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      Phantom limb sensations are obviously very strong in the Candida-biofilm research community. It is striking that this and previous letters to the editor with regard to our publication,
      • Swidsinski A.
      • Guschin A.
      • Tang Q.
      • et al.
      Vulvovaginal candidiasis: histologic lesions are primarily polymicrobial and invasive and do not contain biofilms.
      cite Harriott et al
      • Harriott M.M.
      • Lilly E.A.
      • Rodriguez T.E.
      • Fidel Jr., P.L.
      • Noverr M.C.
      Candida albicans forms biofilms on the vaginal mucosa.
      as work that definitively demonstrated the vaginal candida biofilm in rodents. That is not true. We likewise cite the same author in our article and state that “The only publication claiming Candida albicans forms biofilms on the vaginal mucosa exclusively includes pictures of smears from vagina without vaginal epithelium.”
      Neither Harriott nor anybody else have ever presented microscopic proof of candida biofilm on the vaginal wall. In addition, there are major differences between the experimental model of rodent Candida vaginal infection and human vaginal candidiasis, for example, microbiota, pH, and the enormous inoculum of yeast organisms that is used in the animal model, which alone may simulate biofilm-similar discharge. Until the visual proof of biofilm on the surface of intact human vaginal epithelium is available, all speculations about the existence of vaginal candida biofilms will remain scientifically unsound.

      References

        • Swidsinski A.
        • Guschin A.
        • Tang Q.
        • et al.
        Vulvovaginal candidiasis: histologic lesions are primarily polymicrobial and invasive and do not contain biofilms.
        Am J Obstet Gynecol. 2019; 220: 91.e1-91.e8
        • Harriott M.M.
        • Lilly E.A.
        • Rodriguez T.E.
        • Fidel Jr., P.L.
        • Noverr M.C.
        Candida albicans forms biofilms on the vaginal mucosa.
        Microbiology. 2010; 156: 3635-3644

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