Candida isolated from vaginal mucosa of mothers and oral mucosa of neonates - Occurrence and biotypes concordance

Background: The common occurrence of Candida spp. on the vaginal mucosa of pregnant women suggests this as the source of neonatal candidiasis. Methods: This study investigated the occurrence of yeasts on the vaginal mucosa of 100 mothers at the time of birth, and on the oral mucosa of their respective neonates, all full-term, on the 1st, 3rd, and 9th days after birth by vaginal (72 cases) and cesarean (28 cases) routes. In each case where concordance at the level of species was found between the isolate from the mother and that from the neonate, tests were made to check for concordance between the genotypic and phenotypic profiles (susceptibility to killer toxins, serotyping, proteinase and phospholipase production, and susceptibility to antifungal agents). Results: For the vaginal-route group, yeasts were recovered from the vaginal mucosa of 47.2% of the mothers and from 25% of the neonates. For the cesarean-route group, these rates were 46.4% and 3.6%, respectively. Species found most frequently in the samples from the mothers and the neonates were, respectively C albicans and C guilliermondii. For the vaginal-route group, the rate of mother/neonate concordance at the level of species was 23.5% and no cases of concordance for the cesarean births. Of these cases with species concordance, there was concordance between the genotypic and phenotypic profiles in 6% (2 cases). Conclusion: The vaginal mucosa was not the main route of transmission of the Candida species to the neonate, because there was concordance between the genotypic and phenotypic profiles in only 6% (2 cases).