Species distribution and frequency of isolation of yeasts and dermatophytes from toe webs of diabetic patients.

The paper identifies fungal species, looking at the incidence of fungal isolation and risk factors influencing the development of fungal infection and colonization of interdigital spaces of the feet in 509 diabetic outpatients. Using standard mycologic diagnostic methods, fungi were detected in toe webs of 122 (24%) diabetic patients. The finding of fungi was twice as common in interdigital spaces of one (85/16.7% of the patients) than both feet (37/7.3% of the patients). Yeasts were the most common isolates (95/18.7% of the patients), followed by dermatophytic moulds (24/4.7% of the patients), whereas coexistence of yeasts and dermatophytes was the most infrequent finding (3/0.6% of the patients). From toe webs, 24 fungal species, 21 yeast species belonging to nine genera (Candida, Rhodotorula, Cryptococcus, Trichosporon, Saccharomyces, Blastoschizomyces, Geotrichum, Debaryomyces, and Ustilago) as well as three species of dermatophytes of the genera Trichophyton and Epidermophyton were isolated. The most frequently isolated fungi were Candida parapsilosis (59/11.6% of the patients) and Trichophyton mentagrophytes (16/3.1% of the patients). Although there was no correlation between the incidence of toe web space colonization with yeasts and dermatophytosis with the criteria of patient sex and age, and duration of diabetes, the difference in the incidence according to type of diabetes was statistically significant. In non insulin dependent diabetes mellitus patients, the incidence of fungal isolation from toe webs was statistically significantly higher (30.1%) than in insulin dependent diabetes mellitus patients (19.8%).