Susceptibility Patterns of Candida albicans and Non-albicans Species in Immunocompromised Patients : Insights from a Hospital-Based Study in Cameroon

Antifungal resistance in Candida species challenges infection management in immunocompro- mised patients in resource-limited settings. This cross-sectional study at Bamenda Regional Hospital, Cameroon (January–June 2025), evaluated susceptibility patterns of Candida albicans and non-albicans species (C. glabrata, C. tropicalis) from 500 immunocompromised participants (87.2% female, mean age 31.2 years) across oral, gastrointestinal (GI), and vulvovaginal (VVC) sites. Samples were analyzed per CLSI M44-A2 standards. Prevalence was 3.4% (oral), 5.8% (GI), and 26.6% (VVC) for C. albicans, and 1.2%, 2.0%, and 8.4% for non-albicans species. Clotrimazole showed 100% sensitivity for C. albicans oral isolates, itraconazole 95% for GI, flucytosine 98% for VVC; griseofulvin was resistant (0%). Fluconazole sensitivity was 80% (C. albicans), 60% (non-albicans). Statistical analyses confirmed associations (chi-square: 𝜒 2 = 32.4, p<0.001; ANOVA: F=4.56, p=0.012; Kruskal-Wallis: H=9.87, p=0.007). Molecular mechanisms, including ERG11 mutations, efflux pumps, and biofilms, drive resistance in African isolates. Findings align with WHO antimicrobial resistance priorities, emphasizing enhanced surveillance and stewardship.