Allkja, Jontana and Bakri, Ahmed and Short, Bryn and Gilmour, Andrew and Brown, Jason L. and Bal, Abhijit M. and Newby, Kelly J.M. and Jenkins, Toby and Short, Rob D. and Williams, Craig and Ramage, Gordon (2025) Investigating the prevalence of fungi in diabetic ulcers: an under-recognised contributor to polymicrobial biofilms. APMIS: Journal of Pathology, Microbiology and Immunology, 133 (4): e70025. ISSN 0903-4641
AI Summary:
This study aimed to investigate the prevalence of fungi in diabetic foot ulcers (DFUs). The results showed that routine diagnostic methods were sufficient for fungal detection, but enhanced culture methods allowed for more precise fungal identification.AI Topics:
Diabetic foot ulcers (DFUs) are common complications for diabetic patients, often exacerbated by complex polymicrobial biofilm infections. While the majority of DFU studies are bacterial focused, fungi have also been identified. This study aims to investigate the prevalence of fungi in DFUs, as well as their potential role and influence on persistence and wound healing. Consecutive DFU swabs were collected from 128 patients (n = 349). Fungal positivity was assessed using enhanced culture and real-time qPCR. Routine microbiology cultures were carried out as part of standard care in the clinics, and their results were then compared to our laboratory investigation. Routine and enhanced culture resulted in similar rates of fungal detection (~9%), whereas qPCR resulted in a higher rate of detection (31%). Notably, the predominant yeast Candida parapsilosis was present in ischaemic and penetrating bone wounds. These findings support existing evidence of fungal presence in DFUs. We demonstrated that routine diagnostic methods are sufficient for fungal detection, but enhanced culture methods allow for more precise fungal identification. Finally, while fungal presence does not appear to impact patient outcomes in our study, their role within these infections remains poorly understood, and further studies are needed to fully understand their relationship to the microbiome.
Allkja, Jontana
Author
Allkja, Jontana and Bakri, Ahmed and Short, Bryn and Gilmour, Andrew and Brown, Jason L. and Bal, Abhijit M. and Newby, Kelly J.M. and Jenkins, Toby and Short, Rob D. and Williams, Craig and Ramage, Gordon (2025) Investigating the prevalence of fungi in diabetic ulcers: an under-recognised contributor to polymicrobial biofilms. APMIS: Journal of Pathology, Microbiology and Immunology, 133 (4): e70025. ISSN 0903-4641
See full publications listBakri, Ahmed
Author
Allkja, Jontana and Bakri, Ahmed and Short, Bryn and Gilmour, Andrew and Brown, Jason L. and Bal, Abhijit M. and Newby, Kelly J.M. and Jenkins, Toby and Short, Rob D. and Williams, Craig and Ramage, Gordon (2025) Investigating the prevalence of fungi in diabetic ulcers: an under-recognised contributor to polymicrobial biofilms. APMIS: Journal of Pathology, Microbiology and Immunology, 133 (4): e70025. ISSN 0903-4641
See full publications listShort, Bryn
Author
Allkja, Jontana and Bakri, Ahmed and Short, Bryn and Gilmour, Andrew and Brown, Jason L. and Bal, Abhijit M. and Newby, Kelly J.M. and Jenkins, Toby and Short, Rob D. and Williams, Craig and Ramage, Gordon (2025) Investigating the prevalence of fungi in diabetic ulcers: an under-recognised contributor to polymicrobial biofilms. APMIS: Journal of Pathology, Microbiology and Immunology, 133 (4): e70025. ISSN 0903-4641
Abduljalil, Hafsa and Alshanta, Om Alkhir and Chougule, Safa and Butcher, Mark and Short, Bryn and Mclean, William and Parry, Neil and O'Keeffe, Joanne and Ramage, Gordon (2025) Lactams exhibit potent antifungal activity against monospecies and multispecies interkingdom biofilms on a novel hydrogel skin model. APMIS: Journal of Pathology, Microbiology and Immunology, 133 (1): e13510. ISSN 0903-4641
Jatkowska, Aleksandra and Gkikas, Konstantinos and Nichols, Ben and Short, Bryn and Rizou, Vasiliki-Konstantina and Kapranos, Panagiotis and Klein Gunnewiek, Jennier and Christina, Edelyn and Svolos, Vaios and Quince, Christopher and Gerasimidis, Konstantinos (2024) Dose-dependent effects of enteral nutrition on the faecal microbiota and short chain fatty acids. Clinical Nutrition, 43 (5). pp. 1200-1207. ISSN 0261-5614
See full publications listGilmour, Andrew
Author
Allkja, Jontana and Bakri, Ahmed and Short, Bryn and Gilmour, Andrew and Brown, Jason L. and Bal, Abhijit M. and Newby, Kelly J.M. and Jenkins, Toby and Short, Rob D. and Williams, Craig and Ramage, Gordon (2025) Investigating the prevalence of fungi in diabetic ulcers: an under-recognised contributor to polymicrobial biofilms. APMIS: Journal of Pathology, Microbiology and Immunology, 133 (4): e70025. ISSN 0903-4641
See full publications listBrown, Jason Lee
Author
Allkja, Jontana and Bakri, Ahmed and Short, Bryn and Gilmour, Andrew and Brown, Jason L. and Bal, Abhijit M. and Newby, Kelly J.M. and Jenkins, Toby and Short, Rob D. and Williams, Craig and Ramage, Gordon (2025) Investigating the prevalence of fungi in diabetic ulcers: an under-recognised contributor to polymicrobial biofilms. APMIS: Journal of Pathology, Microbiology and Immunology, 133 (4): e70025. ISSN 0903-4641
Alshehri, Muhanna and Alqahtani, Saeed and Murali, Pranitha and Delaney, Christopher and Johnston, William and Brown, Jason L. (2025) Organotypic tissue model systems for investigating host-pathogen interactions in vitro. Journal of Visualized Experiments, 28 (217): e67487. ISSN 1940-087X
Baz, Abdullah and Bakri, Ahmed and Butcher, Mark and Short, Bryn and Ghimire, Bhagirath and Gaur, Nishtha and Jenkins, Toby and Short, Robert D. and Riggio, Marcello and Williams, Craig and Ramage, Gordon and Brown, Jason L. (2023) Staphylococcus aureus strains exhibit heterogenous tolerance to direct cold atmospheric plasma therapy. Biofilm, 5: 100123. ISSN 2590-2075
See full publications listBal, Abhijit M.
Author
Allkja, Jontana and Bakri, Ahmed and Short, Bryn and Gilmour, Andrew and Brown, Jason L. and Bal, Abhijit M. and Newby, Kelly J.M. and Jenkins, Toby and Short, Rob D. and Williams, Craig and Ramage, Gordon (2025) Investigating the prevalence of fungi in diabetic ulcers: an under-recognised contributor to polymicrobial biofilms. APMIS: Journal of Pathology, Microbiology and Immunology, 133 (4): e70025. ISSN 0903-4641
See full publications listNewby, Kelly J.M.
Author
Allkja, Jontana and Bakri, Ahmed and Short, Bryn and Gilmour, Andrew and Brown, Jason L. and Bal, Abhijit M. and Newby, Kelly J.M. and Jenkins, Toby and Short, Rob D. and Williams, Craig and Ramage, Gordon (2025) Investigating the prevalence of fungi in diabetic ulcers: an under-recognised contributor to polymicrobial biofilms. APMIS: Journal of Pathology, Microbiology and Immunology, 133 (4): e70025. ISSN 0903-4641
See full publications listJenkins, Toby
Author
Allkja, Jontana and Bakri, Ahmed and Short, Bryn and Gilmour, Andrew and Brown, Jason L. and Bal, Abhijit M. and Newby, Kelly J.M. and Jenkins, Toby and Short, Rob D. and Williams, Craig and Ramage, Gordon (2025) Investigating the prevalence of fungi in diabetic ulcers: an under-recognised contributor to polymicrobial biofilms. APMIS: Journal of Pathology, Microbiology and Immunology, 133 (4): e70025. ISSN 0903-4641
Baz, Abdullah and Bakri, Ahmed and Butcher, Mark and Short, Bryn and Ghimire, Bhagirath and Gaur, Nishtha and Jenkins, Toby and Short, Robert D. and Riggio, Marcello and Williams, Craig and Ramage, Gordon and Brown, Jason L. (2023) Staphylococcus aureus strains exhibit heterogenous tolerance to direct cold atmospheric plasma therapy. Biofilm, 5: 100123. ISSN 2590-2075
See full publications listShort, Rob D.
Author
Allkja, Jontana and Bakri, Ahmed and Short, Bryn and Gilmour, Andrew and Brown, Jason L. and Bal, Abhijit M. and Newby, Kelly J.M. and Jenkins, Toby and Short, Rob D. and Williams, Craig and Ramage, Gordon (2025) Investigating the prevalence of fungi in diabetic ulcers: an under-recognised contributor to polymicrobial biofilms. APMIS: Journal of Pathology, Microbiology and Immunology, 133 (4): e70025. ISSN 0903-4641
See full publications listWilliams, Craig
Author
Allkja, Jontana and Bakri, Ahmed and Short, Bryn and Gilmour, Andrew and Brown, Jason L. and Bal, Abhijit M. and Newby, Kelly J.M. and Jenkins, Toby and Short, Rob D. and Williams, Craig and Ramage, Gordon (2025) Investigating the prevalence of fungi in diabetic ulcers: an under-recognised contributor to polymicrobial biofilms. APMIS: Journal of Pathology, Microbiology and Immunology, 133 (4): e70025. ISSN 0903-4641
Delaney, Christopher and Short, Bryn and Rajendran, Ranjith and Kean, Ryan and Burgess, Karl and Williams, Craig and Munro, Carol A. and Ramage, Gordon (2023) An integrated transcriptomic and metabolomic approach to investigate the heterogeneous Candida albicans biofilm phenotype. Biofilm, 5: 100112. ISSN 2590-2075
Ramage, Gordon and Borghi, Elisa and Fortuna Rodrigues, Celia and Kean, Ryan and Williams, Craig and Lopez-Ribot, Jose (2023) Our current clinical understanding of Candida biofilms: where are we two decades on? APMIS: Journal of Pathology, Microbiology and Immunology, 131 (11). pp. 636-653. ISSN 0903-4641
See full publications listRamage, Gordon
Author
Allkja, Jontana and Bakri, Ahmed and Short, Bryn and Gilmour, Andrew and Brown, Jason L. and Bal, Abhijit M. and Newby, Kelly J.M. and Jenkins, Toby and Short, Rob D. and Williams, Craig and Ramage, Gordon (2025) Investigating the prevalence of fungi in diabetic ulcers: an under-recognised contributor to polymicrobial biofilms. APMIS: Journal of Pathology, Microbiology and Immunology, 133 (4): e70025. ISSN 0903-4641
Ware, Alicia and Johnston, William and Delaney, Christopher and Butcher, Mark C. and Ramage, Gordon and Price, Lesley and Butcher, John and Kean, Ryan (2025) Dry surface biofilm formation by Candida auris facilitates persistence and tolerance to sodium hypochlorite. APMIS: Journal of Pathology, Microbiology and Immunology, 133 (4): e70022. ISSN 0903-4641
Abduljalil, Hafsa and Alshanta, Om Alkhir and Chougule, Safa and Butcher, Mark and Short, Bryn and Mclean, William and Parry, Neil and O'Keeffe, Joanne and Ramage, Gordon (2025) Lactams exhibit potent antifungal activity against monospecies and multispecies interkingdom biofilms on a novel hydrogel skin model. APMIS: Journal of Pathology, Microbiology and Immunology, 133 (1): e13510. ISSN 0903-4641
See full publications listAvailable under License Creative Commons Attribution.
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