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. 2023 Apr 14;12(4):595.
doi: 10.3390/pathogens12040595.

Uncovering the Yeast Diversity in the Female Genital Tract: An Exploration of Spatial Distribution and Antifungal Resistance

Mariana Zagalo Fernandes  1   2 , Cátia Filipa Caetano  1   2 , Carlos Gaspar  1   2   3 , Ana Sofia Oliveira  1   2 , Rita Palmeira-de-Oliveira  1   2   3 , José Martinez-de-Oliveira  1 , Joana Rolo  1   2 , Ana Palmeira-de-Oliveira  1   2   3
Affiliations

Uncovering the Yeast Diversity in the Female Genital Tract: An Exploration of Spatial Distribution and Antifungal Resistance

Mariana Zagalo Fernandes et al. Pathogens. .

Abstract

Candida albicans is the leading cause of vulvovaginal yeast infections; however, other species are becoming relevant in this niche. The spatial distribution of these fungi in the female genital tract remains poorly understood. In this study, swab samples were collected from 33 patients, first from the anterior vulva and then from the upper third and right lateral wall of the vagina: 16 were with symptoms of vulvovaginal candidiasis and 17 were without characteristic symptoms; furthermore, the genus and species of each isolate were identified. In vitro susceptibility testing for fluconazole and clotrimazole was performed for all isolates. Candida albicans was the most common species (63.6%), followed by Rhodotorula spp. (51.5%), and then Candida parapsilosis (15.2%). Rhodotorula spp. and C. parapsilosis were more commonly associated with colonization, and C. albicans with infection. Rhodotorula spp. isolates presented a low susceptibility to fluconazole, with the MIC ranging from 32 to >64 µg/mL. Differences in susceptibility to fluconazole and clotrimazole between the pairs of vaginal and vulvar isolates were found for Candida albicans, Rhodotorula spp., and Nakaseomyces glabratus. The results suggest that different niches may impact the susceptibility profiles of the isolates, as well as their different clinical behaviors.

Keywords: Candida albicans; Rhodotorula spp.; susceptibility; vulvovaginal candidosis.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Species isolated from vaginal and vulval samples according to the clinical state information. Each species was considered one time per patient, even if the same species appears in more than one appointment. *—Infection was followed by an asymptomatic diagnosis after treatment.
Figure 2
Figure 2
Isolate spatial distribution: (a) among the samples recovered from patients presenting characteristic symptoms of yeast genital infection; (b) among the samples recovered from patients without symptoms that are characteristic of yeast genital infection. Each species was considered one time per patient, even if the same species appeared in more than one appointment.
See this image and copyright information in PMC

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