title: Risk factors and gene type for infections of MRSA in diabetic foot patients in Tianjin, China.
abstract: The objective was to study risk factors and gene type of DF patients infected with MRSA. A total of 429 DF patients were recruited. The patients with S aureus infections were divided into MRSA and MSSA groups. MRSA were genotyped by SCCmec. pvl and lukE-lukD were detected. A total of 559 pathogens were isolated from them, with G+ bacteria firstly(59.0%), followed G- bacilli (37.7%) and true fungi (3.3%). The 3 most frequently isolated pathogens were S aureus (35.2%), S epidermidis (12.3%), and Pseudomonas aeruginosa (11.2%). SCCmec III MRSA and SCCmec IVa MRSA had the same antibacterial spectrum. mecA positive rate was 100%. lukE-lukD and pvl positive rates were 100% and 0%, respectively. 28 strains belonged to SCCmec III and the others belonged to SCCmec IVa. The G+ cocci were the main pathogens, S aureus and S epidermidis were predominant among them. Antibiotic usage in 6 months prior to hospitalization, long course of ulcer, osteomyelitis and hypoproteinemia are risk factors for MRSA. SCCmec IVa is high in proportion to MRSA isolates, suggesting that CA-MRSA has become major pathogen of DF infection. All the MRSA were harboring lukE-lukD, which has been reported to present poor leucotoxin compared to pvl, and may be a response to atypical local inflammatory reaction in DF infection.
authors.affiliation: 12011 Collaborative Innovation Center of Tianjin for Medical Epigenetics, The Key Laboratory of Hormones and Development (Ministry of Health), Department of Diabetic Foot, Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China.
authors.forename: Shu-Hong
authors.initials: SH
authors.lastname: Feng
authors.forename: Yue-Jie
authors.initials: YJ
authors.lastname: Chu
authors.forename: Peng-Hua
authors.initials: PH
authors.lastname: Wang
authors.forename: Xu
authors.initials: X
authors.lastname: Jun
authors.forename: Ding
authors.initials: D
authors.lastname: Min
authors.forename: Xue-Mei
authors.initials: XM
authors.lastname: Li
mesh_terms: D016022:Case-Control Studies; D002681:China; D017719:Diabetic Foot / Q000382:microbiology*; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification* / Q000235:genetics; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000517:prevention & control
keywords: diabetic foot infections; gene type; methicillin-resistant Staphylococcus aureus; methicillin-susceptible Staphylococcus aureus; risk factors