Assessment the Role of Phagocytic Neutrophil Cells among Different Wagners Grades of Diabetic Foot Ulcers Infection
Abstract
Eidha Ali Bin-Hameed and Maryam Hamed Baras
Foot ulcers complications in diabetes mellitus (DM) patients are one of the significant medical problems. This study aimed to assessment the role of phagocytic neutrophil cells and its relationship with the incidence of diabetic foot ulcers (DFU) infection in diabetic patients. A case-control analytical study was conducted on 60 DM, DFU patients and healthy control group. Blood samples were collected for phagocytic activity testing and swabs samples of DFU were collected and processed for culture and antibiotics susceptibility testing after the ulcers classified according to Wagner’s grades system. Findings revealed that Gram-positive bacteria were the most prevalent in the DFU 57.1% with statistically significant relationship between the bacterial species and grades of Wagner’s classification. Wagner’s ulcers grade I and II were the most prevalence in DFU patients 30% for both. There was a weak negative correlation between phagocytic activity and grade ulcers classified. Amikacin and ciprofloxacin were the most effective antibiotics against bacterial isolates, whereas ampicillin, cefepime and cefadroxil were the most common resistance antibiotics of bacterial isolates. In conclusion, this is the first study carried out in Hadhramout, Yemen to assessment the phagocytic neutrophil cells and its role to fight the bacterial infection of diabetic foot ulcers. When the grade of ulcer increased, the bacterial resistance to antibiotics increased, and this was emphasis the correlation with prevalence of Gram-negative bacteria in the high grade of ulcers with high resistance of antibiotics. In contrast, the grade of ulcer increased, the efficiency of phagocytic neutrophil cells decreased.