title: Genetic relatedness among vaginal and anal isolates of Candida albicans from women with vulvovaginal candidiasis in north-east Brazil.
abstract: Vulvovaginal candidiasis (VVC) is one of the most common causes of vaginitis and affects about 75% of women of reproductive age. In order to better understand the epidemiology and pathogenesis of this disease, we evaluated genetic relatedness among 62 clinical isolates of Candida albicans sequentially obtained from the anus and vagina of patients with sporadic and recurrent VVC. Evaluation of patients' demographic and clinical data, direct examination, and colony forming units (c.f.u.) counts of vaginal and anal samples were also performed. The genotypes of strains were determined with ABC genotyping and Randomly Amplified Polymorphic DNA (RAPD). Genotype A was the most prevalent (93.6%), followed by genotype C (6.4%), whereas genotype B was not found. We found the maintenance of the same ABC genotype, regardless of the body site of each patient. Most of the vaginal strains suffered microevolution, whereas most of the anal strains were replaced during the period of study. Vaginal and anal isolates of C. albicans obtained simultaneously from the same patient showed the same ABC genotype and high genetic similarity as determined by RAPD. Genotype A seemed to be dominant in both vaginal and anal isolates of patients with VVC. Our results corroborate the hypothesis that there are 'substrains' of the C. albicans vaginal clone successfully established, which dominate in an apparently random manner over the course of time. It is suggested that the anal reservoir constitutes a possible source for vaginal infection in most of the cases.
authors.affiliation: Department of Clinical and Toxicological Analysis, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
authors.forename: Mariana
authors.initials: M
authors.lastname: Araújo Paulo de Medeiros
authors.affiliation: Department of Clinical and Toxicological Analysis, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
authors.forename: Ana Patrícia
authors.initials: AP
authors.lastname: Vieira de Melo
authors.affiliation: Department of Medicine, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Sarah Santos
authors.initials: SS
authors.lastname: Gonçalves
authors.affiliation: Department of Infectology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
authors.forename: Eveline Pipolo
authors.initials: EP
authors.lastname: Milan
authors.affiliation: Department of Clinical and Toxicological Analysis, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
authors.forename: Guilherme Maranhão
authors.initials: GM
authors.lastname: Chaves
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000382:microbiology*; D001938:Brazil / Q000453:epidemiology; D002176:Candida albicans / Q000235:genetics* / Q000302:isolation & purification; D002181:Candidiasis, Vulvovaginal / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D015995:Prevalence; D014621:Vagina / Q000382:microbiology*