Cecilia V Tapia1,2, Germán Hermosilla3, Paula Fortes3, Claudio Alburquenque4, Sergio Bucarey5, Hugo Salinas6, Paula I Rodas7, María Cristina Díaz3, Fabien Magne8,9. 1. Programa de Microbiología y Micología, ICBM, Facultad de Medicina, Universidad de Chile, Santiago, Chile. cetapia@med.uchile.cl. 2. Laboratorio Clínica Dávila, Santiago, Chile. cetapia@med.uchile.cl. 3. Programa de Microbiología y Micología, ICBM, Facultad de Medicina, Universidad de Chile, Santiago, Chile. 4. Escuela de Tecnología Médica, Universidad Mayor, Santiago, Chile. 5. Departamento de Ciencias Biológicas Animales, Facultad de Ciencias Veterinarias y Pecuarias, Centro Biotecnológico Biovetec, Universidad de Chile, Santiago, Chile. 6. Departamento de Obstetricia y Ginecología, Hospital Clínico, Universidad de Chile, Santiago, Chile. 7. Center for Integrative Medicine and Innovative Science, Facultad de Medicina, Universidad Andrés Bello, Santiago, Chile. 8. Programa de Microbiología y Micología, ICBM, Facultad de Medicina, Universidad de Chile, Santiago, Chile. fabienmagne@med.uchile.cl. 9. Laboratoire de Biologie, Conservatoire National des Arts et Métiers, Paris, Île-de-France, France. fabienmagne@med.uchile.cl.
Abstract
OBJECTIVE: To study Candida albicans genotypes using RAPD and their susceptibility to fluconazole in healthy pregnant women and in vulvovaginal candidiasis (VVC) patients after topical treatment with clotrimazole. METHODS: Vaginal swabs were collected at t = 0 and t = 1 (1 month later) in pregnant women (control group, n = 33), and before (t = 0), at 1 month (t = 1) and at 2 months (t = 2) after clotrimazole treatment in pregnant women with VVC. RESULTS: Candida albicans was isolated in 30% of healthy pregnant women and 80% of patients with VVC. A high genetic heterogeneity was observed in C. albicans genotypes between individuals. In patients with VVC, topical antifungal treatment with clotrimazole was clinically effective, but only in a 62% C. albicans was eradicated. In patients in which C. albicans was not eradicated, this microorganism persisted for 1 or 2 months after the antifungal treatment. The persistent colonies were not associated with a specific genotype, but they were associated with higher MICs in comparison with colonies isolated from the control group. CONCLUSIONS: Therapy with topical clotrimazole, despite a good clinical outcome, could not eradicate completely C. albicans allowing the persistence of genotypes, with higher MICs to fluconazole. More studies with higher number of patients are needed to validate this preliminary finding.
OBJECTIVE: To study Candida albicans genotypes using RAPD and their susceptibility to fluconazole in healthy pregnant women and in vulvovaginal candidiasis (VVC) patients after topical treatment with clotrimazole. METHODS: Vaginal swabs were collected at t = 0 and t = 1 (1 month later) in pregnant women (control group, n = 33), and before (t = 0), at 1 month (t = 1) and at 2 months (t = 2) after clotrimazole treatment in pregnant women with VVC. RESULTS:Candida albicans was isolated in 30% of healthy pregnant women and 80% of patients with VVC. A high genetic heterogeneity was observed in C. albicans genotypes between individuals. In patients with VVC, topical antifungal treatment with clotrimazole was clinically effective, but only in a 62% C. albicans was eradicated. In patients in which C. albicans was not eradicated, this microorganism persisted for 1 or 2 months after the antifungal treatment. The persistent colonies were not associated with a specific genotype, but they were associated with higher MICs in comparison with colonies isolated from the control group. CONCLUSIONS: Therapy with topical clotrimazole, despite a good clinical outcome, could not eradicate completely C. albicans allowing the persistence of genotypes, with higher MICs to fluconazole. More studies with higher number of patients are needed to validate this preliminary finding.
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