T N Vipina Vinod, Premnath Manjusha, Stanley Jos V, Paul Nimmy, Mathew Jyothis, Radhakrishnan E K
School of Biosciences, Mahatma Gandhi University, Kottayam, Kerala, 686560, India.
Department of General Surgery, Government Medical College, Kottayam, Kerala, 686008, India.
World J Microbiol Biotechnol. 2025 May 2;41(5):161. doi: 10.1007/s11274-025-04362-2.
Emerging antibiotic resistance among bacterial pathogens of diabetic foot ulcers (DFUs) cause a significant threat to the human health. In the study, deep ulcer swabs were collected from 70 diabetic patients with foot ulcer. Among the 187 bacterial strains purified from the same, major representations were identified to be from Klebsiella pneumoniae and Staphylococcus spp. Here, polymicrobial infection (87.14%) was found to be more prevalent than monomicrobial (12.86%). From the antibiotic susceptibility test results, 34 bacterial isolates were identified as MDR pathogens with resistance to β-lactam and carbapenem classes of antibiotics. Furthermore, molecular screening has revealed the presence of antibiotic resistance gene such as blabla, blabla, NDM-1, mecA and blaZ genes among the isolates studied. Biofilm analysis has further revealed 31 strains to have strong and 3 with moderate biofilm production property. Among the MDR strains, K. pneumoniae (DFU2.2) and methicillin-resistant S. aureus (MRSA) (DFU24.3) were subjected to the whole-genome sequencing (WGS) based analysis due to their significant role in the chronicity of DFUs. The resistome prediction from the WGS data of DFU2.2 has revealed it to have the presence of a novel extended β-lactamase gene bla which has not been reported previously from India. Pan-genome analysis of DFU2.2 and DFU24.3 has also provided detailed insight into the genetic diversity, evolution, and pathogenic potential of the selected strains. The findings of this study hence suggest the emerging AMR to be one of the major risk factors challenging the therapeutic response of DFUs, the incidence of which is alarmingly high.
糖尿病足溃疡（DFU）的细菌病原体中出现的抗生素耐药性对人类健康构成了重大威胁。在该研究中，从70名患有足部溃疡的糖尿病患者身上采集了深部溃疡拭子。从这些拭子中纯化出的187株细菌菌株中，主要发现来自肺炎克雷伯菌和葡萄球菌属。在此，发现多重微生物感染（87.14%）比单一微生物感染（12.86%）更为普遍。根据抗生素敏感性试验结果，34株细菌分离株被鉴定为对β-内酰胺类和碳青霉烯类抗生素耐药的多重耐药病原体。此外，分子筛查揭示了在所研究的分离株中存在bla bla、bla bla、NDM-1、mecA和blaZ等抗生素耐药基因。生物膜分析进一步显示，有31株具有较强的生物膜形成特性，3株具有中等生物膜形成特性。在多重耐药菌株中，肺炎克雷伯菌（DFU2.2）和耐甲氧西林金黄色葡萄球菌（MRSA）（DFU24.3）因其在糖尿病足溃疡慢性化中的重要作用而接受了基于全基因组测序（WGS）的分析。对DFU2.2的WGS数据进行的耐药基因组预测显示，它存在一个新的超广谱β-内酰胺酶基因bla，此前在印度尚未有过报道。对DFU2.2和DFU24.3的泛基因组分析也为所选菌株的遗传多样性、进化和致病潜力提供了详细的见解。因此，本研究的结果表明，新出现的抗生素耐药性是挑战糖尿病足溃疡治疗反应的主要风险因素之一，其发生率高得惊人。
