Study of the prevalence and pattern of fungal pneumonias in respiratory intensive care units

Abstract

Background Fungal pneumonia is an infectious process in the lung caused by one or more endemic or opportunistic fungi. Fungal infection occurs following the inhalation of spores, after the inhalation of conidia, or by the reactivation of a latent infection. Hematogenous dissemination frequently occurs, especially in an immunocompromised host. Aim of the work To assess the prevalence of fungal pneumonias in a group of respiratory ICUs and identify their pattern. Patients and methods This study was carried out on 60 patients who were admitted in respiratory ICUs of different hospitals: Ain Shams University and Military Hospitals from March 2018 till February 2019 to assess the prevalence of fungal chest infection in that group of patients and furthermore to identify their pattern. All patients were subjected to the following: history, clinical examination, radiology (plain chest radiograph and computed tomography of the chest), routine laboratory investigations and finally mycological analysis including direct microscopic examination and culture examination of the collected respiratory samples. Results The mean age of all patients was 55.43 years. Regarding sex of the patients, the majority (76.67%) of patients were men, while 23.33% were women. Forty (66.67%) patients out of 60 patients with respiratory diseases had been culture positive for fungus and 20 (33.33%) patients had been culture-negative. The major fungal species encountered in this study were Candida species in 23 (57.5%) cases followed by Aspergillus species in 17 (42.5%) cases. Candida albicans was isolated in 23.33% of patients followed by Aspergillus nonfumigatus (18.33%) then Candida nonalbicans (15%), and finally Aspergillus fumigatus (10%). Conclusion From the current study, we can conclude that pulmonary fungal infection appears to be an important problem in patients with respiratory diseases especially patients who are admitted in respiratory ICUs regardless of their age or sex.