Candidiasis During Pregnancy May Result From Isogenic Commensal Strains

[摘要] Objective:Our laboratory previously demonstrated that asymptomatic vaginal colonization during pregnancy is a factor predisposing patients to subsequent symptomatic vulvovaginal candidiasis. It is unknown whether symptoms result from strain replacement or a change in host relationship to the original colonizing strain. This study wasundertaken to determine whetherCandida albicansisolates from asymptomatic women could be responsible for subsequent symptomatic vaginitis.Methods:We retained isolates ofC. albicansfrom women followed longitudinally through pregnancy, and identifiedsix pairs of cultures from women who were colonized without symptoms and who later became symptomatic(average time 14 weeks). We used a random amplification of polymorphic DNA (RAPD) analysis to determinewhether isolates from our study patients were genetically similar or dissimilar.Results:Analysis of these pairs of yeast strains by RAPD revealed that five of the six women had symptomsapparently due to the same yeast strain that was found initially as a commensal strain. To increase the power ofthese observations, we also performed RAPD analysis on six randomly selected yeast strains from other women inthis study who had not become symptomatic to determine whether any of these unrelated strains matched strainsfrom those women who became symptomatic.Conclusion:Symptomatic yeast vaginitis is usually due to strains ofC. albicansalready carried in the lower genitaltract, underscoring the need to understand regulation of growth and virulence of the organismin vivo.

[学科分类] 妇产科学