Prevalence and Antifungal Susceptibility Patterns of Yeast Isolates at the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana

Aims: To determine the prevalence of yeast species and their antifungal susceptibility profiles at Komfo Anokye Teaching Hospital (KATH), Kumasi.
Study Design: Cross-sectional design.
Methodology: This study was conducted in 2009 at the bacteriology laboratory at KATH, Kumasi, Ghana. In six-months, 528 clinical samples comprising 186(35%) high vaginal swabs, 109(21%) cerebrospinal fluid, 127(24%) urine and 106(20%) sputum were cultured on sabouraud dextrose agar. Yeast growths were identified by their characteristics, indian-ink staining and germ tube test and then confirmed with the API ID 32 C test kits. Antifungal susceptibility tests were performed using ATB™ FUNGUS 3 test kit.
Results: Out of 528 samples tested 67 yielded yeasts giving a prevalence of 12.7%. Candida albicans was the commonest species isolated with a prevalence of 33(49.3%) followed by Candida glabrata 12(17.9%), Candida tropicalis 8(11.9%), Candida dubliniensis 4(6%), Candida krusei 3(4.5%) and Candida sake 2(3%), whilst Candida guilliermondii and Candida parapsilosis prevalence was 1(1.5%) each and Cryptococcus neoformans prevalence was 3(4.5%). All the isolates were susceptible to flucytosine, amphotericin B, fluconazole, itraconazole and voriconazole except C. albicans, C. glabrata, C. tropicalis and C. krusei all having about 79% susceptibility to flucytosine, amphotericin B, and itraconazole (MICs 0.125-8mg/l). Voriconazole was the only agent to which no resistant yeast was detected. All the Candida krusei isolated were resistant to fluconazole (MICs ≥ 64mg/l). Generally yeast resistance ranges from 4.5% to 22.2% to flucytosine, amphotericin B, fluconazole and itraconazole.
Conclusion: There were many yeast species isolated, but Candida albicans was the most common isolate obtained from all the clinical samples tested except cerebrospinal fluid from which Cryptococcus neoformans was the commonest. The overall resistance levels of the isolates ranged from 4.5% to 22.2% to flucytosine, amphotericin B, fluconazole and itraconazole. No resistant strains were detected against voriconazole. This high level of resistance (22.4%) in Ghana calls for further investigation. This is the first report on the yeast types and their antifungal susceptibility patterns in Ghana.