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Etiology of Foot Intertrigo in the District of Afyonkarahisar, Turkey

A Bacteriologic and Mycologic Study

Semsettin Karaca, MD ^*, Mustafa Kulac, MD ^*, Zafer Cetinkaya, MD  and Reha Demirel, MD 

^* Department of Dermatology, Afyon Kocatepe University, School of Medicine, Afyon, Turkey.
Department of Microbiology, Afyon Kocatepe University, School of Medicine, Afyon, Turkey.
Department of Public Health, Afyon Kocatepe University, School of Medicine, Afyon, Turkey.

Corresponding author: Semsettin Karaca, MD, Assistant Professor of Dermatology, Afyon Kocatepe Universitesi, Ahmet Necdet Sezer Uygulama ve Arastirma Hastanesi, Dermatoloji Klinigi (Pembe Hastane), Afyon/Turkey. (E-mail: skaraca{at}aku.edu.tr or shems{at}hotmail.com)

Abstract

Background: Foot intertrigo, occurring in the interdigital space, is mostly caused initially by dermatophytes and yeasts and less frequently by gram-negative and gram-positive bacteria. With time, a "complex" may develop in the setting of moisture and maceration that contains multiple fungal and bacterial organisms.

Methods: We examined and sampled 84 patients with toe web intertrigo for bacteriologic and mycologic studies.

Results: In the culture media, the prominent isolated pathogens as single agents were coagulase-negative staphylococci in 17.9% of patients, which is assessed as contamination from skin flora; Pseudomonas aeruginosa in 16.7%; dermatophytes, Corynebacterium minutissimum, and Staphylococcus aureus each in 11.9%; β-hemolytic streptococcus in 2.4%; and Proteus mirabilis in 1.2%. However, we recovered double pathogens from patients with foot intertrigo as mixed infection in 19 patients (22.6%). The most common predisposing factors were exposure to spa pools and ablutions.

Conclusions: Several pathogens and factors might play a role in toe web infections. Therefore, clinical and microbiologic studies are suggested to assist in the selection of appropriate treatment and the prevention of important complications of toe web infections. (J Am Podiatr Med Assoc 98(1): 42–44, 2008)