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eMediNexus 05 February 2019
A new article published in Frontiers in Microbiology investigated the inhibitory effect of lactic and acetic acids produced by commensal microbiota, at a low vaginal pH in the growth of C. glabrata and C. albicans, and the effect of presence of these organic acids in tolerance of the two Candida species to azoles used in treatment of vaginal infections, as well as the eventual synergistic effects. This in-vitro study demonstrated that under different experimental conditions, lactic acid exerted no significant inhibitory effect against C. albicans or C. glabrata, contrary to the general presumption that the production of this acid confers a protective effect exerted by vaginal lactobacilii. Moreover, C. glabrata and C. albicans exhibited variable susceptibilities to acetic acid that were more pronounced at lower pHs and stronger for the latter specie. While synergism between acetic acid and azoles was observed both for C. albicans and C. glabrata, but lactic acid-azole synergism was only efficient against C. albicans. The results suggested that tolerance to acetic acid at a low pH may play a more relevant role than tolerance to lactic acid in determining competitiveness of C. albicans and C. glabrata in the vaginal tract, including under azole stress. It was stated that treatment of vaginal candidiasis with azoles may depend on the level of acetic and lactic acids present, and improvements could be achieved by synergizing the azole with these acids.
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