Vulvovaginal Candidiasis in Pregnant Women: Antifungal Susceptibility Insights | IJMM 2025

Kpongbo Etienne Angora,  Matenin Ouattara,  Maurine Aline N’guiachi,  Salifou Koné,  N’drin Effoh, Vincent Djohan, Hervé Eby Menan, and  Adèle Kacou N’douba, from the institute of the Côte d’Ivoire. Wrote a research paper about, Vulvovaginal Candidiasis in Pregnant Women: Antifungal Susceptibility Insights. Entitle, Vulvovaginal candidiasis and antifungal susceptibility patterns among pregnant women at the university hospital of Angré, Abidjan, Côte d’Ivoire. This research paper published by the International journal of Microbiology and Mycology | IJMM.an open access scholarly research journal on Microbiology. under the affiliation of the International Network For Natural Sciences| INNSpub. an open access multidisciplinary research journal publisher.

Abstract

Vulvovaginal candidiasis is a frequent reason for consultation in gynecology. Few studies have been conducted in pregnant women, even though they may be asymptomatic. This study aimed to determine the epidemiological profile of vulvovaginal and antifungal susceptibility patterns among pregnant women at the university teaching hospital of Angré in Abidjan. This cross-sectional study was carried out in the gynecology-obstetrics department of the Angré University Hospital from June to October 2024. Swabs were taken from Pregnant women for mycological analyses. Each sample was examined directly and cultured at 37°C on Sabouraud-Chloramphenicol medium. Candida yeasts were identified using Chromagar Candida medium or Vitek 2. Antifungal susceptibility was determined using the agar diffusion method with discs. Of total of 402 women included, 70 were positive on culture, representing an overall vaginal candidiasis carriage rate of 19.2%. The yeast species identified were Candida albicans (48.1%), Candida krusei (27.8%), Candida tropicalis (12.7%), and Candida glabrata (11.4%). Symptoms such as vaginal discharge, vulvar pruritus, and dyspareunia were statistically linked to Candida carriage (p<0.05). Non-albicans species showed low sensitivity to antifungal agents. Candida krusei was only 68% susceptible to amphotericin B and econazole while Candida tropicalis had low susceptibility. This study showed a relatively high frequency of Candida yeasts in pregnant women. The emergence of non- albicans with less susceptibility to the antifungal drugs highlights the importance of systematically screening pregnant women to better manage vulvovaginal candidiasis. 

Introduction

Vulvovaginal candidiasis is a common reason for gynecological consultations and ranks second after bacterial vaginosis (Sobel, 2007; Konaté et al., 2014). It is estimated that 75% of women experience at least one episode of candidiasis during their lifetime. Among these women, some will have several episodes and around 5 to 8% will develop recurrent vulvovaginal candidiasis (VVC), characterized by at least four confirmed episodes in a year (Achkar and Fries, 2010).

Certain risk factors for VVC are related to sexual activity, recent antibiotic use, immunosuppression attributable to conditions such as poorly controlled HIV infection or diabetes, and pregnancy (Benchellal et al., 2011; Roy et al., 2024). All of these factors contribute to an imbalance in the vaginal flora and the onset of clinical and biological symptoms. Pregnancy is the leading factor promoting CVV due to the hormonal changes observed (Ogouyèmi-Hounto et al., 2014; Blomberg et al., 2023). Candida species are part of the normal flora of the genital tract. In healthy asymptomatic non-pregnant women, these yeasts have been found in 20–30% (Achkar and Fries, 2010; Ghaddar et al., 2020). This situation only poses a danger to the fetus and newborn when the manifestations occur in a context of prematurity or when the prognosis may be lifethreatening (Hong et al., 2014; Duarte et al., 2024). When vaginal candidiasis is not asymptomatic, it can lead to vulvar pruritus and characteristic vaginal discharge. These symptoms may be associated with dysuria, dyspareunia, vaginal dryness, or vulvar burning (Gai et al., 2023).

Untreated, vaginal candidiasis can lead to chorioamnionitis with subsequent miscarriage and prematurity in pregnant women, or congenital infection of inflammatory disease in newborns and pelvic inflammatory disease in infertile women (Ahmad and Khan, 2009; Gedefie et al., 2025).

Vulvovaginal candidiasis is most often caused by the overabundance of an opportunistic pathogenic yeast, Candida albicans (approximately 90%), which is a common member of the vaginal flora (Hussen et al., 2024). Moreover, the emergence of Candida species isolated from clinical samples, indicated that nonalbicans species were considered emerging fungal pathogens in pregnant women (Hussen et al., 2024; Gedefie et al., 2025). These yeasts are commensal species of the skin and gastrointestinal tract, but may be present in the vaginal tract of 20 to 30% of asymptomatic healthy women at any given time. If the balance between the colonizing yeast and the host is temporarily disrupted, Candida can cause infections such as vaginal candidiasis, associated with clinical signs of inflammation (Achkar and Fries, 2010). Candida albicans is known to be resistant to certain antifungal drugs and is generally treated with azole antifungals due to their low toxicity and availability (Dovnik et al., 2015; Whaley et al., 2016).

Vulvovaginal candidiasis is a public health issue due to the morbidity associated with symptoms in women (Bitew and Abebaw, 2018). The prevalence varies from one country to another. In Côte d'Ivoire, some studies in women reported that the prevalence rate was higher than 28% from non-pregnant women (Djohan et al., 2012; Konaté et al., 2014). Few studies have focused on vaginal candidiasis in pregnant women. Therefore, the aim of this study was to determine the prevalence of vulvovaginal and antifungal susceptibility pattern among pregnant women at the university teaching hospital of Angré in Abidjan.

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Article source : Vulvovaginal candidiasis and antifungal susceptibility patterns among pregnant women at the university hospital of Angré, Abidjan, Côte d’Ivoire