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The study of the bacteriological profile, the association of complement C3, interleukin-1beta, and zinc therapy of diabetic foot ulcers (type two) was investigated. Twenty diabetics without foot ulcers (group I), 50 diabetics with foot ulcers (group II), and 10 matched normal controls (group III) were enrolled in this study. Diabetic foot ulcers were mostly of grade 2. The most frequent organisms were Clostridium spp., Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli, respectively. Vancomycin, Imipenem, and Meropenem were the most effective against Gram-positive and Gram-negative aerobes, while Imipenem, Meropenem and Chloramphenicol for Gram-positive anaerobes. Group II had abnormal levels of C3 (72%). A significant higher concentration of C3 was found in group II. Group II had abnormal levels of IL-1β (60%). A significant higher concentration of IL-1β was found in group II. Zinc therapy (25 mg/day/oral) induced a highly significant decrease in the frequency of Gram-positive anaerobes and levels of IL-1β. Significantly increases all mineral concentrations in serum level except Mn(+2). The study highlights the prevalence of antibiotic multi-drug resistant bacteria causing foot infections in diabetics which require combined antimicrobial therapy. Altered levels of serum complement C3 and IL-1β might be responsible for depressed immune response which might be causes for delayed wound healing and repeated infections. Zinc supplementation may help in healing the wounds by enhancing the immune response.

The main objective of this study is to isolate actinobacteria has antifungal activity against some dermatophytes, Epidermophyton floccosum, Trichophyton rubrum, Microsporum canis, and Candida albicans, evaluation, and optimization of various cultural and nutritional conditions for maximum antifungal metabolite production. Total 64 actinobacteria were isolated from various localities in Egypt and screened for their antifungal activity against the tested fungi. Out of 64 isolates, the identified Streptomyces canescens MH7 has a good antifungal activity and inhibits the growth of the tested fungi. This isolate was capable of producing glucanase, lipase, and amylase enzymes which are important hydrolytic enzyme in the lysis of the fungal cell wall. Several growth factors were optimized to maximize the production of antifungal metabolites. Streptomyces canescens MH7 had the best antifungal activity in starch casein broth media supplemented with starch as a carbon source, potassium nitrate as a nitrogen source, salinity of 3% (w/v), pH8, incubation temperature at 30°C, incubation for 7 days, and shaking at 180 rpm.

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Oral candidiasis has a strong association with diabetes. This study investigated the prevalence of candidiasis, effects of age and denture wearing on the isolation rate of Candida, virulence factors such as (germ tube (GT), gelatinase assay, phospholipase (PL) activities, biofilm (BF) formation) of different Candida species isolated from 40 confirmed diabetic patients with oral candidiasis and susceptibility of Candida isolates to antifungal agents. The prevalence of candidiasis was (67%) which is more prevalent in middle age (40-60) years (65%) and among females (65%). Sixty Candida isolates were identified among which Candida albicans represented (53.3%), followed by C. glabrata (31.7%), C. tropicalis (10%) and C. krusei (5%). In denture wearers, the isolation rate of all Candida species was 94.7% while in non denture wearers was 53.7%. The minimun inhibitory concentrations (MICs) of ketoconazle as the lowest concentration of antifungal that inhibited 100% of C. krusei while MIC for flucytosine that inhibited 90.6% and 84.2% of C. albicans and C. glabrata respectively, also the MIC for itraconazole and voriconazole that inhibited 93.5% and 81.2% of C. albicans. The MIC of amphotericin B was defined as the lowest drug concentration causing 100% inhibition of all Candida species. Candida albicans and C. tropicalis isolates were positive for all the virulence factors while C. glabrata and C. krusei were negative for GT, gelatinase and PL activities. C. krusei were positive only for BF formation. In Conclusion, Candida spp. in the oral cavity of diabetic patients are potentially pathogenic and can participate in infectious and inflammatory processes since they exhibit most of the virulence factors and resistance to most antifungals. Denture wearing, female sex and middle age are among the risk factors. Controlling serum glucose level and oral hygiene are essential in diabetics.