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Year : 2014  |  Volume : 18  |  Issue : 1  |  Page : 63-69

Proportion of lower limb fungal foot infections in patients with type 2 diabetes at a tertiary care hospital in Sri Lanka

1 Department of Microbiology, University of Sri Jayewardenepura, Sri Lanka
2 Tangalle Base Hospital, Sri Lanka
3 Department of Community Medicine, University of Sri Jayewardenepura, Sri Lanka
4 Diabetic Clinic, Colombo South Teaching Hospital, Kalubowila, Sri Lanka

Correspondence Address:
M M Weerasekera
Department of Microbiology, Faculty Medical Sciences, University of Sri Jayewardenepura, Sri Lanka Colombo
Sri Lanka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2230-8210.126556

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Background: Superficial fungal foot infection (SFFI) in diabetic patients increases the risk of developing diabetic foot syndrome. Sixteen percent of urban population is suffering from diabetes in Sri Lanka. As the diabetes patients are more prone to get fungal foot infections, early intervention is advisable owing to the progressive nature of the infection. There is no data on the prevalence of SFFIs in diabetic patients in Sri Lanka. Objective: To determine the etiological agents causing SFFI in patients with type 2 diabetes. Materials and Methods : Three hundred eighty five diabetic patients were included. Nail clippings and swabs were collected from the infected sites using the standard protocol. Laboratory identification was done and pathogens were identified to the species level by morpho physiological methods. Results: Clinically 295 patients showed SFFI, of which 255 (86%) were mycologically confirmed for infection. Out of 236 direct microscopy (KOH) positives, 227 (96%) were culture positive. Two hundred and fifty one patients (98%) with SFFI had diabetes for more than 10 years. Of the patients with SFFIs 92% had >100 mg/dl FBS and 81% had >140 mg/dl PPBS levels and 80% had both elevated FBS and PPBS. Non-dermatophyte fungal species were the commonest pathogens followed by yeast and dermatophytes. Conclusion: Aspergillus niger was the commonest pathogen followed by Candida albicans. SFFIs were seen significantly with the increasing age, gender, duration of diabetes and with less controlled glycaemic level.

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