Vol. 8(6), pp. 470-475, 5 February, 2014
DOI: 10.5897/AJMR2013.6407
ISSN 1996-0808 ©2014 Academic Journals
http://www.academicjournals.org/AJMR
African Journal of Microbiology Research
Full Length Research Paper
An investigation of the distribution of Candida species
in genitourinary candidiasis and pelvic inflammatory
disease from three locations in Ghana
Gloria Adjapong, Marie Hale and Ashley Garrill*
School of Biological Sciences, University of Canterbury, Private Bag 4800, Christchurch, New Zealand.
Accepted 23 January, 2014
The aim of this study was to determine the frequency of various Candida species in cases of
genitourinary candidiasis and pelvic inflammatory disease (PID) in Ghana. To achieve this, Candida
isolates were recovered from high vaginal swabs of patients with vulvovaginal candidiasis (VVC), urine
samples from patients with urinary tract infections (UTIs) and endocervical swabs from patients with
PID, from three teaching hospitals in Ghana. The hospitals were located at Korle Bu, Komfo Anokye and
Tamale. These isolates were identified to the species level on the basis of the color of the colonies that
they formed on chromogenic medium. Candida albicans was the most common species in high vaginal
swabs from patients present for the first time with VVC in each of the three locations, and was present
in 53.4% of the total swabs. The other species that were present were Candida glabrata (21.6%), Candida
parapsilosis (15.5%), Candida tropicalis (4.7%) and Candida krusei (4.7%). Only single species were
found in these swabs. In patients with VVC for at least the third time, Chi square analysis indicated that
the frequency of each of these species were not statistically different from those present for the first
time, although 15% of the swabs from these patients contained more than one species. For all patients
with VVC, no significant differences were observed in the frequencies of the species between the three
locations. Similar distributions were found in swabs taken from patients with PID. Across the three
locations however, there was a significant difference in the frequency of C. albicans, which was present
in 68 and 69.6% of patients from Komfo Anokye and Tamale, but only 26.7% of patients from Korle Bu.
Twenty one percent of swabs from patients with PID contained more than one species. Urine samples
were also collected from two of the locations, Korle Bu and Tamale, in female patients with candiduria.
In Korle Bu, C. glabrata was the most prominent species (37.8%) followed by C. albicans (22.4%), C.
parapsilosis (21.7%), C. tropicalis (10.5%), C. krusei (7%) and Candida lusitaniae (0.7%). In Tamale, the
species distribution was C. albicans (60.9%), C. glabrata (21.7%), C. parapsilosis (13%) and C. krusei
(4.3%). Statistical analysis indicated a significant difference in the frequency of C. albicans between the
two locations. Fourteen percent of the urine samples contained more than one species. Taken as a
whole, these data highlight a relatively high prevalence of species other than C. albicans, in cases of
genitourinary candidiasis and PID in Ghana. This is consistent with a trend towards the emergence of
other Candida species that may be more resistant to the first line antifungal treatments.
Key words: Genitourinary candidiasis, Candida albicans, Candida glabrata, Candida parapsilosis, Vulvovaginal
candidiasis, Ghana.
INTRODUCTION
Candida infections of the genitourinary tract are of interest
to clinicians as they can occur in both Immuno-compro-
misedand immunocompetent individuals. Such infections
can have significant effects on morbidity; symptoms of
vulvovaginal candidiasis (VVC) for example include local
irritation, burning and pruritus, all of which can contribute