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Fungal Infections Resulting From Prolonged Use of Personal Protective Equipment

Elif Aydin1, Duygu Percin Renders2, Selve Arslan Utku3

  • 1Tavşanlı Vocational School of Health Services, Kütahya Health Sciences University, Kütahya, Türkiye.

Current Microbiology
|April 19, 2025
PubMed

Insights

Prolonged personal protective equipment (PPE) use during the COVID-19 pandemic led to fungal infections in healthcare workers. Many isolates showed resistance to common antifungals like fluconazole and voriconazole.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Dermatology

Background:

  • The COVID-19 pandemic necessitated prolonged use of personal protective equipment (PPE) by healthcare workers.
  • Healthcare workers reported skin issues, including acne, associated with extended PPE usage.

Purpose of the Study:

  • To investigate fungal infections linked to prolonged PPE use among healthcare workers.
  • To isolate, molecularly type, and determine antifungal susceptibility of fungal agents.
  • To evaluate the relationship between fungal infections and PPE use via questionnaire.

Main Methods:

  • Collected samples from 100 healthcare workers with skin issues.
  • Identified fungal isolates using molecular typing.
  • Performed antifungal susceptibility testing for common antifungal drugs.
  • Assessed PPE use and skin reactions through a questionnaire.

Main Results:

  • Fungal isolates identified include Trametes hirsuta, Penicillium chrysogenum, Aspergillus fumigatus, Rhodotorula sp., Candida sp., Pichia fermentans, and Microsporum ferrugineum.
  • High resistance rates observed: 47.6% to fluconazole and 76.2% to voriconazole.
  • N95/FFP2 mask users reported the highest incidence of skin reactions.

Conclusions:

  • This study is the first to report institutional data on PPE-associated fungal infections and antifungal resistance.
  • Prolonged PPE use poses significant dermatological risks to healthcare workers.
  • Healthcare institutions must ensure high-quality PPE, establish usage guidelines, and provide training to mitigate risks.

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