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Invasive fungal infections in Kuwait: A retrospective study
1Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait. ziauddin@hsc.kuniv.edu.kw
Abstract:
A retrospective review of a five year period (1994-1998) revealed that opportunistic mycoses caused by ubiquitous fungal pathogens are a serious problem in the immunocompromised patient population of Kuwait. Patients with renal transplantation and diabetes mellitus were most susceptible to aspergillosis, cryptococcosis, and zygomycosis, whereas patients with candidemia/hematogenous candidiasis had multiple risk factors. Basidiobolomycosis of the rectum in a Bangladeshi male, cryptococcosis due to Cryptococcus neoformans var. gatti in an AIDS patient,fungal peritonitis due to Absidia corymbifera in a patient on peritoneal dialysis, and endocarditis due to Aspergillus terreus detected by direct microscopic examination and culture of the blood clot are some of the notable cases diagnosed during the period under review. The predominance of Candida species other than C. albicans as bloodstream pathogens is another noteworthy observation. Although outbreaks of C. parapsilosis candidemia in neonatal intensive care units contributed significantly to this shift in favour of non-albicans Candida species, a surveillance strategy comprising of molecular, epidemiologic and antifungal susceptibility studies is warranted. With the proposed expansion of organ and bone marrow transplantation facilities in Kuwait, the incidence of opportunistic fungal infections is likely to increase.
Insights
Opportunistic fungal infections pose a significant threat to immunocompromised patients in Kuwait, particularly those with renal transplants or diabetes. Non-albicans Candida species are increasingly prevalent bloodstream pathogens, necessitating enhanced surveillance.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Public Health
Background:
- Opportunistic mycoses are a serious concern for immunocompromised individuals.
- Ubiquitous fungal pathogens cause significant morbidity and mortality in susceptible populations.
Purpose of the Study:
- To review the incidence and types of opportunistic fungal infections in Kuwait from 1994-1998.
- To identify patient populations at higher risk for specific fungal infections.
- To highlight notable cases and trends in fungal pathogens.
Main Methods:
- Retrospective review of medical records over a five-year period (1994-1998).
- Analysis of diagnosed opportunistic fungal infections and associated patient demographics.
- Identification of causative fungal species and clinical presentations.
Main Results:
- Aspergillosis, cryptococcosis, and zygomycosis were common in renal transplant and diabetes mellitus patients.
- Candidemia/hematogenous candidiasis had multiple risk factors.
- Non-albicans Candida species, including Candida parapsilosis, were increasingly observed as bloodstream pathogens, partly due to neonatal intensive care unit outbreaks.
Conclusions:
- Opportunistic fungal infections are a significant problem in Kuwait's immunocompromised population.
- The rise of non-albicans Candida species warrants further investigation and surveillance.
- Anticipated expansion of transplantation services suggests a likely increase in fungal infections, necessitating proactive strategies.
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