondiabetic subjects.Conclusion:Collectively, C. albicans was the most causative agent isolated from diabetes patients and non-diabetes healthy individuals. Genotype A, as the most remarkable genotype, should be mentioned in both groups. Higher potential hydrophobicity and hemolytic activities of Candida species in diabetic patients compared to healthy cases suggest these features triggering pathogenicity of OC in diabetes patients.

Isolation and genotyping of Candida albicans involved in vaginal candidiasis among pregnant women in Sulaymaniyah and Erbil cities

Background and objective: Vaginal candidiasis is a common infection among pregnant women. The current study aimed to investigate the etiologic species of vaginal candidiasis and the genotypes of C. albicans isolated from vaginal samples among pregnant women in the Kurdistan region of Iraq. Methods: Vaginal swabs were collected from pregnant women admitted to the Maternity hospital in Sulaymaniyah and Erbil cities from March 2016 to December 2018. Candida isolates were identified on CHROMagar medium, then confirmed with PCR depending on ITS region. All C. albicans isolates were confirmed using chitin synthase gene (CHS1) and subjected to genotypic analysis based on the transposable intron in 25S rDNA with using CA25S and CA-INT primers. DNA sequencing of 25S rDNA region was done by using CA and CA-INT primers. Results: Among 340 women tested, 114 (33.53%) were positive for vaginal candidiasis. Five Candida species were identified, where they are C. albicans (56.14%), C. glabrata (24.56%), C. kefyr (11.40%), C. tropicalis (5.27%) and C. krusei (2.63%). It has been found that C. albicans significantly (P <0.01) higher than non-albicans species. The genotypes A (450 bp), B (840 bp), and C (450 and 840 bp) of C. albicans were detected. The Genotype A (54.69%) was the most prevalent, followed by Genotype B (34.38%) and Genotype C (10.94%). In regards to genetic variation, genotypes A and B were more similar compared to genotype C. Conclusion: The current study revealed a high prevalence of vaginal candidiasis with different genotypes of C. albicans among pregnant women. Therefore, it is worth considering a vaginal swab culture with clinical symptoms during the diagnosis of vaginal candidiasis. Keywords: Candida; Genotypes; Vulvovaginitis; Candidiasis; Prevalence.

Virulence and antifungal susceptibility of microsatellite genotypes of Candida albicans from superficial and deep locations.

A set of 185 strains of Candida albicans from patients with vulvovaginal candidiasis (VVC) and from non‐VVC clinical sources in southwest China was analysed. Strains were subjected to genotyping using CAI microsatellite typing and amplification of an intron‐containing region of the 25S rRNA gene. Microsatellite genotypes of strains from non‐VVC sources showed high polymorphism, whereas those of VVC were dominated by few, closely similar genotypes. However, among non‐VVC strains, two genotypes were particularly prevalent in patients with lung cancer. 25S rDNA genotype A was dominant in VVC sources (86.7%), whereas genotypes A, B, and C were rather evenly distributed among non‐VVC sources; known genotypes D and E were not found. In an experimental mouse model, isolates from lung cancer and AIDS patients proved to have higher virulence than VVC strains. Among 156 mice infected with C. albicans, 19 developed non‐invasive urothelial carcinoma. No correlation could be established between parameters of virulence, source of infection, and incidence of carcinoma. C. albicans strains from VVC were less susceptible to itraconazole than the strains from non‐VVC sources, whereas there was small difference in antifungal susceptibility between different 25S rDNA genotypes of C. albicans tested against amphotericin B, itraconazole, fluconazole, and flucytosine.

Genotyping of Candida albicans isolated from animals using 25S ribosomal DNA and ALT repeats polymorphism in repetitive sequence.

Background and Purpose: Candida albicans is the most prevalent Candida species isolated from animals. Candidiasis can be systemic in animals or may affect a single organ, such as the mouth, urinary tract, and skin. The aim of the present study was to determine the genetic diversity of C. albicans isolated from different animals and investigate the presence of a relationship between host specificity and genetic typing of C. albicans.Materials and Methods:For the purpose of the study, DNA extraction was performed on 27 clinical isolates of C. albicans obtained from animals. Subsequently, they were subjected to 25S ribosomal DNA amplification and ALT repeats in repetitive sequences (RPSs). The minimum inhibitory concentrations of fluconazole, ketoconazole, clotrimazole, nystatin, amphotericin B, and caspofungin were determined using the microdilution method based on the Clinical and Laboratory Standards Institute M27-S4 standard.Results:Out of 27 C. albicans strains, 11, 6, 5, and 5 cases were recognized as genotypes A (40.8%), E (22.2%), B (18.5%), and C (18.5%), respectively, through amplification using AS-I, which revealed 17 different types of C. albicans. By combining the two typing methods, 27 C. albicans strains were finally divided into 22 genotypes.Conclusion: Different genotypes showed genetic diversity among the C. albicans strains isolated from animal sources. The results revealed no special genotype relationship according to the host, anatomical source of isolation, and antifungal susceptibility.

Genotyping of Candida albicans and Candida dubliniensis by 25S rDNA analysis shows association with virulence attributes in oral candidiasis

ObjectivesThis study genotyped oral isolates of Candida albicans and C. dubliniensis by analyzing 25S rDNA transposable intron and evaluated their virulence attributes in oral candidiasis. DesignC. albicans and C. dubliniensis were isolated from oral cavity of normal carriers (n = 100) and oral candidiasis patients (n = 100), genotyped by PCR, and virulence properties, namely, secreted phospholipase and proteinase activities (using an agar plate method) and binding to buccal epithelial cells, were determined. In addition, antifungal sensitivity was assayed for all Candida isolates. ResultsC. albicans genotypes A, B, C and D (C. dubliniensis) were identified. Genotype B was the most prevalent in both healthy and candidiasis groups and had highest buccal epithelial cell binding ability but lowest secreted phospholipase activity. Genotype C was the third most prevalent, with higher frequency in patients than normal carriers. Genotype A, the second most prevalent, was equally found in both groups. There were no significant differences in secreted proteinase activity among the three C. albicans genotypes. C. dubliniensis, the least prevalent, was more frequent in healthy carriers and demonstrated minimal levels of the virulence properties. When all Candida isolates were compared based on groups of subjects, only secreted phospholipase activity was significantly higher in isolates from candidiasis patients. All Candida isolates were susceptible to clotrimazole, fluconazole, miconazole and nystatin. ConclusionsGenotyping based on the 25S rDNA transposable intron region provided a simple method allowing studies of the pathogenicity of each genotype.

DST659 genotype of Candida albicans showing positive association between biofilm formation and dominance in Taiwan.

Based on multiple locus sequence typing, we previously found that DST659 and DST693 were dominant genotypes of Candida albicans among the bloodstream isolates at Chang-Gung Memorial Hospital at Linkou. Biofilm-forming activity, which is critical for C. albicans virulence, probably contributed to the dominance of antifungal sensitive isolates in hospital. Both in vitro membrane weighting and in vivo zebrafish egg infection assays were used to evaluate the biofilm-forming activity of DST659 and DST693 genotypes. Medical records of the patients infected by these two genotypes were retrospectively reviewed. High biofilm-forming activity of DST659 isolates was demonstrated in vitro and further proved with the zebrafish egg infection model, which showed a positive correlation between the biofilm-forming extent on chorion and the in vitro biofilm activity. Moreover, significantly less embryos survived when infected with DST659 isolates than those with DST693 (1.25%vs. 11.43%), and the high-biofilm subset of DST659 showed a greater reduction in survival of embryos at 48h post-infection than the low-biofilm subset (0vs. 1.92%). Patients infected with DST659 seemed to survive slightly worse than those infected with DST693, although the difference was insignificant. It is noteworthy that DST659-infected patients were associated with a higher incidence in renal insufficiency as compared to those with DST693, the low biofilm genotype. We suggest that a strong biofilm activity of DST659 contributed to a high mortality rate in zebrafish hosts and poor renal function in patients, as well as gaining the dominance in the northern Taiwan.

Genotypes and virulence factors of Candida species isolated from oralcavities of patients with type 2 diabetes mellitus.

This study compared the genotypes and virulence factors of Candida species isolated from oral cavities of healthy individuals and patients with diabetes mellitus (DM). A total of 142 healthy individuals and 73 diabetic patients participated in this study. Study populations were classified into 4 groups as follows: Group I - Healthy, without caries; Group II - Healthy, with caries; Group III - DM, with caries; Group IV - DM, without caries. Diabetic patients' blood glucose and hemoglobin A1c concentrations were determined. Identification of Candida species was performed with conventional methods. Biofilm production, proteinase, phospholipase, and esterase were analyzed. The genetic diversity of Candida species was established using rep-PCR. The most isolated species was Candida albicans. There were statistical differences in terms of isolated Candida frequency between healthy subjects and diabetic patients. There was no statistical difference between the virulence factors of groups. Twelve genotypes were determined. While there were statistical differences in aerobe biofilm production, proteinase, and phospholipase activity between genotypes, there were no statistical differences in anaerobe biofilm production and esterase activity between genotypes. Diabetes has no effect on the activities of virulence factors of Candida species. Different genotypes of Candida albicans exhibited different virulence activities.

Clusters of patients with candidaemia due to genotypes of Candida albicans and Candida parapsilosis: differences in frequency between hospitals

The presence of clusters (identical genotypes infecting different patients) suggests patient-to-patient transmission or a common source for strains. We report the results of a genotyping study based on microsatellite markers of Candida albicans (n = 179) and Candida parapsilosis (n = 76) causing candidaemia, to assess and compare the percentage of patients grouped in clusters during the study period (January 2010 to December 2012). The study was performed in two large tertiary hospitals in Madrid, Spain. We detected 145 C. albicans genotypes (21 in clusters) and 63 C. parapsilosis genotypes (seven in clusters). Clusters involved two to seven patients each. Most of the clusters in the two centres involved two patients for both species, but the number of patients included in each cluster differed between hospitals. Considering both species, the percentage of patients per cluster ranged from 19% to 38% (p < 0.05) in Hospital A and B respectively. Up to 2.9% of genotypes were present in both hospitals. Clusters of C. albicans and C. parapsilosis genotypes causing candidaemia differed between hospitals, suggesting differences in strain transmission. Occasionally, the same genotypes were found in patients admitted to different hospitals located in the same city.

Genotyping of Candida albicans Isolated from broilers by 25S rDNA Analysis

Candida albicans one of the most fungi which isolated from clinical samples that cause many problems to humans, animals and birds. Candidiasis is an opportunistic endogenous mycosis in that perturbance of the microflora or other debilitation of the host. So, this study come to focused on genotyping and antifungal susceptibility profile to Candida albicans isolated from broilers.Ten isolates of Candida albicans were obtained from crop of broilers, samples was collected from poultry diseases lab. in Najaf veterinary hospital of different cases of enteritis broilers. All isolates were identified morphologically and biochemically by Hicandida identification kit and genotyped according to 25s rDNA of transposable intron I region of chromosome R. The results showed that all isolates belonged to the genotype A with amplification product (450 bp). Antifungal sensitivity profile by disc diffusion method showed no resistant to nystatin, ketoconazole and micanazole while three isolates (30%) showed resistant to fluconazole.

Endemic Genotypes of Candida albicans Causing Fungemia Are Frequent in the Hospital

Genotyping of Candida albicans strains causing candidemia can uncover the presence of endemic genotypes in the hospital. Using a highly reproducible and discriminatory microsatellite marker panel, we studied the genetic diversity of 217 C. albicans isolates from the blood cultures of 202 patients with candidemia (from January 2007 to December 2011). Each isolate represented 1 candidemia episode. Multiple episodes were defined as the isolation of C. albicans in further blood cultures taken ≥7 days after the last isolation in blood culture. Of the 202 patients, 188 had 1 episode, 13 had 2 episodes, and 1 had 3 episodes. Identical genotypes showed the same alleles for all 6 markers. The genotypes causing both episodes were identical in most patients with 2 episodes (11/13; 84.6%). In contrast, 2 different genotypes were found in the patient with 3 episodes, one causing the first and second episodes and the other causing the third episode (isolated 6 months later). We found marked genetic diversity in 174 different genotypes: 155 were unique, and 19 were endemic and formed 19 clusters (2 to 6 patients per cluster). Up to 25% of the patients were infected by endemic genotypes that infected 2 or more different patients. Some of these endemic genotypes were found in the same unit of the hospital, mainly neonatology, whereas others infected patients in different wards.

Genotypes of Candida albicans isolated from healthy individuals and their distribution in patients with oral candidiasis

For the study of Candida albicans genotypes involved in development of candidiasis, Candida albicans isolates were collected from healthy volunteers and patients with oral candidiasis and genotyped on the basis of 25S rDNA and microsatellite polymorphisms. In the microsatellite analysis using two microsatellite markers (CDC3 and CAI), 63 healthy volunteer isolates were classified into 35 genotypes (allelic relations to CDC3 alleles 1:2/CAI alleles 1:2), among which genotypes II (115:119/23:23), III (115:123/18:27), and V (123:127/32:41) were found at frequencies of 12.7%, 7.9%, and 7.9%, respectively. In 68 oral candidiasis isolates classified into 39 genotypes, genotypes II and III were identified in 4.4% and 20.6% of the isolates, respectively. The frequency of genotype III was higher in the candidiasis isolates than in the healthy isolates (p < 0.05). These results suggest that genotype III C. albicans assigned by CDC3/CAI is related to the development of oral candidiasis.

Antifungal susceptibility and genotypes of Candida albicans

Objective To test the susceptibilities of Candida albicans to 5 antifungal agents including methylrosanilinium chloride and to estimate their relationship with the genotypes of C.albicans.Methods The susceptibilities of 67 C.albicans isolates to methylrosanilinium chloride, fluconazole, amphotericin B,itraconazole and ketoconazole were determined by using a broth dilution method as described in the National Committee for Clinical Laboratory Standards (NCCLS) document M27-A2.DNA was extracted from the C.albicans isolates and subjected to the amplification of 25S ribosomal DNA (rDNA) introns by PCR.The C.albicans isolates were divided into A,B and C genotypes according to the amplicons.The relationship was analyzed statistically by exact probability test between the genotypes and antifungal susceptibility of C.albicans.Results Of the 67 C.albicans isolates,8.96％ were resistant to fluconazole,2.98％ to itraconazole,1.49％ to ketoconazole,and no resistance to amphotericin B was observed.The minimum inhibitory concentration (MIC) of methylrosanilinium chloride varied from 0.125 to 4 mg/L.Statistical analysis revealed no significant correlation between the genotypes and autifungal susceptibilities of C.albicans (all P ＞ 0.05).Conclusions More attention should be given to the increasing resistance to fluconazole and itraconazole in some isolates of C.albicans as well as to the favorable antifungal activity of methylrosanilinium chloride.The antifungal resistance shows no apparent correlation to the genotypes of C.albicans. Key words: Candida albicans; Drug resistance, fungal; Microbial sensitivity tests; Genotype

Genotyping and fluconazole susceptibility of Candida albicans strains from patients with vulvovaginal candidiasis in Jos, Nigeria

Objective To investigate the fluconazole susceptibility of the genotypes of Candida albicans ( C. albicans) strains isolated from patients with vulvovaginal candidiasis (VVC) in Jos, Plateau State, Nigeria. Methods A total of one hundred and seventy seven (177) Candida isolates were examined. The strains were obtained from 320 female patients with VVC and were identified using both phenotypic and molecular methods. Their genotypes were determined, based on the presence or absence of a transposable intron in the 25S rDNA. Results Eighty four (84) strains were recognized as being C. albicans and all the 84 C. albicans strains resulted to be genotype A. Antifungal susceptibility testing showed that 13 of those isolates (15.48%) were resistant to fluconazole. Conclusions Based on these data, we concluded that C. albicans genotype A was common among VVC patients in Jos, and resistance to fluconazole is quite high. To our knowledge, this is the first study that reports C. albicans genotypes in Jos and its resistance to fluconazole.

Microsatellite-based Genotyping of Candida albicans Isolated from Patients with Superficial Candidiasis

This study aimed to examine the genotype distribution of Candida albicans and the major genotypes involved in superficial candidiasis. The genotypes of C. albicans isolated from the infection sites of patients with superficial candidiasis (referred to as infection isolates) were analyzed by fragment analysis using 4 microsatellite markers (HIS3, CDC3, CAI and CAIII). Genotypes of the infection isolates were compared with those of C. albicans isolated from oral mucosa of non-candidiasis patients (referred to as oral isolates). Isolates of C. albicans showed 4 major genotypes for HIS3/CAI (" a " for 148 : 148 / 23 : 23," b " for 148 : 160 / 33 : 41," c " for 148 : 164 / 32 : 41 and " d " for 152 : 152 / 18 : 27). The genotypes " a "," b " and " d " were commonly found in oral (4.7, 8.8 and 7.6%, respectively) and infection (6.6, 9.2 and 15.4%, respectively) isolates. No isolates of genotype " c " were isolated from infection sites. The genotype " a " was found in the isolates from patients with genitalia candidiasis. Genotyping of multiple isolates from an individual patient showed that C. albicans from infection sites was genetically homogenous as compared with that of oral isolates, even in the same patient with candidiasis.

Genotypes of Candida albicans Involved in Development of Candidiasis and Their Distribution in Oral Cavity of Non-Candidiasis Individuals

Genotype characteristics and distribution of commensal Candida albicans should be studied to predict the development of candidiasis, however, extensive genotype analysis of commensal C. albicans has not been made. In this study, 508 C. albicans isolates were collected from patients with/without candidiasis and divided into 4 isolate groups (SG-1, oral cavity of non-candidiasis patients; SG-2, patients with cutaneous candidiasis; SG-3, patients with vaginal candidiasis; SG-4, patients with candidemia). These isolates were characterized to study the relationship between genotypes and pathogenicity using microsatellite analysis. Using CDC3 and CAI, 5 genotypes (I, 111: 115/33: 41; II, 115: 119/23: 23; III, 115: 123/18: 27; IV, 115: 123/33: 40; and V, 123: 127/32: 41) were found in 4.2%, 8.9%, 7.1%, 2.2% and 3.1% of the isolates, respectively. Genotypes II and III were commonly found in all isolate groups. These genotypes were further divided into 28 types by additional HIS3 and CAIII microsatellite markers. In this analysis, C. albicans with type 6 and type 23 was widely distributed as a commensal species in the oral cavity of non-candidiasis patients and found to be related with candidiasis development. Additionally, genotypes I and IV were found in SG-2 and/or SG-4, suggesting that the fungus with those genotypes is also involved in this development. In contrast, genotype V was not identified in any infective isolates.

Genotypes of Candida albicans from clinical sources in Nairobi Kenya

The present study genotyped Candida albicans isolates from clinical sources in Nairobi. The isolates were from blood, sputum, swabs, urine and catheters tips isolated between 2000 - 2005. Genotypic analysis was done using primer pairs that span the site of the transposable intron in the 25S rDNA. Genotypic analysis indicated that 60% of the C. albicans were genotype A exhibiting one band size of 450 base pair. This was followed by genotype C (16%) with two bands of approximately 450 and 650 amplicon sizes. Eight percent were genotype B with one band size of 650 base pairs. Four percent of the isolates gave a faint band of approximately 550 base pairs. These isolates did not correspond with any of the earlier described genotypes; A, B, C, D and E therefore we placed it in a new genotype BC. Our local C. albicans isolates strain showed slightly different amplicon sizes as those reported previously. Genotype E which corresponds to Candida dubliniensis with amplicon size of 1080 bp was not detected and confirms no reports of C. dubliniensis in Kenya. Although 12% of the isolates were confirmed as C. albicans, no specific band was amplified and could not be genotyped. More extensive work to determine the presence of C. dubliniensis and other possible genotypes of C. albicans may be necessary. Key words: Candida albicans, genotypes, clinical, Kenya.

Genotyping of Candida albicans isolated from AIDS patients in Xinjiang, China

Genotyping of Candida albicans isolated from AIDS patients in Xinjiang, China

Genotyping of Candida albicans by Fragment Analysis of Microsatellites Combined with 25S rDNA and RPS-based Strategies

Because of its high discriminatory potential, fragment analysis of microsatellites has been frequently used for genotyping of Candida albicans at the strain level. In order to evaluate a genotyping system based on the fragment analysis of microsatellites combined with PCRs targeting 25S rDNA and RPS, 456 independent strains of C. albicans were subjected to genotype analysis using 4 microsatellite markers (CDC3, HIS3, CA I and CA III), followed by 25S rDNA and RPS-based genotyping. The fragment analysis using CA I showed the highest discriminatory potential (DP=0.9782), followed by HIS3 (DP=0.8780). Using combined microsatellite markers, 456 C. albicans strains were divided into 384 genotypes (DP=0.9984). PCRs targeting 25S rDNA and RPS were performed to differentiate the strains that showed identical genotypes in the fragment analysis, resulting in 434 genotypes (DP=0.9996). The combined genotyping system showed high discriminatory power at the strain level, and therefore is useful for rapid genotyping in molecular epidemiological studies of candidiasis.

Genotype comparisons of strains of Candida albicans from patients with cutaneous candidiasis and vaginal candidiasis

It is uncertain whether genotypes of Candida albicans (C. albicans) are associated with colonizing body locations or variant conditions of infection. The aim of this study was to investigate whether there are significant associations between strain genotypes and body sites of infection and to determine the potential pathogenesis of cutaneous candidiasis at multiple locations. A total of 151 strains of C. albicans were isolated from 74 infant patients with cutaneous candidiasis and 61 female patients with vaginal candidiasis. Patients were grouped according to the body sites and underlying conditions of infection. Genotypes were identified by polymerase chain reaction (PCR) of the 25S rDNA and PCR-restriction fragment length polymorphism (RFLP) of ALT repeats digested with EcoRI and Clal. Ten genotypes were detected. There were significant differences in genotype frequencies between the two groups. However, we found no clear association between genotypes and the sites of cutaneous infection or the underlying conditions of vaginal candidiasis (VVC). In addition, strains of C. albicans from multiple cutaneous locations of the same patient had identical genotypes. Populations of C. albicans from patients with cutaneous and vaginal candidiasis were genetically different. However, the lack of genetic difference between strains from different body sites with cutaneous infections or from different underlying conditions for VVC suggests no evidence of genotype selection for different skin surfaces or patients with different underlying conditions for VVC.