The association of yeast infections with diabetic foot ulcer

Abstract

Recently, fungal infections have increased, and it has been shown that microbial infections are associated with diabetic foot ulcers. In general, diabetic patients were considered immunocompromised patients with insufficient immune defense and would therefore be at risk of developing a microbial infection, such as bacterial, yeast or filamentous infections. Previous works were designed to investigate the implication of yeast species as etiological agents for developing diabetic foot infections. The results suggested that Candida albicans is the most common species followed by C. dubliniensis, C. tropical and parapsilosis and other pathogenic species. Pathogens are resistant to inconvenient and harsh conditions; to overcome these unwanted conditions, they synthesize a variety of elements that enhance the ability of the pathogen to survive and infect the host. These elements are called virulence factors. Yeast possesses the potential ability to produce these necessary elements, for example, biofilm formation, and hydrolytic enzymes. Two hydrolytic enzymes were selected in this review, phospholipase and aspartyl proteinases (SAP) and h. Each enzyme has a particular function that involves the mechanism of adhesion, penetration, and invasion of pathogenic yeast into the host tissues. The hydrolytic enzyme activities were analyzed at a phenotypic and genotypic level.