Gs Veerabhadra Swamy, Sumana Mahadevaiah Neelambike, Maheshwarappa Yogeesh D, Mahale Rashmi P, Shylaja Chinchana Eshwarappa, Karthik Krishna, Shettar Supreeta R, Megha G K
Clinical Microbiology, Jagadguru Sri Shivarathreeshwara (JSS) Medical College and Hospital, JSS Academy of Higher Education, Mysuru, IND.
Cureus. 2024 Oct 1;16(10):e70605. doi: 10.7759/cureus.70605. eCollection 2024 Oct.
Background Diabetic foot ulcers (DFUs) are common complications in diabetes patients, often leading to sepsis and leg amputation. Methicillin-resistant Staphylococcus aureus (MRSA) infections in DFUs pose challenges due to methicillin resistance with and genes. This study aims to assess the prevalence of MRSA in clinical isolates from DFUs, analyze the antibiogram of MRSA isolates, and detect the presence of the and genes among MRSA isolates. Methodology The isolated colonies were identified and antimicrobial susceptibility was performed using the Vitek-2 Compact system. Methicillin resistance was also confirmed through the disc diffusion method. Confirmed methicillin-resistant isolates were subjected to real-time polymerase chain reaction (RT-PCR) to detect and genes. Results A total of 474 purulent samples from DFUs yielded 541 distinct isolates, comprising 201 gram-positive and 340 gram-negative organisms. Among the gram-positive organisms, species predominated, with 79 isolates, 34 of which were methicillin-resistant. All MRSA isolates (100%) were sensitive to tetracycline, linezolid, teicoplanin, and vancomycin, and 94% were sensitive to cotrimoxazole but least susceptible to ciprofloxacin and levofloxacin. RT-PCR confirmed the presence of genes in all 34 isolates and genes in three isolates. Conclusions The presence of in all 34 MRSA isolates underscores consistent methicillin resistance. The co-occurrence of and in three isolates hints at genetic diversity. Two MRSA isolates positive for were isolated from rural patients involved in farming and animal husbandry, suggesting an occupational risk. The third patient was from a non-rural area, indicating potential alternative transmission pathways warranting further investigation.
糖尿病足溃疡(DFUs)是糖尿病患者常见的并发症,常导致败血症和腿部截肢。由于耐甲氧西林金黄色葡萄球菌(MRSA)携带 mecA 和 mecC 基因而具有耐甲氧西林特性,DFUs 中的 MRSA 感染带来了挑战。本研究旨在评估 DFUs 临床分离株中 MRSA 的流行情况,分析 MRSA 分离株的抗菌谱,并检测 MRSA 分离株中 mecA 和 mecC 基因的存在情况。方法:使用 Vitek-2 Compact 系统对分离的菌落进行鉴定并进行药敏试验。还通过纸片扩散法确认耐甲氧西林情况。对确认的耐甲氧西林分离株进行实时聚合酶链反应(RT-PCR)以检测 mecA 和 mecC 基因。结果:来自 DFUs 的 474 份脓性样本共产生 541 株不同的分离株,包括 201 株革兰氏阳性菌和 340 株革兰氏阴性菌。在革兰氏阳性菌中,葡萄球菌属占主导,有 79 株分离株,其中 34 株耐甲氧西林。所有 MRSA 分离株(100%)对四环素、利奈唑胺、替考拉宁和万古霉素敏感,94%对复方新诺明敏感,但对环丙沙星和左氧氟沙星最不敏感。RT-PCR 证实所有 34 株分离株中均存在 mecA 基因,3 株分离株中存在 mecC 基因。结论:所有 34 株 MRSA 分离株中均存在 mecA 基因,强调了一致的耐甲氧西林特性。3 株分离株中同时存在 mecA 和 mecC 基因暗示了基因多样性。2 株 mecC 阳性的 MRSA 分离株来自从事农牧业的农村患者,提示存在职业风险。第三名患者来自非农村地区,表明可能存在其他传播途径,值得进一步研究。