Vulvo-vaginal candidiasis at the Zion Clinical Laboratory (Yaounde-Cameroon): risk factors, species distribution and antifungal susceptibility testing.

BACKGROUND

Vulvovaginal candidiasis (VVC) is a common infection affecting women of reproductive age, associated with various risk factors. Advances in diagnosis and treatment are ongoing, but antifungal resistance remains a concern. This study aimed to evaluate risk factors, species distribution, and antifungal susceptibility of yeast isolates from reproductive-age women at Zion Clinical Laboratory, Yaoundé, Cameroon.

MATERIALS AND

METHODS

A total of 305 women suspected of vaginitis were enrolled. Socio-demographic and risk factor data were collected. Vaginal swabs were cultured on Sabouraud dextrose agar and CHROMagar Candida. Species identification was performed using MALDI-TOF mass spectrometry. Antifungal susceptibility testing was conducted with the Sensititre Yeast One kit to determine minimal inhibitory concentrations (MICs) for multiple antifungals.

RESULTS

The prevalence of VVC was 32.1 %, significantly associated with age (women aged 21 to 36 years showing higher susceptibility to VVC; P = 0.0001) and vaginal douching (P = 0.0004). Eleven yeast species were identified, with Candida albicans predominating (64.2 %), followed by C. orthopsilosis (15.1 %), Nakaseomyces glabratus (C. glabrata) (4.7 %), and C. tropicalis (3.8 %). Most isolates were highly susceptible (>90 %) to amphotericin B but showed reduced susceptibility to azoles, particularly fluconazole (Diflucan).

CONCLUSION

VVC affects nearly one-third of symptomatic reproductive-age women in this setting, with age and vaginal douching as significant risk factors. The predominance of C. albicans alongside diverse non-albicans species highlights the need for species-level identification. Reduced azole susceptibility stresses the importance of antifungal susceptibility testing to guide effective treatment and prevent resistance. Education on modifiable risk factors is also essential to reduce VVC incidence.