Antifungal Susceptibility of Candida Species and Cryptococcus Neoformans Isolated from Patients at the Komfo Anokye Teaching Hospital in Kumasi
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Date
2010-07-13
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Abstract
Antifungal drugs are prescribed for the treatment of yeast infections at the Komfo Anokye Teaching Hospital yet the susceptibility profiles of the infecting yeasts are unknown. The aim of this study was to determine the common species of yeasts that cause infection among patients attending the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana and to determine their susceptibility profiles to antifungal agents. A total of 528 clinical samples were collected between March and June 2009 and analyzed. Samples collected from individuals consisted of 186 (35%) high vaginal swabs, 109 (21%) cerebrospinal fluid (CSF) samples, 127 (24%) urine samples and 106 (20%) sputum samples. The samples were cultured on sabouraud dextrose agar. Identification of the yeasts was performed using growth characteristics, the germ tube test and the API ID 32 C test kits. Antifungal susceptibility of yeast isolates to antifungal agents was done using ATB™ FUNGUS 3 test kits and the agar disc diffusion method. Sixty- seven (67) out of the 528 samples yielded yeasts giving yeast prevalence of 12.7%. Thirty- three (49.3%) of the isolates were Candida albicans, 12(17.9%) were Candida glabrata, 8(11.9%) Candida tropicalis, 4(6%) Candida dubliniensis, 3(4.5%) Candida krusei, 2(3%) Candida sake, 1(1.5%) Candida guilliermondii, 1(1.5%) Candida parapsilosis and 3(4.5%) Cryptococcus neoformans. All isolates of Candida dubliniensis, Candida sake, Candida parapsilosis, Candida guilliermondii and Cryptococcus neoformans were susceptible to flucytosine, amphotericin B, fluconazole, itraconazole and voriconazole with minimum inhibitory concentrations (MICs) ranging from 0.125 to 8mg/l. All isolates of Candida krusei were resistant to fluconazole with MICs of ≥ 64mg/l. Seventy- nine (79) to 85 % of isolates of C. albicans, C. glabrata, C. tropicalis and C. krusei were susceptible to flucytosine, amphotericin B, and itraconazole with MICs ranging from 0.125 to 8mg/l. Voriconazole exhibited greatest activity against isolates of C. albicans, C. glabrata, C. tropicalis and C. krusei with no resistant strains identified. Voriconazole appeared to be the most effective antifungal against all the yeast isolates tested.
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A Thesis submitted to the Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology in Partial Fulfillment of the Requirements for the Degree of MASTER OF SCIENCE, School of Medical Sciences,