Prevalence of yeast in diabetic foot infections

Abstract

Diabetic foot infections are a serious threat which cause a long term of hospitalization of diabetes patients and lead to amputations. Hence, prompt diagnosis is an important criterion in the treatment of these infections. This study was carried out to determine the prevalence of yeast in diabetic foot infections. The pus samples were collected from patients presenting with diabetic foot ulcer and processed for microbiological investigation. The patients investigated comprised of 82 males and 78 females. Most of the patients were grade I ulcers followed by grade II ulcers. Out of 160 samples, 138 samples were culture positive, in which yeast isolate Candida glabrata was the predominant isolate followed by Candida albicans, Candida dubliniensis, Candida krusei and Candida tropicalis. C. albicans and C. dubliniensis were differentiated by using tobacco agar due to the presence of hyphal fringes. The methylene blue sabouraud dextrose agar and corn meal agar were also used to differentiate C. albicans from non albicans. The antifungal susceptibility pattern showed 29 % of C. albicans was sensitive to Amphotericin B and Clotrimazole, while 75 % of C. glabrata was sensitive to Amphotericin B, Ketoconazole and Itraconazole. C. dublinensis and C. albicans showed the highest percentage of resistant to Ketoconazole, Fluconazole, Nystatin and Itraconazole. Thus, the results indicating that effective alternate drug of choice are required and the proper selection of antifungal agents will play an important role for the treatment of fungal foot infections. This study will also add substantial knowledge of yeast as one of the pathogenic organisms in diabetic foot infections.

Speciation and antifungal susceptibility of Candida isolates from diabetic foot ulcer patients in a tertiary hospital in Kenya

“…The low incidence of resistance to amphotericin B in our study and previous similar studies could be explained by the fact that the agent is not commonly used among diabetic patients due to hypokalemia-associated nephrotoxicity. Our findings contrasts with those from other studies done in different parts of the world that reported up to 100% susceptibility rate of amphotericin B to Candida species [ 38 - 41 ]. Resistance to polyenes in Candida species may be associated with defective C5, 6-desaturase functionality in C. albicans and mutation of ERG 2, 3, 5, 6 and 11 genes involved in ergosterol cell membrane synthesis.…”

Uncontrolled blood sugar tends to increase prevalence of dermatomycosis in diabetic type 2 patients

“…(27) The results of our study showed that the prevalence of dermatomycosis tends to be higher in uncontrolled diabetic patients than in controlled ones. This result is in concordance with Sugandhi et al (28) in that poor glycemic control was significantly associated with fungal infection. Type 2 diabetes was previously known as predisposing factor for fungal infection especi al l y Candida infection and dermatophytosis of the foot and nail.…”

Clinical Study of Coexistence of Fungal Infections in Diabetic Foot Ulcers by 18s rRNA Gene Polymerase Chain Reaction

“…Rasoulpoor et al reached a similar finding in their systematic review analysis, stating that the rate of fungal infection in DFU was higher in elderly individuals [12]. Another study published in 2017 by Sugandhi and Prasanth found that patients in the 51-60 years old age group were more susceptible to fungal infection in DFU due to their physical health conditions [13]. Diabetes duration also acts a vital function in the creation of diabetic foot ulcer and the increase in the occurrence of fungal infection.…”