Epidemiological distribution of Fungal Infections Isolates from Bronchoalveolar Lavage (BAL) in Patients suffering from Chronic Respiratory Diseases in Babylon Province

Abstract

Fungal infections of the lower respiratory tract (LRT) showed a significant clinical challenge specifically in patients with compromised pulmonary function. Early and accurate identification of these pathogens is crucial for effective management of this disease. To determine the prevalence, species distribution, antifungal susceptibility patterns, and independent risk factors associated with fungal isolation from (BAL samples) in Babylon Province, Iraq. A hospital-based cross-sectional study was conducted at Imam Al-Sadiq Teaching Hospital for the periods (October 1,2025 – December 31, 2025), involving (96 patients) with clinical and radiological suspicion of pulmonary mycosis. Furthermore, fungal identification was performed using standard mycological techniques (KOH, SDA, and API 20C AUX). Antifungal susceptibility testing followed (CLSI M27) and (M38) guidelines. Fungal growth was detected in 41.7% (40/96) of BAL samples. Candida were the most common isolate (45%), followed by Aspergillus (22.5%) and Mucorales (20%). Non-albicans Candida accounted for 55% of Candida isolates. Fluconazole resistance was observed in 28% of Candida isolates. Diabetes mellitus and prolonged corticosteroid exposure were significantly associated with fungal isolation (p<0.05). The study showed a significant presence of Candida and Mucor infection in the lower respiratory tract (LRT) of patients in Babylon province. Finally, suggest that demographic factors such as (age and gender) may influence the distribution patterns of specific fungal pathogens infection. Therefore, focusing the need for rapid diagnostic approaches and the study represented an emerging shift toward resistant (non-albicans species) and emphasizes the necessity of susceptibility-guided antifungal therapy in future.

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