A Cross Sectional study on prevalence of fungal infections in Diabetic foot ulcer

Dr Shailendra Kumar Singh, Dr. Rachana Singh

Abstract


Background: Prevalence of diabetes mellitus is being increasing globally as well in India. India has become the diabetic
capital of the world. Fungal infections are often common in diabetes mellitus. Diabetic lower limb wounds account for one of the commonest
forms of complications with diabetes. ese ulcerated lesions are easily susceptible to infections. Several studies have concluded the presence
of varied microbial flora associated with the wounds. e mycology of the lesion is not given equal importance when compared to its bacterial
aspect. Objectives: is study was done in an attempt to study the prevalence and spectrum of fungal infection in diabetic foot ulcers.
Materials and Methods: is was a hospital based cross sectional study conducted over a period of 6 months. A total number of 120 patients
with diabetic foot ulcers were included in this study. Patients already treated with anti-fungal therapy, chemotherapy, immunosuppressant,
radiotherapy and corticosteroids were excluded. Detailed history of all patients was taken. ese patients were evaluated with reference to
clinical symptomatology and biochemical profile for diabetes mellitus. Two tissue samples, which were taken from the bed of the diabetic foot
ulcer from each patient, one was sent for microscopic examination and the other for culture sensitivity both bacterial and fungal. e patients
were treated with regular dressing and antifungal therapy in addition to appropriate antibiotics as per bacterial culture sensitivity. Results
and Observations: Out of the 120 patients, evaluated 20% had positive fungal cultures, among them most common fungal strain was C
albicans and secondly was C tropicalis. Conclusion: Management of diabetic foot ulcers must include antifungal antibiotics as per fungal
culture sensitivity report in addition to routine bacterial culture sensitivity and other modalities.


Keywords


Diabetic foot ulcer, Fungal infection, Culture and sensitivity, Antifungal.

Full Text:

PDF

References


Mohan, V., Sandeep, S., Deepa, R., Shah, B., Varghese, C. 2007. Epidemiology of type 2 diabetes: Indian scenario. Indian J. Med. Res., 125: 217 230.

Pendsey, S.P. 2010. Clinical profile of diabetic foot in India. Int. J. LowerExtremity wounds, 9(4): 180 184.

Reiber, G., Lipsky, B., and Gibbons, G.The burden of diabetic foot ulcers. The AmericanJournal of Surgery, 1998;176(2):5S– 10S.

The Diabetic Foot: Epidomology, Risk Factors And The Status Of Care; The Global Impact;AndrewBoulton, Diabetes Voice, November 2005;(50), Special Issue.

Bowering CK Diabetic foot ulcers. Pathophysiology, assess¬ment, and therapy. Can Fam Physician. 2001 May;47:1007-16.

Crawford F, Inkster M, Kleijnen J, Fahey T. Predicting foot ulcers in patients with diabetes: a systematic review and meta-analysis QJM. 2007 Feb;100(2):65-86.

Mehmood K, Akhtar ST, Talib A, Talib A, Abbasi B, Siraj-Ul- Salekeen et al. Clinical profile and management outcome of dia¬betic foot ulcers in a tertiary care hospital. J. Coll. Physicians Surg. Pak. 2008;18(7):408-12.

Chellan G, Shivprakash S, KarimasseryRamaiyar S, Varma AK, Varma N, Thekkeparambil Sukumaran M, et al. Spectrum and prevalence of fungi infecting deep tissues of lower-limb wounds in patients with type 2 diabetes. J ClinMicrobiol. 2010;48:2097– 102.

Nair S, Peter S, Sasidharan A, Sistla S, Unni A K K. Incidence Of Mycotic Infections In Diabetic Foot Tissue, Journal of cul¬ture collections. 2006-2007;(5):85-89.

Cincholikar DA, Pal R B. Study of fungal and bacterial infec¬tions of the diabetic foot. Indian journal of pathology and mi¬crobiology, 2002;45(1):15-22.

Bansal E, Garg A, Bhatia S, Attri, A K, Chander J. Spectrum of microbial flora in diabetic foot ulcers. Indian journal of pathol¬ogy and microbiology, 2008;51(2):204-8.


Refbacks

  • There are currently no refbacks.