Chaves Celso Raul Silambo, Salamandane Cátia, Maurício Beatriz da Sorte, Machamba Almeida Abudo Leite, Salamandane Acácio, Brito Luísa
Laboratório Clínico do Centro de Saúde de Militar de Matacuane, Avenida Alfredo Lawley No. 42, Beira, Mozambique.
Faculdade de Ciências de Saúde, Universidade Lúrio, Campus Universitário de Marrere, Nampula, 4250, Mozambique.
Infect Drug Resist. 2025 May 31;18:2779-2796. doi: 10.2147/IDR.S521876. eCollection 2025.
Diabetic foot infection (DFI) represents a growing public health problem in Africa, caused by several microorganisms, with being one of the most prevalent pathogens associated with subsequent complications. This study aimed to characterize isolated from the wounds of patients with type 2 diabetes, treated at a health center in Beira, Mozambique, in terms of antibiotic resistance and virulence genes.
Samples were collected by swab, after ulcer debridement, and cultivated onto mannitol salt Columbia agar supplemented with 5% sheep blood, for 24 to 48 h, at 37°C. The antibiotic resistance was assessed by disk diffusion on Mueller-Hinton agar, and Multiplex PCR was used to screen 32 virulence and seven antibiotic resistance genes.
isolates showed high phenotypic resistance to penicillin (100%), cefoxitin (53.3%), trimethoprim/sulfamethoxazole (40%) and vancomycin (22.2%), and a high percentage of multidrug resistance (68.9%). The most prevalent resistance genes were (penicillin, 100%), (cefoxitin, 53.3%) and (vancomycin, 28.9%). The most frequent virulence genes were toxic syndrome staphylococcal toxin, 57.8%), and the colonization factor (37.8%), followed by the Panton-Valentine leukocidin (PLV) genes, (26.7%) and (15.6%). The regulator factor coded by (37.8%) and the adhesion factors coded by (20%) and by (17.8%) were also found.
A high presence of virulence genes encoding exotoxins and colonization and adhesion factors, associated with a high rate of multidrug resistance, was found in isolates. This anticipates increasing difficulty in treating DFI. The greatest resistance was to commonly used antibiotics, particularly penicillin, cefoxitin and vancomycin, with resistance genes, and , frequently detected. This emphasizes the urgent need for improved antimicrobial stewardship, routine molecular surveillance, and improved management strategies for DFI in resource-limited settings to mitigate disease complications and reduce the burden of antimicrobial resistance.
糖尿病足感染（DFI）在非洲已成为一个日益严重的公共卫生问题，由多种微生物引起，其中 是与后续并发症相关的最常见病原体之一。本研究旨在对从莫桑比克贝拉一家健康中心接受治疗的2型糖尿病患者伤口分离出的 进行抗生素耐药性和毒力基因特征分析。
在溃疡清创后通过拭子采集样本，接种于添加5%羊血的甘露醇盐哥伦比亚琼脂上，于37°C培养24至48小时。通过在穆勒-欣顿琼脂上进行纸片扩散法评估抗生素耐药性，并使用多重PCR筛选32个毒力基因和7个抗生素耐药基因。
分离株对青霉素（100%）、头孢西丁（53.3%）、甲氧苄啶/磺胺甲恶唑（40%）和万古霉素（22.2%）表现出较高的表型耐药性，且多重耐药率较高（68.9%）。最常见的耐药基因是 （青霉素，100%）、 （头孢西丁，53.3%）和 （万古霉素，28.9%）。最常见的毒力基因是中毒性休克综合征葡萄球菌毒素（57.8%）和定植因子 （37.8%），其次是杀白细胞素（PVL）基因 （26.7%）和 （15.6%）。还发现了由 编码的调节因子（37.8%）以及由 和 编码的黏附因子（分别为20%和17.8%）。
在 分离株中发现了大量编码外毒素、定植和黏附因子的毒力基因，且多重耐药率较高。这预示着治疗DFI的难度将不断增加。对常用抗生素尤其是青霉素、头孢西丁和万古霉素的耐药性最强，且经常检测到耐药基因 和 。这强调了在资源有限的环境中迫切需要改善抗菌药物管理、进行常规分子监测并改进DFI的管理策略，以减轻疾病并发症并减少抗菌药物耐药性负担。
