Alexander Swidsinski1, Alexander Guschin2, Qionglan Tang3, Yvonne Dörffel4, Hans Verstraelen5, Alexander Tertychnyy6, Guzel Khayrullina2, Xin Luo7, Jack D Sobel8, Xuefeng Jiang7. 1. Moleculargenetic Laboratory for Polymicrobial Infections und Biofilms, Charité, Universitätsmedizin Berlin, Berlin, Germany. Electronic address: alexander.swidsinski@charite.de. 2. Laboratory for Molecular Diagnostic and Epidemiology of Reproductive Tract Infections, Federal Budget Institute of Science, Central Research Institute for Epidemiology, Moscow, Russia. 3. Department of Pathology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. 4. Outpatient Clinic, Charité, Universitätsmedizin Berlin, Berlin, Germany. 5. Department of Obstetrics and Gynecology, Ghent University Hospital, Ghent, Belgium. 6. Department of Pathology, Sechenov First Moscow State Medical University, Moscow, Russia. 7. Department of Obstetrics and Gynecology, First Affiliated Hospital of Jinan University, Guangzhou, China. 8. Wayne State University School of Medicine, Detroit, MI.
Abstract
BACKGROUND: The recent demonstration of a vaginal biofilm in bacterial vaginosis and its postulated importance in the pathogenesis of recurrent bacterial vaginosis, including relative resistance to therapy, has led to the hypothesis that biofilms are crucial for the development of vulvovaginal candidiasis. The histopathology and microbial architecture of vulvovaginal candidiasis have not been previously defined; neither has Candida, containing biofilm been reported in situ. The present study aimed at clarifying the histopathology of vulvovaginal candidiasis including the presence or absence of vaginal biofilm. STUDY DESIGN: In a cross-sectional study, vaginal tissue biopsies were obtained from 35 women with clinically, microscopically, and culture-proven vulvovaginal candidiasis and compared with specimens obtained from 25 healthy women and 30 women with active bacterial vaginosis. Vaginal Candida infection was visualized using fluorescent in situ hybridization with ribosomal gene-based probes. RESULTS: Candida microorganisms were confirmed in 26 of 35 biopsies obtained from women with vulvovaginal candidiasis; however, Candida containing biofilm were not detected in any of the cases. Histopathological lesions were exclusively invasive and accompanied by co-invasion with Gardnerella or Lactobacillus species organisms. CONCLUSION: Histopathological lesions of vulvovaginal candidiasis are primarily invasive in nature and polymicrobial and do not resemble biofilms. The clinical significance of Candida tissue invasion is unknown.
BACKGROUND: The recent demonstration of a vaginal biofilm in bacterial vaginosis and its postulated importance in the pathogenesis of recurrent bacterial vaginosis, including relative resistance to therapy, has led to the hypothesis that biofilms are crucial for the development of vulvovaginal candidiasis. The histopathology and microbial architecture of vulvovaginal candidiasis have not been previously defined; neither has Candida, containing biofilm been reported in situ. The present study aimed at clarifying the histopathology of vulvovaginal candidiasis including the presence or absence of vaginal biofilm. STUDY DESIGN: In a cross-sectional study, vaginal tissue biopsies were obtained from 35 women with clinically, microscopically, and culture-proven vulvovaginal candidiasis and compared with specimens obtained from 25 healthy women and 30 women with active bacterial vaginosis. Vaginal Candida infection was visualized using fluorescent in situ hybridization with ribosomal gene-based probes. RESULTS: Candida microorganisms were confirmed in 26 of 35 biopsies obtained from women with vulvovaginal candidiasis; however, Candida containing biofilm were not detected in any of the cases. Histopathological lesions were exclusively invasive and accompanied by co-invasion with Gardnerella or Lactobacillus species organisms. CONCLUSION: Histopathological lesions of vulvovaginal candidiasis are primarily invasive in nature and polymicrobial and do not resemble biofilms. The clinical significance of Candida tissue invasion is unknown.
Authors: Nicole O Ponde; Léa Lortal; Gordon Ramage; Julian R Naglik; Jonathan P Richardson Journal: Crit Rev Microbiol Date: 2021-01-22 Impact factor: 7.624
Authors: Kathryn W Woodburn; L Edward Clemens; Jesse Jaynes; Lydia-Marie Joubert; Alfred Botha; Hasan Nazik; David A Stevens Journal: Antimicrob Agents Chemother Date: 2019-10-22 Impact factor: 5.191