Introduction: Diabetes mellitus (DM) is a common metabolic disorder with a broad spectrum of cutaneous
manifestations. In diabetic patients, mycotic infections may increase the risk of developing diabetic foot
syndrome.
Aim of the Work: To study the prevalence and mycological pattern of superficial fungal foot infection among
diabetic patients attending Benha University Hospital and determine the susceptibility of some clinical
isolates to different antifungal agents.
Subjects and Methods: Nail clipping and skin swabs from 80 adult diabetic patients complaining from
foot infections were subjected to complete mycological examinations including microscopic examination
to all samples, culture techniques on Sabouraud's dextrose agar. For Candida identification: culture on
Chromogenic Candida agar, germ tube test and sugar assimilation were performed. Antifungal susceptibility
testing of clinical isolates was determined by the disc diffusion method and results were interpreted in
accordance with the Clinical Laboratory Standard Institute (CLSI) criteria; sensitive (S), resistant (R) and
intermediate (I).
Results: Potassium hydroxide (KOH) examination showed positive results in 78.8% of all cases, whereas
positive cultures were obtained in 57.5%, both culture and KOH positivity in (41.3%). Dermatophytes were the
commonest isolated followed by Candida spp and non dermatophytes (60.8%, 28.3% and 10.9% of isolates),
respectively. Among dermatophytes Trichophyton rubrum (23.9%) was the most prevalent isolates followed
by T.mentagrophyte(17.4%). Candida allbicans (17.4%) was the most common yeast pathogen isolated
from feet of diabetic patients. Aspergillus niger constituted (8.7%) from isolates .Toenails were affected in
(65.2%), skin in (34.8%) and both toenails and skin were affected in (13%). There were statistical significant
difference in prevalence of foot infection as regarding to Glycated hemoglobin (HbA1c), the duration of DM
and age of diabetic patients (P |
