Antimicrobial Susceptibility of Candida Species Isolated from HIV Patients with Vulvovaginal Candidiasis in Niamey Republic of Niger

Abstract

Aims: Vulvovaginal candidiasis (VVC) is a prevalent fungal infection. This study aimed to identify the Candida species causing VVC in HIV-positive women in Niamey, Niger Republic, and assess their susceptibility to antifungal treatments. Study Design: Cross-sectional study. Place and Duration of Study: Three tertiary care hospitals of HIV management in Niamey, Niger, from March 2023 to April 2024. Methodology: It is a Cross-sectional study. The study was conducted at Department of Microbiology, Nassarawa State University, Keffi, and tree tertiary hospitals of HIV management in Niamey, Niger, from March 2023 to April 2024. A standardised questionnaire was administered to each participant to gather data on patient demographics and clinical manifestations. Vaginal swabs from 333 women infected with HIV were cultured, and Candida species were isolated and identified using chromatic TM candida and Vitek Antifungal susceptibility testing was done using Vitek 2. Results: The prevalence of vulvovaginal candidiasis (VVC) was 26.12% (n=87) among women living with HIV. The main Candida species isolated were C. albicans (31.03%; n=27), followed by C. krusei (21.83%; n=19), C. glabrata (18.39%; n=16), C. tropicalis (9.19%; n=8), and C. guilliermondii (8.16%; n=3). Most isolates were sensitive to voriconazole (98.61%), micafungin (95.83%), caspofungin, and amphotericin B (91.66%). However, isolates showed lower sensitivity to fluconazole (81.94%) and flucytosine (70.83%). C. glabrata and C. krusei were highly resistant to fluconazole and flucytosine. Conclusion: This study highlights the prevalence of VVC among HIV-positive women in Niamey, Niger, with C. albicans being the most common. Most Candida species were resistant to fluconazole and flucytosine. Overall, this study provided insights for enhancing the management and treatment of VVC in Niger Republic. Therefore, there is a need for routine susceptibility testing, targeted health education, and tailored interventions.