Prevalence and profile of pulmonary fungal pathogens among HIV-infected patients attending University of Maiduguri Teaching Hospital, Nigeria

Abstract

Background Fungal infections in lungs are being diagnosed with increasing frequency. This is related to the increased immunocompromised status and hygienic factors among patients. In view of this, the present study sought to isolate, identify, and determine the prevalence of pathogenic fungi in HIV-infected patients attending the University of Maiduguri Teaching Hospital, Nigeria. Materials and methods Between 5 April 2016 and 27 August 2016, three consecutive sputum samples in the early morning were collected from individual participants. The samples were inoculated onto Petri dishes containing sabouraud dextrose agar in triplicates for isolation. The fungal isolates were identified using standard mycological stains and reagents. Self-administered questionnaires and participants’ hospital cards were used to assess demographic and clinical variables, respectively. Results The prevalence of pulmonary fungal infection among the patients was at 68%. Of the infected patients, male patients accounted for 59.8%, whereas female patients accounted for 40.1%. However, there was no significant association between the prevalence of pulmonary fungal infection and sex of subjects (P=0.630). Candida albicans [24 (23.5%)] accounted for the highest proportion of the fungal isolates, followed by Aspergillus spp. [19 (18.6%)], with the least being Torulopsis dattila [one (0.9%)], Torulopsis glabrata, [one (0.9%)], and Microsporum canis [one (0.9%)]. Subjects with ages between 31 and 35 years that the highest prevalence of pulmonary fungal infections, 28 (27.5%), whereas those between 56 and 60 years, had the least prevalence, 1 (20.0%). Among the 102 participants coinfected with HIV/tuberculosis (TB), 92 (90.2%) had fungal coinfections, representing a relatively higher prevalence compared with those without TB, 10 (20.8%). There was statistical association between the prevalence of pulmonary fungal infections and TB status and age of patients (P<0.05). Conclusion Findings from this study revealed a high prevalence of pulmonary fungi in HIV/TB coinfected patients, with C. albicans being the leading causal fungi responsible for symptoms of pulmonary diseases.

Keywords

• coinfections
• immunosuppression
• mycosis
• opportunistic infections