High Virulence and Antifungal Resistance in Clinical Strains of .

Antifungal resistance and virulence properties of are a growing health problem worldwide. To study the expression of virulence and azole resistance genes in 39 clinical strains of , we used a model of infection of human vaginal epithelial cells with strains isolated from Mexican women with vulvovaginal candidiasis (VVC). The strains were identified by PCR amplification of the ITS1 and ITS2 regions of rRNA. The detection and expression of virulence genes and azole resistance genes and were performed using PCR and RT-PCR, respectively. All strains were sensitive to nystatin and 38 (97.4%) and 37 (94.9%) were resistant to ketoconazole and fluconazole, respectively. , , , , , , , , , and - were present in all strains; was identified in 37 (94.8%) isolates, in 35 (89.7%), in 14 (35.8%), and in 26 (66.6%). In nearly all of the strains, , , , , , and were expressed, whereas was expressed in 20 (51.3%) and in 14 (35.8%). In our in vitro model of infection with , the clinical strains showed different expression profiles of virulence genes in association with the azole resistance gene . The results indicate that the strains that infect Mexican patients suffering from VVC are highly virulent and virtually all are insensitive to azoles.