Melika Sahebanolahadi,1Saman Hakimian,2,*
1. Bachelor student of Microbiology Falavarjan Azad University, Isfahan, IRAN 2. M.sc student of Microbiology Islamic Azad University Central Tehran Branch,Iran,Tehran
Introduction: Diabetes, a disease related to lifestyle, is characterized by chronic hyperglycemia and imposes serious problems. The prevalence of diabetes is rapidly increasing worldwide and a real epidemic of the disease is expected in
this century. Egypt is ranked the eighth country worldwide in the number of diabetic
patients, and by 2045 it is expected to be the sixth country. Diabetes is a systemic disease
that affects almost every part of the body, and the feet are frequently the first to suffer.
The proportion of male patients was greater
than females, and it was noted that the age group (51-68 years) was more affected by
diabetic foot. Diabetic foot infection (DU) was considered to be one of the most
common and dangerous diabetes
complications. So, the most common cause of hospitalization and non-traumatic lower
limb amputation is diabetic foot ulcer. It could lead from soft tissue infection to bone
infection and is a leading cause of lower limb amputation. DFU patients have a 2.5 times
higher risk of death compared to diabetic patients without foot ulcers. Diabetic foot
ulcers, fi left untreated, can become infected
and cause other complications, such as
gangrene, osteomyelitis, and amputation. Surgery and antibiotic therapy are the options
used to control this infection.
Methods: In patients with a healed DFU, significant independent risk factors for DFU
recurrence during a 3-year follow-up period, despite intensive foot care, were: plantar
ulcer location, presence of osteomyelitis, HbA1c>7.5%, and C-reactive protein (CRP>5mg/I. The major predisposing factor
to foot ulceration leading to infection is usually related to peripheral neuropathy. Mostly the diabetic foot infections are mixed bacterial infections
and the proper
management of these infections requires appropriate antibiotic selection based on
culture and antimicrobial
susceptibility. The presence of drug-resistant bacteria in
diabetic foot ulcers creates a big challenge during the treatment, so nanotechnology has
been applied to find an alternative solution instead of antibiotics. Silver metal has been
used in medicine since around 4000
B.C, even before it was recognized that bacteria
constitute the primary cause of infection. The
aim of this study, is comparing the antibacterial activity of silver nitrate and
silver nanoparticles, finding that AgNPs had a high antibacterial effect against isolated
bacteria more than AgNO3, primarily due to their nano-size.
Results: aureus (26%) was the most common bacteria
isolated, followed by E. coli (20%) and Enterococcus spp (15 percent). Extended-
spectrumbeta-lactamase (ESBL) producers made up 53% of the Gram-negative bacteria, Methicillin -resistant
staphylococcus aureus (MRSA) made up 41%, and Vancomycin-
resistant enterococci (VRE). made up 19%. Herbal products through different
mechanisms of action, including
antimicrobial, anti-inflammatory, antioxidant
activity, stimulation of angiogenesis,
production of cytokines and growth factors,
keratinocytes, and fibroblast migration and proliferation may be considered as an
important support during conventional therapy or even as a substitute for synthetic
drugs used for diabetic wound treatment.
Conclusion: aureus is the most common cause of diabetic foot
ulcers. Due to Staphylococcal surface
proteins such a s (protein A) assist the
bacteria to cling to the skin and facilitate the
bacterial colonization in the diabetic foot, and then release many of the virulence factors that invade the immune system such as 3-hemolysin.