Association of complement C3 and interleukin-1 with foot infections in diabetic patients.

The study of the bacteriological profile, the association of complement C3, interleukin-1beta, and zinc therapy of diabetic foot ulcers (type two) was investigated. Twenty diabetics without foot ulcers (group I), 50 diabetics with foot ulcers (group II), and 10 matched normal controls (group III) were enrolled in this study. Diabetic foot ulcers were mostly of grade 2. The most frequent organisms were Clostridium spp., Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli, respectively. Vancomycin, Imipenem, and Meropenem were the most effective against Gram-positive and Gram-negative aerobes, while Imipenem, Meropenem and Chloramphenicol for Gram-positive anaerobes. Group II had abnormal levels of C3 (72%). A significant higher concentration of C3 was found in group II. Group II had abnormal levels of IL-1β (60%). A significant higher concentration of IL-1β was found in group II. Zinc therapy (25 mg/day/oral) induced a highly significant decrease in the frequency of Gram-positive anaerobes and levels of IL-1β. Significantly increases all mineral concentrations in serum level except Mn(+2). The study highlights the prevalence of antibiotic multi-drug resistant bacteria causing foot infections in diabetics which require combined antimicrobial therapy. Altered levels of serum complement C3 and IL-1β might be responsible for depressed immune response which might be causes for delayed wound healing and repeated infections. Zinc supplementation may help in healing the wounds by enhancing the immune response.