The importance of phagocytic index for determining the early period efficacy of treatment modalities, and its relationship with metabolic control parameters in diabetic patients with foot infections
Abstract number: 1134_04_183
Top C., Oncül O., Cevikbas A., Soyogul A., Cavuslu S., Danaci M.
Diabetic patients are more prone to infections and show high morbidity and mortality rates. Prior to the advent of modern antimicrobial therapy, infection accounted for much of the morbidity in diabetics. The aim of this study was to investigate the phagocytic activity changes of neutrophils in type 2 diabetic patients with foot infections during short treatment course and to evaluate the importance of phagocytic index for determining the efficacy of the treatment modalities and its relationship with metabolic control parameters.
The phagocytic activity of neutrophils were determined in blood samples of 38 type 2 diabetic patients with foot infections (14 women and 24 men), mean age and mean duration of diabetes were 66.3 ± 9.4 and 19.1 ± 11.2 (yrs) respectively. All patients receive standard treatment (intensive insulin therapy, antibiotherapy, hyperbaric oxygen therapy and surgical debridement ). Phagocytic activity of neutrophils was determined by a standard method . The phagocytic index, i.e. the number of microbial bodies absorbed by an average leukocyte, and percentage of leukocytes that have phagocytized, i.e. the number of leukocytes out of 100 that have revealed the phagocytic activity and phagocytic index, that is the correlation between the product of phagocytic index and percentage of phagocytosis. Phagocytic activity of neutrophils, C-reactive protein and metabolic control parameter (HbA1c) were determined before the therapy and 2 weeks later.
We observed significant differences in phagocytic index and CRP before and after short-course therapy (p < 0.001, *Wilcoxon signed ranks test). The phagocytic index (%) and CRP(mg/L) before and after 2 weeks therapy were 47.7 ± 11.4 and 62.5 ± 15.6 p < 0.001, 41.4 ± 36.7 and 17.4 ± 18.2 p < 0.001 respectively. The correlation analysis showed a significant relation between phagocytic index and CRP, HbA1c (r = 0.52, p < 0.05 and r = -0.41, p < 0.05 respectively).
The derangement in the carbohydrate metabolism in diabetic may be the reason for the impairment in the bactericidal ability of PMN leucocytes of poorly controlled diabetic patients making them more susceptible to recurrent infections. However the importance of phagocytic activity changes in diabetics has been little studied up to the present time. Our data show that the phagocytic activity changes during short-course therapy have a significant value for determining the efficacy of treatment in diabetic foot infections.
|Session name:||XXIst ISTH Congress|
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