Distribution and Antifungal Resistance Profile of <i>Candida</i> spp. Isolated from Patients Living with HIV at the Yaoundé Central Hospital

Abstract

Background and Purpose: Candidiasis are the most frequent fungal infection, especially in immunocompromised people such as patients living with the human immunodeficiency virus (PLHIV). Data on the fungal prevalence and antifungal resistance rate particularly in PLHIV in Cameroon are scarce. This study aimed to determine the distribution and the antifungal resistance profile of<i> Candida </i>spp. isolated from clinical samples of PLHIV visiting the laboratory service of the Yaoundé Central Hospital. Materials and Methods: A cross-sectional study was carried out on the PLHIV visiting the Central Hospital of Yaoundé laboratory service. Samples were collected according to the signs and symptoms recorded by the patient and inoculated onto Sabouraud + Chloramphenicol agar medium for 24 hours incubation at 35°C ± 2°C. Typical <i>Candida</i> colonies were subjected to a germ tube test to identify <i>Candida albicans</i> and the other species were identified biochemically using API Candida (BioMérieux). The antifungal susceptibility testing was carried out by the disk diffusion method and seven antifungal discs (Bioanalyse) were tested. Results: Overall, 106 unique samples were obtained from participants. The positivity rate of <i>Candida </i>spp. was 37.7%. <i>Candida</i> isolates were mostly recovered from sputum (n=15/40) followed by the oral swabs (n=10/40) and the vaginal swabs (n=08/40). Out of the 40 isolates, <i>Candida albicans</i> was the predominant species 57.5% followed by <i>Candida krusei </i>15%, <i>Candida glabrata </i>and <i>Candida guilliermondii</i> 10% each and <i>Candida famata </i>7.5%. The antifungal drug resistance profile of <i>Candida</i> spp. revealed the highest resistance rates to Amphotericin B (95.0%), Fluconazole (57.5%) and Nystatin (42.5%). Conversely, Clotrimazole, Miconazole and Econazole were the most effective against <i>Candida</i> spp. Conclusion: The high frequency of <i>Candida </i>spp. isolation, resistant to several commonly used antifungals among PLHIV in a hospital setting is a direct call for stakeholders, policymakers and clinicians about antifungal therapy awareness in this vulnerable population.