Prevalence and Antifungal Susceptibility of Candida Species Isolated from HIV Seropositive Women Attending Gynecological Clinic in Kaduna, Nigeria

Abstract

Context:Candidal vulvovaginitis causes discomfort and increased HIV infectivity because viral shedding is increased among these women.Aim:To determine the prevalence of Candida infections among HIV seropositive women in the special treatment (STC) and the gynecological clinics of Barau Dikko Teaching Hospital and the antifungal susceptibility patterns of the isolates.Study Design:We conducted a cross-sectional study among HIV-positive women accessing care in our hospital.Methods and Materials:A total of 312 high vaginal swabs (HVS) were collected from HIV seropositive women with clinical features of vulvovaginitis between February and July 2019. Wet mount preparations in potassium hydroxide (KOH) and Gram stained smears were performed directly on specimens. Cultures for Candida species were performed using Sabouraud dextrose agar (SDA) (Oxoid, UK) at room temperature (28°C) and in the incubator at 37 °C. Antifungal susceptibility of the Candida species to amphotericin B, clotrimazole, fluconazole, and miconazole was assessed using the ATB FUNGUS 4 test kits (bioMerieux, Marcy l'Etoile, France).Statistical Analysis Used:Data collected were analyzed using SPSS, Version 23.Results:Out of the 312 HVS cultured, 40 yielded Candida species giving a point prevalence of 12.8% in the study population. Candida species isolated from HVS specimens wereCandida tropicalis(n= 14, 4.5%),Candida glabrata(n= 13, 4.2%),Candida krusei(n= 11, 3.5%),Candida dubliniensis(n= 1, 0.3%), and othersC. glabrata/C. tropicalis(n= 1, 0.3%). Susceptibility of the isolates to antifungal agents ranged from 27.5% to 52.5%. Amphotericin B was the best performing antifungal agent with a sensitivity of 52.5%.Conclusion:The prevalence from our study was low compared to other studies among HIV seropositive women.