Fungal Colonization On Human Body Surfaces
Project and Seminar Material for Microbiology
Chapter One
1.0 Introduction
Fungi are a major group of living things, originally considered plants lacking chlorophyll, leaves, true stems, roots and reproducing by spores, but now treated as the separate kingdom fungi.
They occur in all environments on the planet and include important decomposers and parasites. Parasitic fungi infect animals including human, other animals, birds, and insects with consequences varying from mild itching to death, in general, humans have a high level of inmate immunity to fungi and most of the infections they cause are mild and self limiting (Adeleke, 2006).
Fungi are contacted during our everyday routines, some which are potentially pathogenic to human and other not human could be exposed simply by walking by a construction areas were the oil has been disturbed and scattered into the wind by the machinery, also can be exposed while jogging, hiking, hunting and fishing. The study of fungi as animal and human pathogen is called mycology (Emmons 1979)
Also, they are eukaryotic, unicellular, or multi-cellular organisms that, because they lack chlorophyll, are dependent upon external food sources. They are ubiquitous in all environments and play a vital role in the Earth’s ecology by decomposing organic matter. Familiar fungi includes yeasts, rusts, smuts, mushrooms, puffballs, and bracket fungi. Many species of fungi live as commensal organisms in or on the surfaces of the human body. “Mold” is the common term for multicellular fungi that growths as a material of intertwined microscopic filaments (hyphae). Exposure of molds and other fungi and their spores is unavoidable except when the most stringent of air filtration, isolation, and environmental sanitation measures are observed, e.g in organ transplant isolation units.
Molds and other fungi may adversely affect human health through three processes. (1) allergy (2) infection and (3) toxicity. One can estimate that about 10% of the population has allergic antibodies to fungal antigens. Only half of these, or 5%, would be expected to show clinical illness. Furthermore, outdoor molds are generally more abundant and important in airway allergic disease than indoor molds leaving the latter with an important, but minor over all role in allergic airway disease.
Chapter Five
5.0 Conclusion
Human skin microflora are important because it plays a strong role in regulating the feeding behaviour and the maintenance of good health. The presence of human skin microflora essential for immunity as these residence microbes defend their territory against diseases causing microbes.
Colonization of the burn wound on human body surface with fungi is not a surprising phenomenon in view of the changes in microbial flora induced by systemic and topical chemotherapy. The origin of the fungi in these patients does not appear to be the gastrointestinal tract as suggested in other studies of diseases complicated by fungemia (Colombo &Guimarães 2003). An epidemiological study demonstrated recovery of Candida from the wounds of 8 to 10% of severely burned patients studied and the absence of fungi in the stool or nasofharynx of these patients (Bruck et al. 1972). Colonization of fungi was found more commonly after third and fourth week postburn.
Species identification revealed that postburn patients harbored various species of Candida. These fungi species are the most common fungal organisms in burn wounds on human body surface (Bruck et al. 1972, Vindenes&Bjerknes 1995)and in this study no other fungi were isolated. The most predominant species obtained was C. tropicalis (10.3%), followed by C. parapsilosis (4.2%). This high incidence of C. tropicalis observed in our study is specially alarming. As it is now well known that unlike C. albicans, which can be found as a commensal, C. tropicalis when present, is not a commensal and is almost always associated with the development of deep fungal infections.
C. albicans has always been considered as the most frequent pathogenic species causing nosocomial fungal infections in burn patients, with mortalility rates due to deep-seated infections raging from 38 to 50% (Macedo et al. 2003). However, recently other species of Candida, as C. tropicalis, has emerged to be equally important in immunocompromised patients (Mathews et al. 2001, Leung et al. 2002, Gupta et al. 2004).
The colonization of the wounds on human body surface with Candidaspecies does not validate the start of antifungal therapy in burned patients. However, if the appearance of the wound on human body surface is suggestive of invasive fungal infection, or if the patient has received intravenous antibiotics for bacterial infections (specially older patients with burn larger than 40% total body surface area), or the patient is in a critical phase suggestive of a generalized breakdown on his/her host defense mechanisms, systemic antifungal therapy should be considered.
The high percentage of multi drug resistant isolates is probably due to empirical use of broad-spectrum antibiotics. However, in the instances of imminent clinical burn wound sepsis, the success of treatment greatly depends on prompt administration of empirical i/v antimicrobial therapy.
5.1 Recommendation
Burns provide a suitable site for bacterial multiplication and infection, mainly because of the larger area involved and longer duration of patient stay in the hospital. To ensure early and appropriate therapy in burn patients, a frequent evaluation of the wound on human body surface is necessary. Therefore, a continuous surveillance of microorganisms and a regular update of their antibiotic resistance pattern is essencial to maintain good infection control programmes in the burn unit, thus improving the overall infection-related morbidity and mortality.
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