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Medicine and Health Sciences


Candida albicans and Gardnerella vaginalis are two common infectious organisms of the female urogenital tract. Single agent boric acid (BA) topical preparations have been a treatment for resistant gynecologic Candida and Gardnerella infections, but it is worth exploring combinations of inhibitors to determine if a more effective treatment may be developed. Our study aims to determine the efficacy of BA alone in comparison to the combination of BA and EDTA (BA + EDTA) by measuring organism growth, size, and morphology. Experiments used 12 clinical strains of Candida albicans and 7 strains of Gardnerella vaginalis. The organisms were grown in varying concentrations of BA and BA + EDTA media. Organisms were characterized by microscopy and flow cytometry. We report that the median effective dose of BA alone was greater than that of BA + EDTA in Candida strains. Microscopic evaluation revealed that exposure to BA and BA + EDTA decreased typical hyphal transformation of Candida, and cells appeared smaller in size. Flow cytometry forward scatter data of Candida grown in inhibitors revealed smaller cells than those grown in control conditions. Cell counts of organisms grown in inhibitors were also significantly decreased compared to control conditions. Incidental evaluation of autofluorescence revealed increased fluorescence of organisms exposed to inhibitors. Preliminary results of Candida strains grown in BA and BA + EDTA also revealed inhibition of virulence-associated protease activity. These data provide evidence supporting the potential use of a combination therapy in Candida and Gardnerella infections and prompt additional investigation into combination therapies with EDTA.


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