SHIFTING PATTERNS IN CANDIDA SPECIES AND RESISTANCE AMONG HEALTHY CARRIERS: INSIGHTS FROM A UNIVERSITY COHORT IN SOUTHERN NIGERIA

Abstract

Background:Yeast infection caused by overgrowth of Candida species, remains a significant global health concern due to increasing antifungal resistance and the emergence of non-albicans species.

Aim:This study aimed to determine the prevalence, species distribution, and antifungal susceptibility of Candida isolates among apparently healthy female students in Okada, Edo State, Nigeria.

Method: A cross-sectional study was conducted involving 120 undergraduate students aged 17-28 years selected through systemic random sampling. High vaginal swabs were collected and cultured on Sabouraud dextrose agar. Identification of isolates was based on cultural characteristics, microscopy, and germ tube test, while antifungal susceptibility was determined using broth dilution technique to establish minimum inhibitory concentrations (MICs).

Results: The overall prevalence of Candida carriage was 33.3%, with the highest occurrence observed among individuals aged 21–24 years (44.2%), showing a statistically significant association (p = 0.017). Non-albicans Candida species predominated (60%) over Candida albicans (40%), indicating an epidemiological shift. Antifungal susceptibility testing revealed complete sensitivity to fluconazole (100%), while high resistance rates were observed for ketoconazole (81.2%) and nystatin (56.2%). Metronidazole showed moderate activity (75%) but is not considered a standard antifungal agent.

Conclusion: The findings highlight a substantial burden of candida carriage and a growing dominance of resistant non-albicans species in the study population. These trends underscore the need for routine species identification and susceptibility testing to guide effective treatment. Enhanced surveillance and rational use of antifungal agents are essential to mitigate the spread of resistant Candida strains.