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| SPECIAL ARTICLE |
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| Year : 2015 | Volume
: 17
| Issue : 1 | Page : 36-38 |
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Fungal isolates 2014
Mini Palathingal Narayanan
Department of Microbiology, Government Medical College, Kozhikode, Kerala, India
| Date of Web Publication | 16-Jun-2015 |
Correspondence Address:
Mini Palathingal Narayanan
Department of Microbiology, Government Medical College, Kozhikode, Kerala
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0972-1282.158806
How to cite this article:
Narayanan MP. Fungal isolates 2014. J Acad Clin Microbiol 2015;17:36-8 |
Mycoses are disorders caused by fungi, which are ubiquitous in their distribution. Though some fungal diseases are endemic to specific geographical regions, e.g., Coccidiodomycosis, most of them occur worldwide, e.g., Candidiasis. Human infections range from superficial infections such as dermatophytosis to those that are often potentially life threatening like histoplasmosis. With the ever increasing number of immunosuppressed patients, awareness of the prevalent mycotic infections and current mode of treatment is of utmost importance. The changing epidemiology of certain fungal infections and relative drug resistance necessitates accurate and rapid identification of fungi to optimise therapeutic decision regarding early antifungal therapy.
The data for a special article on fungal isolates for the year 2014 sent from 11 centres in India were analysed in [Table 1].{Table 1}
All centres used Sabouraud's dextrose agar for primary isolation of fungi. Special media used were Corn meal agar and Chrom agar (Himedia) for candida speciation. All centres used conventional method for identification except two centres, where identification was done using Vitek 2 (bioMerieux). Antifungal susceptibility tests were done for 24 isolates of Candida from the blood by the Vitek system, in the two centres. All were sensitive to Caspofungin, and Micafungin, 17 (70.8%) were sensitive to Fluconazole and 19 (79.1%) were sensitive to Voriconazole.
| Fungal isolates from blood | |  |
Of 197 isolates, 189 (95%) were candida. Of these 35 were Candida albicans (17.7%) and 112 (56%) were non albicans candida (NAC). Few centres have speciated NAC. The distinction between C. albicans and NAC were not done for 42 (21.3%) isolates. The other rare isolates were Trichosporon asahi and Saccharomyces cerevisiae [Chart 1 [Additional file 1]].
Of 112 NAC, 45 was speciated, 34 of which were Candida parapsilosis and six were Candida tropicalis [Chart 2 [Additional file 2]].
| Fungal isolates from urine | | |
Of 672 fungal isolates 663 (98%) were Candida spp., of which 210 were C. albicans (31%), 348 (51%) were Non albicans species of Candida. A total of 105 isolates were not speciated. Other uncommon isolates were Trichosporon and Geotrichum [Chart 3 [Additional file 3]].
Among Non albicans species of Candida, 70 were C. tropicalis, followed by 40 C. parapsilosis [Chart 4 [Additional file 4]].
| Fungal isolates from Exudates | | |
The samples included in exudates were pus, pleural fluid, ascitic fluid. Of the total 192 fungal isolates from exudates, 104 were Candida spp. (54%). Of these 19 (10%) were C. albicans and 25 (13%) non albicans species of candida. Of these, 55 isolates were not speciated. The other isolates were Aspergillus, Paecilomyces, Rhizopus and Penicillium marniffei [Chart 5 [Additional file 5]].
Of 25 NAC, six were identified to species level. C. tropicalis isolated were two, three C. parapsilosis and one isolate of C. glabrata.
| Fungal isolates from other miscellaneous specimens | | |
Bronchial washings, bronchoalveolar lavage, suction tip, endotracheal tube aspirates, bile and vaginal swabs were included in 'others'. A total of 94 fungal isolates were obtained from miscellaneous specimens. Aspergillus spp. tops the list with 34 isolates (36%) from various 'Other' specimens followed by 25 (26%) isolates of C. albicans [Chart 6 [Additional file 6]]. Other isolates were Fonsecaea pedrosoi, Rhizopus, and Mucor.
| Fungal isolates from sputum | | |
Of 509 isolates from sputum, 447 (87%) were Candida species. Of these 221 (43%) were C. albicans. The second common isolate is NAC with 172 (33%) isolates [Chart 7 [Additional file 7]]. Speciation was not done in 54 isolates. The other 62 isolates included Aspergillus fumigatus (55), Mucor, Acremonium and Penicillium.
| Fungal isolates from tissues | | |
Cornea, skin biopsy, nail, nasal, lung and brain tissue were included under tissue specimens. Corneal scrapings (43) were the most common specimen in this category. Fusarium ranks first in the list of isolates from the cornea, that is, 23 (82%). Some rare isolates obtained were Syncephalastrum, Aureobasidium pullulans, Monosporium apiospermum, Phoma and Paecilomyces. Other isolates included Aspergillus, Pencillium and Candida species.
Of 28 fungal isolates from nasal tissue, 21 were Aspergillus spp., and rare isolates were Syncephalastrum, Xylohypha bantiana, Phaeoacremonium, and Alternaria. A wet film of the nasal tissue revealed Rhinosporidium seeberi from centre 6. Histoplasma capsulatum was a significant isolate from fine needle aspiration cytology cervical lymph node from centre 8. Candida spp. was isolated from IV cannula from centre 11. Aureobasidium pullulans was a significant and rare fungus isolated from brain tissue from the same centre.
A total of 59 fungi were from the nail. The isolates were as follows: 18 Aspergillus, 17 Candida spp., 11 dermatophytes, 3 Curvularia, 2 Acremonium, 2 Penicillium and 6 Fusarium. Of the 11 dermatophytes, 8 were Trichophyton spp. and 3 Epidermophyton floccosum.
Some centres did not mention the source of the tissues.
| Fungal isolates from CSF | | |
There were 6 isolates of Cryptococcus from CSF - 4 from centre 5, each from centre 4 to centre 8.
| Conclusion | | |
Non albicans Candida is an emerging pathogen in most of the centres. The isolation of Candida from blood must be considered significant until proved otherwise to avoid delay in administering life-saving drugs. Fungal infections are extremely common in the present scenario. Modern advances in treatment, antibiotics, steroids and immunosuppressive agents have led to an increase in opportunistic fungal infections. Therefore, the study of both opportunistic and pathogenic fungi has gained importance in the field of mycology.
[Table 1]JAcadClinMicrobiol_2015_17_1_36_158806_t1.jpg
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