Isolation And Identification Of Fungal Dermatological Agents Among Patients Attending Thika District Hospital Thika, Kenya

Fungal dermatological conditions are caused by a group of fungi called dermatophytes. They cause infections in almost all parts of the body. The most common cause of skin infections are dermatophytes and opportunistic fungi. Dermatophytoes are not life threatening but they affect the quality of life of the patients as they can cause depression, lack of self confidence and isolation incase of deep lesions. In Kenya the prevalence and distribution of the infections as well as the common dermatological agents are not known. The predisposing factors of these infections are also not well studied in Kenya. The main objective of this study was to isolate and identify fungal dermatological agents from clinical samples from patients presenting with suspected fungal skin infection in Thika District Hospital. The study also examined the possible predisposing factors to fungal infections in patients attending Thika District hospital. Clinical samples from 126 patients were subjected to Potassium hydroxide (KOH) preparation and culture. The KOH digested specimens and fungal colonies were examined and identified macroscopically and microscopically. Patients completed questionnaires to record information on age, gender, site of infection, residence, level of education and occupation. The obtained results were analyzed by SPSS 12 software. The average age of the patients was 15.5 years and the ratio of male to female was 1.7:1. The highest isolation was from the scalp 56(44.4%) others were trunk 35(27.8%), hands 31(24.6%), neck 26 20.6%), feet 14 (11.1%) and face 9(7.1%). Out of 126 samples 107(84.9%) were KOH positive and 106(84.1%) were culture positive. Trichophyton spp. had the highest isolation of 67(62.6%), with T. verrucosum being the most common 21(16.3%) followed by T. sudanenses and T. mentagrophytes each at 12

(9.3%). The other fungal organisms isolated were yeast 26(24.3%), Epidermophyton spp. 3(2.8%), Microsporum spp. 3 (2.8%) and others that were non-dermatophyte were 8(7.5%). There was statistical association between isolation from hands, scalp and neck infection. The p-values were 0.04, 0.02 and 0.012 respectively. The association of gender, residence, age, occupation, knowledge of infection, education and infection was not statistically significant and the P- values were 1.0, 0.81, 0.64, 0.26, 0.36 and 0.11 respectively. The isolation rate of fungal infection was 84.1 % indicating that dermatophytosis in Thika District Hospital is a major cause of morbidity warranting intervention. This study recommends routine mycological investigations in both adults and children with suspected mycoses for better management of dermatological conditions in Thika District Hospital.