State University of Southwest Bahia, Vitória da Conquista, Bahia, Brazil.
Federal University of Bahia, Multidisciplinary Institute in Health, Vitória da Conquista, Bahia, Brazil.
Int J Low Extrem Wounds. 2024 Jun;23(2):252-263. doi: 10.1177/15347346211050771. Epub 2021 Nov 6.
It is necessary to know the resistance profile of to better control diabetic foot ulcer infections, to establish rational antibiotic therapy, and to avoid the development of resistant strains. This cross-sectional study evaluated the clinical parameters, virulence, and antimicrobial resistance profiles of in patients with diabetic foot disease admitted to a public hospital. strains were identified in patients with diabetes with amputation indication. Infected tissue samples were collected, microbes were isolated and identified. The microbial resistance profile was determined. Samples were also analyzed for biofilm formation and other virulence markers. The 34 individuals examined were mostly men, black, aged 60 years on average, and generally had a low income and education level. Most individuals had type 2 diabetes, and the mean time since diagnosis was 13.9 years. On an SF-36 (the Medical Outcomes Study 36-item short-form health survey) quality-of-life questionnaire, 75% of individuals obtained a score equal to 0 for physical impairment. specimens from 17 patients were isolated, corresponding to 50% of samples. Five isolates were classified as methicillin-resistant (MRSA). Molecular typing revealed that 20% of MRSA strains were SCC type V and 80% were type I. All isolates were sensitive to doxycycline; 61.5% were resistant to erythromycin, 38.5% to cefoxitin, 30.7% to clindamycin and ciprofloxacin, 23% to meropenem, 15.3% to gentamicin, 38.5% to oxacillin, and 7.7% (one strain) to vancomycin. Regarding biofilm production, 53% of samples were able to produce biofilms, and 84.6% had and/or genes Additionally, the following enterotoxin genes were identified in the isolates: and (5.9%, 5.9%, 11.8%, and 23.9%, respectively) and types 1 (5.9%) and 2 (11.8%). Genotypic evaluation made it possible to understand the pathogenicity of strains isolated from the diabetic foot; laboratory tests can assist in the monitoring of patients with systemic involvement.
为了更好地控制糖尿病足溃疡感染，制定合理的抗生素治疗方案，并避免耐药菌株的产生，了解 的耐药谱是必要的。这项横断面研究评估了因有截肢指征而入住公立医院的糖尿病足疾病患者的临床参数、毒力和抗菌药物耐药谱。在糖尿病患者中分离出 菌株，这些患者有感染组织样本采集，微生物分离和鉴定。确定微生物耐药谱。还分析了生物膜形成和其他毒力标志物。所检查的 34 个人主要是男性，黑人，平均年龄 60 岁，一般收入和教育水平较低。大多数人患有 2 型糖尿病，平均诊断时间为 13.9 年。在 SF-36（医疗结果研究 36 项简短健康调查）生活质量问卷上，75%的个体在身体障碍方面的得分等于 0。17 名患者的 标本被分离，占样本的 50%。5 株分离物被鉴定为耐甲氧西林金黄色葡萄球菌（MRSA）。分子分型显示，20%的 MRSA 菌株为 SCC 型 V，80%为 I 型。所有分离物均对强力霉素敏感；61.5%对红霉素耐药，38.5%对头孢西丁耐药，30.7%对克林霉素和环丙沙星耐药，23%对美罗培南耐药，15.3%对庆大霉素耐药，38.5%对苯唑西林耐药，7.7%（一株）对万古霉素耐药。关于生物膜产生，53%的样本能够产生生物膜，84.6%有 和/或 基因。此外，在分离株中还鉴定出以下肠毒素基因： 和 （分别为 5.9%、5.9%、11.8%和 23.9%）和 1 型（5.9%）和 2 型（11.8%）。基因型评估使我们能够了解从糖尿病足分离出的 菌株的致病性；实验室检测有助于监测全身受累的患者。
