Katherine Miranda-Cadena

The epidemiology of vulvovaginal candidiasis (VVC) in Ecuador remains poorly reported and outdated. We therefore conducted a 12-month prospective survey to assess the aetiology and antifungal resistance patterns among symptomatic Ecuadorian patients. VVC diagnosis was confirmed by microscopic examination and culture. Isolates were identified by biochemical and molecular methods. In vitro antifungal susceptibilities to amphotericin B, clotrimazole, fluconazole, itraconazole, miconazole, and nystatin were determined by CLSI methods. Among 195 women, 71 VVC episodes were recorded (36.4%), whereof 56 (28.7%) had acute VVC (AVVC) and 15 (7.7%) had recurrent VVC (RVVC). The predominant species was Candida albicans, isolated in pure culture from 45 AVVC (80.3%) and 9 RVVC patients (60%), and in mixed culture from 7 AVVC (12.5%) and 3 RVVC patients (20%). Candida glabrata and Saccharomyces cerevisiae were also isolated in AVVC and RVVC patients, but Candida parapsilosis and Candida famata were only isolated from AVVC. Fluconazole- and miconazole-resistant C. albicans isolates were recovered from 5 (8.9%) and 24 (42.9%) of 56 AVVC patients, respectively, and from 1 (8.3%) and 5 (41.7%) of 12 RVVC patients, respectively. Fluconazole and miconazole resistance is relevant in Ecuador, emphasising the need for targeted antifungal strategies.

The epidemiology of vulvovaginal candidiasis (VVC) in Ecuador remains poorly reported and outdated. We therefore conducted a 12-month prospective survey to assess the aetiology and antifungal resistance patterns among symptomatic Ecuadorian patients. VVC was confirmed by microscopic examination and culture. Isolates were identified by biochemical and molecular methods. In vitro antifungal susceptibilities to amphotericin B, clotrimazole, fluconazole, itraconazole, miconazole, and nystatin were determined by CLSI methods. Among 195 women, 71 VVC episodes were recorded (36.4%), whereof 56 (28.7%) had acute VVC (ACCV) and 15 (7.7%) had recurrent VVC (RVVC). The predominant species was C. albicans, isolated in pure culture from 45 AVVC (80.3%) and nine RVVC patients (60%), and in mixed culture from seven AVVC (12.5%) and three RVVC patients (20%). Candida glabrata and Saccharomyces cerevisiae were also isolated in AVVC and RVVC patients, but Candida parapsilosis and Candida famata (Debariomyces hansenii) were only isolated from AVVC. Fluconazole- and miconazole-resistant C. albicans isolates were recovered from 5 (8.9%) and 24 (42.9%) of 56 AVVC patients, respectively, and from 1 (8.3%) and 5 (41.7%) of 12 RVVC patients, respectively. Fluconazole and miconazole resistance is relevant in Ecuador, emphasising the need for targeted antifungal strategies.

Research on the microbiota–gut–brain axis in autism has primarily focused on bacteria, with limited attention to fungi. There is a growing interest in understanding the involvement of fungi, particularly Candida, in patients with autism spectrum disorder. The aim of this study was to assess the prevalence, antifungal susceptibility profiles and virulence factors of Candida isolates from the guts of Tunisian children with autism. Twenty-eight children with autism and forty-six controls were enrolled. Candida isolates from the faecal samples were identified using biochemical and molecular methods; antifungal susceptibility testing was determined by the EUCAST broth microdilution method and virulence factors, including biofilm formation, cell surface hydrophobicity and phospholipase and proteinase activities, were assessed in vitro. As a result, Candida was detected in 13 children with autism (46.4%) and 14 control children (30.4%). Candida albicans was found to be the most common species isolate in the faeces of both groups of children. Antifungal susceptibility profiles showed that one Candida isolate was resistant to amphotericin B and anidulafungin (3.7%), six were resistant to micafungin (22.2%) and five were resistant to fluconazole (18.5%). All Candida isolates were biofilm producers. Of the twenty-seven isolates, only four showed phospholipase activity (14.8%), eight showed aspartyl-proteinase activity (29.6%) and nine were hydrophobic (33.3%). These results highlight the presence of Candida in the guts of children with autism, as well as the ability to express multiple virulence factors and the antifungal resistance, and they emphasize the need for further studies to confirm intestinal Candida colonization and its potential role in autism.

The ability of Candida to develop biofilms on inert surfaces or living tissues favors recalcitrant and chronic candidiasis associated, in many instances, with resistance to current antifungal thera...