Abstract:
Background: Pregnant women are susceptible to vaginal candidiasis and maternal vulvovaginal
candidiasis is a major risk factor for colonization and/or infection of the infant. The purpose of this
study was to determine the prevalence and antifungal patterns of albicans and non-albicans
Candida among pregnant women attending a tertiary referral hospital.
Methods: Vaginal discharge- cotton swabs were self-collected from pregnant women clinically
proven to have vulvovaginal candidiasis at the antenatal clinic of a tertiary referral hospital between
January and July 2018. Microscopy and culture on Sabouraud's Dextrose Agar with
chloramphenicol was done on the vaginal discharge-cotton swabs. Confirmatory fungal
identification was done using CHROM agarTM Candida. Antifungal susceptibility testing was carried
out using the standardized Kirby Bauer method.
Results: Candida were isolated from 50.81% (126/249) of the swabs and included C. albicans
(80.16%, 101/126), C. glabrata (19.05% (24/126) and C. krusei (0.79%, 1/126). Candida albicans
showed resistance to amphotericin B (70.63%, 89/126), clotrimazole (11.9%, 15/126), nystatin (3.17%, 4/126), fluconazole (23.02%, 29/126), and itraconazole (17.46%, 22/126). Among the nonalbican
Candida species, C. glabrata showed resistance to fluconazole (100% ,24/24),
amphotericin B (100% ,24/24), clotrimazole (14.29%, 18/24), nystatin (1.59%, 2/24), and
itraconazole (18.25%, 23/24). C. krusei showed resistance to fluconazole (100%, 1/1),
amphotericin B (100%,1/1), and itraconazole (100%, 1/1).
Conclusion: The candida species commonly associated with VVC in Eastern Uganda are C.
albicans C. glabrata and C. krusei. Antifungal resistance was highly prevalent among the candida
isolated. The use of CHROMagarTMCandida media for identification of clinically relevant Candida
should be adopted instead of conventional methods that are tedious and time consuming such that
treatment is based on laboratory evidence.
