TITLE:
Candida Co-Infection with Mycobacterium tuberculosis in Tuberculosis Patients and Antifungal Susceptibility of the Isolates
AUTHORS:
Smart Enoch Amala, Asikiya Hanson, Gloria N. Wokem
KEYWORDS:
Tuberculosis, Candida, Co-Infection, Antifungal Susceptibility
JOURNAL NAME:
Journal of Tuberculosis Research,
Vol.8 No.2,
June
29,
2020
ABSTRACT: It had been observed that tuberculosis (TB) subjects can be co-infected
with Candida sp. which was previously
assumed as normal flora of the oral cavity. Candida sp. might become an opportunistic pathogen in immune compromised
individuals. Candida co-infection
with Mycobacterium tuberculosis in TB
patients might complicate underlying disease process in the lungs. Materials and Methods: A total of 400 sputum samples were collected from TB patients and
examined using Ziehl-Neelsen staining technique and MDR/RIF Genexpert system
for TB. Samples positive for Mycobacterium
tuberculosis were cultured on Sabouraud
Dextrose Agar with gentamicin and examined for the presence of budding
yeast cells and pseudohyphae on Gram’s stain. Candida sp. isolated from TB positive sputa were cultured on
CHROMager Candida for identification
to species level and subjected to antifungal susceptibility testing. Results: Out of 400 sputum samples examined for TB 93 (23.3%)
were positive and 32 (34.4%) out of 93 TB positive cases were co-infected with Candida sp. Candida albicans was the most predominant species with a prevalence of 23 (67.6%), C. tropicals 4 (11.8%), C. krusei 4 (11.8%)
and C. parapsilosis 3 (8.8%). One sample had dual infection. Female
subjects had high prevalence (19.4%) than the male (15.7%). Age
group 31 - 40 years had both high prevalence of TB
32.3% and Candida 25.0%. Antifungal
susceptibility testing showed that
isolated Candida sp. were more
susceptible to vericonazole and fluconazole compared to nystatin. Conclusions: Tuberculosis weakens the immune systems of infected persons especially when
prophylactic administration proves abortive or there is non-adherence
to treatment prescriptions. This may
cause the development of multidrug resistance TB. Candida sp. may utilize these opportunities to establish alongside M. tuberculosis and worsen treatment and patient condition. For good
treatment of TB, Candida co-infection should be screened concomitantly with TB in TB suspected individuals.