CORRELATION OF HISTOPATHOLOGICAL FINDINGS WITH BACTERIAL CULTURE AND INFLAMMATORY MARKERS IN DIABETIC FOOT ULCERS

Abstract

Background: Diabetic foot ulcers are among the most serious complications of diabetes mellitus and are associated with chronic infection, delayed wound healing, lower-limb amputation, and increased healthcare burden. Objectives: To determine the correlation of histopathological findings with bacterial culture and inflammatory markers in diabetic foot ulcers. Study Design & Setting: Analytical cross-sectional study conducted in the Department of General Surgery in collaboration with the Departments of Pathology and Microbiology at Department of Pathology, PUMHSW, Nawabshah from September 2026 to February 2026. Methodology: A total of 120 patients with diabetic foot ulcers were enrolled using non-probability consecutive sampling. Deep tissue specimens obtained after surgical debridement were subjected to histopathological examination and aerobic bacterial culture. Blood samples were analyzed for C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and total leukocyte count (TLC). Data were analyzed using SPSS version 27. Correlation between histopathological findings, bacterial culture, and inflammatory markers was determined using Pearson's or Spearman's correlation coefficient, while categorical variables were compared using the Chi-square test. A p-value of ≤0.05 was considered statistically significant. Results: The mean age of the patients was 56.8 ± 10.9 years, and 63.3% were male. Chronic inflammation (43.3%) was the most common histopathological finding, while tissue necrosis was observed in 65.8% of cases. Positive bacterial cultures were identified in 84.2% of patients, with Staphylococcus aureus being the most frequently isolated organism (27.7%). Histopathological findings demonstrated a significant association with bacterial culture results (p = 0.041). Histopathological severity showed significant positive correlations with CRP (r = 0.612, p < 0.001), ESR (r = 0.548, p < 0.001), and TLC (r = 0.471, p < 0.001). Conclusion: Histopathological findings in diabetic foot ulcers demonstrated significant correlations with bacterial culture positivity and inflammatory markers. Integrating histopathological assessment with microbiological and inflammatory marker evaluation may improve diagnostic accuracy, disease severity assessment, and clinical decision-making in the management of diabetic foot ulcers.