European Journal of Experimental Biology Open Access

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Abstract

Distribution of mycotic and bacterial infections among the patients with diabetic foot ulcers referred to diabetes and metabolic disorder clinic, Tehran, Iran 2011-2012

Patients with diabetes demonstrated to be more prone to developing infections than others. Diabetic foot ulcer is a major health problem in these patients. The purpose of the study was to investigate the incidence of fungal and bacterial pathogens in diabetic foot infections. A total of 57 diabetic patients with non-healing diabetic foot infections who were referred to diabetic clinic during 2011 to 2012 were included for the study. Samples were obtained from the depth of the wound by the use of a sterile swab. Direct fresh smear, fungal and bacterial culture were performed for each patient. Fungal contaminations were confirmed by direct microscopy and/or culture and molecular method. In this study, 9 patients (15.7%) did not show any bacterial and fungal infections, 35.4 % (17/48) had yeast and 80.7% had bacterial infections whereas 31.25% showed mix infection. Candida species were the most
predominantly isolated fungi (17patients) including C. albicans (30 %), C. parapsilosis (58 %) and C. glabrata (12%). E. coli and Pseudomonas aeruginosa were the predominantly gram negative bacilli causing infections in diabetic foot ulcer. Staphylococci were the most frequent organisms encountered and S.aureous was isolated from 10 (20.8%) specimens. Other detected gram-positive bacteria were: Streptococci (4%) and Enterococcus faecalis (2%). The results of the study indicate that Candida Sp is the main yeast infection in patients with diabetic foot ulcer. As a result, mycological evaluation of the non-healing diabetic foot ulcers and suitable antifungal therapy due to biofilm formation and drug resistance should always is necessary.