P116 Cutaneous fungal infections in elderly population from Bhopal

Abstract

Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM ObjectivesTo know the distribution of fungal infections based on various demographic characteristics.To study the clinical presentation of the lesions and their distribution.To isolate and identify the fungal pathogens.MethodsHospital-based cross-sectional study for 5-year duration January 2017-December 2021. Study location is the department of Microbiology AIIMS, Bhopal. Elderly patients (60 years and above) visiting as Outpatient and Inpatient of dermatology and venereology, General Medicine, and other departments with cutaneous infections suspected to be of fungal etiology and fulfilling the inclusion criteria comprised the study population. Patients already on antifungals topical or systemic were excluded. Data extraction was based on predesigned proforma for a detailed history and clinical examination entries. Necessary ethical approval and patient consent were obtained. Samples of skin, hair, nail, and exudates were processed for direct microscopy, culture isolation in suitable media, and identification phenotypically.ResultsA total of 480 elderly patients clinically suspected of cutaneous fungal infections were included in the study. Majority of the suspected cases were in 60–70 years age group 360/480 (75%). Males were 349/480 (72.71%) and females were 131/480 (27.29%) of the total suspected cases. Male to female ratio in study population was 2.66: 1. Tinea corporis 140/480 cases (29.17%) was most common clinical type followed by onychomycosis 64/480 cases (13.33%), ulcerations 62/480 (12.92%), T. cruris 56/480 (11.67%), T. pedis 35/480 (7.29%), T. mannum 25/480 (5.21%), and T. facei 12/480 (2.50%) in suspected cases of cutaneous fungal infection. Majority of cases were found in non-dependent 253/480 (52.70%) population. Out of 480 clinically suspected cases of cutaneous fungal infection was demonstrated in 193 cases (40.20%) either by direct microscopy and/or culture.A total of 176/480 cases (36.67%) were KOH positive and 113(23.54%) cases were culture positive.Taking culture as a gold standard sensitivity and specificity of KOH in diagnosing fungal infection was 84.96% and 78.2% respectively. Among 113 culture isolates dermatophytes 53.10% (60/113) were most common mold isolates followed by non-dermatophyte molds 28.3% (32/113), and yeasts 18.59% (21/113). Trichophyton mentagrophytes most common 21.24% followed by T. tonsurans 9.73%, and T. violaceum 7.96% are the common dermatophyte isolates. Aspergillus species is the most common non-dermatophyte mold isolated.Diabetes was the most common comorbid condition in culture-confirmed cases followed by hypertension and thyroid disorder.ConclusionThis study showed the prevalence of cutaneous fungal infection among elderly visiting AIIMS, Bhopal as 23.54% (113/480). With increase in elderly population, changing environmental conditions, and association with non-communicable diseases it becomes important that all elderly patients visiting hospital OPD and those hospitalized for long should be evaluated for fungal infections especially cutaneous.