Mycotic infections in diabetic foot ulcers in Emam Reza hospital, Mashhad, 2006-2008

authors:

avatar Saba Fata 1 , avatar Mohammad Hadi Saeed Modaghegh 2 , avatar Rabe'eh Faizi 2 , avatar Mohammad Javad Najafzadeh 2 , avatar Monavvar Afzalaghaee 3 , avatar Mohsen Ghasemi 2 , avatar Mohammad Mohammadian 2 , avatar Ali Naseri 2 , avatar Mojtaba Meshkat 2 , avatar Abdolmajid Fata ORCID 4 , *

The Health Centre, Nikshahr Health and Cure Network, Iran
Mashhad Vascular and Endovascular Research Surgery Research Centre, Mashhad University of Medical Sciences, Iran
Centraalbureau voor Schimmelcultures Fungal Biodiversity Centre, Utrecht, and Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, The Netherlands
Department of Parasitology and Mycology, and Research Centre for Skin Diseases and Cutaneous Leishmaniasis, Mashhad University of Medical Sciences, fataa@mums.ac.ir, Iran

how to cite: Fata S, Saeed Modaghegh M H, Faizi R, Najafzadeh M J, Afzalaghaee M, et al. Mycotic infections in diabetic foot ulcers in Emam Reza hospital, Mashhad, 2006-2008. Jundishapur J Microbiol. 2011;4(1): -. https://doi.org/10.5812/kowsar.20083645.2586.

Abstract

Introduction and objective: Diabetic foot is the result of uncontrolled diabetes and imperfect sanitary care which leads to necrotic lesions, gangrene and finally amputation. Secondary mycotic infections play a principal role to produce chronic lumpy lesions. This study was designed to investigate the incidence of fungal pathogens in diabetic foot infections.

Materials and methods: The study population included 120 consecutive diabetic patients who were hospitalized in the department of vascular surgery due to diabetic foot during 2006-2008. Direct fresh smear and fungal culture were performed for each patient. Fungal contaminations were confirmed by direct microscopy and/or culture.

Results: The ages of the patients were between 32 to 86 years old. Of those 86(71.7%) individuals were male and 34(28.3%) were female. Direct examinations in 10% KOH were positive for fungal element in 25(20.8%) cases, but cultures were positive in 30(25%) cases. Candida species were the most predominantly isolated fungi (23 patients). Dermatophytic infection due to Trichophyton mentagrophytes was observed in three cases. The isolated opportunistic molds were known as Acremonium spp., Aspergillus fumigatus and Scopulariopsis spp. Significant correlation was found between infection, gender and age of the patients (P=0.0001 and P=0.0001).

Conclusion: This study shows that fungal infection can be observed in about more than 20% of diabetic foot and causes a lesion with poor prognosis. The most common cause of mycotic diabetic foot is different species of Candida spp., especially C. albicans.

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