Prevalence and production of enzimes by Candida isolates from vaginal secretion samples

Abstract

Vulvovaginal candidiasis (VVC) ranks second among causes of vaginitis. Candida albicans is responsible for the majority of symptomatic episodes of VVC. However, one fact to consider is the increase of infections by species of non-C. albicans, which contribute to high rates of recurrence and resistance. The purpose of this study was to isolate Candida spp. samples from vaginal discharge, determine the prevalence of the species and assess the production of hydrolytic enzymes (proteases,
phospholipases, hemolysins, catalase, and gelatinases) in clinical isolates. 144 samples from patients treated at a public hospital in São Luis-MA were analyzed. The production of hydrolytic enzymes was determined in triplicate with specific methods. Statistical analysis was performed using the c2, Kruskal-Wallis and Student-Newman-Keuh tests. Ninety patients had positive cultures for Candida spp. Candida parapsilosis was the main isolated species (43.3%). Forty-three patients (47.8%)
showed clinical manifestations that suggested VVC. The correlation between the presence of Candida species and the presence or absence of symptoms was not statistically significant (x = 3.22, p = 0.073). The expression of enzymes by Candida spp. isolates was recorded with percentages: hemolysins (80%), phospholipases (8.9%), proteinases (17.8%), catalase (64.4%) and gelatinases (10.0%). Statistically significant differences were observed among the isolates for expression of
phospholipases (p=0.0005), with C. albicans being the largest producer and for catalase (p=0.0045) with C. parapsilosis and C. albicans the species with increased expression. This study shows a predominance of non-albicans species in vulvovaginal samples and most of the isolates were producers of hemolysin and catalase, which may contribute to the virulence of the strains of Candida spp. and the development of vaginal infection under appropriate conditions.