Evidence map›Paper›PMID 42304237›Full record

ArticleBMC microbiology2026

Vulvovaginal candidiasis among Yemeni women: prevalence of Candida species, biofilm formation rates, antifungal susceptibility patterns, and biofilm-associated genes ALS1 and HWP1.

Abeer Abdulmahamood Nasher, Rowa Mohammed Assayaghi, Hassan Abdulwahab Al-Shamahy, Ahmed Yahia Al-Jaufy, Arwa Mohammed Othman, Abdul-Al-Raoof Mohammad Al-Shawkany, Emad Hassan Al-Shamahi

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Abeer Abdulmahamood NasherMedical Microbiology and Immunology Department, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen.
Rowa Mohammed AssayaghiMedical Microbiology and Immunology Department, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen. rowamohammed2010@yahoo.com.
Hassan Abdulwahab Al-ShamahyMedical Microbiology and Immunology Department, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen.
Ahmed Yahia Al-JaufyMedical Microbiology and Immunology Department, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen.
Arwa Mohammed OthmanMedical Microbiology and Immunology Department, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen.
Abdul-Al-Raoof Mohammad Al-ShawkanyMolecular Genetic Department, Faculty of Veterinary Medicine, Thamar University, Thamar, Yemen.
Emad Hassan Al-ShamahiOphthalmology Department, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVulvovaginal candidiasis (VVC) is a common fungal infection in women, primarily caused by Candida species. Biofilm formation is a key virulence factor contributing to pathogenicity and antifungal resistance. This study aimed to identify Candida species, evaluate antifungal susceptibility, quantify biofilm formation, and detect virulence gene markers (ALS1 and HWP1) in vaginal isolates from women with VVC.

methodsA cross-sectional study was conducted from December 2021 to June 2024 among 400 women attending obstetrics and gynecology clinics in Sana'a City. Vaginal swabs were collected and cultured in a microbiology laboratory. Antifungal susceptibility of isolates to nystatin, voriconazole, fluconazole, ketoconazole, clotrimazole, miconazole, itraconazole, and amphotericin B was assessed using the disk diffusion method. Biofilm formation was measured using the microtiter plate assay. The presence of ALS1 and HWP1 genes was determined by PCR. Data were analyzed using SPSS version 20, and associations were evaluated with the Chi-square test; P < .05 was considered statistically significant.

resultsC. albicans was identified in 367 (91.8%) isolates, while non-albicans species accounted for 33 (8.2%). Of the 367 C. albicans isolates, 174 (47.4%) formed biofilms: 32 (8%) strong, 72 (18%) moderate, and 70 (17.5%) weak. Biofilm- forming isolates were associated with higher antifungal resistance, with amphotericin B (113; 64.9%) and itraconazole (108; 62.1%) showing the highest resistance, and nystatin the lowest (23; 13.2%). The ALS1 gene was detected in all biofilm- forming C. albicans isolates (174; 100%), while HWP1 was present in 82 (47.1%). Non-biofilm-forming isolates demonstrated lower resistance rates across all drugs.

conclusionsVVC remains highly prevalent in Sana'a, Yemen, with C. albicans as the dominant pathogen. These findings suggest a potential association between biofilm formation and increased antifungal resistance also the presence of key virulence genes-particularly ALS1 and HWP1. However, due to the study's cross-sectional design, a definitive causal relationship cannot be inferred. This study emphasizes the importance of integrating phenotypic and molecular characterization into routine diagnostics and surveillance to improve the management of resistant Candida infections. Continuous monitoring of species distribution is also warranted to detect emerging non-albicans species.

Indexed as

Antifungal AgentsBiofilmsCandidaCandidiasis, VulvovaginalFungal ProteinsMembrane GlycoproteinsAdultCross-Sectional StudiesDrug Resistance, FungalFemaleHumansMicrobial Sensitivity TestsPrevalenceVirulence FactorsALS1 protein, Candida albicansAntifungal AgentsFungal ProteinsHWP1 protein, Candida albicansMembrane GlycoproteinsVirulence FactorsALS1 geneC. albicansHWP1 geneNon-albicans CandidaVulvovaginal candidiasis

Identifiers

PMID42304237
PMCPMC13422352

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.