In vitro susceptibility of vaginal Candida albicans to antifungal drugs in Abidjan (Ivory Coast)

Objective. - The aim of this study was to evaluate in vitro susceptibility of vaginal Candida albicans to common antifungal drugs in Abidjan, Ivory Coast. Patients and methods. - From January to September 2008, 150 women with leucorrhoea were sampled for vaginal mycosis at the Pasteur Institute (Ivory Coast). Samples were analyzed by direct examination, Sabouraud-chloramphenicol and Sabouraud-chloramphenicol-actidione culture. C. albicans was identified after blastesis, chlamydosporulation and auxanogram tests. The susceptibility of this fungus to amphotericine B, 5-fluorocytosine, fluconazole, itraconazole and voriconazole was evaluated by a semi-solid medium microdilution technique: ATB(R) Fungus 3. Results. - Among 62 yeasts strains isolated, C. albicans represented 45 cases or 72.6%. Vaginal itching (P = 0.04) and urinary burning (P = 0.002) was statistically correlated with vaginal candidosis. We observed a range of susceptibility of C. albicans strains to antifungals: 100% to amphotericine B (CMI90 = 0.5 mu g/mL); 98% to 5-fluorocytosine (CMI90 = 4 mu g/mL); 86.7% to voriconazole (CMI50 = 0.06 mu g/mL) and 80% to fluconazole (CMI50 = 2 mu g/mL and CMI90 = 32 mu g/mL). However, only 46.7% of C. albicans strains were sensitive to itraconazole (CMI50 = 0.125 mu g/mL). Conclusion. - These results show that vaginal C. albicans remain sensitive to the most commonly antifungal drugs used in Abidjan. However, this susceptibility should be regularly monitored. (C) 2011 Elsevier Masson SAS. All rights reserved.