A STUDY ON PREVALENCE OF PULMONARY CANDIDIASIS AMONG TUBERCULOSIS PATIENTS AND USE OF CHROMAGAR IN IDENTIFICATION OF CANDIDA SPECIES

Abstract

Introduction: In recent years, fungal infections are on the rise due to various predisposing factors such as long term administration of antibiotics, use of steroids, pulmonary tuberculosis, immunosuppressive drugs and HIV infection. When host resistance is lowered, these opportunistic fungi may become fatal. Candida albicans was the most important pathogen causing pulmonary candidiasis. In recent times, there is increase in incidence of non-albicans Candida. Identification to the species level becomes mandatory in the selection of appropriate antifungal agents. Aim: To find out the prevalence of Candida co-infection among pulmonary tuberculosis patients and to identify the species of Candida using CHROMagar. Materials & Methods: A total of 107 smear positive pulmonary tuberculosis patients were included in this study. Two consecutive sputum samples were collected and subjected to gram staining. Only those samples which showed pus cells with budding yeast cells and pseudohyphae in direct gram stain were cultured on Sabouraud’s dextrose agar (SDA) with gentamycin. The Candida grown was identified and speciated based on the color produced on CHROMagar Candida. Results: Out of 21 Candida isolates, 14 were C. albicans (66.7%), 2 were C. tropicalis (9.5%), 2 were C.krusei (9.5%), 2 were C. parapsilosis (9.5%) and one was C. glabrata (4.8%). Conclusion: The secondary fungal infections are associated with persistence of lung symptoms inspite of successful completion of antituberculous therapy. Hence adequate measures need to be taken for the early identification and treatment of these opportunistic infections.

Keywords: Pulmonary tuberculosis, Candida albicans, non-albicans Candida, antifungal agents