Candida albicans

Candida albicans is an opportunistic yeast (fungus) that can develop in mouth, vagina, skin or nail bed of humans. Some countries call yeast infections thrush. Yeast infections can be especially bad for those with lowered immunity, particularly those undertaking chemotherapy or AIDS treatment, or bone or organ transplants.

NOTE: Because we are only discussing vulvovaginal yeast infections here, we do not include much information regarding systemic, oral or nail fungal infections of C. albicans. There is plenty of information around regarding these other types of infections.

About C. albicans

Candida albicans is normal in the gut flora, generally existing without causing problems, but this yeast can become pathogenic, growing filaments that are described as root-like and invade tissue and organs. This is called dimorphism, (though C. albicans is technically polyphenic).

C. albicans goes through several changes in form, depending on the circumstances it is living in, including specific environmental conditions like oxygen levels (anaerobic conditions), nutrient levels, pH, and temperature.

C. albicans is found in 40-60 per cent of all healthy adults, but cannot survive or multiply outside of the human body. Most Candida species do not cause infection in humans, but several do, including C. albicans.

Most human infections are caused by C. albicans, C. tropicalis, C. parapsilosis and C. glabrata. Candidiasis can be fatal, with estimates ranging from a few thousand to tens of thousands of deaths due to this yeast every year.

The word…
Candida = comes from Latin word candidus, meaning ‘white’
Albicans = comes from Latin word albicō, meaning ‘becoming white’
Candida albicans therefore means ‘white becoming white’
(a tautology, for grammar nerds)

Vulvovaginal yeast infections

About 75 per cent of women will experience a yeast infection at least once in their lives, with almost all of these infections (90 per cent) caused by C. albicans. A severe, treatment-resistant overgrowth of Candida albicans is known as a superinfection, which makes treatment more difficult and prolongs the infection.

Vulvovaginal symptoms of C. albicans infection

• Discharge
• Cottage cheese-like discharge – thick, lumpy
• Not malodourous – may smell sort of milky
• Dry, red appearance of vaginal mucosa or skin
• Itchy
• May become raw
• Paper cuts

Sexual transmission of C. albicans

C. albicans can be sexually transmitted between partners, so if a woman has a vulvovaginal yeast infection and has unprotected sex with a male partner, he can contract the infection on his penis and surrounding areas where vaginal fluids (yeast spores) have come into contact. This can include infections on other parts of the body, like mouth or skin, not just genitals, and applies to female sexual partners too.

Treating C. albicans vulvovaginal yeast infections

C. albicans creates a biofilm, on both human tissue and artificial implants (catheters, medical devices), often found inside biofilms with Staphylococcus aureus. These co-infections lead to worse outcomes, particularly in hospital-acquired infections.

Treating C. albicans vulvovaginal yeast infections

Treatments typically include antifungals applied to a local infection or taken orally. Vulvovaginal infections tend to be treated as a local infection, but there is emerging evidence that vaginal blooms follow an intestinal bloom, thus treating the intestine makes more sense. Many practitioners and the public remain unaware of this and continue to treat vaginal yeasts with over-the-counter antifungals that may contribute to resistant strains emerging, while not addressing the root cause.

Medical antifungals for C. albicans infections

• Amphotericin B – systemic
• Echinocandin – systemic
• Fluconazole – systemic
• Nystatin – oral and oesophogeal
• Clotrimazole – skin, genitals

Antifungal resistance

Antifungal resistance is an increasing problem, with limited options available as treatments, and resistance increasing over time.

Alternatives to topical pharmaceutical antifungals

• Essential oil douche – rosemary, tea tree, thyme – a few drops of essential oil in a cup of warm water
• Povidone-iodine (Betadine) solution
• Probiotic containing Saccharomyces boulardii – used orally and vaginally (ensure vegetable caps for vaginal use or switch caps)
• Probiotic containing general lactobacilli – used orally and vaginally (ensure vegetable caps for vaginal use or switch caps)
• Milk kefir vaginally and orally, but beware high-yeast milk kefir!