Assessment of in vitro biofilm formation by Candida species isolates from vulvovaginal candidiasis and ultrastructural characteristics

Vulvovaginal candidiasis (VVC) is a very common cause of fungal infection that remains a significant problem worldwide, especially concerning its complex pathogenicity. Biofilm dynamics from vaginal isolates requires further investigation. Different assays, such as cell surface hydrophobicity (CSH), biofilm production, fungal metabolism by 2H-tetrazolium-5-carboxanilide (XTT) and phenazine methosulfate (PMS), scanning electron microscopy (SEM) and confocal scanning laser microscopy (CSLM) were used in order to determine the ability of five Candida species isolates from VVC patients to form in vitro biofilms and their ultrastructural characteristics. All yeasts demonstrated the ability to produce biofilm and showed viability up to 48 h after the completion of assay, confirmed by SEM and CSLM, but differences were observed between them. SEM and CSLM also revealed that all VVC isolates adhered only in blastoconidia form, except for Candida parapsilosis. Even though, only one isolate from each Candida species has been used, the results of high biofilm formation, metabolic activity and CSH showed by Candida albicans and C. parapsilosis, as well as by the ultrastructural characteristics, suggest that these species exhibit greater ability of adherence in relation to the others. Ours results support the theory that virulence potential is multifactorial and that other factors not evaluated in this study could be involved in the CVV physiopathogeny.