RESUMEN
Background: Fungal infections play important role in pathogenesis of diabetic foot infections
Objective: to investigate the prevalence of fungi among patient with diabetic foot infections
Methodology: one hundred and twenty diabetic patients hospitalized due to foot infections were enlisted in this study. Deep tissue specimens from depth of the wound and nail samples were collected from the infected sites using the standard protocol. Laboratory identification of samples was done and pathogens were identified to the species level by morpho-physiological methods. Polymerase chain reaction was used to assess the presence of fungi in samples from infected sites
Results: Fungi were found in 51.7% of the patients. Candida albicans were the most predominant isolated organism [40.1%]. Amphotericin B had 100% sensitivity against all Candida isolates. The most susceptible Candida species to fluconazole were C. dubliniensis and C. albicans. The most susceptible Candida species to voriconazole were C. dubliniensis. The most susceptible Candida species to itraconazole were C. dubliniensis. Of the study population, 70.0% had bacterial infection. The predominant isolates were Klebsiella spp. [32.7%]. Mixed fungal and bacterial infections were seen in 20.3% of patients. Sensitivity of Pan fungal PCR was 97.4%, specificity was 92.4%
Conclusion: Fungal infections were more in patients with poor glycemic control.The role of antifungal agents in management of diabetic foot infections needs to be evaluated further
RESUMEN
Background and objectives: Fungal infections of the eye constitute a group of difficult clinical problems for both the ophthalmologist and infectious disease practitioner. Despite the uncommon occurrence of ocular fungal disease, the threat of blindness from conditions such as fungal keratitis or endophthalmitis makes it a serious problem. The incidence of ocular fungal infections has increased over the last few years. This study was conducted to estimate the rate of ocular fungal infections, identify the fungal species causing ocular mycoses, and find out the epidemiological features of mycotic eye infections in patients admitted to the Ophthalmic Center, Mansoura University, Egypt
Methods: Fifty four patients [50 with clinically suspected fungal keratitis and 4 with endophthalmitis] were included in this study. Samples were collected by ophthalmologist and subjected to direct examination with potassium hydroxide [KOH] 10% and culture on Sabouraud's dextrose agar [SDA] without actidion. Experimental fungal keratitis was induced in mice to compare different methods of diagnosis of fungal keratitis
Results: Out of 54 samples collected, four showed fungal growth on SDA from patients with keratitis, while no fungi were isolated from suspected cases of fungal endophthalmitis. Two isolates were Candida albicans and two isolates were Aspergillus fumigatus. Fungal keratitis was more common among female patients in the age group 21-50 years old from rural areas. Contact lens wear, corneal trauma, topical steroid use, and systemic disease [diabetes mellitus] were the most common risk factors for fungal keratitis in our patients. Comparison of different methods of diagnosis of fungal keratitis induced in mice revealed that polymerase chain reaction [PCR] and histopathological examination were the best methods [sensitivity, specificty, and accuracy 100%] followed by Calcofluor White stain [CFW], culture on SDA without actidion, and finally KOH 10% wet mount [86, 100, 93%], [74, 100, 87%], and [54, 100, 78%] respectively
Conclusion: It is important to know the exact aetiology of fungal eye infections to institute appropriate therapy in time. Laboratory confirmation should be undertaken and fungal infection should be ruled out before prescribing corticosteroids and antibiotics. PCR and histopathological examination are cosidered the most sensitive, specific, and accurate method for diagnosing fungal keratitis