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 for less than 3.0%. One suspected case (0.6%) of Penicilium marneffei was isolated although it could not be ascertained due to its high containment requirement. Among the dermatophytes, the most occurring mould was Trichophyton schoenleinii (3.7%) while in non-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 wound infection and may require antifungal intervention for successful management of diabetic foot ulcers.