Evaluation of Candida albicans and anaerobic bacterial co-expansion in vulvovaginal candidiasis
Vulvovaginal candidiasis (VVC) is a common mucosal infection traditionally attributed to Candida albicans (C. albicans). However, this yeast frequently colonizes the vaginal niche without causing symptoms, indicating that additional microbial and host factors contribute to disease onset. This study investigated whether the transition from asymptomatic colonization to symptomatic VVC is associated with a shift in the vaginal microbiota. To this end, vaginal samples from a cohort of 96 non-pregnant women were stratified into three clinical groups: healthy controls (NEG, n=54), asymptomatic carriers (ASYMP, n=20), and symptomatic patients (SYMP, n=22). Extensive clinical and mycological phenotyping was performed, including the measurement of vaginal pH, microscopic assessment of polymorphonuclear (PMN) leukocyte infiltration and C. albicans morphology, qPCR quantification of fungal load, and in vitro testing of clinical isolates for hyphal formation and biofilm production. Finally, to characterize the specific bacterial communities associated with these distinct clinical states, the vaginal microbiota was profiled via 16S rRNA gene amplicon sequencing on a representative subset of 43 samples.