Molecular Characteristics of Methicillin-Resistant (MRSA) Isolated from Diabetic Foot Infection.

BACKGROUND & OBJECTIVE: Diabetic foot ulcer (DFU), is one of the most frequent causes for hospitalizations in patients with diabetes. A major problem in the treatment of DFU is the increased-incidence of methicillin-resistant (MRSA). The aim of this study was to determine the SCC types of MRSA isolates and their epidemiology among patients with diabetes.

METHODS

This study was carried out on 145 diabetic patients with DFUs. The antibiotic susceptibility tests (ASTs) were performed using the disk diffusion method and E-test technique. SCC typing was done by multiplex PCR. Moreover, the presence of virulence toxin genes, including and was detected by PCR assay.

RESULTS

In 145 samples from which was predominantly isolated, 19.48% were MRSA. Analysis of MRSA isolates revealed that the most prevalent SCC type was type IV (46.7%) followed by type III (30.0%) and type V (20.0%). One strain (3.3%) was untypeable. The prevalence of and was 56.7% and 100%, respectively.

CONCLUSION

The high prevalence of MRSA in DFUs represents the high levels of antibiotic usage among patients with diabetes. In this study, resistance to other important clinical antibiotics was detected among MRSA isolates. The high proportion of SCCmec type IV and V strains, even in former hospitalized patients, indicates the entrance of these clones to the clinical setting.