Characterization of Candida Species Isolated from Cases of Lower Respiratory Tract Infection among HIV/AIDS Patients in Calabar, Nigeria

Abstract

This study was designed to identify and characterize the Candida species isolated from lower respiratory tract infections among HIV positive patients and to determine the prevalence rates of Candida infections among these subjects. Two early morning expectorate sputum samples were collected from 272 HIV positive subjects visiting the ART clinics and DOTS centre with cases of lower respiratory tract infection, over a period of 14 months from May 2009 to July 2010 in Calabar. Subjects were recruited for this study upon approval by the Ethical Research Committee of the University of Calabar Teaching Hospital and obtaining written informed consent from the patients. Samples were processed by standard methods for isolation of Candida. Speciation was done by a germ tube test, chlamydospore production on corn meal agar and sugar fermentation and assimilation tests using the Microexpress Candida identification kit (Tulip, India). Out of the 544 sputum samples collected from 272 subjects, Candida species were isolated from 40 (14.7%) and identified after confirming the growth in the second sample. The majority of Candida species among the Candida isolates were Candida albicans (80%) followed by Candida tropicalis 5 (12.5%), Candida dubliniensis 2 (5.0%) and Candida guilliermondii 1 (2.5%). The isolation rate of Candida species from sputum samples was found to be highest among subjects aged 25 -34 years, followed by those aged 15 -24 years. Twenty (7.3%) HIV seropositive subjects had bacterial infections, while 4 (1.5%) subjects had mixed fungal and bacterial infections. This study is the first of its kind to be carried out in Calabar and the South-South geopolitical region of Nigeria, and has shown that pulmonary candidiasis is a health problem among HIV positive patients in Calabar.

Frequency of common hematological manifestations determined in newly diagnosed HIV infected patients

“…Lymphopenia was observed in about 20% of the study participants which was similar to a report by Ogba et al (2013). About 5% of the study participants had neutropenia and are hence at great risk of developing infections at different sites including the skin, mucosa and the lungs (Boxer, 2012).…”

“…as strong predictors of mortality and morbidity in HIV infected patients (Shen et al, 2013).Hematological complications among HIV are generally marked with cytopenias such as anemia, thrombocytopenia, leucopenia, and lymphopenia.The occurrence and severity of the cytopenias normally correlate with the stage of disease (Ogba et al, 2013).…”

“…Anemia is associated with thrombocytopenia and neutropenia because of myelosuppression (Prendushi et al, 2014). Anemia is the most common hematological problem in HIV infected patients (Choi et al, 2011;Ogba et al, 2013;Prendushi et al, 2014).…”

Multiplex polymerase chain reaction identification of Candida species colonized sputum of patients suffering from various respiratory tract disorders in Duhok, Iraq

“…However, several studies showed the regular detection of Candida species in sputa of patients with lower respiratory tract infection, cystic fibrosis, pulmonary tuberculosis and HIV infected patients. [5][6][7][8][9] High isolation rate for Candida species from sputum samples were reported from patients at the age above 50 year in Nepal and India. 23,24 These results are in a agreement with our finding.…”

“…Several studies dealt with the identification and characterized Candida species isolated from sputum in HIV positive patients [5][6][7] and from pulmonary tuberculosis patients. 8,9 In Iraq, however, eight Candida species namely C. albicans, C. curvata, C. glabrata, C. kefyr, C. krusei, C. paropsiloses, C. tropicalis and C. utilis were detected in sputa of patients with pulmonary tuberculosis in Basrah, Iraq.…”