Evaluation of the Relationship Between Bacterial Infection and Immunological Factors with Diabetic Foot Ulcer

Abstract

Diabetes represent a chronic disorder that involve the decline in the levels of insulin produced by the pancreas due to many genetic and environmental factors. The disease involves the elevation of blood sugar in the circulation which may lead to vascular, neurological, ocular and renal complications. In addition, diabetic patients tend to develop ulceration due to wound infection swiftly in the lower limbs due to the reduce in the neurological sensation as well as to elevated sugar circulation which may greatly provoke wound infection and diabetic foot ulcerations. The current study aimed at isolation of the common causes of bacterial infection associated with diabetic foot ulcer as well as the assessment of IL-17 and IL-18 and in those patients and in control healthy group. The present study was conducted in Salah Aldeen province during the period from 1st of November 2023 to 15th of May 2024 and included 150 patients with diabetic foot infection who attended Salah-Alden Hospitals: (Tikrit Teaching Hospital, Balad General Hospital and private surgery clinics). Swabs and whole blood from patients with diabetic foot ulcer were taken and submitted to routine culture and identification of the causative bacterial infection followed by biochemical identification and antibiotics susceptibility test for the isolated microbe. The serum specimens from those positive bacterial isolates were submitted for IL17 and IL-18 ELISA assessment. IL-17, significant elevation P<0.05 of this cytokine was recorded in diabetic patients with foot ulcer with mean 21.94 pg/ml compared to control group. In the same way significant increase of IL-18 (P<0.05) was noted in diabetic patients with foot ulcer with mean 347.15 pg/ml in comparison to control group. In conclusion, diabetic foot ulceration is the result of in controlled elevation of blood glucose and bacterial infection with various pathogens can complicate the scenario, and the significant elevation of IL17 and IL18 in those patients can insight the role played by these cytokines in signaling the immune to recruit cellular and humoral response.