Fungal Infections in Aseer Central Hospital: A Retrospective Laboratory-based Study of 340 Cases during the Years 2011 to 2015

Objectives: The incidence of fungal infections is increasing due to increasing episodes of risk factors such as immune competence; broader used of antibiotics and longer hospital stays. This study aimed to analyze fungal isolates from patients admitted to Aseer Central Hospital between 2011 and 2015 and to shed light on practical recommendations based on scientific evidence for improving laboratory diagnosis.

Methods: Retrospectively, for a period of 4 years (2011-2015), we analyzed 340 specimens submitted to the Microbiology Laboratory, at Aseer Central Hospital, Abha, Saudi Arabia. The study involved the isolation and identification of fungi using standard methods. Cultures were done on Sabouraud dextrose agar (SDA) plates and Brain Heart Infusion Agar + 5% Sheep Blood (BHIA) according to the type of the clinical specimens. Suspected mold and yeast cultures were identified on the basis of colony morphology appeared on SDA and on microscopic features as per standard criteria. Resulted were analyzed using SPSS investigating prevalence among specimens types, sex, age groups and hospital wards.

Results: Of the 340 specimens, positive fungal cultures were obtained in 105 (30.88%), no growth was seen in 218 plates (64.12%) and 17 plates (5%) had been contaminated or overgrown by bacteria. Out of the 105 positive fungal cultures, yeast represented 47 cases (44.76%) of which 23 samples (21.9%) belonged to the genus Candida. Dermatophytes were 18 isolates (17.14%) of which Trichophyton tonsurans was the dominant species 9 patients (8.57%). Aspergillus species were 13 cases (12.38%); Zygomycetes 9 (8.57%); Penicillium species, only 1 case (0.95%) and unidentified molds were 17 (16.19%). Gender showed significant differences (p=0.034) but no differences among ages groups (p = 0.187). Specimens derived from skin represented the highest percentage of fungal infections followed by the lower respiratory tract and subcutaneous tissue. Significance differences were recorded among hospital wards (p = 0.001) nonetheless male and female medical and surgical words revealed relatively higher rates of fungal infections.

Conclusion: These fungi represent a considerable hazard to patient health. What is needed in the region is to increase detection rate, by improving sample quality and expanding laboratory capacity in order to enhance patient's health.