Diabetic Foot Wounds: Which Patients are More Prone to Tetanus?

Abstract

Introduction: Patients who have tetanus-prone wounds, diabetes mellitus, or chronic wounds are more likely to contract tetanus. In this study, we aimed to evaluate the tetanus immunization status of patients with diabetic foot wounds (DFW) and to determine factors that may predict insufficient immunity to tetanus. Materials and Methods: Patients who presented to our outpatient clinics with DFW were included. Tetanus antibody levels below 0.1 IU/ml were defined as “no reliable protection” and levels of 0.1 IU/ml and above were defined as “reliable protection”. Results: Ninety-one patients were enrolled in the study, 66 (72.5%) were male and the mean age was 62±11 years. Sixty-five (71.4%) of the patients had no reliable protection, while 26 (28.6%) had reliable protection. Age, duration of diabetes mellitus, education level, and residency status were significantly different between the immune and nonimmune groups in univariate analysis. In the multivariate logistic regression analysis, age ≥65 years [Odds ratio (OR): 8.33; 95% confidence interval (CI): 2.03-34.16], diabetes mellitus duration ≥11 years (OR: 6.52; 95% CI: 1.97-21.59), and lowest educational level (OR: 10.51; 95% CI: 1.61-68.52) were identified as independent predictors for insufficient tetanus immunity. Conclusion: We found that elderly patients and patients with lower education have a very low rate of immunity against tetanus. Therefore, tetanus vaccination should be conducted in elderly patients with DFW.

Keywords

• vaccine
• educational level
• epidemiology
• elisa
• clostridium tetani