Diagnosis and Epidemiology of Urinary Candida Species in HIV-Positive Patients in a Nigerian Reference Medical Centre

Fungi thrive in hospitalized patients with underlying diseases. The urine samples of, one hundred and eight (108) human immunodeficiency virus (HIV)-positive patients currently on anti-retrovirals at the Federal Medical Centre Jalingo, Nigeria, were cultured on Sabouraud Dextrose Agar to isolate and investigate the occurrence, distribution, morphological, biochemical and genomic characters of Candida species. The prevalence of fungi was 62.0%. It was higher in females (68.0%) than in males (48.5%). All (100.0%) HIV-positive patients older than 74 years were infected while those between 55 and 64 years were least (33.3%) infected. Culturally, 43.3% of the fungal isolates had characteristic growth of Candida species while 56.7% had none. Microscopically, of the 29 Candida isolates, 79.3% had germ tubes typical of Candida albicans while 20.7% showed no hyphal extension (non-albicans species). Yeasts identified as C. albicans were subjected to molecular confirmation due to their close phenotypic relationship with other Candida species using the BLAST search. The similarity between the sequence queried and the biological sequences within the National Center for Biotechnology Information (NCBI) database that speciated the Candida isolated from the HIV-positive patients was approximately 100%. The HIV-positive patients that were between 25 and 34 years accounted for the highest prevalence (34.8%) of Candida albicans while none (0%) of those older than 74 years were infected. Infection rate was higher in females (69.6%) than in males (30.4%). Pregnant females were more (62.5%) infected than non-pregnant females (18.8%). Prevalence was least (18.8%) and equal in non-pregnant females and lactating but non-pregnant females. The effectiveness of the BLAST search, as a diagnostic tool in identifying C. albicans in HIV-infected individuals helped establish an association between C. albicans and HIV infections in patients currently receiving anti-retroviral medication, the distribution of which could possibly determine the clinical manifestations and management of infected patients.