Pathogenicity of Fungi Isolated from the Respiratory System of Patients in Selected Hospitals in Baghdad

Abstract

     Fungal infections of the respiratory system have increased in recent years with the increase in the number of fungal spores due to pollution, so there was a need for a study focusing on fungal species that infect the respiratory system, studying their pathogenicity and diagnosing them accurately to be able to give appropriate treatment and save patients. The study aimed to isolate and diagnose pathogenic fungi from patients with respiratory diseases and to indicate their pathogenicity by studying their virulence, toxicity, and impact on the immune system to know the extent of the danger of these fungi as well as their impact in causing serious opportunistic diseases for patients with respiratory injuries. The current study obtained 22 different fungal isolates belonging to 203 blood and sputum samples collected from people with respiratory diseases of different ages. The age of those affected of both sexes ranged between 17-73 years.  Isolation was carried out from different hospitals in Baghdad, including Kadhimiya Teaching Hospital, Medical City, Euphrates Hospital, and Yarmouk Hospital, from 25/3/2024 to 29/5/2024, to detect fungal species in people suffering from respiratory diseases. The fungus was diagnosed based on external appearance, microscopic diagnosis and biochemical tests. The results of isolation from the blood showed the highest incidence of Penicillium chrysogenum (32.34%), which is the highest among isolated fungi, followed by Penicillium verrucosum, with a recurrence rate of 14.7%. In contrast, yeasts had the highest frequency of isolation from sputum smears which is 29.38% Candida albicans, 20.34% Candida aruis, 10.17% Candida kruse, 10.17% Candida tropicals, and 7.91% Candida glabrata followed by the genus Aspergillus spp., with the incidence of the species Aspergillus terreus was 18.08% and Aspergillus ochraceus was 1.13% the second highest incidence of sputum smears. All isolates conducted tests of the virulence factors to know the severity of the pathogenicity of isolated fungi, and the results showed that Candida albicans was the main yeast capable of germ tube formation. The study also showed the production of eight isolates of the enzyme proteases and phosphatase. The susceptibility to the formation of mycotoxins by Aspergillus fungi was examined under ultraviolet light, which led to the fluorescence of the toxins in blue and green. The ELISA test, which has high sensitivity and excellent specificity, was performed to detect interleukin, and no significant cross-reaction or interference was observed between IL4, IL5, IL17, and their analogues. The results of the study showed a high percentage of interleukin for the three types that were used in the study.