Fungal Infections Resulting From Prolonged Use of Personal Protective Equipment.

This study is the first to investigate fungal infections resulting from prolonged use of personal protective equipment (PPE) among healthcare workers at Kütahya Health Sciences University Evliya Çelebi Training and Research Hospital, during the COVID-19 pandemic. The research aimed to isolate, molecularly type, and assess the antifungal susceptibility of superficial fungal infection agents associated with PPE use. Additionally, the relationship between these fungi and PPE use was evaluated through a questionnaire. Samples were collected from 100 healthcare workers experiencing skin issues. Among them, all N95/FFP2 mask users, 44.3% of glove users, 36.1% of surgical mask users, and 22.9% of hair cap users reported skin reactions, with acne (n = 34) being the most common. Identified fungal isolates included Trametes hirsuta, Penicillium chrysogenum, Aspergillus fumigatus, Rhodotorula sp., Candida sp., Pichia fermentans, and the dermatophyte Microsporum ferrugineum. Antifungal susceptibility tests revealed 47.6% resistance to fluconazole and 76.2% resistance to voriconazole (n = 16). This study provides the first institutional data on PPE-associated fungal infections and antifungal resistance in healthcare settings. These findings highlight the dermatological risks of prolonged PPE use. To mitigate these effects, healthcare institutions should prioritize high-quality materials, establish optimal usage guidelines, and provide continuous training on self-protection.