ArticleAntimicrobial resistance and infection control2022
Importance of Candida infection and fluconazole resistance in women with vaginal discharge syndrome in Namibia.
Article in Antimicrobial resistance and infection control, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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9 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Global prevalence and trends of fluconazole resistance in non-albicans Candida species: a systematic review and meta-analysis.BMC infectious diseases · 2026Pooled it
- High Burden of Vaginal Infections and Multidrug Resistance With Promising Probiotic Candidates From Cervicovaginal Microbiota in North Region, Cameroon.Probiotics and antimicrobial proteins · 2026Article
- Non-albicans Candida vaginal infections in sub-Saharan Africa: a systematic review, meta-analysis, and narrative synthesis of prevalence, antifungal resistance, and clinical implications among women of reproductive age.Tropical medicine and health · 2026Review
- Prevalence and Co-occurrence of Candida albicans and Sexually Transmitted Infections in Lactobacillus-Deficient HIV-Negative Adolescent Girls and Young women.Mycopathologia · 2026Article
- Isolation of non-albicans Candida and associated factors among symptomatic women presenting with abnormal vaginal discharge at Mubende Regional Referral Hospital, Central Uganda: A cross-sectional study.PLOS global public health · 2026Article
- Article
- Fluconazole-resistant vulvovaginal candidiasis in reproductive-age women: a study from Himalayan country.BMC microbiology · 2025Article
- New insights toward personalized therapies for vulvovaginal candidiasis and vaginal co-infections.Frontiers in microbiology · 2025Review
- Use of probiotic lactobacilli in the treatment of vaginal infections:Frontiers in cellular and infection microbiology · 2023Review
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVaginal discharge syndrome (VDS) is a common condition. Clinical management targets sexually transmitted infections (STIs) and bacterial vaginosis (BV); there is limited focus on Candida infection as cause of VDS. Lack of Candida treatment coverage and, if present, antifungal resistance may result in VDS treatment failure. This study aimed to determine the prevalence of Candida infection, antifungal resistance, and coinfections in Namibian women with VDS.
methodsA cross-sectional study was performed using 253 vaginal swabs from women with VDS in Namibia. Demographic data was collected, and phenotypic and molecular detection of Candida species was performed followed by fluconazole susceptibility testing of Candida isolates. BV was diagnosed using Nugent score microscopy; molecular detection of Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis was performed.
resultsCandida species was detected in 110/253 women (43%). Ninety women (36%) had Candida albicans and 24 (9.5%) had non-albicans Candida species. The non-albicans species detected were 19 (17%) Candida glabrata, 4.0 (3.5%) Candida krusei, and 1.0 (0.9%) Candida parapsilosis. Candida albicans were more frequently isolated in younger (p = 0.004) and pregnant women (p = 0.04) compared to non-albicans Candida species. Almost all (98%) Candida albicans isolates were susceptible to fluconazole while all non-albicans Candida species were fluconazole resistant. STIs were diagnosed in 92 women (36%): 30 (12%) with C. trachomatis, 11 (4.3%) N. gonorrhoeae, and 70 (28%) T. vaginalis; 98 (39%) women had BV. Candida infection alone was diagnosed in 30 women (12%), combined with STIs in 42 women (17%) and was concurrent with BV in 38 women (15%). Candida infection was more often detected in swabs from women without C. trachomatis detected (6.4% vs. 16%; OR 0.30; 95% CI 0.10-0.77, p = 0.006).
conclusionsThe high prevalence of Candida infection, especially those due to non-albicans Candida species that are resistant to fluconazole, is a great concern in our setting and may lead to poor treatment outcomes. Access to microbiological testing for Candida species in the context of syndromic management is warranted.
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