The occurrence of fungi from burn wound patients and antifungal susceptibility patterns: a cross-sectional study in Lusaka, Zambia

Abstract

Background: Fungal opportunistic infections in burn wound patients are among the leading cause of morbidity and mortality.Attention remains focused on preventing bacterial infection at the expense of increasing fungal infection in burn wound patients. Objective: To determine the occurrence of common fungi in admitted burn wound patients and their environment: and theirantifungal susceptibility patterns at the University Teaching Hospitals, Lusaka, Zambia. Methods: This laboratory-based cross-sectional study enrolled a total 101 participants whose pus swab specimens were collectedfrom their burn wounds as well as 50 environmental swabs collected from strategic points. Wet mount, gram stain, culture onSabouraud dextrose agar, Corn meal agar and Germ tube were used to identify possible fungal isolates. Agar based disc susceptibilitytest was carried out using fluconazole. Data was analysed using Excel and STAT version 14. Results: Median age was 3 years and median burn % of TBSA was 18 in participants’ who had burn wound fungal infectionand consisted of 3 males and 6 females. Organisms isolated included Candida albicans from 8(7.9%) participants and 2(4%) from50 environmental swabs. 1(1%) Candida spp was isolated from pus swabs. Out of the total 11 Candida isolates, 4 (36.4%) weresusceptible to fluconazole and 7 (63.6%) were resistant. Conclusion: The isolation of Candida albicans and Candida spp from burn wound patients and the hospital ward environmentsuggests presence of fungi in burn wound patients and hospital ward environments. Candida isolated showed varying susceptibilitypatterns to fluconazole. Keywords: Burns; Candida albicans; CLSI; fungal infection; Susceptibility patterns.