EPIDEMICS AND SUSCEPTIBILITY OF DRUGS USED ON VULVOVAGINITIS IN WOMEN IN FOUR STATES OF NORTH CENTRAL NIGERIA

Abstract

The occurrence of Vulvovaginal Candidiasis (VVC) and antifungal resistance to antifungal agents during the last two decades has increased.This study determined the specie distribution and their antifungal susceptibility pattern from cases of vulvovaginitis in women using contraceptives in four selected States of North Central Nigeria. A total of 1600 High Vaginal Swabs (HVS) were collected from women using contraceptive device from the study area. Inoculation and culture was made unto Sabouraud Dextrose Agar (SDA) medium and CHROM agar. Colonies were examined using direct, lactophenol cotton blue and Germ tube test. Susceptibility test to antifungals (Nystatin, Voriconazole, Fluconazole) was performed with commercially prepared antifungal disks. Five species of Candida were isolated from 710 women with Vulvovaginal Candidiasis. Candida albicans was the most frequent isolate which accounted for 43.23% of the species isolated. Out of the non-albicans Candida species 19.01% were C. glabrata, 15.77% for C. tropicalis, 8.87% for C. parapsilosis and C. krusei accounted for 13.09% of the total isolates. C. albicans was 100% susceptible to Nystatin, 92.1% susceptible to Voriconazole, and 71.0% susceptible to fluconazole while 28.9% was resistant to fluconazole. All isolates of C. glabrata were 100% susceptible to Nystatin, Voriconazole and Fluconazole. Candida tropicaliswas susceptible to nystatin (53.5%), voriconazole (85.7%) and fluconazole (100%). However, some isolates of C. tropicalis were 46.4% and 14.3% resistant against nystatin and voriconazole. Candida parapsilosis was 100% susceptible to nystatin and fluconazole while 82.5% were susceptible to voriconazole. Candida krusei was 100% susceptible to Nystatin but 100% resistant to Voriconazole and Fluconazole. The need for confirmation of Candida species and routine antimicrobial susceptibility testing before initiation of therapy is highly recommended.