Resistance of Candida isolates to antifungals using VITEK system at the Rodolphe Mérieux Centre, Bamako, Mali

Abstract Candidiasis is a public health problem and resistance of Candida genus to antifungals is increasing and reported in human pathology. In Mali, few data exist on the resistance of Candida genus to antifungals. The study aim was to assess the resistance of Candida sp isolates to antifungals at the Charles Mérieux Infectious Disease Center (CICM) laboratory in Bamako. Two cross-sectional studies were conducted, one retrospective from January 1, 2009 to December 31, 2018 and the other prospective from January 1, 2019 to December 31, 2019. Samples of superficial lesions (swabs, nail samples, scales from the scalp and skin, diseased hair) were taken at the CICM laboratory as well as the deep samples (CSF, bronchoalveolar lavage: BAL, etc.) received from hospital and community health care centers. Fungal growth on Sabouraud-chloramphenicol medium were carried out. Candida species identification and in vitro antifungals susceptibility testing were performed on Vitek-2 COMPACT. Out of 1224 strains of Candida isolated, 84.80% were obtained from vaginal swabs, and 10.40% from pus. Candida albicans was the most frequently isolated species (67.65%). Candida. krusei the species most resistant to flucytosine (36.96%), followed by Candida lusitaniae (12.5%), Candida tropicalis (3.22%) and C. albicans (1.42%). Candida rugosa was more resistant to amphotericin B (20%), followed by C. krusei (4.17%), Candida glabrata (0.81%) and C. albicans (0.77%). The strains isolated were sensitive to miconazole, nystatin, clotrimazole, econazole and caspofungin. These results show an emergence of resistance from some Candida species to antifungals that deserve regular monitoring.