HWP1 Gene Sequence Diversity and Antifungal Susceptibility Patterns in Colombian Vulvovaginal Isolates of the Candida albicans Species Complex

Abstract

Background: Candida albicans complex species are the main cause of candidiasis. Objectives: The purpose of this study was to report the prevalence and genetic diversity of C. albicans complex using hyphal wall protein 1 (HWP1) gene size polymorphism, as well as the susceptibility patterns to fluconazole and voriconazole. Methods: A total of 170 yeast isolates were obtained from vulvovaginal samples, and phenotypic and proteomic identification was performed. Results: Most clinical isolates were C. albicans complex (n = 153) followed by C. glabrata (n = 13), C. parapsilosis complex (n = 2), and Pichia kudriavzevii (n = 2). Among C. albicans complexes, all isolates were C. albicans sensu stricto and 2.61% and 4.58% were resistant to fluconazole and voriconazole, respectively. Conclusions: The presence of different alleles was confirmed, heterozygosity was more common than homozygosity (71.03% vs. 28.97%), and some isolates showed a homozygosis pattern not previously described. Despite these genetic diversities, no specific genotype was linked to azole resistance.