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Fungal Agents as a Cause of Surgical Wound Infections: An Overview of Host Factors
Unlabelled:
Microbial virulence and host resistance are the determinants of the surgical infections. Bacteria are responsible for the majority of cases, but fungi are rare. The aim of this study was to evaluate the fungi causing surgical infections and discuss host factors predisposing the infection.
Methods:
A total of 824 surgical wound specimens had been evaluated. The specimens were cultured using 5% sheep blood, Sabouraud Dextrose, and Eosin methylene blue agars and the isolates were identified by classical methods and API identification system.
Results:
Growth was obtained in 455 (55.2%) out of 824 specimens. Nine (2%) of the agents of surgical infections were yeasts: Candida albicans was isolated in 5 (55.6%), C tropicalis in 3 (33.3%), and C glabrata in 1 (11.1%) specimen(s). Examining the characteristics of the patients, fungal infection could be explained with the presence of at least 1 predisposing factor. Immunosuppression was closely related with fungal growth.
Conclusion:
Predisposing factors impairing the immune system were detected in most of the patients showing the possibility of onset of fungal, predominantly Candidal infections. It is important for clinicians to be aware of fungal infections that may develop in this group under risk, particularly after surgery and all Candida species isolated from high-risk patients should be identified to species level, as nonalbicans strains are often associated with resistance to antifungal agents.
Insights
Fungal surgical infections, primarily Candida species, are rare but linked to predisposing factors like immunosuppression. Identifying Candida to species level is crucial for effective treatment due to potential antifungal resistance.
Area of Science:
- Surgical infections
- Mycology
- Immunology
Background:
- Surgical site infections are typically bacterial, with fungal causes being uncommon.
- Understanding the role of fungi and host factors in surgical infections is essential.
Purpose of the Study:
- To evaluate the fungi responsible for surgical infections.
- To identify host factors that predispose patients to these fungal infections.
Main Methods:
- 824 surgical wound specimens were cultured on various agars.
- Isolates were identified using classical methods and the API identification system.
Main Results:
- Fungal growth was observed in 2% of positive cultures, with Candida species being the predominant agents.
- Candida albicans, Candida tropicalis, and Candida glabrata were identified.
- Immunosuppression was a significant predisposing factor for fungal surgical infections.
Conclusions:
- Predisposing factors, particularly those impairing the immune system, increase the risk of fungal infections, especially Candidal infections.
- Clinicians must be aware of the potential for fungal infections in at-risk surgical patients.
- Species-level identification of Candida is critical, as non-albicans strains may exhibit antifungal resistance.
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