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J Clin Microbiol. Apr 1996; 34(4): 767–777.
PMCID: PMC228891

Most frequent scenario for recurrent Candida vaginitis is strain maintenance with "substrain shuffling": demonstration by sequential DNA fingerprinting with probes Ca3, C1, and CARE2.

Abstract

The following three basic scenarios have emerged for the genetic relatedness of strains in recurrent vaginal candidiasis: strain maintenance without genetic variation, strain maintenance with minor genetic variation, and strain replacement. To test the frequency of each of the three scenarios, the genetic relatedness of Candida albicans isolates from each of 18 patients with recurrent infections was assessed by sequential DNA fingerprinting with the following three probes: the Ca3 probe; the C1 probe, a subfragment of the Ca3 probe which hybridizes to hypervariable genomic fragments; and the unrelated CARE2 probe. In each of the 18 patients with recurrent infections, the same strain was responsible for sequential infections, suggesting that the predominant scenario is strain maintenance. However, in 56% of these patients, the strain exhibited minor genetic variations in sequential infections. These changes were not found to be progressive. Rather, the changes suggest that substrains of an established infecting strain are shuffled in sequential infections. Results are also presented that in 45% of patients with recurrent infections, oral and vulvovaginal isolates were identical, in 35% they were highly related but not identical, and in 20% they were unrelated. These results differ markedly from those for commensal isolates simultaneously cultured from the oral cavity and vulvovaginal region of healthy individuals. Finally, it is demonstrated that in all eight cases in which C. albicans was isolated from both the male sexual partner of the patient with a recurrent infection and the patient, an isolate from the male partner was identical or highly related to the vulvovaginal strain. These results demonstrate that in patients with recurrent vulvovaginitis, a single strain usually dominates both in the different body locations of the patient and in the male partner and that it is maintained through sequential infections. However, in patients with recurrent infections, different substrains of the established clone dominate in an apparently random fashion, a process that we refer to as "substrain shuffling".

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Selected References

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  • Anderson J, Srikantha T, Morrow B, Miyasaki SH, White TC, Agabian N, Schmid J, Soll DR. Characterization and partial nucleotide sequence of the DNA fingerprinting probe Ca3 of Candida albicans. J Clin Microbiol. 1993 Jun;31(6):1472–1480. [PMC free article] [PubMed]
  • Bedell GW, Soll DR. Effects of low concentrations of zinc on the growth and dimorphism of Candida albicans: evidence for zinc-resistant and -sensitive pathways for mycelium formation. Infect Immun. 1979 Oct;26(1):348–354. [PMC free article] [PubMed]
  • Horowitz BJ, Edelstein SW, Lippman L. Sexual transmission of Candida. Obstet Gynecol. 1987 Jun;69(6):883–886. [PubMed]
  • Iwaguchi S, Homma M, Chibana H, Tanaka K. Isolation and characterization of a repeated sequence (RPS1) of Candida albicans. J Gen Microbiol. 1992 Sep;138(9):1893–1900. [PubMed]
  • Lasker BA, Page LS, Lott TJ, Kobayashi GS. Isolation, characterization, and sequencing of Candida albicans repetitive element 2. Gene. 1992 Jul 1;116(1):51–57. [PubMed]
  • Lee KL, Buckley HR, Campbell CC. An amino acid liquid synthetic medium for the development of mycelial and yeast forms of Candida Albicans. Sabouraudia. 1975 Jul;13(2):148–153. [PubMed]
  • Lockhart SR, Fritch JJ, Meier AS, Schröppel K, Srikantha T, Galask R, Soll DR. Colonizing populations of Candida albicans are clonal in origin but undergo microevolution through C1 fragment reorganization as demonstrated by DNA fingerprinting and C1 sequencing. J Clin Microbiol. 1995 Jun;33(6):1501–1509. [PMC free article] [PubMed]
  • Mercure S, Poirier S, Lemay G, Auger P, Montplaisir S, de Repentigny L. Application of biotyping and DNA typing of Candida albicans to the epidemiology of recurrent vulvovaginal candidiasis. J Infect Dis. 1993 Aug;168(2):502–507. [PubMed]
  • Miles MR, Olsen L, Rogers A. Recurrent vaginal candidiasis. Importance of an intestinal reservoir. JAMA. 1977 Oct 24;238(17):1836–1837. [PubMed]
  • Sadhu C, McEachern MJ, Rustchenko-Bulgac EP, Schmid J, Soll DR, Hicks JB. Telomeric and dispersed repeat sequences in Candida yeasts and their use in strain identification. J Bacteriol. 1991 Jan;173(2):842–850. [PMC free article] [PubMed]
  • Scherer S, Stevens DA. Application of DNA typing methods to epidemiology and taxonomy of Candida species. J Clin Microbiol. 1987 Apr;25(4):675–679. [PMC free article] [PubMed]
  • Schmid J, Rotman M, Reed B, Pierson CL, Soll DR. Genetic similarity of Candida albicans strains from vaginitis patients and their partners. J Clin Microbiol. 1993 Jan;31(1):39–46. [PMC free article] [PubMed]
  • Schmid J, Voss E, Soll DR. Computer-assisted methods for assessing strain relatedness in Candida albicans by fingerprinting with the moderately repetitive sequence Ca3. J Clin Microbiol. 1990 Jun;28(6):1236–1243. [PMC free article] [PubMed]
  • Schröppel K, Rotman M, Galask R, Mac K, Soll DR. Evolution and replacement of Candida albicans strains during recurrent vaginitis demonstrated by DNA fingerprinting. J Clin Microbiol. 1994 Nov;32(11):2646–2654. [PMC free article] [PubMed]
  • Sobel JD. Pathogenesis and epidemiology of vulvovaginal candidiasis. Ann N Y Acad Sci. 1988;544:547–557. [PubMed]
  • Soll DR, Galask R, Isley S, Rao TV, Stone D, Hicks J, Schmid J, Mac K, Hanna C. Switching of Candida albicans during successive episodes of recurrent vaginitis. J Clin Microbiol. 1989 Apr;27(4):681–690. [PMC free article] [PubMed]
  • Soll DR, Galask R, Schmid J, Hanna C, Mac K, Morrow B. Genetic dissimilarity of commensal strains of Candida spp. carried in different anatomical locations of the same healthy women. J Clin Microbiol. 1991 Aug;29(8):1702–1710. [PMC free article] [PubMed]
  • Soll DR, Langtimm CJ, McDowell J, Hicks J, Galask R. High-frequency switching in Candida strains isolated from vaginitis patients. J Clin Microbiol. 1987 Sep;25(9):1611–1622. [PMC free article] [PubMed]
  • Soll DR, Staebell M, Langtimm C, Pfaller M, Hicks J, Rao TV. Multiple Candida strains in the course of a single systemic infection. J Clin Microbiol. 1988 Aug;26(8):1448–1459. [PMC free article] [PubMed]
  • Stein GE, Sheridan VL, Magee BB, Magee PT. Use of rDNA restriction fragment length polymorphisms to differentiate strains of Candida albicans in women with vulvovaginal candidiasis. Diagn Microbiol Infect Dis. 1991 Nov-Dec;14(6):459–464. [PubMed]
  • Vazquez JA, Sobel JD, Demitriou R, Vaishampayan J, Lynch M, Zervos MJ. Karyotyping of Candida albicans isolates obtained longitudinally in women with recurrent vulvovaginal candidiasis. J Infect Dis. 1994 Dec;170(6):1566–1569. [PubMed]

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