Fungal Infection among Diabetic and Nondiabetic Individuals in Nepal

Background. Low immunity, comorbid clinical conditions, and metabolic disorders may be the underlying factors that determine the severity of infection. Diabetes increases the risk of infection and multiple organ damage. In Nepal, the actual burden of fungal infections has not been estimated or is in...

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Main Authors: Bhuvan Saud, Prajuna Bajgain, Govinda Paudel, Vikram Shrestha, Dipendra Bajracharya, Saroj Adhikari, Gunaraj Dhungana, Mamata Sherpa Awasthi
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Interdisciplinary Perspectives on Infectious Diseases
Online Access:http://dx.doi.org/10.1155/2020/7949868
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author Bhuvan Saud
Prajuna Bajgain
Govinda Paudel
Vikram Shrestha
Dipendra Bajracharya
Saroj Adhikari
Gunaraj Dhungana
Mamata Sherpa Awasthi
author_facet Bhuvan Saud
Prajuna Bajgain
Govinda Paudel
Vikram Shrestha
Dipendra Bajracharya
Saroj Adhikari
Gunaraj Dhungana
Mamata Sherpa Awasthi
author_sort Bhuvan Saud
collection DOAJ
description Background. Low immunity, comorbid clinical conditions, and metabolic disorders may be the underlying factors that determine the severity of infection. Diabetes increases the risk of infection and multiple organ damage. In Nepal, the actual burden of fungal infections has not been estimated or is in a limited progress. This study aimed to investigate the status of fungal infection in diabetic and nondiabetic individuals in Bhaktapur, Nepal. Materials and Methods. A total of 670 samples were collected from 134 participants. From each participant, five samples were collected from different sites like an oral wash, toe swab, midstream urine, hair shaft, and nail scrapings. All samples were cultured on Sabouraud dextrose agar. Gram stain was used to observe yeast cells and lactophenol cotton blue stain was used for hyphae. Chlamydospore production by Candida species was observed in cornmeal agar medium by Dalmau Plate method. Candida species isolated were characterized by germ-tube test and differentiated using CHROM agar Candida medium. Candida species isolates were tested for antibiotic susceptibility. Results. Overall, 19.4% of the samples showed fungal growth. The prevalence of fungal infection was higher in diabetic (34.0%) than nondiabetic individuals (4.7%). Fungal growth was found to be higher in oral wash followed by toe, urine, hair, and nail samples. Predominant fungi were Candida species (57.5%), Aspergillus species (28.4%), and Trichophyton species (10.7%). Oral wash, toe, and urine samples in diabetics had a significantly higher fungal prevalence when compared between both groups, p value < 0.05. In Candida isolates, higher resistance was seen against fluconazole 36.8% and ketoconazole 28.9%, whereas other drugs showed low resistance. Conclusion. Diabetic participants are more susceptible to fungal infection than the nondiabetics. Overall, Candida species and Aspergillus species are highly predominant fungi. Candida species are highly resistant to fluconazole and ketoconazole.
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spelling doaj-art-a9546dddd58d491f8069e5081fa736d22025-08-20T03:39:32ZengWileyInterdisciplinary Perspectives on Infectious Diseases1687-708X1687-70982020-01-01202010.1155/2020/79498687949868Fungal Infection among Diabetic and Nondiabetic Individuals in NepalBhuvan Saud0Prajuna Bajgain1Govinda Paudel2Vikram Shrestha3Dipendra Bajracharya4Saroj Adhikari5Gunaraj Dhungana6Mamata Sherpa Awasthi7Department of Medical Laboratory Technology, Janamaitri Foundation Institute of Health Sciences, Hattiban, Lalitpur, NepalDepartment of Medical Laboratory Technology, Janamaitri Foundation Institute of Health Sciences, Hattiban, Lalitpur, NepalDepartment of Medical Laboratory Technology, Janamaitri Foundation Institute of Health Sciences, Hattiban, Lalitpur, NepalDepartment of Medical Laboratory Technology, Janamaitri Foundation Institute of Health Sciences, Hattiban, Lalitpur, NepalTribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, NepalPyuthan District Hospital, Pyuthan, NepalDepartment of Medical Laboratory Technology, Janamaitri Foundation Institute of Health Sciences, Hattiban, Lalitpur, NepalDepartment of Nursing, Janamaitri Foundation Institute of Health Sciences, Hattiban, Lalitpur, NepalBackground. Low immunity, comorbid clinical conditions, and metabolic disorders may be the underlying factors that determine the severity of infection. Diabetes increases the risk of infection and multiple organ damage. In Nepal, the actual burden of fungal infections has not been estimated or is in a limited progress. This study aimed to investigate the status of fungal infection in diabetic and nondiabetic individuals in Bhaktapur, Nepal. Materials and Methods. A total of 670 samples were collected from 134 participants. From each participant, five samples were collected from different sites like an oral wash, toe swab, midstream urine, hair shaft, and nail scrapings. All samples were cultured on Sabouraud dextrose agar. Gram stain was used to observe yeast cells and lactophenol cotton blue stain was used for hyphae. Chlamydospore production by Candida species was observed in cornmeal agar medium by Dalmau Plate method. Candida species isolated were characterized by germ-tube test and differentiated using CHROM agar Candida medium. Candida species isolates were tested for antibiotic susceptibility. Results. Overall, 19.4% of the samples showed fungal growth. The prevalence of fungal infection was higher in diabetic (34.0%) than nondiabetic individuals (4.7%). Fungal growth was found to be higher in oral wash followed by toe, urine, hair, and nail samples. Predominant fungi were Candida species (57.5%), Aspergillus species (28.4%), and Trichophyton species (10.7%). Oral wash, toe, and urine samples in diabetics had a significantly higher fungal prevalence when compared between both groups, p value < 0.05. In Candida isolates, higher resistance was seen against fluconazole 36.8% and ketoconazole 28.9%, whereas other drugs showed low resistance. Conclusion. Diabetic participants are more susceptible to fungal infection than the nondiabetics. Overall, Candida species and Aspergillus species are highly predominant fungi. Candida species are highly resistant to fluconazole and ketoconazole.http://dx.doi.org/10.1155/2020/7949868
spellingShingle Bhuvan Saud
Prajuna Bajgain
Govinda Paudel
Vikram Shrestha
Dipendra Bajracharya
Saroj Adhikari
Gunaraj Dhungana
Mamata Sherpa Awasthi
Fungal Infection among Diabetic and Nondiabetic Individuals in Nepal
Interdisciplinary Perspectives on Infectious Diseases
title Fungal Infection among Diabetic and Nondiabetic Individuals in Nepal
title_full Fungal Infection among Diabetic and Nondiabetic Individuals in Nepal
title_fullStr Fungal Infection among Diabetic and Nondiabetic Individuals in Nepal
title_full_unstemmed Fungal Infection among Diabetic and Nondiabetic Individuals in Nepal
title_short Fungal Infection among Diabetic and Nondiabetic Individuals in Nepal
title_sort fungal infection among diabetic and nondiabetic individuals in nepal
url http://dx.doi.org/10.1155/2020/7949868
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