Skip to main content
Top
Published in: BMC Infectious Diseases 1/2019

Open Access 01-12-2019 | Itraconazole | Research article

Multilocus sequence typing analysis of Candida africana from vulvovaginal candidiasis

Authors: Y. X. Zhu, Y. Shi, S. R. Fan, X. P. Liu, J. Yang, S. L. Zhong

Published in: BMC Infectious Diseases | Issue 1/2019

Login to get access

Abstract

Background

Candida africana is distributed worldwide and colonized in human genitalia and cause mainly vulvovaginal candidiasis (VVC). We report the multilocus sequence typing (MLST) analysis of C. africana from VVC.

Methods

MLST analysis of 43 strains of C. africana, which were isolated from vaginal specimens of patients with VVC, was performed. The enzymatic activity of phospholipase, esterase and haemolysis enzyme production was evaluated.The level of virulent genes and resistant genes mRNA expression was determined by using real-time PCR. Antifungal susceptibilities of the isolates were assayed by using the broth microdilution method. The statistical of the results was determined by the T test and Pearson chi-squared test.

Results

The MLST analysis revealed a substantial degree of genetic homogeneity. The DST782 and DST182 were the main MLST genotypes in C. africana. All the patients were symptomatic and with a high mycological cure rate when treated with commonly used antifungal agents.There were statistically significant differences in biofilm formation and phospholipase activity between C. africana and C.albicans. The level of virulent genes and resistant genes mRNA expression was higher in fluconazole-resistant strains. All C. africana isolates were susceptible to fluconazole, itraconazole, voriconazole, caspofungin, and micafungin. These isolates also exhibited low MICs to amphotericin B, flucytosine, and posaconazole.

Conclusions

Candida africana appear to be with a low level of sequence variation in MLST loci. Candida africana, a lower virulence candida, is susceptible to commonly used antifungal agents.
This paper was presented at the conference of 8th Trend in Medical Mycology (6–9 October 2017, Belgrade, Serbia) and was published on conference abstract.
Appendix
Available only for authorised users
Literature
1.
go back to reference Tietz HJ, Küssner A, Thanos M, de Andrade MP, Presber W, Schönian G. Phenotypic and genotypic characterization of unusual vaginal isolates of Candida albicans from Africa. J Clin Microbiol. 1995;33:2462–5.PubMedPubMedCentral Tietz HJ, Küssner A, Thanos M, de Andrade MP, Presber W, Schönian G. Phenotypic and genotypic characterization of unusual vaginal isolates of Candida albicans from Africa. J Clin Microbiol. 1995;33:2462–5.PubMedPubMedCentral
2.
go back to reference Romeo O, De Leo F, Criseo G. Adherence ability of Candida africana: a comparative study with Candida albicans and Candida dubliniensis. Mycoses. 2011;54:57–61.CrossRef Romeo O, De Leo F, Criseo G. Adherence ability of Candida africana: a comparative study with Candida albicans and Candida dubliniensis. Mycoses. 2011;54:57–61.CrossRef
3.
go back to reference Borman AM, Szekely A, Linton CJ, Palmer MD, Brown P, Johnson EM. Epidemiology, antifungal susceptibility, and pathogenicity of Candida africana isolates from the United Kingdom. J Clin Microbiol. 2013;51:967–72.CrossRef Borman AM, Szekely A, Linton CJ, Palmer MD, Brown P, Johnson EM. Epidemiology, antifungal susceptibility, and pathogenicity of Candida africana isolates from the United Kingdom. J Clin Microbiol. 2013;51:967–72.CrossRef
4.
go back to reference Pagniez F, Jimenez-Gil P, Mancia A, Le Pape P. Étude comparative in vivo de la virulence de Candida africana et de C. albicans stricto sensu. J Mycol Med. 2015;25:107.CrossRef Pagniez F, Jimenez-Gil P, Mancia A, Le Pape P. Étude comparative in vivo de la virulence de Candida africana et de C. albicans stricto sensu. J Mycol Med. 2015;25:107.CrossRef
5.
go back to reference Tietz HJ, Hopp M, Schmalreck A, Sterry W, Czaika V. Candida africana sp. nov., a new human pathogen or a variant of Candida albicans? Mycoses. 2001;44:437–45.CrossRef Tietz HJ, Hopp M, Schmalreck A, Sterry W, Czaika V. Candida africana sp. nov., a new human pathogen or a variant of Candida albicans? Mycoses. 2001;44:437–45.CrossRef
6.
go back to reference Hu Y, Yu A, Chen X, Wang G, Feng X. Molecular characterization of Candida africana in genital specimens in Shanghai, China. Biomed Res Int. 2015;2015:185387.PubMedPubMedCentral Hu Y, Yu A, Chen X, Wang G, Feng X. Molecular characterization of Candida africana in genital specimens in Shanghai, China. Biomed Res Int. 2015;2015:185387.PubMedPubMedCentral
7.
go back to reference Chowdhary A, Hagen F, Sharma C, Al-Hatmi AM, Giuffrè L, Giosa D, et al. Whole genome-based amplified fragment length polymorphism analysis reveals genetic diversity in Candida africana. Front Microbiol. 2017;8:556.CrossRef Chowdhary A, Hagen F, Sharma C, Al-Hatmi AM, Giuffrè L, Giosa D, et al. Whole genome-based amplified fragment length polymorphism analysis reveals genetic diversity in Candida africana. Front Microbiol. 2017;8:556.CrossRef
8.
go back to reference Odds FC, Bougnoux ME, Shaw DJ, Bain JM, Davidson AD, Diogo D, et al. Molecular phylogenetics of Candida albicans. Eukaryot Cell. 2007;6:1041–52.CrossRef Odds FC, Bougnoux ME, Shaw DJ, Bain JM, Davidson AD, Diogo D, et al. Molecular phylogenetics of Candida albicans. Eukaryot Cell. 2007;6:1041–52.CrossRef
9.
go back to reference Shan Y, Fan S, Liu X, Li J. Prevalence of Candida albicans-closely related yeasts, Candida africana and Candida dubliniensis, in vulvovaginal candidiasis. Med Mycol. 2014;52:636–40.CrossRef Shan Y, Fan S, Liu X, Li J. Prevalence of Candida albicans-closely related yeasts, Candida africana and Candida dubliniensis, in vulvovaginal candidiasis. Med Mycol. 2014;52:636–40.CrossRef
10.
go back to reference Sharma C, Muralidhar S, Xu J, Meis JF, Chowdhary A. Multilocus sequence typing of Candida africana from patients with vulvovaginal candidiasis in New Delhi, India. Mycoses. 2014;57:544–52.CrossRef Sharma C, Muralidhar S, Xu J, Meis JF, Chowdhary A. Multilocus sequence typing of Candida africana from patients with vulvovaginal candidiasis in New Delhi, India. Mycoses. 2014;57:544–52.CrossRef
11.
go back to reference Yazdanparast SA, Khodavaisy S, Fakhim H, Shokohi T, Haghani I, Nabili M, et al. Molecular characterization of highly susceptible Candida africana from vulvovaginal candidiasis. Mycopathologia. 2015;180:317–23.CrossRef Yazdanparast SA, Khodavaisy S, Fakhim H, Shokohi T, Haghani I, Nabili M, et al. Molecular characterization of highly susceptible Candida africana from vulvovaginal candidiasis. Mycopathologia. 2015;180:317–23.CrossRef
12.
go back to reference Theill L, Dudiuk C, Morano S, Gamarra S, Nardin ME, Mendez E, et al. Prevalence and antifungal susceptibility of Candida albicans and its related species Candida dubliniensis and Candida africana isolated from vulvovaginal samples in a hospital of Argentina. Rev Argent Microbiol. 2016;48:43–9.PubMed Theill L, Dudiuk C, Morano S, Gamarra S, Nardin ME, Mendez E, et al. Prevalence and antifungal susceptibility of Candida albicans and its related species Candida dubliniensis and Candida africana isolated from vulvovaginal samples in a hospital of Argentina. Rev Argent Microbiol. 2016;48:43–9.PubMed
13.
go back to reference Romeo O, Criseo G. First molecular method for discriminating between Candida africana, Candida albicans, and Candida dubliniensis by using hwp1 gene. Diagn Microbiol Infect Dis. 2008;62:230–3.CrossRef Romeo O, Criseo G. First molecular method for discriminating between Candida africana, Candida albicans, and Candida dubliniensis by using hwp1 gene. Diagn Microbiol Infect Dis. 2008;62:230–3.CrossRef
14.
go back to reference McCullough MJ, Clemons KV, Stevens DA. Molecular and phenotypic characterization of genotypic Candida albicans subgroups and comparison with Candida dubliniensis and Candida stellatoidea. J Clin Microbiol. 1999;37:417–21.PubMedPubMedCentral McCullough MJ, Clemons KV, Stevens DA. Molecular and phenotypic characterization of genotypic Candida albicans subgroups and comparison with Candida dubliniensis and Candida stellatoidea. J Clin Microbiol. 1999;37:417–21.PubMedPubMedCentral
15.
go back to reference Hull CM, Johnson AD. Identification of a mating type-like locus in the asexual pathogenic yeast Candida albicans. Science. 1999;285:1271–5.CrossRef Hull CM, Johnson AD. Identification of a mating type-like locus in the asexual pathogenic yeast Candida albicans. Science. 1999;285:1271–5.CrossRef
16.
go back to reference Bougnoux ME, Tavanti A, Bouchier C, Gow NA, Magnier A, Davidson AD, et al. Collaborative consensus for optimized multilocus sequence typing of Candida albicans. J Clin Microbiol. 2003;41:5265–6.CrossRef Bougnoux ME, Tavanti A, Bouchier C, Gow NA, Magnier A, Davidson AD, et al. Collaborative consensus for optimized multilocus sequence typing of Candida albicans. J Clin Microbiol. 2003;41:5265–6.CrossRef
17.
go back to reference Chau AS, Mendrick CA, Sabatelli FJ, Loebenberg D, McNicholas PM. Application of real-time quantitative PCR to molecular analysis of Candida albicans strains exhibiting reduced susceptibility to azoles. Antimicrob Agents Chemother. 2004;48:2124–31.CrossRef Chau AS, Mendrick CA, Sabatelli FJ, Loebenberg D, McNicholas PM. Application of real-time quantitative PCR to molecular analysis of Candida albicans strains exhibiting reduced susceptibility to azoles. Antimicrob Agents Chemother. 2004;48:2124–31.CrossRef
18.
go back to reference Correia A, Lermann U, Teixeira L, Cerca F, Botelho S, Gil da Costa RM, et al. Limited role of secreted aspartyl proteinases Sap1 to Sap6 in Candida albicans virulence and host immune response in murine hematogenously disseminated candidiasis. Infect Immun. 2010;78:4839–49.CrossRef Correia A, Lermann U, Teixeira L, Cerca F, Botelho S, Gil da Costa RM, et al. Limited role of secreted aspartyl proteinases Sap1 to Sap6 in Candida albicans virulence and host immune response in murine hematogenously disseminated candidiasis. Infect Immun. 2010;78:4839–49.CrossRef
19.
go back to reference Felice MR, Gulati M, Giuffre L, Giosa D, Di Bella LM, Criseo G, et al. Molecular characterization of the N-acetylglucosamine catabolic genes in Candida africana, a natural N-acetylglucosamine kinase (HXK1) mutant. PLoS One. 2016;11:e0147902.CrossRef Felice MR, Gulati M, Giuffre L, Giosa D, Di Bella LM, Criseo G, et al. Molecular characterization of the N-acetylglucosamine catabolic genes in Candida africana, a natural N-acetylglucosamine kinase (HXK1) mutant. PLoS One. 2016;11:e0147902.CrossRef
20.
go back to reference Pakshir K, Zomorodian K, Karamitalab M, Jafari M, Taraz H, Ebrahimi H. Phospholipase, esterase and hemolytic activities of Candida spp. isolated from onychomycosis and oral lichen planus lesions. J Mycol Med. 2013;23:113–8.CrossRef Pakshir K, Zomorodian K, Karamitalab M, Jafari M, Taraz H, Ebrahimi H. Phospholipase, esterase and hemolytic activities of Candida spp. isolated from onychomycosis and oral lichen planus lesions. J Mycol Med. 2013;23:113–8.CrossRef
21.
go back to reference Sanita PV, Zago CE, Mima EG, Pavarina AC, Jorge JH, Machado AL, et al. In vitro evaluation of the enzymatic activity profile of non-albicans Candida species isolated from patients with oral candidiasis with or without diabetes. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;118:84–91.CrossRef Sanita PV, Zago CE, Mima EG, Pavarina AC, Jorge JH, Machado AL, et al. In vitro evaluation of the enzymatic activity profile of non-albicans Candida species isolated from patients with oral candidiasis with or without diabetes. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;118:84–91.CrossRef
22.
go back to reference National Committee for Clinical Laboratory Standards [CLSI]. Reference method for broth dilution antifungal susceptibility testing for yeasts. Approved standard M27-A2. 2nd ed. Wayne: National Committee for Clinical Laboratory Standards; 2008. National Committee for Clinical Laboratory Standards [CLSI]. Reference method for broth dilution antifungal susceptibility testing for yeasts. Approved standard M27-A2. 2nd ed. Wayne: National Committee for Clinical Laboratory Standards; 2008.
23.
go back to reference National Committee for Clinical Laboratory Standards [CLSI]. Reference method for broth dilution antifungal susceptibility testing for yeasts. Approved standard M27-A3. 2nd ed. Wayne: National Committee for Clinical Laboratory Standards; 2012. National Committee for Clinical Laboratory Standards [CLSI]. Reference method for broth dilution antifungal susceptibility testing for yeasts. Approved standard M27-A3. 2nd ed. Wayne: National Committee for Clinical Laboratory Standards; 2012.
24.
go back to reference Pierce CG, Uppuluri P, Tummala S, Lopez-Ribot JL. A 96 well microtiter plate-based method for monitoring formation and antifungal susceptibility testing of Candida albicans biofilms. J Vis Exp. 2010;(44):e2287. Pierce CG, Uppuluri P, Tummala S, Lopez-Ribot JL. A 96 well microtiter plate-based method for monitoring formation and antifungal susceptibility testing of Candida albicans biofilms. J Vis Exp. 2010;(44):e2287.
25.
go back to reference Rao KH, Ghosh S, Natarajan K, Datta A. N-acetylglucosamine kinase, HXK1 is involved in morphogenetic transition and metabolic gene expression in Candida albicans. PLoS One. 2013;8:e53638.CrossRef Rao KH, Ghosh S, Natarajan K, Datta A. N-acetylglucosamine kinase, HXK1 is involved in morphogenetic transition and metabolic gene expression in Candida albicans. PLoS One. 2013;8:e53638.CrossRef
26.
go back to reference Al-Hedaithy S, Fotedar R. Recovery and studies on chlamydospore-negative Candida albicans isolated from clinical specimens. Med Mycol. 2002;40:301–6.CrossRef Al-Hedaithy S, Fotedar R. Recovery and studies on chlamydospore-negative Candida albicans isolated from clinical specimens. Med Mycol. 2002;40:301–6.CrossRef
27.
go back to reference Hasanvand S, Azadegan Qomi H, Kord M, Didehdar M. Molecular epidemiology and in vitro antifungal susceptibility of Candida isolates from women with vulvovaginal candidiasis in northern cities of Khuzestan Province. Iran Jundishapur J Microbiol. 2017;10(8):e12804. Hasanvand S, Azadegan Qomi H, Kord M, Didehdar M. Molecular epidemiology and in vitro antifungal susceptibility of Candida isolates from women with vulvovaginal candidiasis in northern cities of Khuzestan Province. Iran Jundishapur J Microbiol. 2017;10(8):e12804.
28.
go back to reference Mendling W, Krauss C, Fladung B. A clinical multicenter study comparing efficacy and tolerability of topical combination therapy with clotrimazole (Canesten®, two formats) with oral single dose fluconazole (Diflucan®) in vulvovaginal mycoses. Mycoses. 2004;47:136–42.CrossRef Mendling W, Krauss C, Fladung B. A clinical multicenter study comparing efficacy and tolerability of topical combination therapy with clotrimazole (Canesten®, two formats) with oral single dose fluconazole (Diflucan®) in vulvovaginal mycoses. Mycoses. 2004;47:136–42.CrossRef
Metadata
Title
Multilocus sequence typing analysis of Candida africana from vulvovaginal candidiasis
Authors
Y. X. Zhu
Y. Shi
S. R. Fan
X. P. Liu
J. Yang
S. L. Zhong
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2019
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-019-4071-7

Other articles of this Issue 1/2019

BMC Infectious Diseases 1/2019 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.