RT Journal Article
T1 New insights in the role of Candida biofilm in the pathogenesis of recurrent vulvovaginal candidiasis: a prospective clinical study
A1 Díaz-Navarro, Marta
A1 Irigoyen-von-Sierakowski, Álvaro
A1 Delcán, Imani
A1 Monte, Ariadna
A1 Palomo, María
A1 Escribano Subías, María Pilar
A1 Guinea, Jesús
A1 Burillo Albizua, Almudena
A1 Galar, Alicia
A1 Muñoz García, Patricia Carmen
A1 Guembe, María
AB BackgroundDespite the pathogenesis of vulvovaginal candidiasis (VVC) is multifactorial, this study aimed to assess whether phenotypic characteristics, such as biofilm production and quality, along with clinical symptoms, are associated with recurrent VVC (RVVC).MethodsOver 1 year (Oct 2021–Oct 2022), we prospectively included 271 patients ≥18 years who attended our institution, had Candida spp. isolated in vaginal swabs, and provided informed consent. Patients were followed for 1 year. Candida spp. isolates were tested by the following techniques: crystal violet (CV) for biomass quantification, XTT for metabolic activity quantification, and microscopy for biofilm area quantification. Clinical and microbiological data were also collected.ResultsOverall, 55 (20.3%) patients experienced at least one recurrence, with 19 (7.0%) meeting the criteria for RVVC (≥3 episodes/year), with 65 episodes in total. Demographic and clinical characteristics were similar in both study groups. Most isolates were C. albicans (90.0%). Median (interquartile, [IQR]) absorbance values for CV and XTT in 18/19 RVVC and 238/252 non-RVVC isolates were as follows: CV, 1.850 (1.578–2.156) vs. 1.426 (1.081–1.823), p = 0.005; XTT, 0.184 (0.116–0.293) vs. 0.228 (0.147–0.331), p = 0.253. Median (IQR) biofilm occupation area percentage in 16/19 RVVC and 16/252 non-RVVC isolates was, respectively: 13.15 (8.54–16.9) and 10.73 (5.88–17.73), p = 0.710.ConclusionRVVC was associated to high biomass production. Additionally, RVVC clinical isolates exhibited a tendency toward lower metabolic activity, which may contribute to treatment failure.
PB Frontiers Media
YR 2025
FD 2025-03-27
LK https://hdl.handle.net/20.500.14352/120358
UL https://hdl.handle.net/20.500.14352/120358
LA eng
NO Díaz-Navarro M, Irigoyen-von-Sierakowski Á, Delcán I, Monte A, Palomo M, Escribano P, Guinea J, Burillo A, Galar A, Muñoz P and Guembe M (2025) New insights in the role of Candida biofilm in the pathogenesis of recurrent vulvovaginal candidiasis: a prospective clinical study. Front. Microbiol. 16:1566171. doi: 10.3389/fmicb.2025.1566171
NO Funding: This study was supported by the Instituto de Salud Carlos III (ISCIII), co-funded by the European Union (grant PI21/01737), and by CIBER Enfermedades Respiratorias (CB06/06/0058).Acknowledgments: The authors thank the staff of the Department of Clinical Microbiology and Infectious Diseases at Hospital General Universitario Gregorio Marañón for their support.Conflict of Interest: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
NO Instituto de Salud Carlos III
NO European Union
NO CIBER Enfermedades Respiratorias
DS Docta Complutense
RD 19 ene 2026