摘要：Toe webs of diabetic patients (with neuropathic and non-neuropathic feet) and non-diabetic controls were investigated for colonisation by bacteria and fungi in order to establish whether potentially pathogenic organisms were present; each group consisted of patients with macerated or non-macerated toe webs. Both beta-haemolytic streptococci (BHS) and Staphylococcus aureus were isolated, especially from macerated webs. Dermatophytes were found more commonly in diabetic feet but were not related to maceration, and could be shown to produce a substance inhibitory to bacteria cultured from the same sites. A different ecology was demonstrated in the dry neuropathic web where maceration and Gram-negative bacteria were rarely found. We suggest that acute necrotising infection in the foot can either arise close to the toe web due to BHS, possibly in synergism with S. aureus, or from anaerobic bacteria colonising neuropathic ulcers on the plantar surface of the foot.Keywords: Diabetes; foot; flora; neuropathy; gangrene.
