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 |
