-
PloS One 2024Helicobacter pylori infections are generally acquired during childhood and affect half of the global population, but its transmission route remains unclear. It is...
BACKGROUND
Helicobacter pylori infections are generally acquired during childhood and affect half of the global population, but its transmission route remains unclear. It is reported that H. pylori can be internalized into Candida, but more evidence is needed for the internalization of H. pylori in human gastrointestinal Candida and vaginal Candida.
METHODS
Candida was isolated from vaginal discharge and gastric mucosa biopsies. We PCR-amplified and sequenced H. pylori-specific genes from Candida genomic DNA. Using optical and immunofluorescence microscopy, we identified and observed bacteria-like bodies (BLBs) in Candida isolates and subcultures. Intracellular H. pylori antigen were detected by immunofluorescence using Fluorescein isothiocyanate (FITC)-labeled anti-H. pylori IgG antibodies. Urease activity in H. pylori internalized by Candida was detected by inoculating with urea-based Sabouraud dextrose agar, which changed the agar color from yellow to pink, indicating urease activity.
RESULTS
A total of 59 vaginal Candida and two gastric Candida strains were isolated from vaginal discharge and gastric mucosa. Twenty-three isolates were positive for H. pylori 16S rDNA, 12 were positive for cagA and 21 were positive for ureA. The BLBs could be observed in Candida cells, which were positive for H. pylori 16S rDNA, and were viable determined by the LIVE/DEAD BacLight Bacterial Viability kit. Fluorescein isothiocyanate (FITC)-conjugated antibodies could be reacted specifically with H. pylori antigen inside Candida cells by immunofluorescence. Finally, H. pylori-positive Candida remained positive for H. pylori 16S rDNA even after ten subcultures. Urease activity of H. pylori internalized by Candida was positive.
CONCLUSION
In the form of BLBs, H. pylori can internalize into gastric Candida and even vaginal Candida, which might have great significance in its transmission and pathogenicity.
Topics: Female; Humans; Helicobacter pylori; Urease; Helicobacter Infections; Fluorescein-5-isothiocyanate; Agar; Antigens, Bacterial; Gastric Mucosa; Candida; Biopsy; Candidiasis, Vulvovaginal; DNA, Ribosomal; Vaginal Discharge; Urea; Bacterial Proteins
PubMed: 38329956
DOI: 10.1371/journal.pone.0298442 -
Molecular epidemiology and antimicrobial resistance of vaginal Candida glabrata isolates in Namibia.Medical Mycology Jan 2024Candida glabrata is the most common non-albicans Candida species that causes vulvovaginal candidiasis (VVC). Given the intrinsically low susceptibility of C. glabrata to...
Candida glabrata is the most common non-albicans Candida species that causes vulvovaginal candidiasis (VVC). Given the intrinsically low susceptibility of C. glabrata to azole drugs, investigations into C. glabrata prevalence, fungal susceptibility profile, and molecular epidemiology are necessary to optimise the treatment of VVC. This molecular epidemiological study was conducted to determine antifungal drug profile, single nucleotide polymorphisms (SNPs) associated with phenotypic antifungal resistance and epidemic diversity of C. glabrata isolates from women with VVC in Namibia. Candida glabrata isolates were identified using phenotypic and molecular methods. Antifungal susceptibility of strains was determined for fluconazole, itraconazole, amphotericin B, and anidulafungin. Whole genome sequencing was used to determine SNPs in antifungal resistance genes and sequence type (ST) allocation. Among C. glabrata isolates, all (20/20; 100%) exhibited phenotypic resistance to the azole class antifungal drug, (fluconazole), and phenotypic susceptibility to the polyene class (amphotericin B), and the echinocandins (anidulafungin). Non-synonymous SNPs were identified in antifungal resistance genes of all fluconazole-resistant C. glabrata isolates including ERG6 (15%), ERG7 (15%), CgCDR1 (25%), CgPDR1 (60%), SNQ2 (10%), FKS1 (5.0%), FKS2 (5.0%), CgFPS1 (5.0%), and MSH2 (15%). ST15 (n = 8/20, 40%) was predominant. This study provides important insight into phenotypic and genotypic antifungal resistance across C. glabrata isolates from women with VVC in Namibia. In this study, azole resistance is determined by an extensive range of SNPs, while the observed polyene and echinocandin resistance-associated SNPs despite phenotypic susceptibility require further investigation.
Topics: Female; Humans; Antifungal Agents; Candida glabrata; Candidiasis, Vulvovaginal; Fluconazole; Amphotericin B; Anti-Bacterial Agents; Anidulafungin; Molecular Epidemiology; Namibia; Microbial Sensitivity Tests; Drug Resistance, Bacterial; Echinocandins; Azoles; Polyenes; Drug Resistance, Fungal
PubMed: 38308518
DOI: 10.1093/mmy/myae009 -
BMJ Case Reports Jan 2024A primigravida in her late 20s presented to the obstetrics and gynaecology department in labour. On per speculum examination, multiple cystic lesions, 1-5 mm in size...
A primigravida in her late 20s presented to the obstetrics and gynaecology department in labour. On per speculum examination, multiple cystic lesions, 1-5 mm in size were observed occupying the anterior, posterior and lateral vaginal walls. Vaginal wet mount was normal and vaginal cultures were negative. Biopsy findings were consistent with emphysematous vaginitis. Vaginitis emphysematosa is a rare, benign self-limiting condition that presents with multiple, air-filled cysts in the vaginal or ectocervical mucosa. This condition is seen in both gravid and non gravid women, usually associated with a Trichomonas or Gardnerella infection.
Topics: Female; Humans; Pregnancy; Candidiasis, Vulvovaginal; Cysts; Trichomonas Infections; Vagina; Vaginitis; Adult
PubMed: 38290981
DOI: 10.1136/bcr-2023-257778 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2023The aim: To investigate the epidemiology and microbiology of vulvovaginal candidiasis (VVC) after gynecological surgeries, and adverse pregnancy outcomes in Ukraine.
OBJECTIVE
The aim: To investigate the epidemiology and microbiology of vulvovaginal candidiasis (VVC) after gynecological surgeries, and adverse pregnancy outcomes in Ukraine.
PATIENTS AND METHODS
Materials and methods: Multicenter prospective cohort study was conducted from January 2020 to December 2022 and recruited pregnant and non-pregnant women aged 15-65 years who had sought medical help for vaginal dysbiosis the seven medical clinic from five regions of Ukraine.
RESULTS
Results: Between 2020 and 2022, 2,341 women were followed in gynecological practices, and 1,056 (41.5%) women were diagnosed with VVC during the same period. Of the total VVC cases, 31.9% were in non-pregnant and 68.1% in pregnant women. The use of antibiotics (OR=3.48), use hormonal contracep¬tives (OR=2.75) and pregnancy (OR=1.13) were associated with an increase in the risk of VVC diagnosis. Diabetes mellitus (OR=0.44) were additional risk factors. The most common pathogen of VVC was C. albicans, Nakaseomyces glabratus (C. glabrata), followed by Pichia kudriavzevii (C. krusei), C. parapsilosis, C. tropicalis, C. kefyr, C. guillieromondii, C. lusitaniae, and C. rugosa. We found no significant difference in adverse pregnancy outcomes between Candida-positive and Candida-negative women.
CONCLUSION
Conclusions: Vulvovaginal candidiasis after gynecological surgeries in Ukraine is a common medical problem in women that is associated with significant morbidity, and hence frequent medical visits. High prevalence rate of vulvovaginal candidiasis in the present study warrants, the importance of conducting continuous epidemiological surveys to measure changes in species distribution from C. albicans to non-albicans Candida species in Ukraine.
Topics: Female; Humans; Pregnancy; Candida; Candida albicans; Candidiasis, Vulvovaginal; Gynecologic Surgical Procedures; Pregnancy Outcome; Prospective Studies; Ukraine; Adolescent; Young Adult; Adult; Middle Aged; Aged
PubMed: 38290017
DOI: 10.36740/WLek202312102 -
Infection and Immunity Mar 2024Vulvovaginal candidiasis (VVC), caused by is characterized by aberrant inflammation by polymorphonuclear neutrophils (PMNs) in the vaginal lumen. Data from the...
Vulvovaginal candidiasis (VVC), caused by is characterized by aberrant inflammation by polymorphonuclear neutrophils (PMNs) in the vaginal lumen. Data from the established murine model shows that despite potent antifungal properties, PMNs fail to clear due to local heparan sulfate that inhibits the interaction between PMNs and , resulting in chronic vaginal immunopathology. To understand the role of neutrophil extracellular traps (NETs) in defense against at the vaginal mucosa, we investigated the NET-forming capacity of PMNs in chronic VVC-susceptible (CVVC-S/C3H) and -resistant (CVVC-R/CD-1) mouse strains. Immunofluorescence revealed the formation of NETs (release of DNA with PMN-derived antimicrobial proteins) in PMN cocultures using vaginal conditioned medium (VCM) generated from CVVC-R/CD-1 mice, similar to NET-inducing positive controls. Under these NETotic conditions, PMNs released high levels of double-stranded DNA bound with NET-associated proteins, concomitant with substantial killing activity. In contrast, PMN cocultures in VCM from CVVC-S/C3H mice lacked NET formation together with reduced antifungal activity. Similar results were observed : active NET interaction followed by fungal clearance in inoculated CVVC-R/CD-1 mice, and sustained high vaginal fungal burden and no evidence of NETs in inoculated CVVC-S/C3H mice. Furthermore, the level of Ki67 expression, a putative NETotic PMN marker, was significantly reduced in vaginal lavage fluid from CVVC-S/C3H mice compared to CVVC-R/CD-1 mice. Finally, scanning electron microscopy revealed that PMNs in CVVC-R, but not CVVC-S, conditions exhibited NETs in direct contact with hyphae and . These results suggest that VVC-associated immunopathology includes impaired NET-mediated antifungal activity.
Topics: Female; Humans; Animals; Mice; Candidiasis, Vulvovaginal; Extracellular Traps; Antifungal Agents; Disease Models, Animal; Mice, Inbred C3H; Candida albicans
PubMed: 38289125
DOI: 10.1128/iai.00350-23 -
Journal of Natural Products Feb 2024The rise of multidrug resistant fungal infections highlights the need to identify and develop novel antifungal agents. Occidiofungin is a nonribosomally synthesized...
The rise of multidrug resistant fungal infections highlights the need to identify and develop novel antifungal agents. Occidiofungin is a nonribosomally synthesized glycolipopeptide that has a unique mechanism of action, disrupting actin-mediated functions and inducing cellular apoptosis. Antifungal activity has been observed in vitro against various fungal species, including multidrug resistant , and in vivo efficacy has been demonstrated in a murine vulvovaginal candidiasis model. Occidiofungin, a cyclic glycolipopeptide, is composed of eight amino acids and in previous studies, an asparagine residue was assigned at position 7 (ASN7). In this study, new structural variants of occidiofungin have been characterized which have aspartic acid (ASP7), glutamine (GLN7), or glutamic acid (GLU7) at position 7. The side chain of the ASP7 variant contains the only terminal carboxylic acid in the peptide and provides a useful site for selective chemical modifications. Analogues were synthesized at the ASP7 position and tested for antifungal activity. These analogues were shown to be more active as compared to the ASP7 variant against a panel of species. The naturally occurring variants of occidiofungin with a side chain containing a carboxylic acid at the seventh amino acid position can be used to develop semisynthetic analogues with enhanced therapeutic properties.
Topics: Mice; Animals; Antifungal Agents; Burkholderia; Carboxylic Acids; Microbial Sensitivity Tests; Glycopeptides; Peptides, Cyclic
PubMed: 38277493
DOI: 10.1021/acs.jnatprod.3c00777 -
Microorganisms Jan 2024Among the infectious causes of vulvovaginal symptoms, bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) dominate. Apart from infrequent mixed infections, both... (Review)
Review
Among the infectious causes of vulvovaginal symptoms, bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) dominate. Apart from infrequent mixed infections, both are considered independent and caused by unrelated pathogenic mechanisms. Clinical experience, however, is strongly suggestive that in some populations these infections are linked with recurrent BV (RBV) serving as the dominant etiopathogenic trigger for development of recurrent VVC (RVVC) with profound clinical and therapeutic consequences. The biologic basis for this critical interrelationship is discussed and suggests that as a consequence of BV dysbiosis, and not necessarily because of antibiotics prescribed, immune defenses are compromised, neutralizing vaginal yeast tolerance. The consequent BV-induced vaginal proinflammatory environment predisposes to mixed infection or consecutive episodes of post-treatment VVC. Recurrent BV and repeated antimicrobial drug exposure also predispose to acquired fluconazole resistance in isolates, contributing to refractory vulvovaginal candidiasis.
PubMed: 38257934
DOI: 10.3390/microorganisms12010108 -
Microbiological Research Apr 2024Vaginal infectious diseases caused by viruses and bacteria have been linked to the occurrence of dysbiosis, that is, a reduction in the abundance of the normally... (Review)
Review
A molecular view on the interference established between vaginal Lactobacilli and pathogenic Candida species: Challenges and opportunities for the development of new therapies.
Vaginal infectious diseases caused by viruses and bacteria have been linked to the occurrence of dysbiosis, that is, a reduction in the abundance of the normally dominating vaginal Lactobacillus species. Mucosal infections in the vagina and/or vulva caused by Candida species, usually known as vulvovaginal candidiasis (or VVC), are among the leading causes of diseases in the vaginal tract. The existence of a clear link between the occurrence of dysbiosis and the development of VVC is still unclear, although multiple observations point in that direction. Based on the idea that vaginal health is linked to a microbiota dominated by lactobacilli, several probiotics have been used in management of VVC, either alone or in combination with antifungals, having obtained different degrees of success. In most cases, the undertaken trials resorted to lactobacilli species other than those indigenous to the vaginal tract, although in vitro these vaginal species were shown to reduce growth, viability and virulence of Candida. In this paper we overview the role of lactobacilli and Candida in the vaginal micro- and myco-biomes, while discussing the results obtained in what concerns the establishment of interference mechanisms in vivo and the environmental factors that could determine that. We also overview the molecular mechanisms by which lactobacilli species have been shown to inhibit pathophysiology of Candida, including the description of the genes and pathways determining their ability to thrive in the presence of each other. In a time where concerns are increasing with the emergence of antifungal resistance and the slow pace of discovery of new antifungals, a thorough understanding of the molecular mechanisms underneath the anti-Candida effect prompted by vaginal lactobacilli is of utmost importance to assure a knowledge-based design of what can be a new generation of pharmaceuticals, eventually focusing therapeutic targets other than the usual ones.
Topics: Female; Humans; Candida; Lactobacillus; Antifungal Agents; Dysbiosis; Vagina; Candidiasis, Vulvovaginal; Candida albicans
PubMed: 38246122
DOI: 10.1016/j.micres.2024.127628 -
European Review For Medical and... Jan 2024To investigate the non-inferiority of efficacy and tolerability of Lactobacillus plantarum P 17630 soft vaginal capsules compared to the antifungal therapy with... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To investigate the non-inferiority of efficacy and tolerability of Lactobacillus plantarum P 17630 soft vaginal capsules compared to the antifungal therapy with miconazole nitrate 400 mg soft vaginal capsules in patients with symptomatic vulvovaginal infection due to Candida.
PATIENTS AND METHODS
Adult women with vulvovaginal candidiasis were randomized to either L. plantarum P17630 100,000,000 CFU soft vaginal capsules by vaginal route each day for 3 or 6 consecutive days or miconazole nitrate 400 mg soft vaginal capsule. Visual Analog Scale (VAS) scores for vaginitis symptoms were used, and vaginal fluid interleukin 6 (IL6) was dosed. The study was registered in EudraCT database (code LPP17630-C-018; number: 2018-003095-12).
RESULTS
200 patients were included in the study. The mean VAS scores for vaginitis symptoms were progressively reduced in both treatment groups at each visit, without significant difference between groups (p>0.05 for each symptom, at each time point). The efficacy of L. plantarum and the reference medicinal product was maintained at follow-up (day 21). The mean concentration of IL-6 decreased from visit 1 to visit 3 in both groups without a significant difference (p>0.05). No adverse events were reported.
CONCLUSIONS
L. plantarum P17630 100,000,000 CFU soft vaginal capsules are effective and safe for treating vaginal candidiasis without the concomitant use of an antifungal product, which rules out the risk of antimicrobic resistance. The long-term effect on vaginal microflora may add the possibility of reducing the risk of recurrences.
Topics: Adult; Female; Humans; Antifungal Agents; Candidiasis, Vulvovaginal; Lactobacillus plantarum; Miconazole; Vagina; Vulvovaginitis
PubMed: 38235890
DOI: 10.26355/eurrev_202401_34927 -
Indian Journal of Sexually Transmitted... 2023Sexually transmitted diseases (STDs) continue to be a major public health problem with significant burden on the society. Some of this can be attributed to our lack of...
INTRODUCTION
Sexually transmitted diseases (STDs) continue to be a major public health problem with significant burden on the society. Some of this can be attributed to our lack of knowledge about the change of disease spectrum from time to time.
AIMS
The aim of the study was to understand the changing pattern of STDs over the past 17 years (2003-2019).
MATERIALS AND METHODS
It was a retrospective study where data of patients who attended our Suraksha Clinic from 2003 to 2019 were collected. All the cases were subjected to detailed history, examination, and investigations done to rule out STDs.
RESULTS
A total of 2436 patients were included in the study. The majority of the patients were in the age group of 18-30 years. The most frequent diagnosis was vulvovaginal candidiasis, followed by herpes genitalis. 3.3% of patients had human immunodeficiency virus. 4.8% of patients were men sex men (MSM). Overall, viral STDs were most common, followed by fungal and bacterial. To understand the changing trends, data were divided into different phases according to the time period. During Phase 1 (2003-2007), viral STDs were most common, followed by bacterial and fungal. However, this trend changed in Phase 4 (2016-2019) and fungal STDs became most common.
CONCLUSIONS
Despite numerous health initiatives, the number of STD cases is rising day by day. The increasing number of MSM over the study period necessitates dedicated efforts to address the health needs of this population. The National AIDS Control Organization should take necessary measures and steps to address the overall increase in STDs considering recent trends showing a drop in bacterial STDs and an increase in fungal and viral STDs.
PubMed: 38223154
DOI: 10.4103/ijstd.ijstd_100_22