The study of the bacteriological profile, the association of
complement C3,
interleukin-1beta, and
zinc therapy of
diabetic foot ulcers (type two) was investigated. Twenty diabetics without
foot ulcers (group I), 50 diabetics with
foot ulcers (group II), and 10 matched normal controls (group III) were enrolled in this study.
Diabetic foot ulcers were mostly of grade 2. The most frequent organisms were Clostridium spp., Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli, respectively.
Vancomycin,
Imipenem, and
Meropenem were the most effective against Gram-positive and Gram-negative aerobes, while
Imipenem,
Meropenem and
Chloramphenicol for Gram-positive anaerobes. Group II had abnormal levels of C3 (72%). A significant higher concentration of C3 was found in group II. Group II had abnormal levels of IL-1β (60%). A significant higher concentration of IL-1β was found in group II.
Zinc therapy (25 mg/day/oral) induced a highly significant decrease in the frequency of Gram-positive anaerobes and levels of IL-1β. Significantly increases all
mineral concentrations in serum level except Mn(+2). The study highlights the prevalence of
antibiotic multi-
drug resistant bacteria causing foot
infections in diabetics which require combined antimicrobial
therapy. Altered levels of serum
complement C3 and IL-1β might be responsible for depressed immune response which might be causes for delayed wound healing and repeated
infections.
Zinc supplementation may help in healing the
wounds by enhancing the immune response.