Non-Albicans Candida among Symptomatic Vulvovaginal Candidiasis Women in Onitsha, Nigeria

Ejike Chinwe E1; Agbakoba Nneka R2; Ezeanya Chinyere C3; Emele Felix E4; Oguejiofor Charlotte B5

1Department of Medical Microbiology, Chukwuemeka Odimegwu Ojukwu University, Awka Campus, Nigeria. 2Department of Medical Laboratory Science, Nnamdi Azikiwe University, Nnewi Campus. Nigeria.

3Department of Medical Microbiology, Edo University Iyamho, Edo State, Nigeria.

4Department of Medical Microbiology and Parasitology, Nnamdi Azikiwe University, Nnewi Campus, Nigeria

5Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Nnewi Campus, Nnewi, Nigeria.

Corresponding Author: Ezeanya Chinyere C

ABSTRACT

Background: Non-albicans Candida (NAC) species have emerged as important causes of Vulvovaginal candidiasis (VVC) among women of reproductive age. The aim of this study was to establish an association between NAC and symptomatic VVC among female patients in Onitsha, Nigeria. Method: High vaginal specimens from a total of 876 women were evaluated mycologically by standard methods, involving microscopic examination and culture using sabouraud dextrose agar (SDA) and Brilliance Candida agar. Susceptibility of isolates to fluconazole and itraconazole were tested using agar dilution method. Result: Of the 876 samples; yeasts were isolated in 484 (55.3%). The overall occurrence of Non-albicans Candida species was 45%: Candida glabrata (18.2%), Candida krusei (11.6%), Candida tropicalis (4.1%) and Candida dubliniensis (4.1%) and other non-albicans (7%). Among the subjective symptoms presented, vulval pruritus was the commonest (81%), followed by vaginal discharge (70%). High resistance to Itraconazole was observed among non-albicans increasingly involved in VVC. C. tropicalis, C. dubliniensis, C. krusei and C. glabrata showed 100%, 50%, 40% and 25% resistance to Itraconazole respectively. Susceptibility to Fluconazole was 100%. Conclusion: The epidemiological study revealed that NAC is associated with symptomatic VVC. Vulvovaginal Candidiasis is of serious public health concern which affects millions of women annually. Non-albicans Candida has gradually been characterized as the cause of VVC thus posing an emerging threat.

Keywords: Symptomatic Vulvovaginal Candidiasis, Non-albicans Candida species, Fluconazole, Itraconazole