Sabouraud-chloramphenicol Medium Research Articles

Epidemiology of Candida Species Colonizing Mucosae of HIV-Infected Patients in Two Healthcare Centers of Cameroon During 2018-2020

Aims: This study aimed to investigate Candida species colonizing HIV-infected patients in Bafoussam and Yaounde in Cameroon.
 Study Design: Cross-sectional study.
 Place and Duration of Study: Yaoundé Central Hospital (YCH) and Bafoussam Regional Hospital (BRH) between October 2018 and December 2020.
 Methodology: We included 804 HIV-infected (681 women; 123 men; age range 21-81 years). Vaginal discharge, oral swab, stools, and urine were collected, and mycological diagnosis including direct macroscopic and microscopic analyses, culture on Sabouraud chloramphenicol medium, culture on chromogenic medium, germ tube test, evidence of chlamydospores production, biochemical analysis was performed. Yeast isolates were identified using matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS).
 Results: Eight hundred and four patients were recruited, and 2754 samples were collected. The colonization frequency was 17.35%, and 513 yeasts were isolated. Overall, Candida albicans 251 (48.92%) was the most frequently isolated. Non-albicans Candida (NAC) isolates have been classified into 16 species, including Candida krusei (14.23%), Candida glabrata (9.94%), Candida parapsilosis (8.18%), and Candida tropicalis (7.99%) as the major ones. There was a relationship (P-value= 0.00) between antiretroviral therapy and Candida species colonization.
 Conclusion: The results provide information on the epidemiology of Candida species in HIV-infected patients in Cameroon.

Vaginal Candidiasis Caused by Candida Non Albicans: Epidemiological and Mycological Aspects at the University Hospital Center of Brazzaville

Introduction: Vaginal candidiasis is a mycosis caused by a yeast of the genus Candida. Candida albicans was for a long time the first etiology of these mycoses. However, in recent years, an increasing involvement of non-albicans Candida species has been observed. Objective: To describe the epidemiological and mycological aspects of vaginal candidiasis due to Candida non albicans in women who have performed an analysis of the vaginal sample in the Parasitology Mycology laboratory of the University Hospital Center of Brazzaville. Patients, Materials And Method: This was a descriptive and analytical cross-sectional study from July to October 2019 (i.e. 3 months). It concerned all the patients received at the Parasitology-mycology and parasitic immunology laboratory of the CHUB for an analysis of the vaginal sample. The diagnosis was made after direct examination and culture of samples on Sabouraud Chloramphenicol medium with and without Actidione*. The filamentation test on calf serum and the study of the biochemical characteristics of the yeast colonies using the API candida strips from Biomérieux were carried out for each positive culture. Statistical analysis was performed using Epi-info 7.2.2.6 softwares. Results: The frequency of Candida non albicans yeast infection was 64.7%. The median age of patients with Candida non albicans vaginal candidiasis was 35.5 years (25.0 years - 47.0 years) with extremes of 18 and 59 years old. The age group between 18 and 40 was the most represented (68.2%). These were women with secondary education (n=12 ; 54.5%), with a notion of a single sexual partner (n=17 ; 77.3%), pregnant (n=6 ; 27, 3%). In 22.7% there was poor faecal hygiene. The main reasons for taking the samples were… and the non-albicans Candida species were represented by Candida glabrata (36.4%), Candida tropicalis (18.2%), Candida krusei (13.6%), Candida famata (13.6%), Candida parapsilosis (9.1%) and Candida spp (4.6%). Analytical Study Conclusion: Candida non albicansremains the common fungus in our context with a predominance of Candida glabrata. Age, poor faecal hygiene could have a link with the occurrence of these fungal infections, hence the importance of good awareness and systematic research in young women.

Candida albicans and Candida dubliniensis in Periodontitis in Adolescents and Young Adults

Aim This study aims to evaluate the association of Candida albicans and Candida dubliniensis with periodontitis in adolescents and young adults in a Moroccan population. Methods 426 subjects aged between 12 and 25 years were recruited for the study. A pool of plaque sample was taken. Samples were cultured on Sabouraud Chloramphenicol medium at 37°C for 24–48 hours and then identified by the Vitek 2 YST system. Clinical data and presence of Candida albicans and Candida dubliniensis were analyzed using Jamovi (Version 1.8). Results Candida albicans was observed in 25 subjects among 68 diseased patients (37%) and in 60 subjects among 358 healthy patients (17%). It can be reported that under normal yeast conditions, there is a statistically significant difference between these two groups (P < 0.001). Candida dubliniensis was more prevalent in periodontitis than in healthy subjects (P=0.026). Regarding clinical variables, subgroups of periodontitis subjects showed significant statistical differences for periodontal probing depth, clinical attachment loss, and number of decayed teeth in advanced periodontitis in comparison with initial or mild periodontitis. The results also indicate that the presence of the two species of Candida is not related to gender or age (P > 0.05) nor related to the severity of the periodontal disease in this population. Conclusion Within the limits of our study, Candida albicans is more frequently associated with periodontitis. The potential role of C. albicans in periodontitis pathogenesis is very complex. More studies on biofilm associated with different forms of periodontitis are necessary. It is also important to assess the coexistence of periodontitis and caries and the associated biofilms.

Vaginal Candidiasis in Women of Childbearing Age at the University Hospital of Brazzaville: Prevalence and Associated Factors

Introduction: Vaginal candidiasis is a fungal disease caused by a yeast type Candida. It affects more than 75% of women during the period of genital activity. Changes in vaginal pH due to various factors lead to the onset of the infection. Objective: Determine the prevalence of vaginal candidiasis in women of childbearing age and look for associated factors or risk for its occurrence. Patients, Materials and Method: We conducted a cross-sectional analytical study from July to October 2019. It concerned all patients aged 15 to 49 years, received at the Parasitology-mycology and parasitic immunology laboratory of the University Hospital of Brazzaville for an analysis of the vaginal sample. For each vaginal sample, a direct examination and culture on Sabouraud Chloramphenicol medium with and without Actidione were performed. A questionnaire was completed specifying age, medical and surgical history, symptoms and risk factors. Statistical analysis was performed by SPSS 20 using Chi-square test and Student's test and multivariate logistic regression was performed. The test was significant when p Ë‚ 0.05. Results: Among 152 samples analyzed, 88 were positive on direct examination (48.7%) and 34 were positive after culture (22.4%). It concerned patients of mean age 32 years (24 years, 40 years), living with one sexual partner (79.4%), never had abortions (64.7%). We found the use of antibiotics (2.9%), corticosteroid therapy (5.9%) and diabetes (6.6%). Among the women included in the study, 32.4% were pregnant. 38.2% of patients used intimate bath and 14.7% used community bath towels; 23.5% wore synthetic underwear; 26.5% of tight clothing and 26.4% had wrong cleaning mode after defecation (p = 0.003). Symptoms associated with vaginal candidiasis were significantly leucorrhoea (38.2%; p = 0.000), burning sensation (22.4%; p = 0.003) and vulvar pruritus (35.5%; p = 0.016). The risk factors associated with the occurrence of vaginal candidiasis were the presence of leucorrhoea and the wrong cleaning mode after defecation associating both front to back / back to front. Patients with leucorrhoea had a 4.21 folds higher risk of vaginal candidiasis, while those with wrong cleaning mode front to-back / back-to-front had a 28.97 folds higher risk. Conclusion: Vaginal candidiasis is common in women of childbearing age with poor hygienic conditions. The associated factors identified are those found in the literature, among which, leucorrhoea and cleaning mode combined from front to back / back to front.

CONTRIBUTION OF THE MYCOLOGY LABORATORY IN THE MANAGEMENT OF ORAL CANDIDOSIS IN IMMUNODEPRESSED PATIENTS

The authors report a series of 49 cases of oral candidiasis including 20 symptomatic, listed on 100 immunocompromised patients collected at the Mohammed V Military Hospital in Rabat over a 12-month period. The objective of this work was to define the risk factors that lay the foundation for fungal proliferation in the mouth, through early detection in asymptomatic or non-asymptomatic patients. Mycological analysis in the laboratory was based on direct examination and culture on Sabouraud chloramphenicol medium with and without cycloheximide, then identification of the fungal species by API 20 C AUX galleries and the VITEK 2 compact® . The prevalence of oral candidiasis was 49%. The mean age of the patients was 54 years with a sex ratio M / F of 1.04. The contributing factors identified were hyposialia (p = 0.0337), corticosteroid therapy (p = 0.025 and dental removable prostheses (p = 0.000791). The fungal species identified were Candida albicans (79%), Candida dubliniensis (7%), Candida ciferrii (4%), Candida famata (4%), Candida glabrata (4%) and Candida lusitaniae (2%). Conclusion: The oral localization of candidiasis remains very frequent in immunocompromised subjects. Their treatment involves first of all the search for contributing factors and early detection in the presence of asymptomatic forms that only mycological analysis can identify the variety.

Otomycosis at Fann Hospital in Dakar (Senegal): Prevalence and Mycological Study

Otomycosis are auricular infections caused by microscopic fungi which develop essentially in the external ear canal. Their incidence has increased these past years with the emergence of predisposing factors such as the repetitive use of broad -spectrum antibiotics. The objectives of this study were to determine the prevalence of otomycosis at Fann National University Hospital in Dakar and to identify the fungal species responsible for that. This descriptive retrospective study held from October 2011 to December 2017 at 136 patients with clinically suspected otomycosis. External auditory canal exudates collected with swabs in each patient were observed by direct microscopic examination and cultured in Sabouraud Chloramphenicol medium with and without Actidione at 30-37°C. The strains were identified on the basis of macroscopic, microscopic and physiological characteristics. The mycological examination was positive in 59 patients, that is to say, a prevalence of 43.4%. The positivity rate was significantly higher among women (52.6%) than among men (31%) (p=0.012). This rate was significantly higher among patients suffering from otalgia (75.7%) than among others (p=0.023). On the mycological plan, Aspergillus fumigatus and Candida albicans were the species the most isolated (26.3%) followed by Aspergillus niger (22.8%). These results show that fungal agents have an important place in the etiologies of the external otitis at Fann Hospital CHNU. Hence the interest of the mycological diagnosis for a better treatment of patients.

Evaluation of the Allergenic Potential of Anagobaka infant Flours Marketed in the Markets of the District of Abidjan

The aim is to evaluate the sanitary quality of the infant flours of "Anagobaka" imported and sold on the markets of the district of Abidjan. There are eleven flours of "Anagobaka" distributed as follows, four from Adjamé, four from Abobo and three from Treichville, a local artisanal infant flour. An industrial infant flour has been used as a reference. Moisture and pH were measured by the Association of Official Analytical Chemists and contaminants by microbiological methods. Moisture contents of "Anagobaka" flours ranged from 8.79% ± 0.06 to 12.94% ± 0.49. That of local flours was 6.56% ± 0.21. These values ​​are above the norm of 5%, while the reference has a content which is 3.59% ± 0.2 respecting the norm. However, all these flours have an acidic pH of 5.25 ± 0.01 at 6.83 ± 0.01 After inoculation on Sabouraud chloramphenicol medium with the various suspensions of flours, the species Aspergillus flavus was identified in the brands, Jone Family, Bolero strawberry, Lady B, Fincap , Egg Banana and Glad Family at respective loads of 1400 cfu / g ± 173.21, 11.102 cfu / g ± 200, 9.102 cfu / g ± 200, 6.102 cfu / g ± 100, 4.102 cfu / g ± 100 and 2.102 cfu /g ± 00.( Whereas, the association Aspergillus flavus and Mucor sp was found in the Jone Family brand flour, at a load of 14.102 cfu / g ± 173.21.) All flours were free of other germs. The presence of molds does not meet microbiological standards recommended and represent a danger to the health of these children.

Recurrent vulvo-vaginal candidiasis in Abidjan (Côte d’Ivoire): Aetiology and associated factors

Recurrent vulvovaginal candidiasis (RVVC) is a major health problem for sexually active women because of its severe effect on their quality of life. A thorough knowledge of their epidemiology leads to their efficient management. Therefore, a cross-sectional study was conducted in 2014 in women with leucorrhoea associated or not with other clinical signs. Recurrence was based on the occurrence of at least four annual episodes of Candida vulvo-vaginitis. An individual interview based on a questionnaire was conducted to identify the socio-demographic parameters that could be associated with the RVVC. Vaginal samples were collected at the obstetrical gynaecology department of the University Hospital of Cocody and at the Pasteur Institute of Côte d’Ivoire. On each sample, a direct examination and culture on Sabouraud-chloramphenicol medium with or without actidione were performed. Yeast identification was performed using chromogenic media (CandiSelect®4 [Bio-Rad]) and the study of sugar assimilation using the Auxacolor® 2 gallery (Bio-Rad). A total of 400 patients were included. The average age was 29.2 years (SD=7.2 years). Of these, 94 had recurrent vulvovaginal candidiasis, with a prevalence of 23.5% (CI95%: 19.49–28.02). Five species of the genus Candida have been identified: Candida albicans (59.6%), Candida glabrata (19.1%), Candida tropicalis (16%), Candida krusei (4.2%) and Candida inconspicua (1.1%). Some factors such as education level, history of sexually transmitted infection, type of underwear used, frequency of personal hygiene and type of product used for these hygiene have been associated with the occurrence of RVVCs. The occurrence of RVVCs is relatively high in our study population. Non-albicansCandida species occupy a significant place in this disease epidemiology. By addressing the factors associated with the occurrence and/or persistence of RVVCs, it will be possible to reduce their incidence in sexually active women.

Epidemiology of Otomycosis at the Military Hospital Avicenne of Marrakech (Morocco)

Otomycosis is a fungal infection mainly affecting the outer ear, but can spread to the in nerear and become severe. The disease can cause a serious damage for its recurrence and resistance to treatment. The purpose of this work is to determine the prevalence of otomycosis in first place, then in second place to specify the contributing factors and to describe the spectrum of fungi involved. We conducted a prospective study over a period of 6 months between March 2018 and August 2018 in laboratory of parasitology and mycology at the Military Hospital Avicenna of Marrakech. Fore ach patient we performed an atrial sampling with sterile swabs. A direct examination and culture on Sabouraud-Chloramphenicol media with and without cycloheximide were carried out. The identification of fungi was based on the macroscopic, microscopic and phenotypic characteristics of colonies. Our study included 67 patients, of which 28 were positive, giving an overall prevalence of 41% with female predominance. The average age of our patients was 40 years old. Many factors enhanced the otomycosis, the daily cleaning of the external ear canal was the most recurrent factor (46%), followed by frequent bathing (35%). The most common species were Aspergillus niger (46%), Aspergillus flavus (35%), and Candida albicans (17%). This study demonstrates the importance of otomycosis in the etiologies of otitis in our population. The management of these infections must include a mycological study in order to establish an antifungal therapy adapted to the pathogen.

English

Recurrent vulvo-vaginal candidiasis is a major issue in pubescent females because of the fact that it is a source of health discomfort. For a better medical treatment, an analysis of susceptibility of Candida species to antifungal agents is fundamental. Therefore, this study aims to determine the susceptibility of Candida spp. to antifungal agents isolated in recurrent vulvo-vaginal candidiasis. This cross-sectional study was carried out in 2014 among 400 women with vaginal discharge. The recurrent vulvovaginitis was defined by the occurrence four times at least in a year. Vaginal swabs were cultured on Sabouraud-chloramphenicol medium, and Candida spp. were identified using a chromogenic technique. Susceptibility testing was performed using a microdilution method. In vitro susceptibility to antifungal agents test was performed using amphotericin B, 5-fluorocytosine, fluconazole, itraconazole and voriconazole against isolated Candida spp. Of 94 women positive from Candida spp., Candida albicans (59.6%) was the most prevalent with 59.6%. C. albicans did not show any resistance to amphotericin B and voriconazole. The susceptibility Candida glabrata to itraconazole was 50% and this species was relatively susceptible to fluconazole (77.8%) and voriconazole (83.3%). The medical treatment of recurrent vulvovaginal candidiasis requires a precise diagnosis based on a mycological analysis and the susceptibility to antifungal drugs. &nbsp; Key words: Recurrent vulvovaginal candidiasis, susceptibility, antifungal, Candida species.

Candidoses vulvo-vaginales chez les femmes enceintes au centre hospitalier Mère et Enfant de Nouakchott (Mauritanie)

AimTo determine the prevalence and the associated risk factors of vulvovaginal candidiasis in pregnant women in Mauritania. Patients and methodThe study was carried out at the laboratory of the Mère et Enfant Center in Nouakchott, from November 1, 2016 to February 5, 2017. It concerned all pregnant women in the third trimester that came to the natal consultation at the gynecology service. These women must have given their informed consent in written form. After completing the survey to collect epidemiological and clinical data, a sample was collected to perform fresh direct examination and culture on Sabouraud-Chloramphenicol media. ResultsTwo hundred pregnant women were included in the study. Culture on Sabouraud-Chloramphenicol media was positive in 52 patients corresponding to a prevalence of 26%. The germ tube test was positive for 61.5% of isolated Candida. Clinical signs are dominated by leucorrhea (56%), pelvic pain (25%) and vulvar pruritus (11%). Among women with positive culture, 55.76% had received local antifungal treatment in the form of an ovula during pregnancy. ConclusionThis study shows that vulvovaginal candidiasis is frequent in pregnant women attending gynecology at the Mère et Enfant Hospital Center in Nouakchott.

Contribution of predominant yeasts to the occurrence of aroma compounds during cocoa bean fermentation

Cocoa flavor is the most important organoleptic property according to chocolate consumers. Raw cocoa beans sourced from Ivory Coast are not known for their fine aroma quality. In the global framework of raw cocoa quality improvement, this study dealt with the determination and control of the conditions of the aroma compound formation and aimed to determine the potential contribution of yeast associated with the fermentation to the formation of sensory profiling for cocoa beans. Using the method of SPME–GC–MS, the potential for flavor contribution of some predominant yeasts isolated from cocoa fermentation assays performed around Abidjan and then grown on Sabouraud-chloramphenicol medium was determined. Also, the flavor precursor compounds of final corresponding raw cocoa bean samples prepared according to specific post-harvest processing were analyzed. A total of around ten species of yeast involved in cocoa fermentation but among them, six strains were namely identified as Saccharomyces cerevisiae, Candida tropicalis, Pichia kudriavzevii, Pichia galeiforms, Galactomyces geotrichum and Wickerhamomyces anomalus. These identified yeasts produced a total of 33 aroma compounds grouped into four families such as esters, alcohols, acids and others. Among all yeasts involved in fermentation performed in Abidjan, P. kudriavzevii, S. cerevisiae, G. geotrichum and W. anomalus could be considered as the most important contributors to the formation of cocoa specific aroma compounds. These cocoa aroma producing capacities of yeast isolates could be used to improve the sensory profiling raw cocoa beans or other fermented food stuffs. Furthermore some specific yeast isolates could be used as biological markers to predict the determining of chocolate sensorial characteristics and to indicate the geographical origin or processing story of cocoa bean batches.

Cryptoccocal meningitis in Yaoundé (Cameroon) HIV infected patients: Diagnosis, frequency and Cryptococcus neoformans isolates susceptibility study to fluconazole

Cryptococcal meningitis is a mycosis encountered especially in patients with Acquired Immunodeficiency Syndrome and is fatal in the absence of treatment. Information on epidemiology, diagnosis and susceptibility profile to antifungal drugs, are scarce in Cameroon. Authors evaluated the diagnosis possibilities of the cryptococcal meningitis in Cameroon, and studied the antifungal susceptibility of isolated strains to fluconazole, used as first line treatment of the disease in Cameroon. Between December 2009 and July 2011, 146 cerebrospinal fluids obtained from HIV patients with suspicion of meningitis were analysed. The diagnosis procedure involved macroscopic and cyto-chemical analysis, India ink test, culture on Sabouraud chloramphenicol medium and antigen latex agglutination test. Antifungal susceptibility testing of isolated strains to fluconazole was done by the E-test(®) method. The diagnosis of cryptococcal meningitis gave 28.08% positive cases. Among these patients, 80% were at stages III and IV and 20% at stage I of the HIV infection, according to the WHO previous classification. Cyto-chemical analysis showed current findings in the case of cryptococcal meningitis. India ink test and latex agglutination test exhibited very high sensitivity and specificity (>94%). Fluconazole antifungal susceptibility testing gave MICs lower than 32μg/mL to 92.7% of isolated strains and MICs greater than this value to 7.3% of isolates. These results showed that cryptococcal meningitis remains a real problem among HIV infected patients in Yaoundé. The emergence of fluconazole reduced susceptibility strains is worrying. Nevertheless, efficacy of rapid detection tests is interesting because this will help in rapid diagnosis and treatment of patients.

Mucormycose rhinofaciale : à propos d’un cas

Mucormycosis is the third among deep fungal opportunistic infections after candidiasis and aspergillosis. It is a rare fungal infection in children, but often fatal, which occurs in immunocompromised patients. It is caused by fungi belonging to the order of mucorales. It causes extensive damage and decaying soft parts. The authors report the case of a sinonasal mucormycosis with fatal outcome in a child suffering from hemophagocytic syndrome.PL, aged 23 months, resulting from non-consanguineous parents, hospitalized for management of hemophagocytic syndrome lasting for 2 months suspected on clinical and biological data. This diagnosis was confirmed on histology. The etiological diagnosis was negative. A broad-spectrum antibiotics and corticosteroids was introduced. A month later, the patient developed necrotic lesions in the nose and facing the right maxillary sinus. CT scan of facial mass objectived ethmoïdomaxillary bilateral sinusitis. The mycological examination of a nasal swab showed the presence of non-compartmentalized hyphae, culture on Sabouraud chloramphenicol medium without actidione at 37°C isolated Absidia corymbifera. Treatment with amphotericin B was initiated but not tolerated. The negative trend was rapidly leading to death.Rhinocerebral mucormycosis is a rare fungal infection in children, we must know how to keep it in mind. The mycological examination and/or histology of a local levy allows rapid diagnosis. Treatment should be initiated urgently to improve the prognosis.