Prevalence analysis of fungi in chronic lower extremity ulcers 

Background. Lower extremity ulcers are a major cause of morbidity in elderly patients and can be colonized by many different microorganisms, including fungi. The purpose of this prospective study was to determine the prevalence of fungal colonization and/or infection at the ulcer site and the surrounding skin.

Swabs were taken from 152 lower extremity ulcers and the surrounding skin. Direct microscopic examination and cultures for fungal and bacteriological investigations were obtained. The characteristics of the patients, ulcers, and surrounding skin were studied.

Fungi were isolated from 6% of ulcers and 27.6% of the skin samples. Three species were found: Candida albicans (2% of ulcers, 4.6% of surrounding skin), Candida parapsilosis (2% of ulcers, 11% of surrounding skin), and Candida ciferrii (0.6% of surrounding skin). Fungal infections were found in 2% of ulcers and 8.5% of skin samples from the surrounding skin.

The prevalence of fungal colonization was less robust than that observed in previous studies. No relationship was found between fungal infection and patient or ulcer characteristics. However, there was significant Corynebacteria colonization in the fungal infection group (P = 0.02). It would be interesting to conduct similar studies in order to evaluate the effect of antifungal treatment on infected wounds.