A Comparative Study Of The Homology Of Candida In Vagina And Intestinal Tract Of Patients Suffering From Vulvovaginal Candidiasis

Background: Vulvovaginal candidiasis is one of the most common infections seen in women genital diseases. Up to three quarters of all women will suffer at least one episode of this condition during their lifetime, around 5% of them suffering a recurrent vulvovaginal candidiasis. The mechanism of recurrence is not clear yet. Nowadays the disease is easily treated with topical azole antifungal medications in single or short-term doses . There are good therapeutic effects, but the relapse rate is high.Objective: To investigated the relationship of the genotypes of the Candida strains between the vagina and intestinal tract of the patients suffering from vulvovaginal candidiasis are same and demonstrate that the Candida strains from intestinal tract may be the pathogens.Methods: We cultivated the vaginal discharge and archos swabs of 43 VVC patients. Then we cultivated the double positive samples in YPD medium and extract the genome DNA of these samples. By means of the genome DNA as templates, we undertook ITS1-ITS2 PCR and RAPD PCR respectively. The products of ITS1-ITS2 PCR were purified, reclaimed and then carried out sequencing. And we analyzed the products of RAPD PCR by Gynetools from syngene Software after gel electrophoresis.Results: 1. Of 43 patients, the vaginal discharge of 7 patients have not identified yeast buds by wet mount, but there are Candida flora on CHROMagar medium. The false negative rate is 16.28%. 2. The pathogens of 27 VVC patients are all cadida albicans. Of the 16 RVVC patients, the pathogens of 14 are cadida albicans and the other 2 are albican glabrata. 3. Of the 27 VVC patients, there are 7 double-positive sample and the rate is 25.93%; Of the 16 VVC patients, there are 10 double-positive sample and the rate is 62.50%. By chi-square test, we get P<0.05. 4. About 4 pairs of samples by sequencing ,the base sequences of every pair are same. Of the 18 pairs of samples by RAPD PCR, excluding the 18th and 32th samples, the similarity coefficients(S_AB) of the other pairs all exceed 0.9. Their genetypes are mostly same.Conclusions: 1. There are the same genotypes of Candida strains in vaginal andintestinal tract of the patients suffering from vulvovaginal candidiasis with Candidacolonization in intestinal tract. The Candida flora in intestinal tract should be one ofthe pathogen resources of vulvovaginal candidiasis. 2. For RVVC patients, thecultivation of archos swab is suggested. If the result is positive, it is better to add oralantifungal agents for reducing recurrence.