Spectrum of Systemic Yeast Infections in Leukemia Patients in Cameroon and Sensitivity of Isolates to Griseofulvin, Ketoconazole and Organic Extracts of Four Medicinal Plants

Abstract

Clinical management of leukemia patients with hydroxyurea -based chemotherapy drugs and radiotherapy often does not yield very quick therapeutic benefits in patients, especially in tropical resource limited countries. Evidence based supportive and palliative care plan is critical in the clinical management of leukemia patients, which clinicians and oncologists in Africa often do not adequately implement during in-patient management in hospitals for a number of reasons including cost and knowledge. The spectrum of opportunistic infections in leukemia conditions is not well known and considered during management plans. In this study, we report the spectrum of systemic yeast infections amongst leukemia patients attending Phytobiotechnology Research Foundation clinic in Cameroon from June 2012 to June 2015 for the presence of various opportunistic systemic mycoses. All the patients in this study were already receiving hydroxyurea therapy for more than one year at the hospitals in Cameroon. The screening and testing were done through visual observation, KOH microscopy, in addition to culture tests on potato and malt extract agars. Twenty patients screened, were found with systemic yeast infections. Culture of urine, mouth swabs, vaginal fluids and blood yielded a 80% isolates of Candida albicans, and 20% Non Albicans Candida (NAC) including Cryptococcus species isolated from oral swab only. The results generally show that systemic yeasts are prevalent in leukemia patients and its co morbidity may possibly complicate effective chemotherapy treatment. The anti-yeast activity of Persea americana, magnifera indica, Moringa oleifera, and Allium sativum was significant with zones of inhibitions exhibited by Moringa oleifera and Allium sativum showing a better ant yeast activities than with ketoconazole and griseofulvin. The results also suggested the need to exploit alternative botanicals in the comanagement of leukemia as well as its attending opportunistic infections is a critical step toward generating a better treatment for leukemia.

Isolation and Identification of Candida spp. In immunocomparomised patients and Detection some virulence factors.

“…For sputum samples the results showed that C.albicans were most isolated 3(60%), followed by C.glabrata 2(40%), as illustrated in table (3). (36) isolated 12 isolates of C.albicans from 98 sputum. which were agreement with our results ,and Jaffer (1998) (37) in Babylon province reported that C. albicans (69.2%) was the most common isolate in a study of pulmonary fungal infection, less frequency are C. tropicalis (19.2%), C. kefyr (7.6%) and C. krusei (3%).…”

“…There were many studies which have been conducted on opportunistic fungi in immunocompromesid patients. One of these studies was byYongabi et al(2009) …”