An investigation of the distribution of Candida species in genitourinary candidiasis and pelvic inflammatory disease from three locations in Ghana

Abstract

The aim of this study was to determine the frequency of various Candida species in cases of genitourinary candidiasis and pelvic inflammatory disease (PID) in Ghana. To achieve this, Candida isolates were recovered from high vaginal swabs of patients with vulvovaginal candidiasis (VVC), urine samples from patients with urinary tract infections (UTIs) and endocervical swabs from patients with PID, from three teaching hospitals in Ghana. The hospitals were located at Korle Bu, Komfo Anokye and Tamale. These isolates were identified to the species level on the basis of the color of the colonies that they formed on chromogenic medium. Candida albicans was the most common species in high vaginal swabs from patients present for the first time with VVC in each of the three locations, and was present in 53.4% of the total swabs. The other species that were present were Candida glabrata (21.6%), Candida parapsilosis (15.5%), Candida tropicalis (4.7%) and Candida krusei (4.7%). Only single species were found in these swabs. In patients with VVC for at least the third time, Chi square analysis indicated that the frequency of each of these species were not statistically different from those present for the first time, although 15% of the swabs from these patients contained more than one species. For all patients with VVC, no significant differences were observed in the frequencies of the species between the three locations. Similar distributions were found in swabs taken from patients with PID. Across the three locations however, there was a significant difference in the frequency of C. albicans, which was present in 68 and 69.6% of patients from Komfo Anokye and Tamale, but only 26.7% of patients from Korle Bu. Twenty one percent of swabs from patients with PID contained more than one species. Urine samples were also collected from two of the locations, Korle Bu and Tamale, in female patients with candiduria. In Korle Bu, C. glabrata was the most prominent species (37.8%) followed by C. albicans (22.4%), C. parapsilosis (21.7%), C. tropicalis (10.5%), C. krusei (7%) and Candida lusitaniae (0.7%). In Tamale, the species distribution was C. albicans (60.9%), C. glabrata (21.7%), C. parapsilosis (13%) and C. krusei (4.3%). Statistical analysis indicated a significant difference in the frequency of C. albicans between the two locations. Fourteen percent of the urine samples contained more than one species. Taken as a whole, these data highlight a relatively high prevalence of species other than C. albicans, in cases of genitourinary candidiasis and PID in Ghana. This is consistent with a trend towards the emergence of other Candida species that may be more resistant to the first line antifungal treatments.

Performance of Chromogenic Candida Lab-Agar® Medium in Presumptive Identification of Candida Species from Clinical Samples at Sourô Sanou University Hospital of Bobo-Dioulasso, Burkina Faso

“…In our study, C. albicans (43.37%) was the most common yeast encountered in all clinical sources. This result is consistent with previous reports from symptomatic patients in Burkina Faso and other parts of the world [5,[32][33][34][35][36]. In this study, Candida non-albicans species together represented a greater proportion than C. albicans did, meaning that in Burkina Faso, almost half of suspected candidiasis cases are caused by non-albicans species.…”