Antimicrobial resistance among fungi from patients with urinary tract infections in Ojo, Lagos, Nigeria

Dauphin Dighitoghi Moro Dauphin Dighitoghi Moro,Oluwole Moses David Oluwole Moses David

doi:10.30574/gscbps.2021.14.3.0082

Dauphin Dighitoghi Moro Dauphin Dighitoghi Moro, Oluwole Moses David Oluwole Moses David

Open Access

https://doi.org/10.30574/gscbps.2021.14.3.0082

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Abstract

The incidence of fungal urinary tract infections has risen gradually and has thus constituted a public health challenge. The aim of this study was to determine the prevalence of urinary tract infections by fungi in two health centres in Ojo, Lagos. A total of 200 patients attending the health centers constituting 160 males’ urines and 40 females’ vaginal swabs were recruited for this study. Midstream urine samples and vaginal swabs were aseptically collected and processed using standard mycological techniques. Fungal isolates were identified based on cultural characteristics, lactophenol blue stain, chlamydospore formation, colony colour on CHROM agar Candida medium and API yeast identification. Antifungal susceptibility testing of the isolates was performed by using the Broth dilution and Kirby-Bauer disk diffusion methods using two of the most commonly used antifungal agents. A total of 122 fungal isolates, of which 68 (55.7%) were Candida spp. and 54(44.3%) Aspergillus spp. were recovered. The Candida spp. included 64 (52.5%) C. albicans and 4(3.3%) C. glabrata while Aspergillus spp. included A. flavus, 20(16.4%), A. fumigatus, 24 (19.8%) and A niger, 10(8.2%). The most common fungal pathogens in the urinary tracts of the subjects were Candida albicans and Aspergillus fumigatus. Both C. albicans and A. fumigatus were highly susceptible to both fluconazole and amphotericin B in dimethyl sulphoxide and water (90-100%). Similarly, all Aspergillus spp. were susceptible to both antifungals except A. flavus which showed a slight resistance (10-15%), which appears to be emerging. Both fluconazole and amphotericin B still show high chances of therapeutic efficacy against fungal infections of the urinary tracts.

Highlights

Fungal infections of the urinary tract are increasing in incidence, mostly due to the increasing use of antibiotics instrumentation and indwelling urinary catheters [1]
The most common fungal pathogens in the urinary tracts of the subjects were Candida albicans and Aspergillus fumigatus. Both C. albicans and A. fumigatus were highly susceptible to both fluconazole and amphotericin B in dimethyl sulphoxide and water (90-100%)
The urine and vaginal samples cultured on sabouraud dextrose agar (SDA), HiChrome Candida Differential Agar and Analytical Profile Index (API) Yeast identification kit had Candida spp. and Aspergillus spp

Summary

Introduction

Fungal infections of the urinary tract are increasing in incidence, mostly due to the increasing use of antibiotics instrumentation and indwelling urinary catheters [1]. Aspergillosis of the urinary tract may occur by 3 ways namely 1) by ascending infection from the lower tract, 2) from haematogenous dissemination or 3) due to Aspergillus cast in renal pelvis [4]. Renal aspergillosis due to haematogenous dissemination is the most common while localized infection is very rare [5]. Candiduria is the presence of Candidia species in urine, in hospitalized patients, especially those in the intensive care units (ICUs) who often have multiple predisposing factors which include diabetes mellitus, indwelling urinary catheters, exposure to antimicrobial agents, cancer, long hospitalization, sex and age [6].

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