Research Article

Assessment of Cytological Features of Sputum Samples Obtained From Immunocompromised Patients Coinfected with Some Pulmonary Pathogens in Kano State, Nigeria

1 Department of Medical Laboratory Science, Faculty of Allied Health Sciences, College of Health Sciences Bayero University Kano, Nigeria
2 Department of Medical Laboratory Science, Faculty of Allied Health Sciences, College of Medical Sciences, Ahmadu Bello University, Zaria, Nigeria
3 Bauchi State Hospital Management Board
4 Department of Anatomic Pathology and Forensic Medicine, Kaduna State University College of Medicine, Kaduna, NW Nigeria, 900001
* Corresponding author: zakariyyab10@gmail.com
Published: Dec, 2020
Pages: 5438-5445

Abstract

Patients with advanced stages of Human immunodeficiency virus (HIV) infection, or Acquired immunodeficiency syndrome (AIDS), are vulnerable to secondary opportunistic infections. The aim of the study was to assess the cytological features of sputum samples obtained from patients co-infected with pulmonary pathogens in Kano. Sputum samples were collected from HIV infected patients attending Aminu Kano Teaching Hospital and digested using potassium hydroxide and epithelial and non-epithelial cells were harvested, smeared and fixed using alcohol for Papanicolaou staining method for cellular morphology. The sputum samples were also smeared using Ziehl-Neelsen (ZN) stain for Mycobacterium tuberculosis, and another smear was stained using Grocott’s Methanamine Silver (GMS) staining method for fungi. A total of 65 HIV infected patients were studied. Majority (53.8%) of the participants, were males and 46.2% were females. Cellular features of the sputum samples revealed the presences of mild inflammatory changes in 21.5% of patients, moderate inflammation in 1.5%, negative findings in 61.5%% and unsatisfactory smears in 15.4%. The commonest opportunistic pathogens detected were Candida species (24.5%), Mycobacterium species (20%) and Aspergillus species (9.2%). The study identified that majority of the cytological changes observed in the sputum samples of the HIV infected patients studied were inflammatory changes, which might be due to the presence of Mycobacterium turberculosis, Candida species and Aspergillus species. Hence, the cytological features of the sputum samples could play an important role in detecting the pulmonary pathogens.

References

  1. Ammanagi, A.S., Dombale, V.D., Miskin, A.T., Dandagi G.L. and Sangolli S.S. (2012). Sputum cytology in suspected cases of carcinoma of the lung (Sputum cytology a poor man's bronchoscopy!). Lung India 29(1):19-23.
  2. Adisa, J.O., Bukar, M.A., Egbujo, E.C., Muhammad, B. (2013). Cytologic assessment of pulmonary aspergillosis in immunocompromised subject in Maiduguri, North Eastern Nigeria. Journal of Medicine and Medical Sciences 4(6):237-240.
  3. Anupriya, W, Ravinder, K., Satish, K.A., Shyama, and Prena B. (2007). AIDS-related opportunistic mycoses seen in a tertiary care hospital in North India. Journal of Medical Microbiology 93(91):26.97
  4. Bharathi. M and Usha R. (2002). Pathogenic fungal isolates in sputum of HIV positive patients. Journal of AIDS and Other Infections Diseases 36: 107-113.
  5. Bezabhe, W.M., Chalmers, L., Bereznicki, L.R., Peterson, G.M. (2016). Adherence to antiretroviral therapy and virologic failure: a meta-analysis. Medicine (Baltimore) 95:e3361.
  6. Boyton, R.J., Altmann, D.M., Wright. A., Kon, O.M. (2007). Pulmonary infection with Cryptococcus neoformans in the face of underlying sarcoidosis. Respirator 74:462-6.
  7. Bibbo, M. and Wilbur, D. (2008). Comprehensive Cytopathology. 3rd Ed Saunders Elsevier. Philadelphia p.309-320.
  8. Bhagwath, P., Rastogi, P., Menezes, R.G., Valiathan, M., Mohan Kumar, T. S. and Raghavendra Babu Y. P. (2009). Sudden death due to pulmonary aspergillosis. Journal of Forensic and Legal Medicine 16(1):37-40.
  9. Chakraborty N. (2000). HIV-Co Opportunistic Infections - A Current Picture in Tropical Climatic Eastern Indian Seropositive Population. CMR Virus Unit, India 20:136-152.
  10. Chakraborty, P. and Nishith K.P. (2008). Laboratory Diagnosis of Fungal Infections. Manual of Practical Microbiology and Parasitology:186.
  11. Daniel, T.M. (1999). Rapid diagnosis of tuberculosis; Laboratory technique applicable in developing countries. Review of Infectious Disease; 471-478.
  12. Dauda, M. (2010). Evaluation of the efficacy of directly observed treatment short course (DOTS) in patients with tuberculosis and HIV Co-infection in Kano, Nigeria. Review in Infection (1)5:218-22323
  13. Demay. R. M. (1996). The Art and Science of Cytopathology Respiratory. Chicago: American Society of Clinical Pathologists Press, Vol. 1 200-230.
  14. Drury, R. A. B, and Wallington E. A. (1980), Carleson's Histological Technique, fifth edition. Oxford University press, New York, Toronto.
  15. Esebelahie. N.O., Enweani, B.O. and Omoregie. R. (2013). Candida colonization in asymptomatic HIV patients attending a tertiary hospital in Benin city. Nigeria Libyan journal of medicine 8:1-5
  16. Hormoz. E. (2012). Diagnostic difficulties in pulmonary cytology and proper use of ancillary test. Annual scientific meeting.
  17. Kirunga. C and Ntozi P. M. (1997). Socio-economic determinants of HIV serostatus: a study of Rakai District, Uganda. Health Transiition Review; 7:175-18
  18. Karuga, T.K. (2014). Patterns of opportunistic infection and cytological changes in sputum specimen from HIV infected patients at Mbagathi district Hospital, Kenya. University of Nairobi. MSc thesis. Available at https://www.sciencedirect.com/science/article/abs/pii/s0031302516312272
  19. Khan. A., Khan S and Malik A. (2012). Profile of Candidiasis in HIV infected patients. Iranian Journal of Microbiology 4: 204-209.
  20. Matee M, Mtei, L., Lounasvaara, T., Wieland-Alter, W., Waddell, R., Lyimo, J., Bakari, M., Pallangyo, K., von Reyn, C.F. (2008). Sputum microscopy for the diagnosis of HIV-associated pulmonary tuberculosis in Tanzania. BMC Public Health 8:68
  21. Mulla, S.A., Patel, M.G, Vaghela, G and Motala, N. (2007). A study of opportunistic infection in HIV-seropositive patients. Indian Journal of Community Medicine 32: 208-209.
  22. Nash, G, Irvine, R and Kerschmann. (1997). Pulmonary aspergillosis in Acquired Immune Deficiency Syndrome: autopsy study of an emerging pulmonary complication of human immunodeficiency virus infection. Hum pathol 28:1268-75.
  23. Padayatchi, N.K., Abdikarim, Q. (2011). HIV-Associated with Tuberculosis. Clinical Development on Immunology Pii:585919
  24. Saha, K., Firdaus, R. and Santra, P. (2011). Recent patterns of co-infection amongst HIV seropositive individuals in tertiary care hospital, Kolkata. Virology Journal 8:4-9.
  25. Santos, J.P.V., Leite, L.F.G., Adad, S.J., Vergara, M.S., Micheletti, A.M.R. (2019). Main findings and diagnostic yield of bronchoalveolar lavage, bronchial brushing and transbronchial biopsy in HIV positive patients. Rev Inst Med Trop São Paulo; 61z61.
  26. Saidu, A.S., Bunza M. D. A., Abubakar U et al. (2009). A survey of opportunistic infections attending major hospitals in Kebbi State, Nigeria. Bayero Journal of Pure and Applied Sciences 2:70–74.
  27. Selvaggi. G., Gerber, M. (1986). Pulmonary cytology in patients with the acquired immunodeficiency syndrome (AIDS) Diagn. Cyropathol (3):187-9330. 30.
  28. Saini. S. and Deorukhkar. S. C. (2012). Opportunistic infections in Human Immunodeficiency Virus (HIV) infected patients from rural tertiary care hospital of western Maharashtra. IJBAR 3:908-910.
  29. World Health Organization. (2009). Laboratory Manual for diagnosis of Fungal Opportunistic infections in HIV/AIDS patients.
  30. Yassin, M. A., Luelseged, T. and Girma, E. (2004). HIV and Tuberculosis Co-infection in the Southern Region of Ethiopia: A Prospective Epidemiological Study 36: 670-673.
How to Cite

F.B, S., Z.M, B., A.Y, H., & G.I., A. (2020). Assessment of Cytological Features of Sputum Samples Obtained From Immunocompromised Patients Coinfected with Some Pulmonary Pathogens in Kano State, Nigeria. Nigerian Journal of Microbiology, 34(2), 5438-5445. https://doi.org/10.67614/njm.2020.letppkrn

S. F.B, B. Z.M, H. A.Y, and A. G.I., "Assessment of Cytological Features of Sputum Samples Obtained From Immunocompromised Patients Coinfected with Some Pulmonary Pathogens in Kano State, Nigeria," Nigerian Journal of Microbiology, vol. 34, no. 2, pp. 5438-5445, December 2020. doi: 10.67614/njm.2020.letppkrn

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