الفهرس 
List of contents
Immunological status of diabetic foot patientsOnly 14 pages are availabe for public view
 |  | from | 108 |  |  |
| | | from | 108 | | |
Abstract
Introduction: Diabetic patients will develop a foot ulcer by 15% at any time of their lives, and a foot ulcer was the beginning of leg amputations 85% of cases. Patients with uncontrolled diabetes are more susceptible to skin infections due to increase blood sugar leading to reduce the effectiveness of bacteria fighting cells. Carbuncles, boils, and other skin infections may be risky if not well managed. An altered immunity in patients with foot ulceration is important in several ways. Some markers of inflammation were up regulated (C-reactive protein (CRP), fibrinogen and interleukin 6 (IL-6)) while some were not (interleukin 8 (IL-8) and interleukin 18 (IL-18)). The aim of work: Isolation and Identification of bacterial species causing diabetic foot infections. Determination of antibiotic susceptibility pattern of the isolated bacteria. Estimation of serum level of interleukin -6 (IL-6). Research Plan: Eighty cases were included in this study, 60 of them were diabetic patients with infected foot lesions (group 1), 14 were diabetic without infected foot lesion (group 2), and 6 were non diabetic healthy persons (group 3).The samples were collected by swabs for bacteriological examination. All swabs ware examined by direct Gram stained films. Specimens were inoculated on ordinary nutrient agar, blood agar and Mac Conkey’s agar, and incubated aerobically and anaerobically at 37°C for 24h to 48h. Identification of the obtained growth was done by colony morphology Gram stained film and biochemical reactions. Antibiotic sensitivity testing was done using the disc diffusion (Kirby-Bauer) method on Mullar Hinton agar. Venus blood samples were collected to detect the level of IL6 using ELIZA test. Results: A total of 86 bacteria were isolated from 60 cases of infected diabetic foot lesion Gram negative bacteria were the commonest bacteria isolated accounting for 46% followed by Gram positive accounting for 33% of all isolates, anaerobic Gram positive accounting 14% and lastly anaerobic Gram negative bacteria accounting for 7 %. When we measured level of interleukin 6 in serum of case and control groups we found that median level of IL-6 was found to be (12.73 pg/ml) in case( group1) which is higher than only diabetic patient with uninfected ulcer(group 2) and Normal person (group 3) which accounting (4.73, 2.79 pg/ml) respectively. Conclusion: The majority of cases belonged to grade 2 and 3 of International Working group on the Diabetic Foot Classifications of Diabetic Foot Infection. The most commonly isolated bacteria Gram negative bacteria followed by Gram positive bacteria, and lastly anaerobic bacteria. Our antibiotic sensitivity testing demonstrated that Meronem was the most sensitive antibiotic while Carbenicillin, Cefazolin, and Cephalothin were the most resistant antibiotics. The median level of IL-6 was found to be higher in ( group1) than (group2) and (group3) cases.