Prevalence and Antifungal Susceptibility of Candida spp. Amongst Pregnant Women in Two Hospitals in N'Djamena (Chad)

Abstract

Background and Objective:The lack of epidemiological data on vulvovaginal candidiasis in pregnant women in Chad is a real public health problem.This study aimed to provide baseline information on the existence of vulvovaginal candidiasis in pregnant women.Materials and Methods: A cross-sectional analytical study was conducted at the Mother and Child University Teaching Hospital and the Hospital Our Lady of the Apostles in N'Djamena (Chad).The cervicovaginal swab was taken and used for mycological examination.A total of 168 samples were cultured on Chrom Agar Candida medium for isolation and identification of Candida species.Five antifungal agents including amphotericin B (AMB), ketoconazole (KTC), fluconazole (FLU), nystatin (NY), and miconazole (MCZ) were used to test the sensitivity of the field isolates.The dilution technique was used for antifungal susceptibility testing on the Sabouraud medium.The data were analyzed using SPSS 26 software and potential risk factors were evaluated with the administration questionnaire using a binary logistic regression model.Statistical signi cance was measured at p<0.05.Results: Of the 168 vaginal swabs taken, 79 were positive for Candida spp., presenting a prevalence of 47.02% of vulvovaginal candidiasis in pregnant women in Chad with the Hospital Our Lady of the Apostles in N'Djamena and the Mother and Child University Teaching Hospital presenting a prevalence of 89.60 and 11.39%, respectively.Identification of yeast isolates showed that C. albicans was the majority species (65.82%), followed by C. krusei (27.64%),Candida spp.(5.06%), and C. tropicalis (1.26%).Risk factors for vulvovaginal candidiasis were primiparous women, multiparous women, and women aged 15-22 years.The antifungal sensitivity of the isolates showed total resistance to Amphotericin B 100% in all species.Conclusion: Multispecies vulvovaginal candidiasis was found in pregnant women in this study.Amphotericin B showed resistance to contact with isolated Candida.It is therefore important that amphotericin should not be prescribed for the treatment of vulvovaginal candidiasis.