Spectrum of fungal pathogens in sputum samples from pulmonary tuberculosis suspected patients at Kotebe primary hospital Addis Ababa Ethiopia
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Date
2018-10
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Addis Ababa University
Abstract
Background: pulmonary mycosis is a systemic fungal infection that occurs when fungi cause’s
diseases of the lungs. Mycobacterium tuberculosis (MTB), the causative agent of pulmonary
tuberculosis is one of the major micro organisms that infect this site. Clinical and radiological
characteristics of pulmonary mycosis are very similar to that of pulmonary tuberculosis thereby
making the disease easily misdiagnosed and mistreated as tuberculosis.
Objective: To assess spectrum of fungal etiologies in sputum samples from pulmonary
tuberculosis suspected patients at Kotebe primary hospital Addis Ababa, Ethiopia.
Methods: A cross sectional descriptive study was conducted at Kotebe primary hospital on 423
sputum samples from presumptive TB patients. Sputum samples were collected aseptically and
Presence of pulmonary Tuberculosis was screened by Xpert MTB-Rif/assay. Microscopically
fungal elements were screened using 10%KOH. Cultural identification of the different
pathogenic fungi was performed using SDA and BHI medium incubated at 25c0 and 37c0 for 4-
6weeks respectively for each sputum samples. Identification was performed by noting; the
growth form, and rate of growth, surface and reversed coloration on SDA and BHI agar plates.
Yeasts were identified by conventional biochemical tests and assimilation characteristics. Data
analysis was carried out using SPSS version 23 software.
Results: 423 presumptive TB patients were enrolled in this study of which 50.6% were males.
MTB was detected in 7.3% of the patients. Mycotic agents were isolated from 179(42.3%)
patients of which 106(59.2%) were males. Co- infection of pulmonary Tuberculosis and a fungal
agent was seen in 51.6% of MTB positive subjects. 62.7% of HIV positive patients included
showed positive fungal culture. Out of the total isolates in this study, the genuses Aspergillus
and Candida were the predominant fungal agents 8.7% and 23.9% respectively. C. cruzi was the
predominant fungi in MTB positive subjects. Other fungal etiologies isolated in our study
include; Penicillium, S. apiospermum, Fusarium, Mucor, Acremonium, Rhodotorulla, curvularia,
Exserohilum species
Conclusion; High incidence of fungal isolation (42.3%) was obtained in patients with respiratory
symptoms. We recommend for policy makers to conduct further studies and consider the need of
fungal screening in these patients
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Keywords
Respiratory fungal infection, presumptive TB patients, HIV infection