A Study on Fungal Profile of Mycotic Infections in a Tertiary Care Centre in Manipur, India

Abstract

Fungal infections represent a growing public health challenge in tertiary care hospitals, particularly among immunocompromised patients. In resource limited settings, conventional diagnostic methods remain the mainstay for detection and epidemiological surveillance. The objective is to characterize the fungal profile of mycotic infections in a tertiary care centre in Imphal, Manipur, using conventional diagnostic techniques. A retrospective study was conducted over one year (January 2024–January 2025) in the Department of Microbiology, Jawaharlal Institute of Medical Sciences, Imphal. A total of 402 clinical specimens were processed by direct microscopy (KOH wet mount) and culture on Sabouraud’s Dextrose Agar. Yeasts were identified by germ tube test and HiChrome Candida differential agar, while molds were characterized by LPCB staining. Among 402 samples, 175 (44.0%) pathogenic fungi were isolated. Culture positivity was highest among ICU patients (58.8%), followed by IPD (48.5%) and OPD (32.3%). Elderly patients (>70 years) demonstrated the highest positivity rate (57.6%). Non-albicans Candida spp. predominated (60.0%), with Candida tropicalis most frequent, particularly in urine and respiratory samples. Candida albicans accounted for 23.4% of isolates, while dermatophytes (Trichophyton mentagrophytes and T. rubrum) were common in nail clippings. Occasional molds (Fusarium spp., Aspergillus fumigatus) and rare isolates such as Cryptococcus neoformans were also recovered. KOH wet mount showed limited sensitivity (32.0%) but high specificity (89.9%) compared to culture. This study highlights the significant burden of fungal infections in Imphal, with a predominance of non-albicans Candida and higher culture positivity among elderly and ICU patients