a School of Medicine, Department of Infectious Diseases and Clinical Microbiology , University of Adnan Menderes , Aydin , Turkey.
b REDPROM Research Center , University of Adnan Menderes , Aydın , Turkey.
Infect Dis (Lond). 2018 Apr;50(4):273-279. doi: 10.1080/23744235.2017.1393839. Epub 2017 Oct 27.
Outcomes of antibiotic treatment of diabetic foot infections (DFIs) may depend not only on the antimicrobial susceptibility of the aetiologic agents, but also their ability to produce virulence factors. This study aimed to use polymerase chain reaction (PCR) with specific primers to investigate the presence of virulence genes among isolates of Pseudomonas aeruginosa isolates cultured from specimens from diabetic foot and other infections.
We examined 63 P. aeruginosa isolates from inpatients at two University Hospitals for the presence of 23 known bacterial virulence genes, including lasI, lasR, lasA, lasB, rhll, rhlR, rhlAB, aprA, fliC, toxA, plcH, plcN, ExoS, ExoT, ExoU, ExoY, phzI, phzII, phzM, phzS, pvdA, pilA and pilB.
Seven virulence genes (lasl, lasR, lasB, rhll, rhlR, rhlABand Exo T) were present in each isolate. No isolate expressed or presented aprA gene. We found that fliC (p = .01), toxA (p = .041) and phzS (p < .001) were statistically and significantly more common in diabetic foot isolates, while plcH (p < .001) was significantly more common in other infections.
Among clinical isolates of P. aeruginosa from patients with DFIs, three virulence genes that can play important roles in tissue penetration (fliC), tissue damage and survival under anaerobic condition (phzS) and cell death (toxA) were significantly more common than isolates from other infections. The Multilocus sequence typing (MLST) analysis of diabetic foot isolates failed to point/indicate the existence of a specific clone or was not able to characterize/identify a specific clone/clonal complex group. Development of new agents to inhibit the synthesis of these genes may improve outcomes in DFIs treatment.
抗生素治疗糖尿病足感染（DFI）的结果可能不仅取决于病原体的抗菌敏感性，还取决于其产生毒力因子的能力。本研究旨在使用聚合酶链反应（PCR）和特定引物来研究从糖尿病足和其他感染部位标本中培养的铜绿假单胞菌分离株中存在的毒力基因。
我们检查了两所大学医院的 63 株铜绿假单胞菌分离株，以确定 23 种已知细菌毒力基因的存在情况，包括 lasI、lasR、lasA、lasB、rhll、rhlR、rhlAB、aprA、fliC、toxA、plcH、plcN、ExoS、ExoT、ExoU、ExoY、phzI、phzII、phzM、phzS、pvdA、pilA 和 pilB。
每个分离株均存在 7 种毒力基因（lasl、lasR、lasB、rhll、rhlR、rhlAB 和 ExoT）。没有分离株表达或存在 aprA 基因。我们发现 fliC（p=.01）、toxA（p=.041）和 phzS（p<.001）在糖尿病足分离株中更为常见，而 plcH（p<.001）在其他感染中更为常见。
在糖尿病足患者的铜绿假单胞菌临床分离株中，三个可在组织穿透（fliC）、组织损伤和厌氧条件下生存（phzS）和细胞死亡（toxA）中发挥重要作用的毒力基因明显比其他感染分离株更为常见。对糖尿病足分离株的多位点序列分型（MLST）分析未能指出/表明存在特定克隆或无法对特定克隆/克隆复合体群进行特征描述/鉴定。开发抑制这些基因合成的新药物可能会改善糖尿病足感染的治疗效果。
