Abstract:
Fungal co-infection with Mycobacterium tuberculosis is most likely because most of the
pulmonary tuberculosis patients are co-infected infected with HIV/AIDS making them
highly immunocompromised with high risk of acquiring opportunistic fungal pathogens.
The study objective was to determine fungal pathogens co-infection with
Mycobacterium tuberculosis in patients attending Mbagathi District Hospital
Tuberculosis reference laboratory. One hundred and seventy two samples of sputum
from the patients having pulmonary tuberculosis were subjected to mycological
investigations for fungal pathogens like Pneumocystis jirovecii, Cryptococcus spp.,
Candida spp., Aspergillus spp. and other systemic fungal pathogens. The study was done
using samples from confirmed tuberculosis patients at Mbagathi District Hospital. First
morning expectorate sputum samples intended for mycobacteriological investigations
were subjected to mycological investigation using microscopy and culture. From this
study the results showed that adults were much infected with pulmonary tuberculosis
than children. It was indicated that males were more infected with pulmonary
tuberculosis than the females. The study indicated that Mycobacterium tuberculosis coinfect with yeasts as indicated in the following results: Amomg the 46 yeasts isolates 33
(19.2%) were Candida albicans, 3 (1.7%) were Candida dubliensis, 1 (0.6%) was
Candida guilliermondii, 3 (1.7%) were Candida tropicalis, 2 (1.2%) were Cryptococcus
lauretii. 126 samples (73.3%) were negative for yeasts. From the study, Candida
albicans were the most predominant yeasts that co-infected with Mycobacterium
tuberculosis. Mycobacterium tuberculosis also co-infected with the fungi inform of mold as shown in
the following results: Among the samples involved 2 organisms (1.2%) were identified
as Aspergillus flavus 3 (1.7%) were Aspergillus fumigatus, 4 (2.3% )were isolated as
Aspergillus niger, 2 (1.2%)were Scytalidium hyalinum, 4 (2.3%) were isolated as
Trichosporon asahii. 157 samples (91.3%) were negative for molds. Aspergillus niger
and Trichosporon asahii were the most predominant molds that co-infected with
Mycobacterium tuberculosis.Pneumocystis jirovecii were also isolated from the sputum
samples and all the 172 samples were subjected to Toluidine Blue 0 for the detection of
the Pneumocystis jirovecii and a total of 19 samples (11.0 %) positive for Pneumocystis
jirovecii and a total of 153 samples (89%) were negative for Pneumocystis jirovecii.
Bacteria were also isolated from the sputum samples as follows: 4 bacteria (2.3%) were
isolated as Gram negative rods, 10 (5.8%) were Gram positive cocci, 6 (3.5%) were
isolated as Gram positive rods.152 samples (88.4%) were negative for bacteria. Male
adults were more susceptible to pulmonary tuberculosis than females or children with
prevalence of 59.9%. The most predominant yeasts that co-infected with pulmonary
tuberculosis were the Candida albicans with a prevalence of 19.2%. This was due to the
fact that Candida albicans are normal flora of respiratory system. In this study there was
significant co-infection of yeasts with Mycobacterium tuberculosis with a chi-squire pvalue of 0.02. According to this study, there was no significant co-infection of molds
and Pneumocystis jirovecii with Mycobacterium tuberculosis after calculation of chisquire p-values of 0.28 and 0.86 respectively.