Prevalence of fungal pathogens among respiratory tract infections and associated risk factors

Abstract

Objectives: The aim of this study was to determine the prevalence and types of fungal pathogens in respiratory infections and associated risk factors in a tertiary care hospital in North India. Material and Methods: A total of 380 respiratory samples – including bronchoalveolar lavage, sputum, endotracheal secretions, endobronchial ultrasound, and lung tissue samples – were collected from symptomatic patients admitted to various pulmonary units. Samples were processed using standard mycological techniques, including microscopy and culture. Results: The present study was conducted in the Mycology Section of the Central laboratory, Department of Microbiology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab. A total of 380 respiratory samples were obtained from symptomatic patients hospitalized in various pulmonary units. Out of the total 380 samples, 147 (38.6%) showed growth, among which 72.10% were male, while 27.9% were female. The highest incidence of pulmonary fungal infection was found in the age group of 50–79 years, while the lowest incidence was seen in patients ≤30 years of age. Cough (87.7%), dyspnea (81.02%), breathlessness (69.18%), fever (60%), weight loss (56.2%), and chest pain (43%) were the predominant symptoms in the patients. About 73% of positive patients had diabetes mellitus, 51% of patients were on prolonged antibiotic use, 47% of patients had history of allergy, 35% of patients had asthma while 15% of patients had history of usage of steroids, 11% of patients had prior history of tuberculosis, while 3% of them were on chemotherapeutic agents. Around 3% of patients had co-infection of tuberculosis (TB) with human immunodeficiency virus. Aspergillus flavus (38.09%) and Aspergillus fumigatus (29.9%) represented the two most commonly isolated fungi in the current study followed by Aspergillus niger (10.51%), Candida albicans (8.1%), Mucor (6.8%), and Penicillium (4.6%) while Aspergillus versicolor (2.0%) was the least commonly isolated fungus. Conclusion: Pulmonary fungal infections are prevalent among hospitalized patients, particularly older adults with underlying risk factors. Aspergillus species predominate among the isolated fungal pathogens, highlighting the need for early detection and targeted therapy in at-risk populations. Early detection is crucial for effective management.