title: Prevalence of Candida co-infection in patients with pulmonary tuberculosis.
abstract: BACKGROUND
  Candida species are emerging as a potentially pathogenic fungus in patients with broncho-pulmonary diseases. The synergistic growth promoting association of Candida and Mycobacterium tuberculosis has raised increased concern for studying the various Candida spp . and its significance in pulmonary tuberculosis patients during current years.
  
  
  OBJECTIVE
  This study was undertaken with the objective of discovering the prevalence of co-infection caused by different Candida species in patients with pulmonary tuberculosis.
  
  
  METHODS
  A total of 75 patients with pulmonary tuberculosis diagnosed by sputum Ziehl-Neelsen staining were included in the study. Candida co-infection was confirmed using the Kahanpaa et al. criteria. Candida species were identified using gram stain morphology, germ tube formation, morphology on cornmeal agar with Tween-80, sugar fermentation tests and HiCrome Candida Agar.
  
  
  RESULTS
  Candida co-infection was observed in 30 (40%) of patients with pulmonary tuberculosis. Candida albicans was the most common isolate observed in 50% of the patients with co-infection, followed by C. tropicalis (20%) and C. glabrata (20%). Candida co-infection was found in 62.5% of female patients, while it was observed in only 29.4% of the male patients (P value 0.0133). Mean ± SD age of the patients with C. glabrata infection was 65.83 ± 3.19, while the mean ± SD age of the patients with other Candida infections was 43.25 ± 20.44 (P value 0.0138).
  
  
  CONCLUSIONS
  Many patients with pulmonary tuberculosis have co-infection with Candida spp. The prevalence of non-albicans Candida species is increasing and may be associated with inadequate response to anti-tubercular drugs. C. glabrata infection has a strong association with old age.
authors.affiliation: Department of Microbiology, Mahatma Gandhi Medical College & Research Institute, Pondicherry.
authors.forename: Arunava
authors.initials: A
authors.lastname: Kali
authors.forename: Mv Pravin
authors.initials: MP
authors.lastname: Charles
authors.forename: Mariya Joseph
authors.initials: MJ
authors.lastname: Noyal
authors.forename: Umadevi
authors.initials: U
authors.lastname: Sivaraman
authors.forename: Shailesh
authors.initials: S
authors.lastname: Kumar
authors.forename: Joshy M
authors.initials: JM
authors.lastname: Easow
keywords: C. glabrata; Candida co-infection; prevalence; tuberculosis
references.citation: Clin Infect Dis. 2004 Jan 15;38(2):161-89
references.pmid: 14699449
references.citation: Clin Infect Dis. 2005 Nov 1;41(9):1365-6
references.pmid: 16206121
references.citation: Clin Microbiol Rev. 1999 Jan;12(1):80-96
references.pmid: 9880475
references.citation: PLoS One. 2010 Jan 20;5(1):e8796
references.pmid: 20098716
references.citation: Iran J Microbiol. 2011 Dec;3(4):183-8
references.pmid: 22530086
references.citation: Can J Microbiol. 1954 Oct;1(2):85-9
references.pmid: 14352043
references.citation: J Postgrad Med. 1982 Jan;28(1):24-9
references.pmid: 7050368
references.citation: J Investig Clin Dent. 2012 Feb;3(1):51-5
references.pmid: 22298521
references.citation: Probl Tuberk Bolezn Legk. 2005;(3):14-6
references.pmid: 15945445
references.citation: East Afr Med J. 2005 Dec;82(12):609-13
references.pmid: 16619704
references.citation: Acta Pathol Microbiol Scand B Microbiol Immunol. 1972;227:1-147
references.pmid: 4554942
references.citation: Am J Respir Crit Care Med. 1997 Aug;156(2 Pt 1):583-90
references.pmid: 9279244
references.citation: Clin Microbiol Rev. 2008 Oct;21(4):606-25
references.pmid: 18854483