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

Reham S Shalaby; Maha M Gaafar; Mohamed A El Basshar; May S Soliman; Marwan M Yousry; Yasmin A Elmahdy

doi:10.3889/oamjms.2023.9602

Authors

Reham S Shalaby Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
Maha M Gaafar Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
Mohamed A El Basshar Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
May S Soliman Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
Marwan M Yousry Department of General Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
Yasmin A Elmahdy Department of Clinical and Chemical Pathology

DOI:

https://doi.org/10.3889/oamjms.2023.9602

Keywords:

Invasive fungal infection, Diabetic foot ulcer, Amputation

Abstract

BACKGROUND: Clinicians frequently ignore fungal infections in diabetic foot ulcers and do not regularly explore profound tissue from the injury for fungal culture and sympathy.

AIM: The present study aimed to detect the etiologic substances and the regularity of fungal corruptions in ulcerated diabetic foot tissue samples utilizing two important diagnostic methods, namely, conventional microbiological methods and conventional 18s rRNA gene polymerase chain reaction (PCR) for detection of fungal foot infection.

MATERIALS AND METHODS: One-hundred diabetic patients suffering from diabetic foot infections were enrolled in the present study. Deep tissue specimens from the depth of the wound were collected from the infected sites using aseptic techniques. Laboratory samples were examined, and morphophysiological methods identified pathogens to the species level. Fungi were detected in samples from infected sites using the PCR.

RESULTS: The presence of fungal infection was detected in 17 (17%) of the 100 patients recruited in our study using conventional PCR. Conventional microbiological methods, on the contrary, revealed the presence of fungal infection in 14 patients (14%). Candida albicans was the most isolated pathogen (71%).

CONCLUSION: In patients with chronic diabetic foot ulcers that are not responding to long-term antibiotic treatment, fungal pathogens should be considered. Early recognition of fungal corruptions in high-risk persons is serious for avoiding severe outcomes, that is, as foot amputation.

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