Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellin, Colombia.
Sexual Health and Cancer Group, School of Microbiology, Universidad de Antioquia, Medellin, Colombia.
Mycoses. 2024 Apr;67(4):e13720. doi: 10.1111/myc.13720.
Recurrent vulvovaginal candidiasis (RVVC) is an important and underestimated fungal infection.
We aimed to determine the fungicidal and proliferative capacities of neutrophils and peripheral blood mononuclear cells (PBMCs), respectively and the clinical and microbiological characteristics of a cohort of Colombian patients diagnosed with RVVC.
A cross-sectional study was conducted. A total of 66 women were included (40 diagnosed with RVVC and 26 healthy women [HW]). Demographic and clinical data were recorded. Vaginal fluid samples were obtained for isolation, identification and antifungal susceptibility testing of Candida species using selective culture media and the Vitek 2.0® system. Blood samples were also obtained to evaluate cell subpopulations; furthermore, neutrophils and PBMCs were isolated to determine their fungicidal and proliferative capacities, respectively.
The median age was 29 (IQR: 34-23) for RVVC and 24 (IQR: 30-23) for HW. Only two species of the genus Candida were identified: Candida albicans (92.5%) and Candida lusitaniae (7.5%). Resistance to fluconazole, voriconazole, flucytosine and amphotericin B was observed on six C. albicans isolates and one C. lusitaniae isolate. Only the family history of vulvovaginal candidiasis was associated with RVVC occurrence. The RVVC group exhibited a significantly higher number of neutrophils but with lower fungicidal activity in comparison to HW; likewise, PBMCs from RVVC patients presented a lower proliferation index when stimulated with C. albicans.
Contrary to what has been reported worldwide, in Colombian patients with RVVC, C. albicans was the main isolated species without increased antifungal resistance. The diminished fungicidal and proliferative capacities of neutrophils and PBMCs, respectively, could suggest a possible alteration in the innate and adaptive immune responses.
复发性外阴阴道念珠菌病（RVVC）是一种重要且被低估的真菌感染。
我们旨在分别确定中性粒细胞和外周血单核细胞（PBMC）的杀菌和增殖能力，并确定一组被诊断为 RVVC 的哥伦比亚患者的临床和微生物学特征。
进行了一项横断面研究。共纳入 66 名女性（40 名诊断为 RVVC 和 26 名健康女性[HW]）。记录人口统计学和临床数据。采集阴道液样本，用于分离、鉴定和使用选择性培养培养基和 Vitek 2.0®系统进行抗真菌药敏试验。还采集了血液样本以评估细胞亚群；此外，分离中性粒细胞和 PBMC 以分别确定其杀菌和增殖能力。
RVVC 的中位年龄为 29（IQR：34-23），HW 为 24（IQR：30-23）。仅鉴定出念珠菌属的两种物种：白色念珠菌（92.5%）和葡萄牙念珠菌（7.5%）。在 6 株白色念珠菌和 1 株葡萄牙念珠菌分离株中观察到对氟康唑、伏立康唑、氟胞嘧啶和两性霉素 B 的耐药性。仅外阴阴道念珠菌病的家族史与 RVVC 的发生相关。RVVC 组的中性粒细胞数量明显更高，但杀菌活性低于 HW；同样，RVVC 患者的 PBMC 在受到白色念珠菌刺激时表现出较低的增殖指数。
与全球报道的情况相反，在哥伦比亚 RVVC 患者中，白色念珠菌是主要分离株，没有增加的抗真菌耐药性。中性粒细胞和 PBMC 的杀菌和增殖能力分别降低，可能提示先天和适应性免疫反应存在潜在改变。
