Sensitivity Profile of Fungal Pathogens Responsible for Lower Respiratory Tract Infections in Yaounde

Abstract

Background: Infectious diseases of the respiratory tract are known as respiratory tract infections (RTIs). An infection of this type usually is further classified as an upper respiratory tract infection (URI or URTI) or a lower respiratory tract infection (LRI or LRTI). LRIs are the leading cause of death among all infectious diseases. The objective of our study was to bring out the sensitivity profile of fungal pathogens responsible for lower respiratory tract infections in Yaounde Methods: We carried out a transverse and descriptive study during a 6 month period (February to June 2021), at the Jamot hospital in Yaounde. Included in this study were patients suffering from a lower respiratory tract infection from whom the medical practitioner had requested a sputum or broncho alveolar liquid analysis A macroscopic, microscopic, fungal culture of the sample was carried out and a germ tube test, fungal sensitivity test as well as specie identification using the ID 32 C gallery was carried out on the positive cultures Statistical analysis was carried out using the R version 3.6.1 software. The mean was calculated with the aid of the Kruskal Wallis rank sum test. Results: 300 patients participated in this study. They had mean age ± standard deviation of 41.59 ± 17.5 years and extremities of 1 and 91years. The male /female ratio was 2:1 Fungal infection was positive in 127 patients (42.33 %), 75 (59%) Candida albicans, 25 (19.68%) Cryptococcus humicola, 10 (7.87%) Candida tropicalis, 6 (4.72%) Candida krusei, 4 (3.14%) Candida famata, 4 (3.14%) Candida sake and 3 (2.36%) Cryptococcus curvatus. As far as antifungigram is concerned, the total drug susceptibility was Nystatine (98.47%), Amphotericine B (86.91%), Miconazole (55.42%), Econazole (52.61%), Ketoconazole (52.57%) and Fluconazole (14.42%).The prevalence of fungal pathogens was 42.33%. Of the 300 patients, 71 had tuberculosis, 24 were HIV positive and 6 were diabetic we had 5 patients with HIV, tuberculosis and fungal co-infection, 16 with HIV and fungal co-infection and 6 with HIV and tuberculosis co-infection. Conclusion: This study shows a relative high prevalence (42.33%) of the colonization of the respiratory tract by fungal pathogens. The fungal pathogens responsible for lower respiratory tract infections are Candida albicans, Candida tropicalis, Candida krusei, Candida famata, Candida sake, Cryptococcus humicola and Cryptococcus curvatus. The drug of choice is Nystatine and Fluconazole presents a very limited activity. Additional studies should be carried out in other towns in order to better document this issue in Cameroon.