Clinic-mycological spectrum of infection in diabetic foot ulcers in a tertiary care hospital.

BACKGROUND AND PURPOSE

In diabetic foot ulcers, if fungal agents, such as species penetrate the cutaneous or depth of the ulcer, it can increase the wound severity and make it more difficult to heal.

MATERIALS AND METHODS

A cross-sectional study was performed on 100 diabetic patients with a foot ulcer from December 2019 to November 2020 in northern Iran. Patient data and wound grades were recorded in a questionnaire. infection was confirmed by direct microscopic examination and culture. To identify the causative agent, polymerase chain reaction-restriction fragment length polymorphism using enzyme and the partial amplification of () gene were performed.

RESULTS

Mean age of the participants was 62.1 ± 10.8 years old, and 95% of them had type 2 diabetes. Moreover, more than 83% of them had diabetes for a duration of 10 years. In addition, 59% of the patients were male, and 66% > of them had poor education levels. Besides, 99% of them were married, and 52% were rural. Furthermore, 95% of the participants had neuropathic symptoms and 88% used antibiotics. The HbA1C level was > 9% in 69% of them, and the mean ulcer grade of the patients was 2.6±1.05. infection was detected in 13% of the deep tissue and 7% of the tissue surrounding the wound. The predominant Candida isolate was (71.5%) and (14.3%). Infections caused by filamentous fungi were not detected. There was a statistically significant relationship between infection and gender, rural lifestyle, HbA1C, and ulcer grade.

CONCLUSION

Mycological evaluations of diabetic foot ulcers are often ignored. The present study revealed that is the most common causative agent of deep-seated foot ulcer infection in these patients and may require specific treatment. Therefore, more attention of physicians to infections, early diagnosis, and prompt treatment can help accelerate wound healing and prevent amputation.