Dunyach-Remy Catherine, Ngba Essebe Christelle, Sotto Albert, Lavigne Jean-Philippe
Institut National de la Santé Et de la Recherche Médicale U1047, Université de Montpellier, UFR de Médecine, Nîmes 30908, France.
Service de Microbiologie, Centre Hospitalo-Universitaire Carémeau, Nîmes 30029, France.
Toxins (Basel). 2016 Jul 7;8(7):209. doi: 10.3390/toxins8070209.
Infection of foot ulcers is a common, often severe and costly complication in diabetes. Diabetic foot infections (DFI) are mainly polymicrobial, and Staphylococcus aureus is the most frequent pathogen isolated. The numerous virulence factors and toxins produced by S. aureus during an infection are well characterized. However, some particular features could be observed in DFI. The aim of this review is to describe the role of S. aureus in DFI and the implication of its toxins in the establishment of the infection. Studies on this issue have helped to distinguish two S. aureus populations in DFI: toxinogenic S. aureus strains (harboring exfoliatin-, EDIN-, PVL- or TSST-encoding genes) and non-toxinogenic strains. Toxinogenic strains are often present in infections with a more severe grade and systemic impact, whereas non-toxinogenic strains seem to remain localized in deep structures and bone involving diabetic foot osteomyelitis. Testing the virulence profile of bacteria seems to be a promising way to predict the behavior of S. aureus in the chronic wounds.
足部溃疡感染是糖尿病常见、往往严重且代价高昂的并发症。糖尿病足感染（DFI）主要是多微生物感染，金黄色葡萄球菌是最常分离出的病原体。金黄色葡萄球菌在感染过程中产生的众多毒力因子和毒素已得到充分表征。然而，在DFI中可观察到一些特殊特征。本综述的目的是描述金黄色葡萄球菌在DFI中的作用及其毒素在感染发生中的影响。关于这个问题的研究有助于区分DFI中的两种金黄色葡萄球菌群体：产毒素金黄色葡萄球菌菌株（携带编码表皮剥脱毒素、EDIN、PVL或TSST的基因）和不产毒素菌株。产毒素菌株通常存在于更严重程度且有全身影响的感染中，而不产毒素菌株似乎局限于涉及糖尿病足骨髓炎的深部结构和骨骼中。检测细菌的毒力谱似乎是预测金黄色葡萄球菌在慢性伤口中行为的一种有前景的方法。
