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Introduction: Pulmonary fungal infections are a significant etiology of morbidity among immunocompromised and immunosuppressed patients. This study aimed to determine the prevalence of fungal pathogens and associated risk factors among pulmonary tuberculosis (PTB) and non-PTB patients attending Federal Teaching Hospital, Gombe, Nigeria. Methods: Three consecutive early morning sputum samples were collected from 43 PTB patients and 173 non-PTB persons and then examined for fungal pathogens using standard mycological stains, microscopy, and biochemical assays. All the participants were screened for HIV by the World Health Organization HIV testing algorithm and M. tuberculosis infection using GeneXpert ® nested PCR equipment. Samples with at least two significant fungal growths were considered positive. Results: Out of 216 sputa, 73.6% showed fungal growth in cultures. One hundred percent and 67% of PTB and non-PTB participants had positive sputa culture, respectively. In PTB patients, Candida albicans (25.6%) and Aspergillus fumigatus (20.9%), and in non-PTB individuals A. fumigatus (51.7%) and A. nigar (17.2%) were the most prevalent species. Age and residential areas were significantly associated with fungal infection in PTB and non-PTB subjects (p˂0.05). Cigarette smoking, prolonged antibiotic use, and having domestic pets were significant risk factors for developing pulmonary fungal infections in both groups (p˂0.05). None of the studied risk factors was significantly associated with pulmonary mycosis among TB patients (p˃0.05). However, prolonged use of antibiotics was a significant risk factor of pulmonary fungal infection among non-TB patients (p=0.009). Conclusion: Our study showed that PTB was a predisposing factor for fungal infection, especially among individuals with low socioeconomic status.

Background: Pulmonary mycosis (PM) poses a great diagnostic challenge due to the lack of pathognomonic and radiological features, especially in the absence of mycology laboratory tests. This study was aimed to isolate, phenotypically identify, determine the prevalence of pulmonary fungal pathogens and antifungal susceptibility pattern of isolates of presumptive tuberculosis (PTB) patients attending Federal Teaching Hospital (FTH) Gombe, Nigeria. Methods: After ethical approval, three consecutive early morning sputa were collected from 216 participants with presumptive of PTB attending FTH Gombe, between May 2, 2017 and May 30, 2018. Samples were processed using standard mycological staining, microscopy, sugar biochemistry, and antifungal susceptibility test protocols. Sociodemographic variables and risk factors of pulmonary fungal infection were assessed through structured questionnaires. Pulmonary fungal infection was defined by the positive culture in at least two sputa. PTB was defined by Genexpert® nested polymerase chain reaction. Results: Of the 216 participants, 19.9% had PTB and 73.6% had pulmonary fungal pathogens. Among the isolated pulmonary fungal pathogens, Aspergillus fumigatus made the highest occurrence, while 6.5% had PTB-fungal co-infection. No significant association existed between the prevalence of PM with age and sex of participants (P < 0.05). Cigarette smoking (adjusted odds ratio [aOR] = 15.9 [95% confidence interval (CI): 0.9–268.8]), prolong antibiotic use (aOR = 77.9 [95% CI: 4.7–1283]) and possession of domestic pet (aOR = 77.9 [95% CI: 4.7–1283]) were significant risk factors of PM (P < 0.05). Penicillium citrinum, Mucor spp. and Aspergillus flavus are more susceptible to voriconazole, and Candida albicans was found to be more susceptible to Nystatin. Of the 159 fungal isolates, 92.5% were resistant to fluconazole. Conclusion: Findings from this study revealed high level pulmonary fungal pathogens, especially among PTB patients. A majority of fungal isolates were resistant to fluconazole. It's recommended that persons should do away with or minimize risk factors for pulmonary fungal pathogens identified in this study.