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Emergence of fluconazole-resistant candida infections in diabetic foot ulcers: Implications for public health

Publication Type : Journal Article

Thematic Areas : Medical Sciences

Publisher : Indian Journal Community Medicine,

Source : Indian Journal Community Medicine, Volume : 44 | Issue : 5 , 2019

Keywords : Candida albicans, Candida infection, Candida parapsilosis, diabetic foot ulcer, fluconazole resistance

Campus : Kochi

School : School of Medicine

Department : Microbiology

Year : 2019

Abstract : It is well documented in the literature that fungal infections are common in diabetic foot ulcers (DFUs). This has led to an overuse of antifungal agents, namely fluconazole, with a consequent risk of emergence of resistance to this drug. Previous studies have shown a 3.9% prevalence of fluconazole resistance in DFU, but limited data exist regarding the change in resistance pattern over the last decade. Objectives: Our aim was to study the prevalence of resistance to fluconazole in patients with DFU and culture-proven fungal infections. Materials and Methods: We retrospectively studied 1438 patients with type 2 diabetes and nonhealing foot ulcers who had fungal cultures performed during the course of their treatment. The data were collected for all patients who presented to our foot clinic over a period of 18 months. Results: The prevalence of positive fungal culture was 17.38% (250/1438). 151/200 positive cultures belonged to Candida species. Resistance to fluconazole was observed in 9.3% (17/200). The most common organism with resistance to fluconazole was Candida auris (10/17). Conclusions: High prevalence of fluconazole resistance is a potential cause of concern, and the rational use of this drug is important in the community. The above results could have an impact on public health, as fluconazole is one of the safest and effective oral antifungal agents available. The spread of resistance could have implications for its use in other situations including systemic fungal infections.

Cite this Research Publication : Chankramath S Arun, Priyanka Raju, Vivek Lakshmanan, Anil Kumar, Arun Bal, Harish Kumar "Emergence of fluconazole-resistant candida infections in diabetic foot ulcers: Implications for public health", Indian Journal Community Medicine, 2019

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