Maffei C M, Paula C R, Mazzocato T S, Franceschini S
Departamento de Parasitologia, Microbiologia e Imunologia da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo.
Mycopathologia. 1997;137(2):87-94. doi: 10.1023/a:1006878908668.
Fourteen out of 80 pregnant women receiving prenatal care presented signs and symptoms of recurrent vaginal candidiasis. Candida albicans strains were isolated from 12 patients (85.7%), and these were submitted to morphotyping (morphological characteristics of the colony), antifungal typing (pattern of sensitivity to amphotericin B, 5-fluorcytosine, myconazole, ketoconazole and fluconazole) and genotyping (electrophoretic migration of DNA fragments digested with EcoRI and HinfI). Alteration of morphotype and antifungal type was observed in 50% of the patients, but the genotype of the strains isolated from the same patients at different times was identical in all subjects. The predominant morphotypes presented continuous fringes and the basic changes observed among antifungal types was the emergence of strains resistant to myconazole, which was the drug used for the treatment of the first episode of vaginitis. We conclude that recurrent vaginal candidasis is caused by the persistence of a single yeast genotype that undergoes morphological and behavioral changes in the presence of antifungal agents due to the selective pressure to which it is submitted.
在接受产前护理的80名孕妇中，有14名出现复发性阴道念珠菌病的体征和症状。从12名患者（85.7%）中分离出白色念珠菌菌株，并对这些菌株进行形态分型（菌落的形态特征）、抗真菌分型（对两性霉素B、5-氟胞嘧啶、咪康唑、酮康唑和氟康唑的敏感性模式）和基因分型（用EcoRI和HinfI消化的DNA片段的电泳迁移）。在50%的患者中观察到形态型和抗真菌型的改变，但在所有受试者中，从同一患者在不同时间分离出的菌株的基因型是相同的。主要的形态型呈现连续的边缘，抗真菌型之间观察到的基本变化是出现了对咪康唑耐药的菌株，咪康唑是用于治疗阴道炎首发症状的药物。我们得出结论，复发性阴道念珠菌病是由单一酵母基因型的持续存在引起的，由于其所承受的选择压力，该基因型在抗真菌药物存在的情况下会发生形态和行为变化。
