Resistance of Candida albicans to antifungal drugs in Abidjan (Cote dIvoire)

This study aimed to evaluate the resistance levels of strains of Candida albicans to the antifungals commonly used in Abidjan, Cote d’Ivoire. This is a prospective study that was carried out from July to October 2017 at the mycology laboratory of the Institut Pasteur of Cote d’Ivoire. 105 Candida isolates, obtained from swabs taken from patients receiving out-patient treatment, were seeded on chromogenic medium. Identification of Candida species was carried out by MALDI-TOF mass spectrometry (Vitek MS bioMérieux). The susceptibility of C. albicans strains to 5-fluorocytosine, amphotericin B, fluconazole, itraconazole and voriconazole was evaluated using the microdilution technique in a semi-solid medium to determine the minimum inhibitory concentration with the ATB1 Fungus 3 kit. Out of 105 Candida strains, 68 (64.8%), including C. albicans, were identified on the chromogenic medium and confirmed by MALDI-TOF spectrometry. These C. albicans strains exhibited varying levels of resistance to the antifungals tested: 1.5% for 5-fluorocytosine, 26.3% for fluconazole, 39.7% for itraconazole, 27.9% for voriconazole. No resistance to amphotericin B was observed. C. albicans strains taken from ear pus swabs exhibited greater resistance (P = 0.0113). C. albicans is developing increasing resistance to common antifungals, hence the need for regular surveillance in resource-poor countries.