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Volume 15
Issue 6
10.3390/pathogens15060625
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Article

Escalating Antifungal Resistance Among Candida Species in Reproductive-Age Women in Vietnam: Implications for Women’s Health and Healthcare Systems

by
Bac V. G. Nguyen
1,
Tu Thien Nhat Nguyen
2,
Bang Chau Ngoc Tu
3,
Hung Van Cao
4,
Bich Ngoc Thi Nguyen
5,
Thanh Tri Vu
5,
Gia-Phong Vu
6,
Hoai Thu Le
7 and
Phuoc Vinh Nguyen
2,8,*
1
School of Pharmacy, University of Medicine and Pharmacy, Ho Chi Minh City 700000, Vietnam
2
Faculty of Pharmacy, University of Health Sciences, Vietnam National University Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
3
Faculty of Biology and Biotechnology, University of Sciences, Vietnam National University Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
4
Faculty of Medicine, University of Health Sciences, Vietnam National University Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
5
Thu Duc General Hospital, Ho Chi Minh City 700000, Vietnam
6
Program in Comparative Biochemistry, University of California, Berkeley, CA 94720, USA
7
Center of Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
8
Research Center of Discovery and Development of Healthcare Products, Vietnam National University Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
*
Author to whom correspondence should be addressed.
Pathogens 2026, 15(6), 625; https://doi.org/10.3390/pathogens15060625
Submission received: 12 May 2026 / Revised: 5 June 2026 / Accepted: 8 June 2026 / Published: 11 June 2026
(This article belongs to the Special Issue Emerging Fungal Pathogens and Polymicrobial Infections: Antimicrobial Tolerance, Resistance Mechanisms, and Innovative Therapeutic Approaches)
Versions Notes

Abstract

Vulvovaginal candidiasis (VVC) is a common fungal infection among reproductive-age women and is increasingly challenged by the emergence of non-albicans Candida species and reduced azole susceptibility. This prospective cross-sectional study investigated 235 symptomatic reproductive-age women attending two healthcare facilities in Ho Chi Minh City, Vietnam, to determine VVC prevalence, Candida species distribution, pregnancy-associated patterns, antifungal susceptibility, and diagnostic performance. Vaginal swabs were cultured on Sabouraud Dextrose Agar and CHROMagar™ Candida, while species identification was confirmed by PCR-RFLP targeting the ITS region. Susceptibility to fluconazole and clotrimazole was assessed using the disk diffusion method. Candida spp. was detected in 55.7% of participants. C. albicans accounted for 50.3% of isolates, whereas non-albicans Candida species represented 49.7%, indicating a substantial species shift. VVC was more frequent among pregnant women, particularly in the third trimester. Most C. albicans, C. tropicalis, and C. parapsilosis isolates remained susceptible to azoles; however, C. glabrata showed markedly reduced susceptibility to fluconazole and clotrimazole. CHROMagar™ Candida reliably identified C. albicans but misclassified several non-albicans Candida isolates compared with PCR-RFLP. These findings highlight the need for routine species-level diagnosis, antifungal susceptibility testing, and strengthened VVC surveillance in reproductive and antenatal healthcare settings in Vietnam.
Keywords: vulvovaginal candidiasis; Candida albicans; non-albicans Candida; pregnancy; antifungal resistance; Vietnam; PCR-RFLP vulvovaginal candidiasis; Candida albicans; non-albicans Candida; pregnancy; antifungal resistance; Vietnam; PCR-RFLP

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MDPI and ACS Style

Nguyen, B.V.G.; Nguyen, T.T.N.; Tu, B.C.N.; Cao, H.V.; Nguyen, B.N.T.; Vu, T.T.; Vu, G.-P.; Le, H.T.; Nguyen, P.V. Escalating Antifungal Resistance Among Candida Species in Reproductive-Age Women in Vietnam: Implications for Women’s Health and Healthcare Systems. Pathogens 2026, 15, 625. https://doi.org/10.3390/pathogens15060625

AMA Style

Nguyen BVG, Nguyen TTN, Tu BCN, Cao HV, Nguyen BNT, Vu TT, Vu G-P, Le HT, Nguyen PV. Escalating Antifungal Resistance Among Candida Species in Reproductive-Age Women in Vietnam: Implications for Women’s Health and Healthcare Systems. Pathogens. 2026; 15(6):625. https://doi.org/10.3390/pathogens15060625

Chicago/Turabian Style

Nguyen, Bac V. G., Tu Thien Nhat Nguyen, Bang Chau Ngoc Tu, Hung Van Cao, Bich Ngoc Thi Nguyen, Thanh Tri Vu, Gia-Phong Vu, Hoai Thu Le, and Phuoc Vinh Nguyen. 2026. "Escalating Antifungal Resistance Among Candida Species in Reproductive-Age Women in Vietnam: Implications for Women’s Health and Healthcare Systems" Pathogens 15, no. 6: 625. https://doi.org/10.3390/pathogens15060625

APA Style

Nguyen, B. V. G., Nguyen, T. T. N., Tu, B. C. N., Cao, H. V., Nguyen, B. N. T., Vu, T. T., Vu, G.-P., Le, H. T., & Nguyen, P. V. (2026). Escalating Antifungal Resistance Among Candida Species in Reproductive-Age Women in Vietnam: Implications for Women’s Health and Healthcare Systems. Pathogens, 15(6), 625. https://doi.org/10.3390/pathogens15060625

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