1. INTRODUCTION AND OBJECTIVES DISCUSSION AND CONCLUSION
Prevalence of Candida species Isolated from Clinical and Environmental Sources in Nnamdi Azikiwe University Teaching Hospital, Nnewi – Nigeria.
1 Odeyemi,Oluwayemisi; 2 Enweani, Ifeoma; 2 Agbakoba,Nneka; 2 Ochiabuto, Barbara; 3 Odeyemi, Sunday.
1,Microbiology Department, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.
2, Faculty of Health Sciences & Technology, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria
3,Defense Reference Laboratory, Mogadishu Cantonment, Asokoro, Abuja,Nigeria.
INTRODUCTION AND OBJECTIVES
INTRODUCTION Candida species are yeast like fungi that can form true hyphae and pseudohyphae. They are the most common cause of opportunistic mycoses worldwide. Candida species are confined to human and animal reservoirs. The genus Candida includes about 154 species. Among these, six are most frequently isolated in human infections. While Candida albicans is the most abundant and significant species, Candida tropicalis, Candida glabrata, Candida parapsilosis, Candida krusei, and Candida lusitaniae are also isolated as causative agents of Candida infections. However, they are frequently recovered from the hospital environment including foods, countertops, air-conditioning vents, floors, respirators, and medical personnel .They are also normal commensals of diseased skin and mucosal membranes of the gastrointestinal, genitourinary, and respiratory tracts (Yang, 2003). Patients who are critically ill and in medical and surgical intensive care units (ICUs) have been the prime targets for opportunistic nosocomial fungal infections, primarily due to Candida species. On a daily basis, virtually all physicians are confronted with a positive Candida isolate obtained from one or more various anatomical sites. High-risk areas for Candida infection include medical and surgical wards, neonatal wards, pediatric wards, and adult ICUs. Candida infections can involve any anatomical structure. (Pappas et al., 2003). Candida species  have been implicated as a major cause of nosocomial infections. Several host factors predispose to Candida inflections which are physiological,trauma,hematological,latrogenic,intravenous drug addiction,malnutrition and malabsorption. OBJECTIVES The objectives of this study is to determine the prevalence of Candida species isolated from clinical samples  of staff and patients visiting NAUTH, Nnewi and those from hospital environment.
DISCUSSION AND CONCLUSION
DISCUSSION
In this study, four Candida species were isolated from both environmental and clinical samples in NAUTH viz; Candida albicans, Candida parapsilosis, Candida glabrata and Candida tropicalis. Microbiological analysis of the environmental and clinical samples revealed that Candida albicans is most prevalent in the clinical samples of both patients (18.8%) and staff (10%) (P<0.05). This agrees with the historical findings that, c. albicans accounted for 70 to 90% of the isolates recovered from infected patients while C. glabrata and C. tropicalis accounted for approximately 5 % each. Other Candida species were only rarely isolated from clinical specimens (Anane et al., 2007). Finding from this study also revealed that C. parapilopsis was most prevalent in the environmental samples with a prevalence of 6.3% (P>0.05). C.parapilopsis is typically a commensal of human skin and its pathogenicity is limited by intact integument. C. parapilopsis is notorious for its capacity to grow in total parenteral nutrition and to form biofilms on catheters and other implanted devices, for nosocomial spread by hand carriage and for persistence in the hospital environment (Clark et al., 2004).
CONCLUSION This study has revealed that Candida species exist in NAUTH both on environmental and clinical samples. Candida albicans and Candida parapsilosis were found to be most prevalent in clinical and environmental samples respectively.
METHODS AND RESULTS
METHODS Ethical approval was obtained from the ethical committee of Nnamdi Azikiwe University Teaching Hospital ,Nnewi, Anambra state, Nigeria. The method was carried out by collecting and analyzing environmental and clinical samples. A total of 636 samples were collected for the study consisting of 96 environmental and 540 (220 from staff and 320 from patients) clinical samples. Environmental samples were randomly collected using sterile swab sticks to swab some environmental surfaces (tables, beds, floor, palms, baby couches, sink, door handles, chairs, cups used for scooping water for hand washing). In addition, clinical samples (urine, High Vagina Swab (HVS), wounds swabs, stool, blood culture, sputum) were collected from both patients and staff members in NAUTH. Isolation and identification of the Candida species were done using Sabouraud and Candida CHROM agars. RESULTS Findings revealed that C. albicans was more prevalent in the clinical samples (18.8% for patients and 10.0% for staff) than C. parapsilopsis (5.0% for patients, 2.7% for staff), C. glabrata (1.9% for patients and 0.9% for staff) and C. tropicalis (0.6% for patients and 0% for staff) (P<0.05). On the other hand, Candida parapsilosis was more prevalent (6.3%) in the environmental samples than C. albicans (5.2%) and C. tropicalis (1%) (P<0.05). These are shown in the pie charts below; fig.1, fig.2 and fig 3. This shows that C. albicans is more incriminated in candidosis than other species of Candida organisms. It also shows that C. albicans and C. parapsilosis are potential sources of nosocomial fungal infections acquired from hospital environment.
REFERENCES
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ACKNOWLEDGEMENT
I acknowledge all the staff of Nnamdi Azikwe University Teaching Hospital, Nnewi - Anambra State, Nigeria for their support during the sample collection and all the patients and staff who submitted their samples for the research work.