Vaginal Candida colonization, species distribution, associated factors and antifungal susceptibility patterns among women attending Bowen University Teaching Hospital, Ogbomoso

Authors

  • Yemisi O. Adesiji Department of Medical Microbiology and Parasitology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
  • Aishat C. Eesuola Department of Biomedical Laboratory Science, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
  • Jemimah F. Olayiwola Department of Biomedical Laboratory Science, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
  • Tolulope J. Ogunniyi Department of Medical Laboratory Science, Thomas Adewumi University, Oko, Nigeria
  • Janet M. Oladejo Department of Medical Microbiology and Parasitology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
  • Olufemi O. Aworinde Department of Obstetrics and Gynaecology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
  • Richard O. Ojedele Research and Genomic Unit, Nigeria Centre for Disease Control and Prevention, Nigeria

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20262516

Keywords:

Nigeria, Risk factor antifungal profiling, Vaginal Candida colonization, Vulvovaginal candidiasis

Abstract

Background: Vaginal colonization by Candida species is prevalent among women and may serve as risk factor to vulvovaginal candidiasis (VVC), especially when the vaginal microbiota is disrupted. However, the prevalence of vaginal Candida colonization (VCC), associated risk factors, and antifungal patterns remain limited in Nigerian settings. This study aimed to determine the prevalence, associated factors, and antifungal patterns of vaginal Candida isolated among women attending Bowen University Teaching Hospital, Ogbomoso, Nigeria.

Methods: This hospital-based cross-sectional study enrolled 176 consenting symptomatic and asymptomatic women between June and November, 2025. Data were collected using a semi-structured questionnaire and High vaginal swabs (HVS) were collected from participants. The HVS samples were examined using microscopy, culture on Sabouraud Dextrose Agar, CHROMagar, and Internal Transcribed Spacer-Polymerase Chain Reaction (ITS-PCR) for confirmation of Candida. Antifungal profiling was assessed by disk diffusion on Mueller-Hinton agar supplemented with glucose and methylene blue. Data were analyzed using SPSS version 26, with statistical significance set at p≤0.05.

Results: Among the 176 participants, 48(27.3%) participants were positive for VCC.  Candida parapsilosis was the most frequent isolate, 25/48 (52.1%). In multivariate analysis, vaginal discharge (AOR=4.971, 95% CI: 1.485-16.646, p=0.009) and pregnancy (AOR=5.584, 95% CI: 1.344-23.209, p=0.018) were a strong significant predictor of Candida colonization. C. parapsilosis significantly emerged to be the most resistant to fluconazole (25(54.3%) (p=0.008).

Conclusions: VCC was common in this population, with predominance of C. parapsilosis. These findings provide local evidence supporting routine laboratory identification of Candida and antifungal testing, particularly in suspected, recurrent, persistent, or complicated VVC.

References

Denning DW, Kneale M, Sobel JD, Rautemaa-Richardson R. Global burden of recurrent vulvovaginal candidiasis: a systematic review. Lancet Infect Dis. 2018;(11):e339-47.

Farr A, Effendy I, Frey Tirri B, Hof H, Mayser P, Petricevic L, et al. Guideline: Vulvovaginal candidosis (AWMF 015/072, level S2k). Mycoses. 2021;(6):583–602.

Nyirjesy P, Brookhart C, Lazenby G, Schwebke J, Sobel JD. Vulvovaginal candidiasis: a review of the evidence for the 2021 centers for disease control and prevention of sexually transmitted infections treatment guidelines. Clin Infect Dis. 2022;(Supplement_2):S162-8.

Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L, et al. Clinical practice guideline for the management of candidiasis: 2016 update by the infectious diseases Society of America. Clin Infect Dis. 2015;(4):e1-50.

Sobel JD, Sobel R. Current treatment options for vulvovaginal candidiasis caused by azole-resistant Candida species. Exp Opini Pharmacoth. 2018;(9):971-7.

Adesiji Y, Ndukwe N, Okanlawon B. Isolation and antifungal sensitivity to Candida isolates in young females. Open Medi. 2011;(2):172-6.

Olowe O, Makanjuola O, Olowe R, Adekanle D. Prevalence of vulvovaginal candidiasis, trichomoniasis and bacterial vaginosis among pregnant women receiving antenatal care in Southwestern Nigeria. Euro J Microbiol Immunol. 2014;(4):193-7.

Nurat A, Ola B, Olushola S, Mikhail T, Ayodeji A. Molecular and phenotypic identification of Candida isolates from pregnant women in Ogbomoso, Southwestern Nigeria. Int J Reproduct Contracept Obstetr Gynecol. 2016;317-22.

Mbakwem-Aniebo C, Uche Osadebe A, Athanasonny E, Omezurike Okonko I. Prevalence of Candida spp. and age-related disparities amongst women presenting with vaginitis at the Obstetrics and Gynaecology (O&G) Clinic in a Tertiary hospital in Port Harcourt, Nigeria. Afr Heal Sci. 2020;(1):51-8.

Hussen I, Aliyo A, Abbai MK, Dedecha W. Vaginal candidiasis prevalence, associated factors, and antifungal susceptibility patterns among pregnant women attending antenatal care at bule hora university teaching hospital, Southern Ethiopia. BMC Pregnan Childb. 2024;(1).

Aguin TJ, Sobel JD. Vulvovaginal candidiasis in pregnancy. Curr Infect Dis Rep. 2015;(6).

Dong Z, Fan C, Hou W, Rui C, Wang X, Fan Y, et al. Vaginal exposure to Candida albicans during early gestation results in adverse pregnancy outcomes via inhibiting placental development. Fronti Microbiol. 2022;12:816161.

Sanguinetti M, Posteraro B, Lass‐Flörl C. Antifungal drug resistance among Candida species: mechanisms and clinical impact. Mycoses. 2015;(S2):2-13.

Ali M, Edrees WH, Al-Shehari WA, Xue G, Al-Hammadi S, Qasem EA, et al. Antifungal susceptibility pattern of Candida species isolated from pregnant women. Fronti Cell Infect Microbiol. 2024;14:1434677.

Brotman RM, Klebanoff MA, Nansel TR, Andrews WW, Schwebke JR, Zhang J, et al. A Longitudinal study of vaginal douching and bacterial vaginosis-a marginal structural modeling analysis. Am J Epidemiol. 2008;(2):188-96.

Egbuchulem KI. The basics of sample size estimation: an editor's view. Annals of Ibadan postgraduate medicine. 2023;21(1):5.

CLSI. Method for Antifungal Disk Diffusion Susceptibility Testing of Yeasts; Approved Guideline, 2009. Available at: https://webstore.ansi.org/preview-pages/CLSI/preview_M44-A2+Vol.+29+No.+17+.pdf. Accessed 04 June 2026.

Haron M, Omwenga EO, Musyoki S, Awuor SO. Incidence, antifungal resistance properties, and virulence traits of candida species isolated from HIV/AIDS patients from county hospitals in Kenya. PAMJ-One Heal. 2024;(15(6)).

Africa CWJ, Abrantes PM dos S. Candida antifungal drug resistance in sub-Saharan African populations: A systematic review. F1000Research. 2017;5:2832.

Weldegebreal F, Negesa AS, Ayana DA, Wilfong T, Dheresa M, Yadeta TA, et al. Bacterial vaginosis, vaginal Candida colonization and antifungal susceptibility patterns in pregnant women of eastern Ethiopia: a prospective study. Sci Rep. 2025;15(1):42059.

Tsega A, Mekonnen F. Prevalence, risk factors and antifungal susceptibility pattern of Candida species among pregnant women at Debre Markos Referral Hospital, Northwest Ethiopia. BMC Pregnan Childb. 2019;19(1):527.

Ghaddar N, Anastasiadis E, Halimeh R, Ghaddar A, Dhar R, AlFouzan W, et al. Prevalence and antifungal susceptibility of Candida albicans causing vaginal discharge among pregnant women in Lebanon. BMC Infect Dis. 2020;20(1):32.

Zangl I, Pap IJ, Aspöck C, Schüller C. The role of Lactobacillus species in the control of Candida via biotrophic interactions. Microbial Cell. 2020;(1):1-14.

Downloads

Published

2026-07-29

How to Cite

Adesiji, Y. O., Eesuola, A. C., Olayiwola, J. F., Ogunniyi, T. J., Oladejo, J. M., Aworinde, O. O., & Ojedele, R. O. (2026). Vaginal Candida colonization, species distribution, associated factors and antifungal susceptibility patterns among women attending Bowen University Teaching Hospital, Ogbomoso. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 15(8), 2914–2923. https://doi.org/10.18203/2320-1770.ijrcog20262516

Issue

Section

Original Research Articles