Fungal infections among diabetic foot ulcer- patients attending diabetic clinic in Kenyatta National Hospital, Kenya.

Abstract

OBJECTIVE:

To isolate and identify fungal pathogens associated with dermatophytoses in diabetic patients and identify the spectrum of yeasts colonising diabetic foot ulcers at Kenyatta National Hospital. DESIGN:

A cross sectional Laboratory based study. SETTING:

The Kenyatta National Hospital diabetic clinic. SUBJECTS:

Sixty one patients with diabetic foot ulcers from August to November 2009. RESULTS:

The five most occurring pathogens were Biopolaris hawaiiensis (5.5%), Trichophyton schoenleinii (3.7%), Aspergillus niger (3.0%), Trichophyton rubrum (3.0%), Fusarium oxysporum (3.0%). Other moulds accounted forless than 3.0%. One suspected case (0.6%) of Penicilium marneffei was isolated although it couldnotbe ascertained due to its high containment requirement. Among the dermatophytes, the most occurring mould was Trichophyton schoenleinii (3.7%) while innon-dermatophyte was Biopolaris hawaiiensis (5.5%). Eight pathogenic yeasts were identified with C. parapsilosis (6.1%) being the most common followed by C. famata (3.0%). Fungal infestation was highest in callus formation (78.6%). CONCLUSION:

Fungal aetiological agents are significant cause of diabetic woundinfection and may require antifungal intervention for successful management of diabetic foot ulcers.