Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
Zoonosis Research Center, Jahrom University of Medical Sciences, Jahrom, Iran.
Mycoses. 2021 Jul;64(7):771-779. doi: 10.1111/myc.13280. Epub 2021 May 3.
Vulvovaginal candidiasis (VVC) is a common and debilitating long-term illness affecting million women worldwide. This disease is caused mainly by Candida albicans and a lesser extent by other species, including the two phylogenetically closely related pathogens Candida africana and Candida dubliniensis.
In this study, we report detailed molecular epidemiological data about the occurrence of these two pathogenic yeasts in Iranian patients affected by VVC, or its chronic recurrent form (RVVC), and provide, for the first time, data on the antifungal activity of two new drugs, efinaconazole (EFN) and luliconazole (LUL).
A total of 133 vaginal yeast isolates, presumptively identified as C albicans by phenotypic and restriction analysis of rDNA, were further analysed by using a specific molecular method targeting the HWP1 gene. All C africana and C dubliniensis isolates were also tested for their in vitro susceptibility to a panel of modern and classical antifungal drugs.
Based on the molecular results, among 133 germ-tube positive isolates, we identify 119 C albicans (89.47%), 11 C africana (8.27%) and 3 C dubliniensis (2.26%) isolates. C africana and C dubliniensis showed low MIC values for most of the antifungal drugs tested, especially for EFN and LUL, which exhibited a remarkable antifungal activity. High MIC values were observed only for nystatin and terbinafine. Although C albicans remains the most common Candida species recovered from Iranian VVC/RVVC patients, our data show that its prevalence may be slightly overestimated due to the presence of difficult-to-identify closely related yeast, especially C africana.
外阴阴道念珠菌病（VVC）是一种常见且使人虚弱的长期疾病，影响着全球数百万妇女。这种疾病主要由白色念珠菌引起，在较小程度上由其他物种引起，包括两种在系统发育上密切相关的病原体——非洲念珠菌和都柏林念珠菌。
在这项研究中，我们报告了有关这两种致病性酵母在伊朗 VVC 或其慢性复发性形式（RVVC）患者中发生的详细分子流行病学数据，并首次提供了两种新药——依氟康唑（EFN）和卢立康唑（LUL）的抗真菌活性数据。
总共分析了 133 株阴道酵母分离株，这些分离株通过表型和 rDNA 限制分析初步鉴定为白色念珠菌，然后进一步通过针对 HWP1 基因的特定分子方法进行分析。所有非洲念珠菌和都柏林念珠菌分离株也进行了体外药敏试验，以检测一组现代和经典抗真菌药物。
根据分子结果，在 133 株芽管阳性分离株中，我们鉴定出 119 株白色念珠菌（89.47%）、11 株非洲念珠菌（8.27%）和 3 株都柏林念珠菌（2.26%）。非洲念珠菌和都柏林念珠菌对大多数测试的抗真菌药物显示出低 MIC 值，特别是对依氟康唑和卢立康唑，它们表现出显著的抗真菌活性。只有制霉菌素和特比萘芬的 MIC 值较高。尽管白色念珠菌仍然是从伊朗 VVC/RVVC 患者中分离出的最常见的念珠菌物种，但我们的数据表明，由于存在难以识别的密切相关酵母，尤其是非洲念珠菌，其流行率可能被略微高估。
