Abstract：
Recurrent vulvovaginal candidiasis (RVVC) due to fluconazole resistance in Candida albicans isolates causes a wide range of complications. A number of 63 Candida albicans isolates obtained from vulvovaginal candidiasis (VVC) were identified by Internal Transcribed Spacer-Restriction Fragment Length Polymorphism (ITS-RFLP). Antifungal susceptibility testing was performed by broth microdilution method according to the CLSI protocol. The role of CDR1 and MDR1 genes in progress of VVC to RVVC was examined and the activity of virulence-related enzymes was assessed. Candida albicans was diagnosed in 62.4 % cases, of which 22.2 % were confirmed as RVVC. Voriconazole was the most active drug among five tested antifungals. The mean expression level of CDR1 and MDR1 was higher in RVVC isolates compared to multidrug azole-resistant VVC isolates. Our results demonstrated that the expression of CDR1 and MDR1 and the level of phospholipase and proteinase activities could be quite important to induce fluconazole resistance in C. albicans and to progress of VVC to become RVVC in involved patients.
摘要：
由于白色念珠菌分离物中的氟康唑耐药性，复发性外阴阴道念珠菌病（RVVC）会引起多种并发症。通过内部转录间隔物限制性片段长度多态性（ITS-RFLP）鉴定了从外阴阴道念珠菌病（VVC）获得的63种白念珠菌分离株。根据CLSI方案通过肉汤微量稀释法进行抗真菌药敏试验。检查了CDR1和MDR1基因在VVC到RVVC的进展中的作用，并评估了毒力相关酶的活性。62.4%的病例诊断为白色念珠菌，其中22.2%被确认为RVVC。伏立康唑是五种测试抗真菌药物中最活跃的药物。与多药耐药的VVC分离株相比，RVVC分离株中CDR1和MDR1的平均表达水平更高。我们的结果表明，CDR1和MDR1的表达以及磷脂酶和蛋白酶活性的水平可能对白色念珠菌中诱导氟康唑耐药性和使VVC发展为涉及患者的RVVC非常重要。
