Evidence for a Correlation Between Proteinase Secretion and

Candida albicans isolates from nondiabetic, nonpregnant outpatients with vaginitis were compared for in vitro proteinase secretion with isolates from women without specific can-didal vaginitis symptomatology (carriers). Proteinase production was assayed in medium containing bovine hemoglobin (BH-P; 39 isolates in 69 independent determinations) or bovine serum albumin (BSA-P; 39 isolates in a single determination each). All isolates had measurable, consistent BH-P secretion, and most also showed detectable BSA-P ac-tivity. However, isolates from patients were more proteolytic than those from carriers, with the difference being statistically highly significant. When the patients with vaginitis were categorized according to signs and symptoms, the highest BH-P values were recorded for those with full symptomatology, whereas the only BSA-P-negative isolates were from the group without vaginitis. Isolates from the patient and carrier groups did not differ as a whole in their growth potential in vitro, and all were germ tube responders in serum, independent of their source. In host-parasite relationships expression of the dis-ease depends on the balance between the virulenc