Typology of yeasts and dermatophyte that are identified as the cause of superficial infection in patients with diabetes, determination of antifungal susceptibility of yeasts

Diabetes mellitus (DM) is a disease characterized by chronic hyperglycemia, carbohydrate and fat metabolism disorders. More than 30% of diabetic patients have a skin involvement of any type during the course of their illness. In diabetic patients, the most common infections among superficial skin infections are dermatophytosis nd candidiasis.In this study, to be examined in Firat University Faculty of Medicine, Department of Medical Microbiology, Mycology Laboratory, between 2009-2010, 130 pieces of skin and nail scrapings were taken from a total of 80 diabetic patients with suspected superficial mycosis in Department of Internal Medicine, Department of Endocrinology polyclinic and/or the inpatient ward and the samples were examined mycologically.In the clinical samples, direct microscopic examination, and mycological culture, conventional diagnostic methods and for the identification of yeasts API ID32C (MiniApi, Biomerieux, France) kit and, disc diffusion antifungal susceptibility tests were applied according to CLSI criteria using voriconazole and fluconazole discs on Candida spp. strains.While direct microscopic examination was positive in the 89 (68%) cases of 130 clinical samples which were taken with suspicion of mycosis, in 41 (32%) cases it was found to be negative. Growing detected in 78 (60%) of mycological cultures of the samples, no growth detected in 46 (35%) and contamination was found in 6 (5%) of the cultures.Trichophyton rubrum in 28 (36%) of 78 culture positive samples, Trichophyton mentagrophytes in 3 (4%) of the cases, Trichophyton rubrum and Candida spp. in 11 (14%) cases, Trichophyton mentagrophytes and Candida spp. in 2 (3%) cases, Trichophyton rubrum and Trichophyton mentagrophytes in 5 (% 6) cases and Candida spp. in 29 (37%) cases were isolated.Out of isolated 29 Candida spp., 16 (55%) were Candida albicans, 7 (24%) were Candida sake, 4 (14%) were Candida parapsilosis and 2 (%7) were Candida krusei. The results of antifungal susceptibility testings indicate while the most resistant strains to fluconazole were Candida parapsilosis (%100) and Candida sake (%72), the most resistant strains to voriconazole were again Candida parapsilosis (%25) and Candida sake (%14).As a result, by taking into account of the risk factors, it is concluded that the protective precautions are necessary to prevent superficial skin infections in patients with diabetes and detecting the infectious agent, testing antifungal susceptibility and treating with an appropriate antifungal drug before the treatment of candidiasis that develops especially in again this group of patients have great importance.