Isolation and Multidrug Resistance Profiling of Candida albicans from Clinical Specimens in Bauchi Metropolis, Nigeria

Background: Candida albicans remains a major cause of opportunistic fungal infections worldwide. However, the emergence of multidrug-resistant (MDR) strains possessing potent virulence factors, such as phospholipases and proteinases, poses significant diagnostic and therapeutic challenges in clinical settings. Aim: The aim of this study was to isolate Candida albicans from clinical specimens in Bauchi Metropolis and determine its multidrug-resistance profile. Place of Study: This study was carried out at selected hospitals (ATBU Teaching Hospital, Specialist Hospital Bauchi and General Hospital Bayara) and at the Department of Microbiology Laboratory, Abubakar Tafawa Balewa University (ATBU), Bauchi, Nigeria. Methodology: A total of 130 clinical samples (oral 47, high vaginal 38, urine 18, wound 16 and sputum 11) were collected and processed for Candida identification using Gram staining, germ tube tests, chlamydospore formation on Corn Meal Agar, CHROMagar Candida, growth at 45°C and standard microbiological techniques. Antifungal susceptibility testing for fluconazole (25 µg), ketoconazole (10 µg), itraconazole (10 µg) and nystatin (50 units) was performed using the disc diffusion method on Mueller-Hinton Agar + 2% Glucose + Methylene Blue, following CLSI M44-A2 and CLSI M60 1st Edition (2023) guidelines. Quality control was performed using C. albicans ATCC 90028. Multidrug resistance was defined as resistance to two or more classes of antifungal agents. Results: Of the 130 clinical specimens evaluated, 72 Candida isolates were recovered, with Candida albicans being the predominant species (73.6%). Antifungal susceptibility testing showed the highest susceptibility to ketoconazole, with 25 isolates (47.1%), and itraconazole, with 24 isolates (45.2%). Resistance was highest to nystatin, with 25 isolates (47.2%), followed by fluconazole, with 21 isolates (39.6%). Overall, 47.2% of C. albicans isolates were classified as multidrug-resistant (MDR). Conclusion: This study identified a substantial proportion of multidrug-resistant C. albicans isolates. The findings highlight the importance of routine antifungal susceptibility testing and antifungal stewardship programmes in the management of resistant fungal infections.