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Ángel González Marín is a professor at the School of Microbiology and the coordinator of the Basic and Applied Microbiology research group. Photo: UdeA Communications Department / Andrea Vargas 

Vulvovaginal candidiasis is one of the most common infections in women. It is estimated that three out of four women experience at least one episode in their lifetime, with symptoms such as heavy discharge, burning, a stinging sensation, and itching. It is unusual for it to occur frequently, with more than three episodes per year. This situation is known as recurrent vulvovaginal candidiasis, a chronic condition that is as uncomfortable as it is understudied, affecting nearly 10% of women worldwide. Why does it happen, and what factors explain this recurrence? These are the questions that the study “Candidiasis vulvovaginal recurrente: caracterización clínica, epidemiológica, inmunológica y microbiológica en una cohorte de mujeres colombianas” (Recurrent Vulvovaginal Candidiasis: Clinical, Epidemiological, Immunological, and Microbiological Characterization in a Cohort of Colombian Women) aims to answer. 

In recognition of this research’s results, Ángel González Marín, professor at the School of Microbiology and coordinator of the Basic and Applied Microbiology research group (MICROBA), received the "Research Award for professors in the area of Health Sciences” on October 9th, the Classic Day on which the UdeA celebrates its 222 years of history.  

On the trail of recurrent candidiasis 

Candida fungus is a yeast that naturally inhabits the skin, mouth, and intestines without causing problems. However, various factors can alter the balance of the microbiota and promote its growth, which causes the infection known as candidiasis. Antibiotic use, hormonal changes during pregnancy or after menstruation, poor hygiene practices, and practices such as the use of perfumed products or douching, as well as some underlying conditions like uncontrolled diabetes, are some of the causes. Diet also plays a key role. A diet rich in sugars and refined carbohydrates can trigger the infection. "With greater availability of glucose in the body, microorganisms use it as a food source to grow and invade tissue," explained the bacteriologist. However, the origins of vulvovaginal candidiasis recurrence are still unclear. 

González Marín noted that the research aims to demystify and clarify the origins of the disease to improve women's quality of life. "Imagine the itching and discomfort with frequent episodes throughout the year. This infection not only affects women's physical health but also their sexual and emotional health and job stability. Not much is known about the disease, and it carries negative cultural and stigmatizing connotations because it is believed only to appear when women have an irresponsible sex life," the professor said. 

According to the jury, the research was recognized on the UdeA Classic Day for its "measurable social impact," reflected in "the free delivery of results, which represents a genuine commitment to the community." The research focused on 40 Colombian women with a clinical diagnosis of recurrent vulvovaginal candidiasis and no underlying medical conditions. The search for patients took a year and a half, and due to its specific nature, "this was perhaps the most difficult part of the research," stated Professor González Marín. 

Once the patients were selected, the research group shared the proposal and educated them about the infection and its care. They took fluid samples and gave them a test to identify the causative microorganism. Finally, they underwent resistance testing to determine whether the Candida growing in their bodies was resistant to the antifungals commonly used to treat the disease. With these results, the patients were referred back to their physician with the necessary supplies to begin treatment. 

The research involved undergraduate, master's, and doctoral students, which is why the 2025 University Distinctions juries highlighted its valuable contribution to the development of human talent. Professor Ángel González Marín proudly emphasized that the project's success would not have been possible without the work of his co-researchers: Jeiser Marcelo Consuegra Asprilla and Carolina Rodríguez Echeverri, researchers from the School of Microbiology, as well as others who also contributed to the process. "They all started with me as undergraduate students. They're the ones you hope will continue later, when you're gone, when you've completed your cycle. You leave certain lines of research open, and they have the mission to continue them," he stated. 

This study was developed thanks to a call from Universidad de Antioquia’s Committee for the Development of Research (CODI), which aimed to strengthen scientific production and promote the growth of young researchers. Universidad del Rosario also participated. 

A contribution to public health 

Ángel González Marín has been an associate professor at Universidad de Antioquia for 18 years and led the research project "Recurrent Vulvovaginal Candidiasis: Clinical, Epidemiological, Immunological, and Microbiological Characterization in a Cohort of Colombian Women." Photo: UdeA Communications Department / Andrea Vargas  
 
Professor González Marín dreams of this research going further. "My vision for the project is to develop a prophylactic and therapeutic vaginal suppository or gel for the treatment of recurrent vulvovaginal candidiasis," he explained. 

Prophylactic treatment prevents infections, while therapeutic treatment seeks to treat them once they appear. In other words, the researcher added, the next step is to move toward a broader study that will enable the development of a drug or molecule without the adverse effects of the antibiotics or antifungals currently used to treat this disease, which cause long-term resistance and have significant adverse effects that can affect other organs in a woman's body. 

The most viable alternative is the creation of a gel. González Marín enthusiastically stated that the group already has results from a pilot test. "We are evaluating some postbiotics, which come from probiotics, especially lactobacilli. Lactobacilli are part of the normal microbiota of the vaginal mucosa; therefore, it is a natural treatment, so to speak, as it could be used preventively without the adverse effects produced by an antibiotic." The professor added that, although drug development technologies have advanced significantly, the research group still has much to do. 

The study on recurrent vulvovaginal candidiasis could have broad implications for public health policies in the future. Professor González Marín emphasized the importance of this and similar research in contributing to updating clinical guidelines and treatment protocols and developing new therapeutic molecules. "If we achieve an effective treatment, we could reduce the number of medications and resistance, the number of medical appointments and absences from work, and thereby reduce the costs that women currently bear to treat this infection," he said. 

Bacteriologist by profession, doctor at heart 

Professor González Marín wanted to be a doctor, but ended up in microbiology almost by chance. Or, as he says with a laugh, "by fate, which comes and tells you: you're stuck there, and you have to keep going." He graduated as a bacteriologist from UdeA before the program adopted the name Microbiology. He avoided research, laboratory work with animals, and English, but, ironically, it was precisely there that he found his path, he recalled with humor. 

He specialized in systemic mycoses, severe fungal infections that primarily affect the lungs and can be life-threatening, especially in individuals with weakened immune systems. However, after completing his postdoctoral fellowship in medical mycology at the University of Texas and concluding this portion of his research on endemic mycoses, he decided to direct her knowledge toward a more human and clinical purpose and investigate a problem that affects millions of women, such as recurrent vaginal candidiasis. "Improving women's quality of life. I think that's my mantra from now on," he stated. 

For Professor Ángel González Marín, receiving this award is a recognition that boosts his work. " It's the cherry on top, a vote of confidence that tells you you're doing things right."