Case Report: Rhabdomyolysis and Flare-up of Lupus Erythematosus as Complications of Tuberculostatic Drug Therapy in a Pakistani Patient with Mycobacterium africanum Infection

tients whose skin is colonized with pathogenic Candida may serve as a reservoir for horizontal transmission; their skin colonization may also increase their own risk of subsequent invasive infection.We aimed to determine the prevalence of Candida skin colonization among inpatient neonates, children and adults in Mozambican hospitals using point-prevalence surveys, and to further characterize these cultured Candida species.Methods and materials: Point-prevalence surveys were conducted between 5-22 February 2024 in the intensive/high care units of three hospitals in Mozambique (Manhia District Hospital (MDH) (located in a rural area in the south), Maputo Central Hospital (MCH) (located in an urban area in the capital) and Quelimane Central Hospital (QCH) (located in an urban area in the central region).Study investigators obtained informed consent from parents/guardians of patients.Clinical and epidemiological data were collected from medical files of admitted participants.We collected composite skin swab specimens from the axilla and groin areas using flocked swabs.These were immediately placed in Amies transport medium and transported to the laboratory for processing.Swabs were cultured on Sabouraud agar with chloramphenicol at 35 C for 48h.Wet prep was used to identify any yeastlike colonies, which were then sub-cultured on Candida Plus chromogenic agar medium and incubated at 35 C for 72 hours.Results: A total of 63 patients were swabbed, including 36 (57%) from MCH, 17 (27%) from QCH and 10 (16%) from MDH.Among the 63 participants, Candida species was identified from skin swabs in 17 (27%).The skin colonization prevalence by hospital was 31% (11/36) at MCH, 29% (5/17) at QCH and 10% (1/10) at MDH.Overall, Candida species was detected from 11% (7/63) neonates, 8% (5/63) children and 8% (5/63) adults.The Candida prevalence by hospital and broad age group was highest at MCH; 17% (6/36) among neonates, 8% (3/36) among children and 6% (2/36) among adults.Conclusion: Candida skin colonization was common among inpatients admitted to intensive/high care units in Mozambican hospitals.Follow-up point prevalence surveys may be useful to track trends and detect multi-drug resistant Candida species such as Candida auris which are endemic in neighbouring countries.Further phenotypic and genotypic characterization of cultured isolates will be conducted at the National Institute for Communicable Diseases (NICD) in South Africa.