ANTIFUNGAL SUSCEPTIBILITY OF OROFUNGAL INFECTIONS AMONG HIV- POSITIVE PATIENTS IN CHUKWUEMEKA ODUMEGWU OJUKWU UNIVERSITY TEACHING HOSPITAL, AWKA ANAMBRA STATE

Abstract

Fungal diseases are life-threatening and are responsible for a largely silent epidemic, often hidden killers causing substantial morbidity and mortality in susceptible individuals. This study was carried out to determine the prevalence, risk factors and antifungal susceptibility of orofungal infections among HIV positive patients in Chukwuemeka Odumegwu Ojukwu University, Awka. The study was a hospital based cross sectional study carried out between January 2022 and August 2022. A total of 120 patients who gave their consent were used for the study. Oral swab sample of the patients were taken with the aid of sterile swab sticks, and cultured on Sabouraud’s dextrose agar, Chrome agar and blood agar at 37°C incubation. Fungal organisms isolated were characterized accordingly using Gram stain, germ tube tests, sugar fermentation and assimilation tests, and also with fungal atlas for mold identification. ITS region molecular typing was also used to identify the top four most frequently occurring isolates. Structured questionnaires were used to obtain demographic details of the participants and for risk factors evaluation. Isolates were also evaluated for pathogenicity using haemolysis and enzyme assays. Antifungal susceptibility testing of the isolates was conducted using the disc diffusion method. Data obtained were statistically analyzed. The oro-fungi organisms isolated are Candida albicans, Candida glabrata, Candida krusei, Candida tropicalis, Candid neoformans, and Aspergillus fumigatus. Overall prevalence of the isolates in the participants (n=120) showed that C. albicans was the most prevalent isolate with an occurrence of 90% while Cryptococcus neoformans were the least occurring isolates with the occurrence 2.99%. Gender distribution were: COOUTH 71 male (59.17%) 49 female (40.83%), Age range 36-45 years had the highest frequency of 45.83% while age range 56-65 years had the lowest patient frequency of 10.83%. The distribution based on marital status, of which married subjects accounted for 43.33% and single patients were 56.67 % frequency. It was observed that 56.67% of patients that participated in the study had university education as their highest educational level, and they accounted for the most population that took part in the study. A 5.83% frequency that took part in the study had no education and accounted for the least participation frequency in the study. Students had the highest participation frequency of 47.5% while artisans participated the least with a frequency of 7.5%. 6.67% of the participants had Hepatitis B vaccination while 97.5% of the participants were already participating in HAART. The clinical history of examined patients showed that 68.33% had white patches on the tongue which is the highest frequency, followed by bad breath which accounted for 67.17% of the participants. Antifungal exposure profiling of the participants showed that they have significant (p<0.05) exposure to fluconazole while they had least exposure to vericonazole and itraconazole.