Epidemiological and mycological profile of superficial mycoses in diabetic patient

Introduction: Superficial mycoses, especially those of nails, scalp and skin, are very common in various countries. The presence of specific terrain, as well as other factors, can affect the prevalence of these. In this sense, diabetic patients are more susceptible to infections especially fungal infections because of changes in the immune system and macro and microvascular changes. The objective of our study was to determine the epidemiological and mycological profile of superficial mycoses in diabetic patients at the Mohammed VI Hospital in Oujda (Morocco).
Material and methods: This is a retrospective, observational and descriptive study spread over 34 months, from January 2021 to October 2023 at the Parasitology-Mycology laboratory of the Mohammed VI Hospital Center of Oujda. We collected demographic and mycological data for the included patients. In the laboratory, upon reception of the samples, a direct examination (DE) of the sample was obtained after clarification by KOH to better visualize the mycelial filaments or yeasts and culture on both media: Sabouraud with chloramphenicol and Sabouraud with chloramphenicol and cycloheximide is systematically carried out.
Results:  We collected 136 diabetic patients referred to our laboratory for suspicion of superficial mycosis. The latter was confirmed in 46 of the 136 diabetic patients (33.82%) referred to our laboratory, which corresponds to 50 lesions among the 166 sites taken, a prevalence of 30.12%. At the mycological examination, the DE allowed the confirmation of the diagnosis of mycoses in 64% (n=32) and showed most often mycelial filaments (n=21; 65.62%) especially at the level of the feet and yeasts were observed in particular at the level of the nails of the hands (n=11; 34.37%). While culture was positive in all cases without exception (100%; n=50), dermatophytes were the most frequently isolated fungi (n=30; 60%), followed by yeasts (n=20; 40%). By species, T. rubrum (n=30; 60%) was the only isolated dermatophyte species, followed by Candida albicans (n=17; 34%).
Conclusion: In recent years, we have seen an increase in the prevalence of superficial mycoses in diabetic patients which is why we conducted this study. The results show on the one hand that the most isolated fungi in the superficial mycoses of these patients are dominated by dermatophytes, as T. rubrum represents the most frequently encountered species. Furthermore, the high prevalence of the latter demonstrates the significance of implementing important prevention measures.