Incidence, Virulence Markers and Antifungal Susceptibility Profile of Candida Species among Contraceptive Users in Benue and Niger States, Nigeria

Abstract

Candida species are responsible for vulvovaginal candidiasis and resistance to antifungal drugs is a challenge. This study determined the incidence of vaginal candidiasis, antifungal susceptibility pattern and virulence markers of Candida species among contraceptive users. A total of 800 High Vaginal Swabs (HVS) were collected from women using contraceptive devices and inoculated onto Sabouraud Dextrose Agar (SDA) medium and CHROM agar. Candidal colonies were examined using lactophenol cotton blue and Germ tube test. The isolates were then subjected to a disc diffusion method using voriconazole, nystatin, and fluconazole on Mueller-Hinton agar to determine the susceptibility pattern of the isolates. Virulence markers which include heamolytic activity, coagulase production and biofilm formation were determined using standard microbiological methods. The incidence of vulvovaginal candidiasis in the study area is 44.88%. Candida albicans (33.98%) was the most frequent isolate while a preponderance of C. glabrata (16.99%) was observed among non-albicans Candida species. All the Candida species demonstrated at least one of the virulence markers, except C. parapsilosis which did not produce biofilm. Candida albicans and Candida tropicalis were 100% susceptible to nystatin, voriconazole and fluconazole. All the Candida glabrata isolates were susceptible (100%) to the three antifungal drugs. Candida parapsilosis and Candida krusei were 100% susceptible to nystatin. This current study revealed the incidence and the distribution of Candida species among contraceptive users. The isolates showed varying susceptibility patterns to the drugs except Candida krusei which was 100% resistant to voriconazole and fluconazole.