title: Detection of Candida spp. in the vagina of a cohort of nulliparous pregnant women by culture and molecular methods: Is there an association between maternal vaginal and infant oral colonisation?
abstract: BACKGROUND
  Most studies describing vaginal Candida spp. in pregnancy focus on symptomatic vaginitis, rather than asymptomatic colonisation, and solely utilise microbiological culture. The extent to which asymptomatic vaginal carriage may represent a reservoir for infant oral colonisation has been highly debated.
  
  
  METHODS
  This study formed part of the Candida and Staphylococcus Transmission Longitudinal Evaluation (CASTLE) study, in Melbourne, Australia, from 2009 to 2011 and used culture and molecular methods to examine vaginal swabs collected late in the third trimester of pregnancy for Candida spp. Oral swabs from infants were also examined using culture methods.
  
  
  RESULTS
  Overall, 80 of 356 (22%) women were positive for Candida spp; the majority being Candida albicans (83%). Candida glabrata and other Candida spp. were also identified, but in much lower numbers. Molecular analysis identified numerous positive samples not detected by culture, including 13 cases of C. albicans. In addition, some positive samples only recorded to genus level by culture were accurately identified as either C. albicans or C. glabrata following molecular analyses. Eighteen infants recorded positive Candida spp. cultures, predominantly C. albicans. However, there were only four (25%) mother/infant dyads where C. albicans was detected.
  
  
  CONCLUSIONS
  This study provides valuable data on asymptomatic colonisation rates of Candida spp. within an asymptomatic population of women late in pregnancy. The utilisation of molecular methods improved the rate of detection and provided a more accurate means for identification of non-albicans Candida spp. The low mother/infant colonisation rate suggests that non-maternal sources are likely involved in determining infant oral colonisation status.
authors.affiliation: Judith Lumley Centre (formerly Mother & Child Health Research), La Trobe University, Melbourne, Victoria, Australia.|Women's Centre for Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia.|School of Women's and Infants' Health, University of Western Australia, Subiaco, Western Australia, Australia.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Payne
authors.affiliation: Judith Lumley Centre (formerly Mother & Child Health Research), La Trobe University, Melbourne, Victoria, Australia.
authors.forename: Meabh
authors.initials: M
authors.lastname: Cullinane
authors.affiliation: Women's Centre for Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia.
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Garland
authors.affiliation: Women's Centre for Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia.|Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Sepehr N
authors.initials: SN
authors.lastname: Tabrizi
authors.affiliation: Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.|Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Donath
authors.affiliation: Deakin Population Health, Deakin University, Burwood, Victoria, Australia.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Bennett
authors.affiliation: Judith Lumley Centre (formerly Mother & Child Health Research), La Trobe University, Melbourne, Victoria, Australia.
authors.forename: Lisa H
authors.initials: LH
authors.lastname: Amir
mesh_terms: D002176:Candida albicans / Q000235:genetics / Q000302:isolation & purification*; D041221:Candida glabrata / Q000235:genetics / Q000302:isolation & purification*; D002180:Candidiasis, Oral / Q000175:diagnosis* / Q000382:microbiology; D002181:Candidiasis, Vulvovaginal / Q000175:diagnosis* / Q000382:microbiology / Q000635:transmission*; D002353:Carrier State / Q000175:diagnosis* / Q000382:microbiology; D046508:Culture Techniques; D004271:DNA, Fungal / Q000032:analysis; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D009055:Mouth / Q000382:microbiology; D009172:Mycology / Q000379:methods; D010298:Parity; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000382:microbiology; D060888:Real-Time Polymerase Chain Reaction; D014621:Vagina / Q000382:microbiology
chemical_list: D004271:DNA, Fungal
keywords: CHROMagar; Candida spp.; infant; real-time PCR; vagina