Consuegra-Asprilla Jeiser Marcelo, Taborda Felipe, Pérez Verónica, Torres Brajhan, Rodríguez-Echeverri Carolina, Muñoz Julián E, González Ángel
Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellin, Colombia.
Translational Microbiology and Emerging Diseases Research Group (MICROS), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia.
Mycoses. 2025 Feb;68(2):e70031. doi: 10.1111/myc.70031.
Recurrent vulvovaginal candidosis (RVVC) has been associated with increased antifungal resistance. Recently, we reported that Candida isolates from Colombian patients with RVVC did not show an increase in antifungal resistance.
The aim of this study was to evaluate the virulence of Candida isolates from patients with RVVC.
A total of 40 Candida isolates were evaluated (37 C. albicans and 3 C. lusitaniae ). C. albicans isolates were divided into two groups based on the number of VVC episodes in patients per year: Group 1 (four to seven episodes; n = 26) and Group 2 (≥ eight episodes; n = 11). The XTT assay was used to assess biofilm formation. Galleria mellonella larvae were used for survival analysis and fungal load assessment, and the qPCR technique to determine the expression of the PRA1 gene.
It was observed that C. lusitaniae and C. albicans isolates from patients with ≥ eight VVC episodes per year exhibited a greater capacity to form biofilms compared to those from patients with four to seven VVC episodes. Moreover, in the G. mellonella model, larvae inoculated with isolates from RVVC patients exhibited approximately 80% mortality. Similarly, larvae infected with C. albicans from patients who experienced ≥ eight VVC episodes showed a significantly higher fungal load compared to the other evaluated groups; likewise, the expression of the PRA1 gene was significantly higher in isolates from patients with ≥ eight VVC episodes.
These results indicate that Candida isolates from patients with RVVC exhibit a high degree of virulence and suggest that virulence may be one of the mechanisms explaining recurrence rather than antifungal resistance itself.
复发性外阴阴道念珠菌病（RVVC）与抗真菌耐药性增加有关。最近，我们报道来自哥伦比亚RVVC患者的念珠菌分离株未显示出抗真菌耐药性增加。
本研究的目的是评估来自RVVC患者的念珠菌分离株的毒力。
共评估了40株念珠菌分离株（37株白色念珠菌和3株葡萄牙念珠菌）。白色念珠菌分离株根据患者每年VVC发作次数分为两组：第1组（4至7次发作；n = 26）和第2组（≥8次发作；n = 11）。采用XTT法评估生物膜形成。利用大蜡螟幼虫进行生存分析和真菌负荷评估，并采用qPCR技术测定PRA1基因的表达。
观察到，与每年有4至7次VVC发作的患者分离株相比，每年有≥8次VVC发作的患者的葡萄牙念珠菌和白色念珠菌分离株形成生物膜的能力更强。此外，在大蜡螟模型中，接种RVVC患者分离株的幼虫死亡率约为80%。同样，与其他评估组相比，感染≥8次VVC发作患者的白色念珠菌的幼虫真菌负荷显著更高；同样，≥8次VVC发作患者分离株中PRA1基因的表达也显著更高。
这些结果表明，来自RVVC患者的念珠菌分离株具有高度毒力，并表明毒力可能是解释复发的机制之一，而非抗真菌耐药性本身。
