Afro-Egypt J Infect Endem Dis 2011 Dec ;1(2):19-27
Assessment Of C-Reactive Protein And Macrophage Migration Inhibitory Factor In Diabetic Foot Infection
Ahmed MR, Ibrahim GA, Bakr HG, Meawed TE
Internal Medicine Department, Faculty of Medicine, Zagazig University,Egypt .
ameer_10100@yahoo.com
ABSTRACT
Background and study aim: : Diabetic foot ulcer is a universal health problem. Neuroischemic changes and infection are responsible for its occurrence and complications. Altered or complete loss of sensation and microvascular disease complicated by unchecked infection can precipitate tissue necrosis and gangrene. A threat for a rapid test predicting early infected foot ulcer emerges. C-reactive protein (CRP) and macrophage migration inhibitory factor (MIF) are involved in innate inflammatory response. We aimed at evaluation of the ability of C-reactive protein and macrophage migration inhibitory factor to differentiate between early infected and non infected diabetic foot ulcers and to detect risk factors of diabetic foot ulceration.
Patients and methods: : 52 diabetic patients were selected, examined and classified into 3 groups : Group (I): Included 12 patients with non-infected diabetic foot ulcer (grade І), group (П): Included 30 patients with mildly infected diabetic foot ulcer (grade П) and group (ПI): Included 11 diabetic patients free from foot wounds used as a control group. In addition to routine laboratory investigations, serum CRP was measured using. Enhanced Immuno-tubidimetric Assay. MIF level was detected by ELISA. Swabs from the diabetic foot ulcers were taken for aerobic and anaerobic cultures.
Results : Statistically significantly elevated Hb A1C%, MIF and CRP levels were detected in mild infected diabetic foot ulcer compared to studied groups (P <0.05). Dermatological changes were statistically significant risk factors for diabetic foot ulcers, accounted for 88.1% of ulcer cases. The most frequently isolated organism was E coli. The most common site for ulcers was the toes representing 50% of the cases.
Conclusion : CRP and MIF can differentiate early infected from non-infected diabetic foot ulcers.