Candida colonization of the vagina of HIV-seropositive pregnant women and their seronegative counterparts at selected health-care centers in Akure, Ondo State, Nigeria

Ebhodaghe, B.I ; AKO-NAI, K .A ; Aderoba, A ; Anderson, W.A ; Kassem, O.O (2016-01)

 Annals of Tropical Medicine and Public Health,VOL;9,Issue;6,Page;10


Background: Candida colonization of the vagina is a risk factor in pregnancy. Candida isolates have been implicated in adverse pregnancy outcomes. The study determined the incidence of Candida species recovered from the vagina of HIV-seropositive and HIV-seronegative pregnant women that attended antenatal clinics in Akure, Ondo State between November 2014 and December 2015. Materials and Methods: Two hundred and forty pregnant women aged 19–43 participated in the study, which included 114 HIV-seropositive subjects with mean age 31.81 years and 126 HIV-seronegative subjects with mean age 29.05 years as controls. High vaginal swab was collected from each subject using sterile cotton-tipped applicator, streaked onto Mycological Agar - supplemented with streptomycin. Each sample was incubated 24 h for yeast and 72–120 h for the growth of molds. Yeast colonies that grew on Mycological Agar were picked and studied. Thereafter, colonies resembling Candida were identified using sugar assimilation and fermentation. Candida isolates were further speciated using Candida Ident Agar, modified. Antifungal resistance profile was identified with azoles, polyenes, echinocandins, flucytosine, and griseofulvin drugs. Antifungal resistant assay was determined by disc and agar well diffusion. Results: Altogether, 157 Candida isolates were recovered from HIV-seropositive and HIV-seronegative subjects. Candida albicans constituted 46.5%, Candida dubliniensis and Candida glabrata 15.3% each, Candida krusei 12.1%, Candida spp. 5.7%, and Candida tropicalis and Candida pseudotropicalis 2.5% each. Antifungal resistance was widespread with azoles, polyenes, echinocandins, flucytosine, and griseofulvin. Conclusion: C. albicans was the predominant isolate recovered (17.2% HIV-seropositive and 29.3% HIV-seronegative subjects). Widespread antifungal resistance seems high and suggests possible abuse of these drugs