Author(s)
Annmarie, Abodeely, BS1
Viraj, Kothari, BS1
Mary, Thomas, BS1
Gloria, Yun, BS1
Ashir Raffe, BS1
Jeffrey Ng, DPM1
Susan Rice, DPM1
Thomas Vitale, DPM1
Kimberley Quinn, BS2
Kurt Degenhardt, PhD2
Paramita Basu, PhD1,2
Affiliation(s)
1 New York College of Podiatric Medicine; 2 Touro College of Osteopathic Medicine
Abstract:
Purpose:
Interdigital maceration is a common podiatric condition caused by excessive moisture, leading to microbial infection. Standard treatments range from foot hygiene practices to topical and oral antimicrobials which often lack target specificity. The widespread use of antibiotics raises concerns about resistance development. Additionally, treatment with topical antibiotics and antifungals can disrupt the skin's microbiome and affect pH levels. Acidic environments have been shown to inhibit microbial growth, suggesting pH modulation as a potential alternative treatment strategy. While pH management has shown promise in treating microbial infections, clinical data on pH effectiveness in interdigital maceration remains limited. This study aims to identify the microbes involved and assess baseline pH of interdigital maceration samples, as well as evaluate microbial growth patterns under varying pH conditions to explore pH as a therapeutic factor.
Methods:
Tissue samples were collected from five patients with interdigital maceration (two per patient). Samples were preserved in phosphate-buffered saline and analyzed via qRT-PCR to identify colonizing organisms. Four laboratory strain counterparts of the pathogens commonly found in interdigital maceration patients were used as process controls in addition to the cultures derived from the patients. Cultures were grown in Tryptic Soy (TS) broth adjusted to pH levels from 3 to 9. Inoculated media were incubated, and microbial growth was monitored using spectrophotometric analysis at 0, 12, 24, and 48 hours (OD600).
Results:
Identified pathogens included Acinetobacter baumannii, Staphylococcus aureus, Eschericia coli, mixed skin flora (?-hemolytic Streptococci, Coagulase-negative Staphylococci), Corynebacterium minutissimum, Pseudomonas aeruginosa, and dermatophytic fungi. Bacterial samples showed higher growth in alkaline conditions, while fungi thrived at lower pH in acidic environments. Both acidic (pH 3) and alkaline (pH 9) conditions significantly reduced microbial growth compared to neutral pH (p < 0.01), highlighting the inhibitory potential of non-neutral pH environments.
Conclusion:
This study identified some of the key microorganisms responsible for interdigital maceration and demonstrated that pH significantly affects their microbial growth. These findings support the therapeutic potential of pH-based treatments. Further research with larger sample sizes and finer time-point analysis is warranted to refine this approach and enhance treatment efficacy.