Abstract
The study of the bacteriological profile, the association of complement C3, interleukin-1beta, and zinc therapy of diabetic foot ulcers (type two) was investigated. Twenty diabetics without foot ulcers (group I), 50 diabetics with foot ulcers (group II), and 10 matched normal controls (group III) were enrolled in this study. Diabetic foot ulcers were mostly of grade 2. The most frequent organisms were Clostridium spp., Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli, respectively. Vancomycin, Imipenem, and Meropenem were the most effective against Gram-positive and Gram-negative aerobes, while Imipenem, Meropenem and Chloramphenicol for Gram-positive anaerobes. Group II had abnormal levels of C3 (72%). A significant higher concentration of C3 was found in group II. Group II had abnormal levels of IL-1β (60%). A significant higher concentration of IL-1β was found in group II. Zinc therapy (25 mg/day/oral) induced a highly significant decrease in the frequency of Gram-positive anaerobes and levels of IL-1β. Significantly increases all mineral concentrations in serum level except Mn+2. The study highlights the prevalence of antibiotic multidrug resistant bacteria causing foot infections in diabetics which require combined antimicrobial therapy. Altered levels of serum complement C3 and IL-1β might be responsible for depressed immune response which might be causes for delayed wound healing and repeated infections. Zinc supplementation may help in healing the wounds by enhancing the immune response.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1. N.S. Raja 2007 Microbiology in diabetic foot infections in a teaching hospital in Malaysia: a retrospective study of 194 cases J Microbiol Immunol Infect 40 39–44.
-
2. M. Stumvoll B.B. Goldstein T.W. Jvan Haeften 2005 Type 2 diabetes principles of pathogenesis and therapy Lancet 365 1333–1346.
-
3. IDF. Diabetes Atlas. Fourth edition. International Diabetes Federation (2009). Available at www.diabetesatlas.org.
-
4. S.E. Shoelson J. Lee A.B. Goldfine 2006 Inflammation and insulin resistance J Clin Invest 116 1793–1801.
-
5. M.V. Donath M. Boni Schnetzler J.A. Ethngsgaard Heshses 2009 Islet inflammation impairs the pancreatic b-cell in type 2 diabetes Physiologu 24 325–331.
-
6. G.W. Gibbons G.M. Eliopoulos 1995 Infection of the diabetic foot G.P. Kozak D.R. Campbell R.G. Frykberg G.M. Habershaw Management of Diabetic Foot Problems 2nd ed. Saunders WB Philadelphia 121–129.
-
7. G.E. Reiber 2001 Epidemiology of foot ulcers and amputations in the diabetic foot The Diabetic Foot J.H. Bowkers M.A. Pfeifer Levin and O'Neal's 6th ed. Mosby St. Loius 13–32.
-
8. M.E. O'Donnell S.A. Badger M. Anees Sharif R.R. Makar I.S. Young B. Lee C.V. Soong 2009 The effects of cilostazol on peripheral neuropathy in diabetic patients with peripheral arterial disease Angiol 59 695–704.
-
9. R.G. Frykberg 2002 Diabetic foot ulcers: pathogenesis and management Am Fam Physician 66 1655–1662.
-
10. S. Schubert J. Heesemann 1995 Infections in diabetes mellitus Immun Infekt 23 200–204.
-
11. W.F. Wagner 1981 The disvascular foot: a system for diagnosis and treatment Foot Ankle 2 64–67.
-
12. V. Urbancic-Rovan M. Gubina 1997 Infections in superficial diabetic foot ulcers Clin Infect Dis 25 Suppl2 S184–185.
-
13. B.A. Lipsky A.R. Berendt H.G. Deery J.M. Embil W.S. Joseph A.W. Karchmer 2004 Diagnosis and treatment of diabetic foot infections Clin Infect Dis 39 885–910.
-
14. A. Cunha Burke 2000 Antibiotic selection for diabetic foot infections: A review. infections: A review J Foot Ankle Surg 39 4 253–257.
-
15. Z. Pataky A. Golay A. Rieker R. Grandjean L. Schiesari H. Vuagnat 2007 A First evaluation of an educational program for health care providers in a long-term care facility to prevent foot complications Int J Low Extrem Wounds 6 69–75.
-
16. J. Brandao-Neto C.A. Silva A.A. Rezende M.G. Almedia V.S.P. Sales J.S. Marchini 2003 Zinc pharmacokinetics in insulin-dependent diabetes mellitus patients after oral zinc tolerance test Nutr Res 23 141–150.
-
17. M. Palmi A. Meini 2002 Role of the nitric oxide/cyclic GMP/Ca2 signaling pathway in the pyrogenic effect of interleukin-1beta Mol Neurobiol 25 133–147.
-
18. M. Recasens A. Lopez-Bermejo W. Ricart 2005 An inflammation score is better associated with basal than stimulated surrogate indexes of insulin resistance J Clin Endocrinol Metab 90 112–116.
-
19. J.C. Stanley A.M. Collier 2008 The diabetic foot and ankle J Orthop Trauma 23 1 61–68.
-
20. P.R. Murray E.J. Baron M.A. Pfaller F.C. Tenover R.H. Yolken 1999 Manual of Clinical Microbiology American Society for Microbiology Washington, DC.
-
21. National Committee of Clinical Laboratory Standards. Performance standards for antimicrobial susceptibility testing. 14th informational supplement. NCCLS document M100-S14. Wayne, PA: National Committee for Clinical Laboratory Standards (2004).
-
22. J.J. Lai G.C. Jamieson 1993 Determination of dysprosium in monkey serum by inductively coupled plasma atomic emission spectrometry after administration of sprodiamide injection, a new contrast medium for magnetic resonance imaging J Pharm Biomed Anal 11 1129–1134.
-
23. R. Sokal F.J. Rohlf 1995 The Principles and Practice of Statistics in Biological Research 2nd ed W.H. Freeman New York.
-
24. E.M. Shankar V. Mohan G. Premalatha R.S. Srinivasan A.R. Usha 2005 Bacterial aetiology of diabetic foot infections in South India Eur J of Intern Med 16 567–570.
-
25. B. Ozer A. Kalaci E. Semerci N. Duran S. Davul A.N. Yanat 2010 Infections and aerobic bacterial pathogens in diabetic foot Afr J Microbiol Res 4 20 2153–2160.
-
26. G. Candel M. Alramadan M. Matesanz A. Diaz F. Gonzalez-Romo I. Candel A. Calle J.J. Picazo 2003 Infections in diabetic foot ulcers Eur J Int Med 14 341–343.
-
27. J.V. Hena L. Growther 2010 Studies on bacterial infections of diabetic foot ulcer Afr J Cln Exp Microbiol 11 3 146–149.
-
28. G. Dhanasekaran G. Sastry M. Viswanathan 2003 Microbial pattern of soft tissue infections in diabetic patients in South Indian Asian J Diabetes 5 8–10.
-
29. A. Ozkara T. Delibası Y. Selcoki M.F. Fettah Arikan 2010 The major clinical outcomes of diabetic foot infections: One centre experience Cent Eur J Med 3 4 464–469.
-
30. A. Abdulrazak Z.I. Bitar A.A. Al-Shamali L.A. Mobasher 2005 Bacteriological study of diabetic foot infections J. Diabetes Complicat 19 138–141.
-
31. A.T. El-Tahawy 2000 Bacteriology of diabetic foot infections Saudi Med J 21 4 344–347.
-
32. R. Gadepalli B. Dhawan V. Sreenivas A. Kapil A.C. Ammini R. Chaudhry 2006 A clinico-microbiological study of diabetic foot ulcers in an Indian tertiary care hospital Diabetes Care 29 1727–1731.
-
33. Kandemir E. Akbay E. Sahin A. Milcan R. Gen 2007 Risk factors for infection of the diabetic foot with multi-antibiotic resistant microorganisms J Infect 54 439–445.
-
34. J.M. Fernandez-Real 2006 Genetic predispositions to lowgrade inflammation and type 2 diabetes Diabetes Technol Ther 8 55–66.
-
35. B. Vozarova C. Weyer R.S. Lindsay 2002 High white blood cell count is associated with a worsening of insulin sensitivity and predicts the development of type 2 diabetes Diabetes 51 455–461.
-
36. M.J. Walport 2001 Complement-second of two parts N Engl J Med 344 1140–1144.
-
37. L.N. Islam M. Hossain M.H. Zahid 2006 Complement mediated bactericidal activity and humoral immune response in type 2 diabetes mellitus Int J Diabetes Metab 14 92–97.
-
38. O. Oncul S. Yildiz U.S. Guree E. Yeniiz T. Qyrdedi C. Top P. Gocer B. Akarsu A. Cevikbas S. Cavuslu 2007 Effect of the function of polymorphonuclear leukocytes and interleukin-1beta on wound healing in patients with diabetic foot infections J Infect 54 250–256.
-
39. S.N. Zykova T.G. Jenssen M. Berdal R. Olsen R. Myklebust R. Sejelid 2000 Altered cytokine and nitric-oxide secretion in vitro by macrophages from diabetic type II-like db/db mice Diabetes 49 1451–1458.
-
40. S. Warald C. Guillet Y. Boirie M.P. Vasson 2004 In vivo evidences that insulin regulates human polymorphonuclear neutrophil functions J Leukoc Biol 76 1104–1110.
-
41. E.A. Nelson S. O'Meara S. Golder J. Dalton D. Carig C. Lglesias 2006 Systematic review of antimicrobial treatments for diabetic foot ulcers Diabet Med 24 348–359.
-
42. K.S. Reed M.P. Pai 2004 Adjunctive granulocyte colony-stimulating factor therapy for diabetic foot infections Ann Pharmacother 38 12 2150–2153.
-
43. C. Top S. Yildiz O. Oncul T. Qydedi A. Cevikbas U.G. Soyogul S. Cavuslu 2007 Phagocytic activity of neutrophils improves over the course of therapy of diabetic foot infections J Infect 55 369–373.
-
44. U.S. Gűrer P. Gocer N. Erten E. Ryman B. Gurbuz A. Uzer A. Karan A. Cevikbas 2006 The effect of some antibiotics on polymorphonuclear leukocyte functions of elderly patients in vitro before and after zinc supplementation Int J Immunopharaco 6 808–816.
-
45. A.J.M. Boulton 2008 The diabetic foot: grand overview, epidemiology and pathogenesis Diabetes Metab Res 24 Suppl1 S3–S6.
-
46. W. Maret H.H. Sandstead 2006 Zinc requirements and the risks and benefits of zinc supplementation J Trace Elem Med Biol 20 3–18.
-
47. E. Heidarian M. Amini M. Parham 2009 Effect of zinc supplementation on serum homocysteine in type 2 diabetic patients with microalbuminuria Rev Diabet Stud 61 64–70.
Monthly Content Usage
| Abstract Views | Full Text Views | PDF Downloads | |
|---|---|---|---|
| Aug 2020 | 4 | 0 | 0 |
| Sep 2020 | 5 | 0 | 0 |
| Oct 2020 | 2 | 0 | 0 |
| Nov 2020 | 0 | 1 | 0 |
| Dec 2020 | 13 | 0 | 0 |
| Jan 2021 | 4 | 0 | 0 |
| Feb 2021 | 0 | 0 | 0 |
Copyright Akadémiai Kiadó
AKJournals is the trademark of Akadémiai Kiadó's journal publishing business branch.
Copyright Akadémiai Kiadó AKJournals is the trademark of Akadémiai Kiadó's journal publishing business branch.
Powered by PubFactory