Vulvovaginal Candidiasis: Profile of Antifungal Susceptibility Test of Candida Strains to Antifungal Drugs from 2018 to 2022, Ouagadougou, Burkina Faso
Background: Vulvovaginal candidiasis (VVC) is a common cause of significant morbidity, affecting millions of women worldwide. It is estimated that approximately 75%of women of childbearing age will have at least one episode of candidiasis in their lifetime. In the last decades, resistance to azoles has become a public health problem. Although studies on vulvovaginitis have been done, there is lack of VVC studies in our area. The aim of this study was to describe the etiological and resistance profiles of vulvovaginal candidiasis to standard antifungus at the Saint Camille Hospital of Ouagadougou (HOSCO), Burkina Faso. Methods: We conducted a prospective study from January 2018 to December 2022. From vulvovaginal swabs, Candida species were identified using the ChromID？ Candida Agar medium and the API？ Candida gallery. Antifungal susceptibility testing was performed using Kirby-Bauer agar disk diffusion. Results: A total of 4789 women were sampled. The average age of sexually active women was 27.80+/？6.77 years, with extremes ranging from 15 to 64 years. Vaginal Candida infections accounted for 74.16% of the cases. The 20 - 29 age group was the most affected by vulvovaginal candidiasis. Pregnant women accounted for 28.76% of our study population. Women in the second (2nd) trimester of pregnancy had more Candida infections. Candida albicans was the most isolated species (55.12%), followed by Candida glabrata (27.64%), Candida tropicalis (6.91%), Candida famata (6.67%), Candida krusei (2.56%). All the Candida species isolated showed very high of resistance to Fluconazole (45.2%), Miconazole (23.7%) and Clotrimazole (45.7%). Conclusion: Species-specific antifungal results should always be considered to avoid antifungal resistance associated with vulvovaginal candidiasis. Identifying the causative species using vaginal fungal cultures can help guide therapy and improve outcomes for these patients.
References
[1]
Boyd Tressler, A., Markwei, M., Fortin, C., Yao, M., Procop, G.W., Soper, D.E., et al. (2021) Risks for Recurrent Vulvovaginal Candidiasis Caused by Non-Albicans Candida versus Candida albicans. Journal of Women’s Health, 30, 1588-1596. https://doi.org/10.1089/jwh.2020.8811
[2]
Djohan, V., Angora, K.E., Vanga-Bosson, A.H., Konaté, A., Kassi, K.F., Kiki-Barro, P.C.M., et al. (2019) Recurrent Vulvo-Vaginal Candidiasis in Abidjan (Côte D’ivoire): Aetiology and Associated Factors. Journal de Mycologie Médicale, 29, 127-131. https://doi.org/10.1016/j.mycmed.2019.04.002
[3]
Bamba, S., Zida, A., Sangaré, I., Cissé, M., Denning, D. and Hennequin, C. (2018) Burden of Severe Fungal Infections in Burkina Faso. Journal of Fungi, 4, Article No. 35. https://doi.org/10.3390/jof4010035
[4]
Farhan, M.A., Moharram, A.M., Salah, T. and Shaaban, O.M. (2018) Types of Yeasts That Cause Vulvovaginal Candidiasis in Chronic Users of Corticosteroids. Medical Mycology, 57, 681-687. https://doi.org/10.1093/mmy/myy117
[5]
Al-Rusan, R.M., Darwazeh, A.M.G. and Lataifeh, I.M. (2017) The Relationship of Candida Colonization of the Oral and Vaginal Mucosae of Mothers and Oral Mucosae of Their Newborns at Birth. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 123, 459-463. https://doi.org/10.1016/j.oooo.2017.01.003
[6]
Mtibaa, L., Fakhfakh, N., Kallel, A., Belhadj, S., Belhaj Salah, N., Bada, N., et al. (2017) Vulvovaginal Candidiasis: Etiology, Symptomatology and Risk Factors. Journal de Mycologie Médicale, 27, 153-158. https://doi.org/10.1016/j.mycmed.2017.01.003
[7]
World Health Organization (2022) WHO Fungal Priority Pathogens List to Guide Research, Development and Public Health Action.
[8]
Morio, F., Jensen, R.H., Le Pape, P. and Arendrup, M.C. (2017) Molecular Basis of Antifungal Drug Resistance in Yeasts. International Journal of Antimicrobial Agents, 50, 599-606. https://doi.org/10.1016/j.ijantimicag.2017.05.012
[9]
Tovo, S.F., Ouattara, A., Yonli, A.T. and Djigma, W.F. (2019) Prevalence of Lower Genital Tract Infections in Women: Case of Saint Camille Hospital of Ouagadougou from 2015 to 2018. International Journal of Current Research, 11, 7721-7727.
[10]
Dovo, E.E., Zohoncon, T.M., Tovo, S.F., Soubeiga, S.T., Kiendrebeogo, I.T., Yonli, A.T., et al. (2022) First Detection of Mutated ERG11 Gene in Vulvovaginal Candida albicans Isolates at Ouagadougou/Burkina Faso. BMC Infectious Diseases, 22, Article No. 678. https://doi.org/10.1186/s12879-022-07619-5
[11]
Dembélé, R., Kagambega, A.B., et al. (2021) Prevalence and Characterization of Bacterial and Yeast Vaginal Infections in a Public Health Institution of Ouagadougou, Burkina Faso. Archives of Clinical Microbiology, 12, 147-151.
[12]
Zida, A., Yacouba, A., Bamba, S., Sangare, I., Sawadogo, M., Guiguemde, T., et al. (2017) In Vitro Susceptibility of Candida albicans Clinical Isolates to Eight Antifungal Agents in Ouagadougou (Burkina Faso). Journal de Mycologie Médicale, 27, 469-475. https://doi.org/10.1016/j.mycmed.2017.07.001
[13]
Gruénais, M. (2004) Les qualités de l’offre de soins confessionnelle en Afrique subsaharienne. Autrepart, 29, 29-46. https://doi.org/10.3917/autr.029.0029
[14]
Procop, G.W., et al. (2018) Method for Antifungal Disk Diffusion Susceptibility Testing of Yeasts.
[15]
CLSI (2009) M44-A2: Method for Antifungal Disk Diffusion Susceptibility Testing of Yeasts; Approved Guideline. 2nd Edition.
[16]
Mbakwem-Aniebo, C., Uche Osadebe, A., Athanasonny, E. and Omezurike Okonko, I. (2020) Prevalence of Candida Spp. and Age-Related Disparities Amongst Women Presenting with Vaginitis at the Obstetrics and Gynaecology (O&G) Clinic in a Tertiary Hospital in Port Harcourt, Nigeria. African Health Sciences, 20, 51-58. https://doi.org/10.4314/ahs.v20i1.9
[17]
Venugopal, D., Husain, K., Mustafa, S.A. and Sabeen, S. (2021) Epidemiology, Risk Factors and Antimicrobial Profile of Vulvovaginal Candidiasis (VVC): A Study among Women in the Central Region of Saudi Arabia. Journal of Medical Mycology, 31, Article ID: 101049. https://doi.org/10.1016/j.mycmed.2020.101049
[18]
Waikhom, S.D., Afeke, I., Kwawu, G.S., Mbroh, H.K., Osei, G.Y., Louis, B., et al. (2020) Prevalence of Vulvovaginal Candidiasis among Pregnant Women in the Ho Municipality, Ghana: Species Identification and Antifungal Susceptibility of Candida Isolates. BMC Pregnancy and Childbirth, 20, Article No. 266. https://doi.org/10.1186/s12884-020-02963-3
[19]
Faria-Gonçalves, P., Rolo, J., Gaspar, C., Palmeira-de-Oliveira, R., Martinez-de-Oliveira, J. and Palmeira-de-Oliveira, A. (2021) Virulence Factors as Promoters of Chronic Vulvovaginal Candidosis: A Review. Mycopathologia, 186, 755-773. https://doi.org/10.1007/s11046-021-00592-8
[20]
Nyoyoko, V., Christopher, M., Antia, U. and Eyo, I. (2021) Prevalence of Vulvovaginal Candidiasis in Pregnant Women. Microbes and Infectious Diseases, 3, 714-719. https://doi.org/10.21608/MID.2021.87167.1175
[21]
Sy, O., Diongue, K., Ahmed, C.B., Ba, O., Moulay, F.C., Lo, B., et al. (2018) Candidoses vulvo-vaginales chez les femmes enceintes au centre hospitalier Mère et Enfant de Nouakchott (Mauritanie). Journal de Mycologie Médicale, 28, 345-348. https://doi.org/10.1016/j.mycmed.2018.02.006
[22]
Mulinganya, G., De Vulder, A., Bisimwa, G., Boelens, J., Claeys, G., De Keyser, K., et al. (2021) Prevalence, Risk Factors and Adverse Pregnancy Outcomes of Second Trimester Bacterial Vaginosis among Pregnant Women in Bukavu, Democratic Republic of the Congo. PLOS ONE, 16, e0257939. https://doi.org/10.1371/journal.pone.0257939
[23]
Ogouyèmi-Hounto, A., Adisso, S., Djamal, J., Sanni, R., Amangbegnon, R., Biokou-Bankole, B., et al. (2014) Place des candidoses vulvo-vaginales au cours des infections génitales basses et facteurs de risque associés chez les femmes au Bénin. Journal de Mycologie Médicale, 24, 100-105. https://doi.org/10.1016/j.mycmed.2014.01.003
[24]
Fahami, R. (2013) Abnormal Vaginal Discharge. BMJ, 347, f4975. https://doi.org/10.1136/bmj.f4975
[25]
Nadembega, C., Djigma, F., Ouermi, D., Karou, S. and Simpore, J. (2017) Prevalence of Vaginal Infection in 15 to 24 Years Women in Ouagadougou, Burkina Faso. Journal of Applied Pharmaceutical Science, 7, 209-213. https://doi.org/10.7324/japs.2017.70131
[26]
Djohan, V., Angora, K.E., Vanga-Bosson, A.H., Konaté, A., Kassi, F.K., Yavo, W., et al. (2012) Sensibilité in Vitro des souches de Candida albicans d’origine vaginale aux antifongiques à Abidjan (Côte d’Ivoire). Journal de Mycologie Médicale, 22, 129-133. https://doi.org/10.1016/j.mycmed.2011.11.005
[27]
Waikhom, S.D., Afeke, I., Kwawu, G.S., Mbroh, H.K., Osei, G.Y., Louis, B., et al. (2020) Prevalence of Vulvovaginal Candidiasis among Pregnant Women in the Ho Municipality, Ghana: Species Identification and Antifungal Susceptibility of Candida Isolates. BMC Pregnancy and Childbirth, 20, Article No. 266. https://doi.org/10.1186/s12884-020-02963-3
[28]
Sangaré, I., Sirima, C., Bamba, S., Zida, A., Cissé, M., Bazié, W.W., et al. (2018) Prevalence of Vulvovaginal Candidiasis in Pregnancy at Three Health Centers in Burkina Faso. Journal de Mycologie Médicale, 28, 186-192. https://doi.org/10.1016/j.mycmed.2017.08.006
[29]
Agbedo, E.S., Osumah, O.R., Woghiren, E.P. and Omusi, I.P. (2023) Prevalence of Candida albicans among Pregnant and Non-Pregnant Women Attending a Medical Facility in Oredo, Edo State, Nigeria. Journal of Applied Sciences and Environmental Management, 27, 101-105. https://doi.org/10.4314/jasem.v27i1.15
[30]
Osman Mohamed, A., Suliman Mohamed, M., Hussain Mallhi, T., Abdelrahman Hussain, M., Ali Jalloh, M., Ali Omar, K., et al. (2022) Prevalence of Vulvovaginal Candidiasis among Pregnant Women in Africa: A Systematic Review and Meta-Analysis. The Journal of Infection in Developing Countries, 16, 1243-1251. https://doi.org/10.3855/jidc.15536
