Fungal infection in foot diabetic patients

Abstract

Diabetic patients are more susceptible to cutaneous fungal infections. Cutaneous lesions and Foot infections are a frequent complication of patients with diabetes mellitus, accounting for up to 20% of diabetes-related hospital admissions. Foot ulcers and other foot problems are a major cause of morbidity and mortality in people with Diabetes mellitus. The higher blood sugar levels cause increasing the cutaneous fungal infections in these patients. More than 75% of diabetes mellitus (DM) patients are at risk for diabetic ulcers. About 15% of foot ulcers in diabetic patients lead to amputations. Although every 30 seconds one leg is amputated in the world due to DM, 80% of these cases are preventable. Poor controlled had significantly higher fungal infection in diabetic foot ulcers and require careful attention and management. The findings of various studies indicate that the prevalence of fungal infections in patients with diabetic foot ulcers is increasing and there are many drug resistance issues reported in this area, therefore more attention is important in diabetic centers about this neglected issue.

Dermatophytes and ringworm infection

“…Squamous-hyperkeratotic type (hyperkeratosis and acanthosis) where the pinkish skin of the heels, sides, and soles of the foot is covered in tiny silvery scales (moccasin foot), and vesiculous-dyshidrotic type. The etiology of the complex infection, which is a combination dermatophyte and bacterial infection, is polymicrobial infection and is clinically more severe [36]. Melikoğlu et al, (2023) stated that the dermatophyte that cause tinea pedis were identified as T. rubrum, T. mentagrophytes, M. Canis, E. Floccosum, T. verrucosum and T.violaceum with decreasing frequency [37].…”

Innovative Functional Biomaterials as Therapeutic Wound Dressings for Chronic Diabetic Foot Ulcers

“…Significantly, 50 to 60% of DFUs become infected, predominantly with bacterial colonies of S. aureus , C. striatum , and P. aeruginosa , and fungal colonies of C. albicans [ 5 , 34 , 35 , 36 , 37 , 38 ]. Moreover, between 20 and 25% exhibit deep infections with some anaerobic bacteria, such as Bacteroides spp., Prevotella spp., and Clostridium spp., which can spread to the bone, further exacerbating the risk of mortality and the socioeconomic burden [ 8 , 28 , 39 ].…”

Bioactive Antimicrobial Peptides as Therapeutic Agents for Infected Diabetic Foot Ulcers

“…Furthermore, DFUs have a polymicrobial basis, and the risk for the diabetic foot syndrome development is mostly associated with mycotic infections [ 11 , 12 , 13 , 14 , 33 ]. However, few studies have considered the prevalence of fungal colonies in DFUs.…”

“…Therefore, further studies will need to include more models of infection with anaerobic bacteria, fungi, and biofilms, since infected DFUs tend to have a multi-kingdom basis. Indeed, non-healing DFUs have been highly associated with fungal pathogens and anaerobic bacteria [ 11 , 12 , 13 , 14 , 17 , 18 ]. It is noteworthy that the infection models used in the different studies presented herein include microorganisms that are more pathogenic and predominant in DFUs, such as S. aureus (MSSA and MRSA), P. aeruginosa , E. coli , and A. baumannii , as well as some Candida spp.…”

“…The persistent hyperglycemia, chronic inflammation, hypoxia, peripheral neuropathy, impaired angiogenesis, and difficulty to fight infections in diabetes are factors that impair the wound healing progress. Importantly, around 60% of DFUs become infected, predominantly with bacterial colonies of S. aureus and C. striatum , and fungal colonies of C. albicans [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. Moreover, anaerobic bacteria of the Bacteroidales order, namely Bacteroides spp.…”