In vitro susceptibility of Candida albicans clinical isolates to eight antifungal agents in Ouagadougou (Burkina Faso).

INTRODUCTION: In recent years, the infection Candida albicans infection worldwide has risen, and the incidence of resistance to traditional antifungal therapies is also increasing. The aim of this study was to evaluate in vitro susceptibility of C. albicans clinical isolates to eight antifungal agents in Ouagadougou. MATERIALS AND METHODS: A cross-sectional study was conducted from January 2013 to December 2015 at Yalgado Ouédraogo University Teaching Hospital. Two hundred seven strains have been isolated from 347 symptomatic patients received in different clinical services. Samples were cultured on Sabouraud Dextrose Agar supplemented with Cloramphenicol. Isolates were diagnosed as C. albicans using germ tube test, chlamydospore formation on Corn Meal Agar, and Api-Candida test (Biomérieux). Antifungal susceptibility testing was performed by disk diffusion method and isolates classified as susceptible, susceptible dose-dependent and resistant. RESULTS: Three hundred forty-seven (347) patients are included in this study. Two hundred and six (206) out of 347 collected samples (59.36%) were found positive for C. albicans. The strains were mostly isolated from vulvovaginal (49%) and oral infections (40.3%). The highest resistance rates of azoles were obtained with fluconazole (66.5%), itraconazole (52.3%) and ketoconazole (22.9%) when all clinical isolates were included. The resistance rates of fluconazole, itraconazole and ketoconazole remain highest for vulvovaginal and oral isolates. The rate of resistance to the polyene amphotericin B was 32.0% for all clinical isolates and was 56.4% for vulvovaginal strains. Resistance rate to nystatin was 6.3% for all clinical isolates. Cross-resistance analysis with data of all clinical strains revealed that the incidence of resistance to ketoconazole and itraconazole in fluconazole-resistant isolates was significantly higher than recorded for fluconazole-susceptible isolates. CONCLUSION: In vitro C. albicans antifungal susceptibility test in this study showed relatively high resistance to commonly and widely used azoles (fluconazole, ketoconazole). Most C. albicans clinical isolates were susceptible to nystatin.

[Chloroquine resistance of Plasmodium falciparum. Study of a surveillance method based on placental apposition and determination of blood chloroquine in pregnant women]. / Chloroquino-résistance de Plasmodium falciparum. Etude d'une méthode de surveillance reposant sur l'apposition placentaire couplée au dosage de la chloroquinémie chez la femme enceinte.

We investigated placental malaria infection and blood chloroquine concentration in pregnant women to assess a new method of monitoring the chloroquine resistance (CQ-R) of Plasmodium falciparum. We studied two groups of women: 96 women taking the usual prophylactic treatment of 300 mg chloroquine per week and 108 controls given no treatment. We carried out placental apposition, a thick smear and determination of blood chloroquine concentration after delivery. Malarial infection of the placenta was more frequent and the density of parasites higher in controls than in women given prophylaxis. Blood chloroquine concentrations were adequate in all women given prophylaxis (above 200 ng/ml, with a mean of 500 ng/ml). Twenty-six per cent of placentas in the treated group and 51% of placentas in the control group were infected. The placental infection rates for the two groups were compared. The frequency of chloroquine-resistant strains was about 50% (2 or 3 times higher than the CQ-R frequencies obtained in studies using in vivo tests). The simplicity of placental apposition makes this technique potentially valuable. However, determination of blood chloroquine concentration is also required and can only be carried out in a reference center.