Species distribution and antifungal susceptibility pattern of candida isolates from pregnant women in a tertiary hospital in Nigeria

Abstract

Introduction: Information regarding the resistance pattern of Candida species in developing countries is limited. Most sensitivity studies were performed on few isolates and/or few antifungal agents using the disc diffusion method because of limited resources. Methods and Material: We evaluated six antifungal agents against Candida isolates recovered from the vagina of apparently healthy pregnant women using the E-test method. Results: One hundred and seventy Candida isolates recovered from 500 participants were identified and subjected to an antifungal susceptibility test. Candida albicans(53.5%) was the most common specie identified, followed by Candida glabrata(14.1%). C. albicans was mostly resistant to itraconazole (31.9%), with MIC 50 and 90 of 0.038 mg/L and 6 mg/L, respectively. Resistance to 5-fluorocytosine, fluconazole, and voriconazole was not observed for C. albicans. Caspofungin resistance was observed in 3 C. albicansand 1 C. glabrata isolates. Resistance to amphotericin B (50%) and itraconazole (100%) were the highest for C. glabrata. Flucytosine and voriconazole resistance was not observed in this study. Conclusion: The observed species diversity and the presence of C. albicans resistance to 3 of the 6 antifungal agents tested justify the need for a regular surveillance of the sensitivity pattern to antifungal drugs in Nigeria.

Species distribution and antifungal susceptibility patterns of Candida isolates from a public tertiary teaching hospital in the Eastern Cape Province, South Africa

“…This, in turn, leads to the selection of less susceptible isolates, with an inherent or acquired resistance to fluconazole, especially C. albicans and C. tropicalis isolates (8,9,12,13,27). The widespread use of fluconazole does not only lead to selection of antifungal drug resistant species, but also to a shift from C. albicans as the leading cause of candidiasis to non-albicans species such as C. glabrata and C. tropicalis as the causative agents of Candida infections (14,28). …”

“…The increase in isolation of non-albicans Candida species is in parallel with a decrease in the isolation of C. albicans . ( 1 , 14 , 18 , 20 )…”

“…Inocula from 24–48 h SAB-agar cultures were re-cultured onto commercially prepared ChromAgar Candida plates and incubated for 48–72 h at 37°C. Intense colony coloration was observed after incubation and species differentiation was done according to the manufacturer’s instructions ( 14 , 15 ).…”

“…The changes in the epidemiology of Candida species is in parallel with the emergence of antifungal drug resistant species. Antifungal drug resistance is associated with an uncontrolled distribution and prolonged use of antifungals to treat recurrent infections in immunocompromised patients ( 13 , 14 ). Furthermore, as it is imperative for laboratories to provide identification to the species level, there is continued isolation of new species which are resistant to currently available antifungals.…”

Antifungal resistance of candida species isolated from HIV patients in a tertiary care hospital, Mysuru, Karnataka

“…Increased infections, prolonged use of antifungals to treat recurrent infections and the emergence of antifungal resistance have created the need for antifungal susceptibility testing. [ 1 2 ] The knowledge about the effects and burden of antifungal resistance is less compared to that of antibiotic-resistant bacterial infections, which are widely recognized as a public health problem. [ 3 ] This highlights the need to understand the reasons for their emergence, create awareness among medical and public health communities about these infections, and greater attention to prevent and control them.…”