Diagnostic Rating (Value) of Serum IL6, IL17A, and TLR-2 Levels for Detecting Infected Diabetic Foot

Background˸ Diabetic foot ulcers are a serious complication often linked to antibiotic-resistant bacteria like MRSA, with risks of amputation or death. Early diagnosis is vital for better outcomes. Objective: to evaluate the diagnostic role of the inflammatory markers TLR-2, IL-6, and IL-17A in distinguishing between infected and non-infected ulcers in diabetic patients, as well as to study their relationship with MRSA. Methodology: a case-control study was conducted from September 2024 to February 2025 at three hospitals in Najaf Governorate, Iraq, and included 150 participants: 50 diabetic foot patients with MRSA, 50 diabetic patients without ulcers, and 50 healthy controls. S. aureus was isolated using culture media, identified using the VITEK®2 device, and then confirmed as MRSA using HiCrome MeReSa medium. Serum concentrations of TLR-2, IL-6, and IL-17A were also measured using ELISA. Results: the results showed significant increases in the levels of all three immune markers in diabetic foot patients compared to both the diabetic and healthy control groups (p < 0.001). TLR-2 and IL-17A were found to be strong independent predictors of infection, while IL-6 levels were elevated but less predictive. These results suggest that TLR-2, IL-17A, and IL-6 play a role in the inflammatory response associated with diabetic foot infections and may be useful biomarkers for early diagnosis, particularly in cases associated with MRSA infection. Conclusion: TLR-2, IL-17A, and IL-6 levels are elevated in diabetic foot ulcer patients, especially those infected with MRSA, suggesting their potential utility as early diagnostic biomarkers and their involvement in the inflammatory pathways of diabetic foot infections.