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Fungal Infection among Diabetic and Nondiabetic Individuals in Nepal

Bhuvan Saud1, Prajuna Bajgain1, Govinda Paudel1

  • 1Department of Medical Laboratory Technology, Janamaitri Foundation Institute of Health Sciences, Hattiban, Lalitpur, Nepal.

Interdisciplinary Perspectives on Infectious Diseases
|December 9, 2020
PubMed
Abstract

Insights

Diabetic individuals in Nepal show a significantly higher prevalence of fungal infections, particularly from oral and toe samples. Candida species are the most common fungi and exhibit resistance to fluconazole and ketoconazole.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Endocrinology

Background:

  • Diabetes mellitus is a known risk factor for infections and organ damage.
  • Fungal infection burden in Nepal remains largely unquantified.
  • Metabolic disorders and low immunity can influence infection severity.

Purpose of the Study:

  • To investigate the prevalence and types of fungal infections in diabetic versus nondiabetic individuals in Bhaktapur, Nepal.
  • To identify common fungal species and their antifungal resistance patterns.

Main Methods:

  • Collected 670 samples from 134 participants (diabetic and nondiabetic) from various body sites.
  • Utilized Sabouraud dextrose agar for fungal culture and Gram stain, lactophenol cotton blue, and Dalmau Plate methods for identification.
  • Identified Candida species using germ-tube tests and CHROM agar, and assessed antibiotic susceptibility.

Main Results:

  • Overall fungal growth was 19.4%, with significantly higher prevalence in diabetics (34.0%) compared to nondiabetics (4.7%).
  • Predominant fungi included Candida (57.5%), Aspergillus (28.4%), and Trichophyton (10.7%), with oral wash and toe samples showing higher rates in diabetics.
  • Candida isolates demonstrated high resistance to fluconazole (36.8%) and ketoconazole (28.9%).

Conclusions:

  • Diabetic individuals are more susceptible to fungal infections.
  • Candida and Aspergillus species are the predominant fungal pathogens identified.
  • Candida species exhibit significant resistance to commonly used antifungal agents like fluconazole and ketoconazole.

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