MYCOLOGICAL PROFILE OF LOWER RESPIRATORY TRACT SAMPLES- A STUDY FROM NORTH INDIA

Abstract

INTRODUCTION: Opportunist fungal infections are on the rise due to a changing health care Paradigm. Since the data of systemic fungal
infections from our valley are scant, we conducted this study to evaluate the prevalence of fungal infections in chronic lower respiratory infections
not resolved by antibacterial chemotherapy and to observe the mycological profile from lower respiratory tract samples of such patients..
MATERIALS AND METHODS: This was a retrospective study conducted for a period of 4 years from January 2015 to Jan 2019 in the
Department of Microbiology, Government Medical College Srinagar. A total of 221 lower respiratory tract samples (148- bronchoalveolar lavage,
49- sputum, and 22-pleural fluid and 2-endo bronchial biopsy samples) were received from patients with suspected chronic non-resolving lower
respiratory tract infections from Chest Disease Hospital, Srinagar. Specimens were processed for detection of bacteria, fungi and mycobacteria as
per standard methods.
RESULTS: The most common host factors in our study population were patients with post primary pulmonary tuberculosis lesions (cavitary)
{n=70}, chronic obstructive pulmonary disease {n=20}, bronchiectasis {n=10}, non-resolving consolidation {n=70}, and uncontrolled diabetes
mellitus {n=50}.The commonest co-morbid condition associated was diabetes mellitus. The male to female ratio was 1.2:1.Out of 221 samples,
97(44.29%) tested positive for fungal elements. Sixty-five percent of fungi isolated were Aspergillus spp. Among these, Aspergillus fumigatus was
found to be the most common species isolated (16%). Scopulariopsis spp.( 6.5%) and Rhizopus spp (5%) were other molds grown on culture.
CONCLUSION: Patients with respiratory tract symptoms not responding to conventional treatment should be screened for fungi by microscopy
and culture in addition to other diagnostic modalities.