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New Marker for Diabetic Foot Infection Grades Tested

Procalcitonin, a 116-amino acid peptide of calcitonin, is a new diagnostic marker of bacterial infections…. 

With procalcitonin being used as a new diagnostic marker of bacterial infections, Dr. Shler Ghafour Raheem and colleagues evaluated its use in grades of diabetic foot and assessed the microbial isolates of patients with diabetic foot infection and their relation with procalcitonin level in their sera.

An 11 month, cross-sectional study was carried out on 90 diabetic foot patients in Iraq. The patients were clinically assessed and their foot lesions were graded according to the Wagner classification system. Serum procalcitonin was estimated by Vitek Immuno Diagnostic Assay System (VIDAS® B-R-A-H-M-S PCT). Bacterial specimens were collected and processed using standard procedures for microbiological culture and diagnosis.

Results showed statistically significant (p=0.006) procalcitonin increase with higher Wagner grades. From the 90 diabetic foot infections, 130 pathogens were isolated, 51% of patients had polymicrobial infection, 41% had monomicrobial infection, and 8% had no growth. Procalcitonin levels were higher in polymicrobial infections (0.35+0.04), followed by Gram-negative (0.23+0.03) and then Gram-positive (0.18+0.05).

The authors concluded that procalcitonin may be useful as a new diagnostic marker in infected diabetic foot patients, especially those with higher Wagner grades and with polymicrobial infections.