Molecular Aspect of Drug Resistance in Candida albicans Isolates of Women with Vulvovaginal Candidiasis

Vulvovaginal candidiasis is one of the frequent vaginal infections in women caused by Candida albicans. We evaluate the expression of ERG11, CDR1 and CDR2 genes by quantitative RT-PCR in Candida albicans strains isolated from women in north of Iran. Of 50 samples, 23 (46%) were determined to be Candida albicans strains. In phenotypic assays, 20 (~87%) of strains were resistant to doses of fluconazole (≥128–2048 μg/mL). Also, 43.47 and 26.08% of isolates were resistant to ketoconazole and clotrimazole, respectively. Overexpression or mutation of ERG11 and upregulation of CDR1 and CDR2 genes was found in some resistant isolates compared to strain ATCC10231. Multidrug resistance in in the isolates was due to the upregulation of abovementioned genes as well as decreased affinity of ERG11 to azoles. Thus, we need to new strategies and drugs to treat vulvovaginitis in Guilan’s women.