Njovu Israel Kiiza, Musinguzi Benson, Mwesigye James, Kassaza Kennedy, Turigurwa Joseph, Nuwagira Edwin, Bazira Joel, Kabanda Taseera, Mpeirwe Moses, Ampaire Lucas, Mutekanga Andrew, Kiguli James, Achan Beatrice, Itabangi Herbert
Department of Microbiology, Mycology Unit, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
Department of Medical Laboratory Science, Faculty of Health Sciences, Muni University, Arua, Uganda.
Ther Adv Infect Dis. 2021 Aug 31;8:20499361211042477. doi: 10.1177/20499361211042477. eCollection 2021 Jan-Dec.
Pulmonary mycoses are important diseases of the respiratory tract caused by pulmonary fungal pathogens. These pathogens are responsible for significant morbidity and mortality rates worldwide; however, less attention has been paid to them. In this study we determined the prevalence of pulmonary fungal pathogens among individuals with clinical features of pulmonary tuberculosis at Mbarara Regional Referral Hospital.
This was a hospital based cross sectional survey. Sputum samples were collected from each study participant. For each sample, the following tests were performed: Sabouraud dextrose agar for fungal culture, GeneXpert for (MTB) and potassium hydroxide for fungal screening. Filamentous fungal growth and yeasts were further examined with lactophenol cotton blue staining and germ tube respectively.
Out of 113 study participants, 80 (70.7%) had pulmonary fungal pathogens whilst those with pulmonary tuberculosis numbered five (4.4%). [21 (22.58%)] and species [16 (17.20%)] were the pathogens most identified among others. Two (1.7%) TB GeneXpert positive participants had fungal pathogens isolated from their sputum samples. We established a prevalence of 57 (71.3%) for pulmonary fungal pathogen (PFP) isolates, three (60.0%) for MTB in HIV positive patients and 18 (22.5%) for PFP, and zero (0.0%) for MTB in HIV negative patients. On the other hand, two (100%) HIV positive patients had both PFP isolates and MTB.
Our findings highlight the diversity of neglected pulmonary fungal pathogens whose known medical importance in causing pulmonary mycoses cannot be overemphasised. Therefore this presents a need for routine diagnosis for pulmonary mycoses among TB suspects and set-up of antimicrobial profile for pulmonary fungal isolates to support clinical management of these cases.
肺部真菌病是由肺部真菌病原体引起的重要呼吸道疾病。这些病原体在全球范围内导致了相当高的发病率和死亡率；然而，它们受到的关注较少。在本研究中，我们确定了姆巴拉拉地区转诊医院具有肺结核临床特征的个体中肺部真菌病原体的流行情况。
这是一项基于医院的横断面调查。从每位研究参与者收集痰液样本。对每个样本进行以下检测：用于真菌培养的沙氏葡萄糖琼脂培养基、用于检测结核分枝杆菌（MTB）的GeneXpert以及用于真菌筛查的氢氧化钾。丝状真菌生长和酵母分别用乳酚棉蓝染色和芽管试验进一步检查。
在113名研究参与者中，80名（70.7%）有肺部真菌病原体，而患有肺结核的有5名（4.4%）。曲霉菌属[21名（22.58%）]和念珠菌属[16名（17.20%）]是最常被鉴定出的病原体。两名（1.7%）GeneXpert检测结核呈阳性的参与者痰液样本中分离出了真菌病原体。我们确定肺部真菌病原体（PFP）分离株的流行率为57名（71.3%），HIV阳性患者中MTB为3名（60.0%），PFP为18名（22.5%），HIV阴性患者中MTB为零（0.0%）。另一方面，两名（100%）HIV阳性患者同时有PFP分离株和MTB。
我们的研究结果突出了被忽视的肺部真菌病原体的多样性，其在引起肺部真菌病方面的已知医学重要性再怎么强调也不为过。因此，这表明有必要对结核病疑似患者进行肺部真菌病的常规诊断，并建立肺部真菌分离株的抗菌谱，以支持这些病例的临床管理。
