Antifungal resistance among Candida species from patients with genitourinary tract infection isolated in Benin City, Edo state, Nigeria

Abstract

Even though there are abundant documented works on the prevalence of Candidaspecies affecting the genitourinary tracts in Nigeria, yet data on their susceptibilities to antifungal agents are lacking. To determine the antifungal resistance amongCandida species from the genitourinary tracts, 439 urine and high vaginal swab (HVS) samples collected from April to September, 2008 from female patients clinically diagnosed of genitourinary tract infection were inoculated onto Sabouraud dextrose agar (SDA). Isolates from SDA were plated on CHROMagar to ensure detection of mixed cultures. Germ tube and carbohydrate assimilation tests performed were necessary for isolate identification. Susceptibility testing was carried on the isolates using broth dilution method. The occurrence rate of Candida species were as follows: Candida albicans 138(63.9%), Candida glabrata 68(31.5%),Candida krusei 6(2.9%) and Candida tropicalis 4(1.9%). The rate of occurrence ofCandida species in high vaginal swab (82.9%) was significantly higher than that of urine (17.7%) using Chi-square test for statistical analysis. Distribution of Candidaspecies among different age groups showed the highest incidence in age brackets 26 - 35, followed by 16 - 25, while the ages of 46 and above had the least. High rate of susceptibility was observed for each isolate against fluconazole (97.2%) and ketoconazole (94.9%). The resistance rate was low for fluconazole (2.8%) and ketoconazole (5.6%). These results incriminated C. albicans as the most commonCandida species causing genitourinary tract infection in women. This surveillance study has established fluconazole and ketoconazole as very effective antifungal agents for the treatment of genitourinanry tract infections caused by Candidaspecies. Key words: Genitourinary tract infection, Candida species, antifungal resistance, ketoconazole, fluconazole.