Abstract

This study investigated fungal infection in foot ulcers among People Living with Diabetes Mellitus (PLWDM) in Kano, northwestern Nigeria. One thousand and five hundred (1,500) consented PLWDM were screened for superficial body lesions (hair, nail, skin, and ulcers) and 300 fulfilled the selection criteria, of which 19 had diabetic foot ulcers. Swabs from the ulcer sites were cultured on Sabouraud Dextrose Agar (SDA), while identification of yeasts and moulds isolates was done using Gram staining, germ tube test, Chrom agar, lacto-phenol cotton blue mount and slide cultures. Antifungal susceptibility testing was by agar well diffusion method using fluconazole, itraconazole, ketoconazole, and clotrimazole. Socio-demographic data, medical history and other risk factors were also documented. Fungi were recovered in foot ulcers with a prevalence of 78.95% (15/19), with Candida albicans (33.33%), Candida tropicalis (20%), Aspergillus fumigatus (13.33%), and Aspergillus flavus (13.33%) as predominant species. Others include Candida glabrata, Aspergillus niger, and Fusarium species, each constituting 6.67%. All the isolates show excellent susceptibility to itraconazole, ketoconazole, and clotrimazole, but there was high resistance to fluconazole. This study demonstrates a significantly high prevalence of fungal infections in diabetic foot ulcers and thus, recommend routine screening and prompt treatment of fungi to minimize or eliminate complications associated with diabetic foot ulcers.