Prevalence of Vaginitis at the University Hospital Center of Yaounde (CHUY) and Effect of Plant Extracts Combinations and Conventional Antifungals on the Growth of Multidrug-Resistant <i>Candida albicans</i>

Background: The spread of vaginal infections in Cameroon and the resistance of the causative pathogens to antimicrobials require regular monitoring to establish new therapies. The objective of this study was to determine the prevalence of vaginitis among pregnant women at the University Hospital Center of Yaoundé (CHUY) and to evaluate the effects of combinations of plant extracts and conventional antifungals on the growth of Candida albicans isolates. Methods: Cervicovaginal samples collected from women were used to identify the involved pathogens and determination of infection prevalence. The effects of aqueous extracts of Alchornea cordifolia, Antrocaryon klaineanum, and Cylicodiscus gabunensis were then evaluated on the growth of five Candida albicans isolates, all resistant to at least three antifungals. This involved determining their sensitivity to the plant extracts and identifying inhibition parameters (MIC and MFC). Subsequently, combinations of plant extracts and plant extracts/conventional antifungals were prepared and tested on the isolates’ growth. The determination of the FICI (Fractional Inhibitory Concentration Index) highlighted the effects of the combinations on C. albicans. Results: The prevalence of genital infections at CHUY was 70% during the study period, comprising 30% for vulvovaginal candidiasis (VVC) and 40% for bacterial vaginosis. From the samples collected, nine C. albicans isolates were obtained, five of which were multi-resistant to at least three antifungals. A high resistance rate was recorded with azoles, notably Fluconazole at 88.88%, compared to 77.77% for Miconazole and Econazole. The plant extracts showed inhibitory properties on the growth of C. albicans, with inhibition diameters ranging from 6 to 15 mm. Both the plant extracts and the conventional antifungal (Amphotericin B) inhibited C. albicans growth with MIC values ranging from 0.097 to 6.25 mg/mL. The combination of A. cordifolia and A. klaineanum extracts exhibited a synergistic effect, especially on isolates Cab2, Cab3, and SR ATTCP 37037 (FICI = 0.498; 0.372; and 0.186). The combination of A. cordifolia and Amphotericin B also demonstrated a synergistic effect on C. albicans isolates Cab3 and Cab8 (FICI = 0.380; 0.505). These results indicate that combinations of A. cordifolia and A. klaineanum, as well as A. cordifolia and Amphotericin B, could be exploited in developing effective drugs against genital infections caused by C. albicans.