Prevalence and Risk Factors of Superficial Fungal Infection among Patients Attending a Tertiary Care Hospital in Central Nepal

Abstract

Fungal infections of hair, nail, and skin are common worldwide and tend to increase. The present study was conducted to determine the prevalence of dermatomycoses, estimate the efficiency of rapid potassium hydroxide (KOH) wet-mount, and observe the hygienic status and the predisposing risk factors. Altogether 115 samples (nail = 77, skin = 30, and hair = 8) were obtained in a duration of December 2019 to June 2020 at Grande International Hospital, Nepal. The samples were examined by KOH wet-mount microscopy and further processed for culture. The dermatophyte test medium (DTM) was used to isolate dermatophytes separately. The fungal colonies obtained in SDA, SDA with cycloheximide/chloramphenicol and dermatophyte medium were subjected to lactophenol cotton blue (LPCB) reagent to study fungal morphology. The yeast colonies grown on SDA were subjected to Gram staining, germ-tube tests, and biochemical tests for identification. CHROMagar was used to distinguish different Candida species based on its pigment production in the medium. Various factors (age, sex, occupation, and hygiene condition) were analyzed which were associated with mycological infection. Out of 115 samples, the presence of fungal elements was detected in 20 samples by KOH. Nondermatophyte molds were the most isolated fungus in nails, skin, and hair, followed by yeast and dermatophytes, respectively. Dermatomycosis molds were the most common causative agents with 22 (14.7%) cases, followed by yeasts with 6 (5.21%) cases. Candida albicans was isolated from 5 (4.3%) cases, whereas Rhodotorula species accounted for a single (0.8%) case. Dermatophytes were isolated from 5 (4.3%) cases. Among them, n = 4(3.4%) cases revealed Trichophyton rubrum and Trichophyton mentagrophytes was isolated from single (0.8%) case. The most isolated nondermatophyte mold that follows criteria as a pathogen in our study was Cladosporium species 6 (25%) out of 27 total fungal isolates. Poor hygiene and sweating were found to be statistically significant ( P < 0.05 ) in fungal cases detected by both KOH and culture. Dermatophytes and nondermatophyte fungi were emerging as important causes of fungal infection. Both direct microscopy and culture followed by LPCB together were vital tools for the diagnosis of fungal infections.

Nanosponge hydrogel of octadecyl 3-(3,5-di-tert-butyl-4-hydroxyphenyl) propanoate of Alcaligenes faecalis

“…Dermatomycoses, or superficial fungal skin diseases, are caused by a variety of pathogens, including dermatophytes, yeasts, and molds (Costa-Orlandi et al 2023 ; Jaishi et al 2022 ). Because of exo-enzymes secreted by the fungal pathogen at the site of infection, such as keratinase (Veraldi 2013 ), inflammatory symptoms and indications, such as pruritus and erythema, are very common (AbouSamra et al 2020 ).…”

“…Our ODHP-NS-HG formulation has significantly decreased the levels of COX-2 compared to the infected untreated group (B) implying its additional anti-inflammatory effect along with its antifungal one (Das et al 2011 ; López et al 2011 ). In the injured region, tumor necrosis factor (TNF)-α is rapidly produced, causing inflammation in wound tissues (Jaishi et al 2022 ). Hence, TNF-α was elevated in infected untreated groups while it was neutralized significantly in ODHP-NS-HG–treated group E indicating good healing of the injured area.…”

The difference of fungal growth Rhizopus sp. in SDA and PDA Media from toe nail samples of construction workers

“…Molds that were not dermatophytes had an isolation rate that was similar to that of dermatophytes. It is crucial to conduct more research on the incidence of onychomycosis, fungi that cause nail infections, and shifts in the species distribution of these agents in Ethiopia (Jaishi et al, 2022).…”

“…It was becoming clear that both dermatophytes and nondermatophytes fungi could cause fungal infections. For the diagnosis of fungal infections, direct microscopy and culture followed by LPCB were essential methods (Jaishi et al, 2022).…”