Distribution of Candida Species and Their Susceptibility to Antifungal Drugs in Dakar, Senegal

The large spectrum of Candida species and their susceptibility to antifungal drugs has made the identification of Candida species and the detection of drug resistance necessary for the management of Candida infection. This study was carried out to determine the distribution of Candida species and to evaluate their susceptibility to antifungal drugs. A prospective observational and descriptive study was conducted from March to June 2016 in the laboratory of Parasitology-Mycology at Fann University Hospital in Dakar. Samples were analyzed by direct microscopy and culture. Identification of Candida species was based on filamentation test, chlamydosporulation formation, auxanogramme (AUXACOLORTM Bio-Rad) and Candi-Select® 4 (Bio-Rad,). The susceptibility of Candida species to antifungal drugs was tested using Fungitest® (Bio-Rad) against 5-fluorocytosine, amphotericin B, miconazole, ketoconazole, itraconazole and fluconazole. A descriptive analysis was performed using Stata MP 14. Among 336 specimens received for mycological examination, 68 (20.2%) were positive for Candida. The most identified Candida species were C. albicans (58.8%), C. glabrata (16.2%), C tropicalis (7.4%), C krusei (7.4%), C. parapsilosis (4.4%), C. dubliniensis (4.4%) and C. kefyr (1.5%). The majority of isolates were susceptible to ketoconazole (94.3%), fluconazole (85.7%), amphotericin B and 5 fluoro-cytosine (88.6%). The susceptibility rates were lower for itraconazole (51.4%) and miconazole (68.6%). One strain of C. albicans was resistant to 5 fluoro-cytosine, one strain of C. glabrata and C. tropicalis were resistant to itraconazole. The results of this study provide useful information regarding the distribution of Candida species and the susceptibility to antifungal drug. Routine identification of Candida species and monitoring of resistance patterns are necessary to manage Candida infection and to control the spread of resistance in clinical isolates of Candida species.