ROLE OF PATHOGENS IN DIABETIC FOOT INFECTION AND THE POTENTIAL OF IMMUNOPROTEOMICS AS A DIAGNOSTIC AND PROGNOSTIC TOOL
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Abstract
Introduction: Diabetic foot infection (DFI) stands as a prevalent and debilitating complication of diabetes mellitus, posing significant challenges to patients' quality of life and healthcare systems worldwide.
Objectives: The main objective of the study is to find the role of pathogens in diabetic foot infection (DFI) and the potential of immunoproteomics as a diagnostic and prognostic tool.
Material and methods: This prospective observational study was conducted at Rashid Latif Medical and Dental College, Lahore from June 2021 to November 2021. Data were collected from 550 diabetic patients suffering from DFI. Data were collected through a systematically designed questionnaire which included clinical evaluation, including medical history assessment, physical examination, and wound assessment.
Results: Data were collected from 550 patients from both genders. There were 60% male and 40% female. Mean age of patients was 65.09 ± 8.3 years and the mean duration of diabetes was 11.98 ± 6.51 years. 70% of the patients also suffering from hypertension, 45% Peripheral Neuropathy and 30% from Peripheral Vascular Disease. Staphylococcus aureus, both methicillin-sensitive (MSSA) and methicillin-resistant (MRSA) strains, are the most prevalent pathogens, with MRSA exhibiting a resistance rate of 30%. Enterococcus spp., Escherichia coli, and Pseudomonas aeruginosa are also prevalent, with Escherichia coli showing notable resistance rates of 60% to ciprofloxacin and 40% to gentamicin. Elevated levels of IL-6 and TNF-alpha show positive correlations with wound size (IL-6: r = 0.65, p < 0.001; TNF-alpha: r = 0.55, p = 0.005), tissue depth involvement (IL-6: r = 0.50, p = 0.002; TNF-alpha: r = 0.45, p = 0.015), and amputation rate (IL-6: r = 0.75, p < 0.001; TNF-alpha: r = 0.70, p < 0.001).
Conclusion: It is concluded that the role of pathogens and host immune response in diabetic foot infections (DFI) is important for guiding effective treatment strategies.
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Umar Akhtar
Dentist and M. Phil Microbiology, Dental Surgeon at the Smile Dental Clinic, Lahore -Pakistan
Usama Jabbar
Medical Officer, Mujahid Hospital, Faisalabad - Pakistan
Sama Khaliq
Dentist and MPhil Microbiology, Department of Pathology, Rashid Latif Medical and Dental College, Lahore - Pakistan
Zainab Khan
House Officer, King Edward Medical University, Mayo Hospital, Lahore - Pakistan
M Faisal Javaid
Associate Professor Biochemistry Niazi Medical and Dental College, Sargodha - Pakistan
Shoaib Ahmed
Associate Professor Biochemistry. Rai Medical College, Sargodha - Pakistan
Zahra Jabeen
Department of Biochemistry, Government College University, Faisalabad - Pakistan