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Members of the Candida rugosa species complex have been described as emerging fungal pathogens and are responsible for a growing number of Candida infections. In this communication we report the isolation of Candida rugosa and Candida mesorugosa in Ghana. To the best of our knowledge this is the first description of this species complex from a clinical setting in Africa.The isolates were identified on the basis of their rRNA gene internal transcribed spacer (ITS) sequences. For one isolate, obtained from sputum, the sequence grouped well with that of C. rugosa. Two other isolates from urine had sequences that grouped with Candida mesorugosa. Morphologically, C. rugosa formed white, wrinkled, and flat colonies on Sabouraud Dextrose Agar (SDA), whereas C. mesorugosa formed white, smooth colonies. On chromogenic medium, the isolates formed small, dry greenish-blue colonies with a pale or white border, similar to C. albicans. The C. rugosa isolate produced pseudohyphae in human serum and on CMA-Tween 80 agar. In contrast, the C. mesorugosa isolates did not generate pseudohyphae in human serum, but generated a few pseudohyphae with abundant blastoconidia on CMA-Tween 80 agar. Growth was observed at 37 °C and 42 °C but not at 45 °C.The two C. mesorugosa isolates had Minimum Inhibitory Concentrations (MICs) of 6 and 48 μg ml(-1) for fluconazole and are thus resistant. The C. rugosa isolate had an MIC of 24 μg ml(-1), indicative of resistance. All three isolates were susceptible to itraconazole and voriconazole (with respective MICs of < 0.125 μg ml(-1)).

Previous studies on Candida species in a clinical setting in Ghana have shown a prevalence of Candida albicans. Despite this, very little is known about the various strain types and their population genetic structure. In this study three microsatellite loci, CAI, CAIII and CAVI, were used to investigate the population genetic structure of C. albicans from clinical isolates in Ghana. In all, 240 clinically unrelated C. albicans isolates were recovered from patients reporting at three teaching hospitals. All the isolates were heterozygous for at least one of the three loci, except for one isolate, which was homozygous for all three loci. Sixty-seven unique alleles and 240 different genotypes were generated by the three polymorphic microsatellite loci, resulting in a very high discriminatory potential of approximately 0.98. There was no significant difference in allele frequencies from the small number of anatomical sites sampled, regardless of the host conditions although high genotypic diversities were observed among the isolates. There was evidence for clonal reproduction, including over-expression of observed heterozygotes across the populations. The populations deviated significantly from Hardy-Weinberg equilibrium and pair-wise genotypic linkage disequilibria comparisons across the three loci were significant, also suggesting a clonal population. The overall Wright FIS for the three loci was negative, and the overall FST value was not significantly different from zero for the three loci analyzed, indicating a clonal and homogeneous population across the three sampling locations from Ghana.

BackgroundUnderstanding transmission dynamics is useful for tuberculosis (TB) control. We conducted a population-based molecular epidemiological study to understand TB transmission in Ghana.MethodsMycobacterium tuberculosiscomplex (MTBC) isolates obtained from prospectively-sampled pulmonary TB patients between July, 2012 and December, 2015 were confirmed as MTBC using IS6110PCR. MTBC lineages were identified by large sequence polymorphism and single nucleotide polymorphism assays and further characterized using spoligotyping and standard 15-loci MIRU-VNTR typing. We used the n-1 method to estimate recent TB transmission and identified associated risk factors using logistic regression analysis.FindingsOut of 2,309 MTBC isolates, we identified 1,082 (46·9%) single cases with 1,227 (53·1%) isolates belonging to one of 276 clustered cases (clustering range; 2-35). Recent TB transmission rate was estimated to be 41·2%. While we see no significant difference in the recent transmission rates between lineages ofMycobacterium africanum(lineage-5 (31·8%); lineage-6 (24·7%), p=0·118), we found that lineage-4 belonging to theM. tuberculosistransmitted significantly higher (44·9%, pInterpretationsOur findings indicate high recent TB transmission suggesting occurrences of unsuspected outbreaks. The observed reduced transmission rate ofM. africanumsuggests other factor(s) may be responsible for its continuous presence in West Africa.FundingWellcome Trust Intermediate Fellowship Grant 097134/Z/11/Z to Dorothy Yeboah-Manu.

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.

Aims: This study investigated the antimicrobial effect of aqueous and ethanol extracts of the flower buds of Eugenia caryophyllata (Myrtaeae) against a wide range of bacteria and yeasts cells isolated clinically from patients. Methodology: The agar diffusion method was used to establish the antimicrobial activity and the zones of inhibition caused by the extracts. The antimicrobial effects of 16% and 32% aqueous and ethanol extracts of Eugenia caryophyllata were investigated against 111 pathogenic bacteria and yeasts cells. The microbes used consisted of 11 Proteus mirabilis, 20 Salmonella typhi , 15 Pseudomonas aeruginosa, 18 Escherichia coli , 19 Staphylococcus aureus, 12 Klebsiella pneumoniae, and 16 Candida albicans species. Results: The ethanol extracts inhibited the growth of all the microbes employed in the study with inhibition zones ranging from 8.00±0.00 mm to 24.00±0.00 mm. The aqueous extracts however exhibited different degrees of antimicrobial activity with zones of inhibition ranging from 6.00±0.00 mm to 13.33±0.29 mm. Conclusion: Our study concludes that the aqueous and ethanol extracts of the flower

Vulvovaginal candidiasis (VVC) and recurrent vulvovaginal candidiasis (RVVC) affect millions of women and are typically treated with azoles. We know little about azole susceptibility of Candida species from VVC versus RVVC patients, and nothing about African isolates. We have investigated the susceptibility of Candida isolates from Ghana to fluconazole, itraconazole and/or voriconazole. The percentage of Candida albicans isolates showing susceptibility was significantly lower in RVVC than VVC patients. Isolates of Candida parapsilosis and Candida tropicalis showed a similar trend. For Candida glabrata there was no observed difference. The data indicate a decreased susceptibility in selected Candida species from RVVC patients.