Investigation of fungal flora in hammams, Turkish baths: A field study

Yıl 2019, , 640 - 643, 01.09.2019

Ünsal Savcı , Mustafa Şahin

https://doi.org/10.28982/josam.611224

Öz

Aim: Hammams, also known as Turkish Hammams or Turkish Baths, have preserved their traditional importance and popularity in various countries, namely, Turkey, Morocco, Yemen, and Algeria. In this study, we aimed to evaluate the fungal flora in hammams and its effects on public health.

Methods: This cross-sectional study was performed by collecting two hundred forty samples from different areas of the baths and the tools used. Collected samples were inoculated on Sabouraund dextrose agar and Potato dextrose agar for mycological evaluation. Agar plates were incubated at 25 °C and 37 °C for four weeks and fungal growth was observed every day. For identification of isolated fungi, micro and macro morphology was evaluated; germ tube test, biochemical tests and VITEK®2 Compact (Biomerieux, France) equipment were used. 

Results: We determined that molds are the most common fungi in Turkish hammams. Aspergillus spp. (n=20), Scedosporium apiospermum/boydii (n=5), Alternaria ulocladium (n=1), Rhizomucor spp. (n=1) and Penicillium spp. (n=1) were isolated in collected samples. Isolated yeasts were Trichosporon spp. (n=6), Candida albicans (n=1) and Candida tropicalis (n=1). Trichophyton tonsurans, the dermatophyte, was isolated in two samples. Fungus was most commonly isolated from slippers, and not at all isolated from towels or peshtemals. 

Conclusion: In our study, the most isolated molds were fungi, found in the nature, and the isolation rate was exceptionally low. Dermatophytes are the most common culprit of fungal transmission in public places such as baths. Compared to previous studies conducted in swimming pools, wrestling cushions, mosque carpets and slippers, our study showed that Turkish baths with high humidity and temperatures are not rich in fungal flora and that the risk of fungal contamination is low.

Anahtar Kelimeler

Hammam, Turkish bath, Fungi, Dermatophytes

Türk hamamlarında fungal floranın araştırılması: Bir saha çalışması

Öz

Amaç: Türk hamamı veya Türk banyosu olarak da bilinen hamamlar, günümüzde Türkiye, Fas, Yemen ve Cezayir gibi bazı ülkelerde geleneksel önemini ve popülerliğini korumaktadır. Bu çalışmada hamamlardaki fungal floranın ve halk sağlığına etkilerinin değerlendirilmesi amaçlanmıştır. 

Yöntemler: Bu kesitsel çalışma, hamamın farklı alanlarından ve kullanılan aletlerden iki yüz kırk örnek toplanarak gerçekleştirildi. Toplanan örnekler mikolojik değerlendirme için Sabouraund dekstroz agar ve Patates dekstroz agara inoküle edildi. Agar plakları dört hafta boyunca 25°C ve 37°C'de inkübe edildi ve her gün fungal büyümeleri gözlendi. İzole edilen fungilerin identifikasyonu için; mikro ve makro morfoloji, germ tüp testi, biyokimyasal testler ve VITEK®2 Compact (Biomerieux, France) cihazı kullanıldı. 

Bulgular: Çalışmamızın sonunda, Türk hamamlarında küflerin en yaygın funguslar olduğu belirlendi. Toplanan örneklerden izole edilen küfler, Aspergillus spp. (n=20), Scedosporium apiospermum/boydii (n=5), Alternaria ulocladium (n=1), Rhizomucor spp. (n=1) ve Penicillium spp. (n=1) idi. İzole edilen mayalar Trichosporon spp. (n=6), Candida albicans (n=1) ve Candida tropicalis (n=1) idi. Dermatofit olarak iki örnekte Trichophyton tonsurans izole edildi. En sık fungal izolasyon terliklerde görülürken, havlu ve peştemallerde fungal izolasyon görülmedi.

Sonuç: Çalışmamızda en fazla izole edilen küfler doğada ve çevrede oldukça yaygın bulunan fungilerdir ve çalışmamızda izolasyon oranı oldukça düşük bulunmuştur. Hamam gibi ortak kullanılan yerlerde fungal bulaş için en önemli grup dermatofitlerdir. Yüzme havuzları, güreş minderleri, cami halı ve terliklerinde önceki çalışmalar ile karşılaştırıldığında, bizim çalışmamız, yüksek nem ve sıcaklığa sahip Türk hamamlarının fungal flora açısından zengin olmadığını ve fungal kontaminasyon riskinin düşük olduğunu göstermiştir.

Anahtar Kelimeler

: Hamam, Türk Banyosu, Fungi, Dermatofitler

Kaynakça

• 1. Benammar L, Menasria T, Chergui A, Benfiala S, Ayachi, A. Indoor fungal contamination of traditional public baths (Hammams). International Biodeterioration&Biodegradation. 2017;117:115-22.
• 2. Dahdah MJ, Scher RK. Dermatophytes. Curr Fungal Infect Rep. 2008;2:81.
• 3. Hilmarsdottir I, Haraldsson H, Sigurdardottir A, Sigurgeirsson B. Dermatophytes in a Swimming Pool Facility: Difference in Dermatophyte Load in Men’s and Women’s
• 4. Dressing Rooms. Acta Derm Venereol. 2005;1:1-1.
• 5. Goksugur N, Karabay O, Kocoglu E. Mycological flora of the Hammams, traditional Turkish bath. Journal Compilation. 2006;49:411–14.
• 6. Yenisehirli G, Karat E, Bulut Y, Savci U. Dermatophytes Isolated from the Mosques in Tokat, Turkey. Mycopathologia. 2012;174:327–30.
• 7. Kavanagh K. Fungi: Biology and Applications. 2nd ed. 2011, Wiley-Blackwell.
• 8. Svejgaard EL. Epidemiology of dermatophytes in Europe. Int J Dermatol. 1995;34:525-28.
• 9. Hannuksela ML, Ellahham S. Benefits and risks of sauna bathing. Am J Med. 2001;110:118-26.
• 10. Murray PR, Rosenthal KS, Pfaller MC. Medical Microbiology. Başustaoğlu AC et al. (Translated), 6.th ed, 2010. Atlas Press. Ankara
• 11. Chen TC, Ho MW, Chien WC, Lin HH. Disseminated Scedosporium apiospermum infection in a near-drowning patient. J Formos Med Assoc. 2016;115:213-4.
• 12. Luplertlop N, Muangkaew W, Pumeesat P, Suwanmanee S, Singkum P. Distribution of Scedosporium species in soil from areas with high human population density and tourist popularity in six geographic regions in Thailand. PloS one. 2019;14:e0210942.
• 13. Hannuksela M, Vaananen A. The sauna, skin and skin diseases. Ann Clin Res. 1988;20:276-8.
• 14. Hamada N, Abe N. Physiological characteristics of 13 common fungal species in bathrooms. Mycoscience. 2009;50:421-9.
• 15. Ilkit M. Onychomycosis in Adana, Turkey: a 5-year study. Int J Dermatol. 2005;44:851-4.
• 16. Demir F, Kustimur S. Investigation of Some Virulence Factors in Trichosporon spp. Strains. Mikrobiyol Bul. 2017;48:628-38.
• 17. Bhattacharyya S, Gupta P, Banerjee G, Jain A, Singh M. In-vitro inhibition of biofilm formation in Candida albicans and Candida tropicalis by heat stable compounds in culture filtrate of Aspergillus flavus. J. Clin. Diagn Res. 2013;7:2167-88.
• 18. Pitt JI, Hocking AD. Fungi and Food Spoilage. Springer Press. 2009, New York
• 19. Hiruma J, Ogawa Y, Hiruma M. Trichophyton tonsurans infection in Japan: Epidemiology, clinical features, diagnosis and infection control Authors. J Dermatol. 2015;42:245-9.