Antifungal Susceptibility Pattern of Candida species Isolated from Non-Vaginal Infection Sites

Candida species are opportunistic fungal pathogens whose management is increasingly complicated by a global shift toward non-albicans species and antifungal resistance. Although most Candida research in Nigeria has focused on vaginal candidiasis, non-vaginal sites such as blood, urine, sputum, swabs and cerebrospinal fluid remain under-characterised. This study determined the antifungal susceptibility pattern of Candida species isolated from non-vaginal clinical specimens at the University of Ilorin Teaching Hospital (UITH), Nigeria. In this cross-sectional laboratory-based study, 28 non-vaginal Candida isolates were identified to species level by internal transcribed spacer (ITS) region sequencing, and antifungal susceptibility was determined using the automated VITEK 2 system (AST-YST card), interpreted against CLSI M27 breakpoints. Data were analysed in SPSS version 26 using Fisher's exact test, with significance set at p≤0.05. Candida tropicalis (39.3%) and Candida albicans (32.1%) were the predominant species, alongside non-albicans and emerging species including Pichia kudriavzevii, Candidozyma auris, Candida auris, Nakaseomyces glabrata and Clavispora lusitaniae. Isolates were completely susceptible to fluconazole, voriconazole and micafungin (100.0% each), with high susceptibility to caspofungin (95.8%) and flucytosine (88.0%); amphotericin B recorded the lowest susceptibility (80.0%), with 16.0% resistance. Susceptibility to fluconazole and flucytosine varied significantly with species (p<0.001), while susceptibility to the other agents did not differ significantly between species. These findings show that non-vaginal Candida isolates at UITH remain broadly susceptible to first-line antifungals, but species-dependent variability in azole and flucytosine susceptibility, together with the recovery of Candida auris/Candidozyma auris, supports routine species-level identification and continued surveillance to guide rational antifungal use.