Serum C - Reactive Protein Level in Diabetic Foot Patients and Their Relation with Bacterial Isolates

Abstract

Background: Foot infections are one of the major complications of diabetes mellitus and a significant risk factor for lower extremity amputation. C-reactive protein is an acute-phase reactant, rises dramatically in response to infection. Aim: To determine the microbial isolates of patients with diabetic foot infections and their relation with C-reactive protein level in their sera. Materials and Methods: A prospective study of 90 patients with diabetic foot infections admitted to different public and private hospitals in Erbil city center-Iraq between June 2011 and May 2012 was undertaken. Bacteriological specimens were obtained and processed using standard procedure. The patients serum had been tested for C-reactive protein by high sensitive Enzyme linked Immunosorbent Assay (ELISA). Results: A total of 130 pathogens were isolated from 90 diabetic foot patients 46 (51%) of the patients had polymicrobial infection, 37 (41%) had single organism and 7 (8%) had no growth. Gram positive (G+ve) bacteria 60(53%) were more commonly isolated than Gram negative (G-ve) bacteria 53(47%). Staphylococcus aureus and Escherichia coli were the most frequently among G+ve and G-ve isolates respectively. No significant difference was found between mean serum levels of C-reactive protein in patients infected with G+ve bacteria versus G-ve bacteria, although their concentration was more in the later. However, highly significant differences (P<0.01) were observed between both G+ve and G-ve bacteria versus no bacterial isolate in patients. Conclusion: C-reactive protein serum level was higher in patient with diabetic foot foot infected by G-ve bacteria, although G+ve bacteria represented a major bacterial isolates.