Assessment role of phagocytic neutrophil cells among different Wagner’s grades of diabetic foot ulcers infections

Background: Foot ulcers complications in diabetes mellitus (DM) patients are one of the significant medical problems and an economic burden. The aim of this study is to assessment role of phagocytic neutrophil cells and its relationship with the incidence of diabetic foot ulcers (DFU) infection of diabetic patients. A total of 60 venipuncture blood samples collected from diabetes mellitus, diabetic foot ulcer patients and healthy persons as control group. 20 swabs from the DFU patients were collected and processed for culture and susceptibility test after the ulcers classified according to Wagner’s grades system. Phagocytic cells activity test was performed to determine the efficiency of phagocytic neutrophil cells in diabetic patients. Results: : Gram positive bacteria were the most prevalent in the DFU patients 57.1% with statistical significant relationship between the type of bacteria and grades of Wagner’s classification followed by Gram negative bacteria in high grades of ulcers. Wagner’s ulcers grade 1 and 2 were the most prevalence in DFU patients 30%. There was a weak negative correlation between the efficiency of phagocytic neutrophil cells activity and grade ulcers classified (r = -0.323). Amikacin and ciprofloxacin were the most effective antibiotics against 90.5% and 81% of the bacterial isolates respectively, whereas ampicillin, cefepime and cefadroxil were less effective antibiotics against the bacterial isolates. Conclusion: When the grade of ulcer increased, the bacterial resistance to antibiotics increased, and this was emphasis the correlation with prevalent of Gram negative bacteria in the high grade of ulcers with high resistance of antibiotics. In contrast, the grade of ulcer increased, the efficiency of phagocytic neutrophil cells decreased.