Genotype distribution of Candida albicans strains associated with different conditions of vulvovaginal candidiasis, as revealed by microsatellite typing

Objective: To compare genotypes of Candida albicans strains causing different conditions of vulvovaginal candidiasis ( VVC) in Chinese women. Methods: C albicans strains were isolated from the vaginas of patients with different conditions of VVC. The genotypes of the strains were investigated based on single-strand conformation polymorphisms ( SSCP) of the PCR amplified microsatellite locus CAI. Results: A total of 93 independent C albicans strains was isolated from patients with mild-to-moderate ( n = 37) or severe ( n = 56) VVC. Thirty of the patients enrolled suffered recurrent VVC. Twenty-six distinct genotypes tentatively designated as A to Z were identified from the 93 C albicans strains compared on the basis of their CAI SSCP patterns. The majority ( 72.0%) of the strains possessed genotypes A to D, which were similar in the CAI SSCP profiles and were designated as the dominant genotypes. The overall frequencies of the four dominant genotypes were 87.5% ( 49/ 56) and 48.6% ( 18/ 37; p<0.001) in the C albicans strains from patients with severe and mild-to-moderate VVC, respectively. The strains with the dominant genotypes occupied 83.3% ( 25/ 30) and 66.7% ( 42/ 63; p= 0.094) in the C albicans strains from patients with recurrent VVC and sporadic VVC, respectively. Conclusion: The frequency of C albicans strains with the dominant genotypes ( A to D) from patients with severe VVC was significantly higher than that from patients with mild-to-moderate VVC, implying that the CAI genotype distribution of C albicans strains correlates with the severity of VVC.