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1. . ., . . : // . 2014; 4 (45): 3842.
2. Hong E., Dixit S., Fidel P. L., Bradford J., Fischer G. Vulvovaginal candidiasis as a chronic disease: diagnostic criteria and definition // J Low Genit Tract Dis. 2014; 18: 3138.
3. De Cremer K., Staes I., Delattin N. et al. Combinatorial drug approaches to tackle Candida albicans biofilms // Expert Rev Anti Infect Ther. 2015; 13 (8): 973984.
4. Sobel J. D. Recurrent vulvovaginal candidiasis // Am J Obstet Gynecol. 2016; 214 (1): 1521.
5. Al Rushood M., McCusker C., Mazer B. et al. Autosomal dominant cases of chronic mucocutaneous candidiasis segregates with mutations of signal transducer and activator of transcription 1, but not of Toll-like receptor 3 // J. Pediatr. 2013; 163 (1): 277279.
6. Kavanaugh N. L., Zhang A. Q., Nobile C. J. et al. Mucins suppress virulence traits of Candida albicans // MBio. 2014; 5: e01911.
7. Aballéa S., Guelfucci F., Wagner J. et al. Subjective health status and health-related quality of life among women with Recurrent VulvovaginalCandidosis (RVVC) in Europe and the USA // Health Qual Life Outcomes. 2013; 11: 169.
8. Fox E. P., Cowley E. S., Nobile C. J. et al. Anaerobic bacteria grow withinCandida albicansbiofilms and induce biofilm formation in suspension cultures // Curr Biol. 2014; 24: 24112416.
9. . ., . ., . . . TLR- // . 2011; 6 (1): 9197.
10. Nobile C. J., Johnson A. D. Candida albicans biofilms and human disease // Annu Rev Microbiol. 2015; 69: 7192.
11. Jaeger M., Plantinga T. S., Joosten L. A. et al. Genetic basis for recurrent vulvovaginal candidiasis // Curr Infect Dis Rep. 2013; 15: 136142.
12. Fox E. P., Nobile C. J. A sticky situation: untangling the transcriptional network controlling biofilm development in Candida albicans // Transcription. 2012; 3: 315322.
13. Xie Z., Thompson A., Sobue T. et al. Candida albicans biofilms do not trigger reactive oxygen species and evade neutrophil killing // J Infect Dis. 2012; 206: 19361945.
14. Nobile C. J., Schneider H. A., Nett J. E. et al. Complementary adhesin function in C. albicans biofilm formation // CurrBiol. 2008; 18: 10171024.
15. Xu H., Jenkinson H. F., Dongari-Bagtzoglou A. Innocent until proven guilty: mechanisms and roles of Streptococcus-Candida interactions in oral health and disease // Mol Oral Microbiol. 2014; 29: 99116.
16. Nett J. E., Zarnowski R., Cabezas-Olcoz J. et al. Host contributions to construction of three device-associated Candida biofilms // Infect Immun. 2015; 83: 46304638.
17. Nobile C. J., Mitchell A. P. Microbial biofilms: e pluribus unum // CurrBiol. 2007; 17: 349353.
18. Zarnowski R., Westler W. M., Lacmbouh G. A. et al. Novel entries in a fungal biofilm matrix encyclopedia // MBio. 2014; 5: e0133314.
19. . ., . ., . . // . 2014; 16 (1): 104109.
20. Jack A. A., Daniels D. E., Jepson M. A. et al. Streptococcus gordoniicomCDE (competence) operon modulates biofilm formation with Candida albicans // Microbiology. 2015; 161: 411421.
21. Peters B. M., Noverr M. C. Candida albicanse Staphylococcus aureuspolymicrobial peritonitis modulates host innate immunity // Infect Immun. 2013; 81: 21782189.
22. Lindsay A. K., Hogan D. A. Candida albicans: molecular interactions with Pseudomonas aeruginosa and Staphylococcus aureus // Fungal Biol Rev. 2014; 28: 8596.
23. Van de Veerdonk F. L., Joosten L. A., Netea M. G. The interplay between inflammasome activation and antifungal host defense // Immunol Rev. 2015; 265 (1): 172180.
24. Chatzimoschou A., Simitsopoulou M., Antachopoulos C. et al. Differential effects of antifungal agents on expression of genes related to formation of Candida albicans biofilms // Mycoses. 2016; 59 (1): 4347.
25. Nobile C. J., Fox E. P., Nett J. E. et al. A recently evolved transcriptional network controls biofilm development in Candida albicans // Cell. 2012; 148: 126138.
26. Mathe L., Van Dijck P., Mathe L., Van Dijck P. Recent insights into Candida albicans biofilm resistance mechanisms // Curr Genet. 2013; 59: 251264.
27. Bonhomme J., dEnfert C. Candida albicans biofilms: building a heterogeneous, drug-tolerant environment // CurrOpinMicrobiol. 2013; 16: 398403.
28. Nyirjesy P. Management of Persistent Vaginitis // Obstet Gynecol. 2014; 124: 1. Acta Obstet Gynecol Scand. 2015 Sep; 94 (9): 989996. DOI: 10.1111/aogs.12697. Epub 2015, Jul 14. 135146.
29. Watson C. J., Pirotta M., Myers S. P. Use of complementary and alternative medicine in recurrent vulvovaginal candidiasisresults of a practitioner survey // Complement Ther Med. 2012; 20 (4): 218221.
30. . ., . . // . 2012; 7: 3136.
31. Aguin T. J., Sobel J. D. Vulvovaginal candidiasis in pregnancy // Curr Infect Dis Rep. 2015 Jun; 17 (6): 462. DOI: 10.1007/s1190801504620.
32. Farr A., Kiss H., Holzer I., Husslein P., Hagmann M., Petricevic L. Effect of asymptomatic vaginal colonization with Candida albicans on pregnancy. Outcome // Acta Obstet Gynecol Scand. 2015, Sep; 94 (9): 989996. Doi: 10.1111/aogs. 12697. Epub 2015, Jul 14.