Abstract:

Background: Esophageal Candidiasis (EC) is the most common cause of esophagitis among patients who undergo esophagogastroduodenoscopy (OGD) at Mwanza, Tanzania. Little is known on the species distribution, antifungal susceptibility profiles and treatment outcomes of patients with esophageal Candidiasis. This study was designed to determine Candida species distribution, susceptibility pattern and treatment outcome of esophageal candidiasis among patients undergoing OGD in Mwanza, Tanzania.

Methods: This was a follow up study involving patients undergoing OGD in four hospitals in Mwanza for any indication and found to have EC from May 2015 to December 2015. Samples were collected by esophageal brushing technique during OGD, transported in a Stuart transport media to microbiology laboratory for culture and sensitivity. Patients were managed according to National guideline. Patients were followed by means of telephone for any resolution of symptoms at day 5, 14 and 21.

Results: A total 99 patients which EC during the study period were recruited. Candida spp. were detected in 65 (65.6%) of patients with EC. Candida albicans was the predominant species 57 (87.6%) followed by C. tropicalis 4 (6.2%). Majority of isolates were sensitive to fluconazole 59 out of 65 (90.8%). Of the non-albicans Candida spp detected, 50% (4/8) were resistant to fluconazole. Non-albicans candida spp showed 100% sensitive to nystatin. All isolates were sensitive to amphotericin B. Treatment of esophageal candidiasis with fluconazole achieved a significant clinical improvement 96.9% (96/99).

Conclusion: C. albicans is the commonest cause of EC in Mwanza, Tanzania. Non-albicans Candida spp are associated with fluconazole resistant. Further studies should be done to explore the role non-albicans Candida spp in causing EC in our settings.