A ten year retrospective study of mycological infections at a tertiary hospital in Lagos, Nigeria

Abstract

Background: Mycoses have increased in importance largely due to medical progress and the increase in the population at risk. The HIV epidemic is one of the major factors that has contributed to the dramatic increase in the prevalence of invasive fungal infections.

Objectives: To identify the types of fungi isolated, determine the pattern of requests to the laboratory and possible barriers to mycology diagnosis.

Methods: This is a retrospective study. Data of all samples sent to the mycology laboratory from 2000–2010 were retrieved manually from the laboratory registers and entered into Microsoft excel spreadsheet. A total of 403 single samples were sent, no patient had multiple samples.

Results: 207 of the samples were culture positive. The patients age range was from 5 weeks to 78 years, majority (86.1%) of them were out-patients and most (79.4%) of the samples taken from them were skin scrapings. The isolated organisms were Dermatophytes (43%), Candida spp (41.5%), Malassezia furfur (7.7%) and Aspergillus spp (5.3%). Higher proportion of the in-patients had Candida spp (66.7%) and Aspergillus spp (14.8%) , while more of the out-patients had dermatophytes isolated (42.3%). There was a progressive increase in number of isolates from 2001-2005. The most commonly isolated organisms were dermatophytes; commonly T. mentagrophyte (31.4%) and Candida spp (41.5%); commonly C. albicans  (27.1%).There were no samples from critically ill patients or from patients normally considered at risk of invasive fungal infections.

Conclusion: Superficial mycosis was the major diagnosis. There is an urgent need to drive the awareness of invasive fungal infections in our environment and introduction of serological and molecular diagnostic techniques.

Keywords: Mycoses, Lagos, retrospective study, dermatophytes, Candida spp