title: Virulence Potential of Staphylococcus aureus Strains Isolated from Diabetic Foot Ulcers Among Patients from Southern Poland.
abstract: The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was investigated among infected diabetic foot ulcers in hospitalized and nonhospitalized patients in southern Poland to assess the virulence patterns and antimicrobial resistance among these strains. MRSA was detected in 10.3% of all studied isolates, from the hospitalized patients only. The rest of the isolates was methicillin susceptible. The minimal inhibitory concentration that inhibits 50% of bacterial isolates (MIC50) for vancomycin was 1.0 mg/mL. The mupA gene was detected in six (8.8%) isolates, in one MRSA strain and five methicillin-sensitive S. aureus (MSSA) strains. Among the mupA-positive strains, two were resistant to mupirocin (1 MRSA and 1 MSSA). Such results raise serious concern about the usage of mupirocin in MRSA decolonization. The pvl gene was not detected among the study isolates. The majority of isolates (70.6%) possessed the lukE gene, with no significant difference in prevalence between MRSA and MSSA isolates. An interesting finding was the presence of enterotoxin genes among the study isolates. Diabetic foot may therefore be a reservoir of bacteria, containing genes localized on mobile genetic elements that could be easily transferred to other non-pathogenic strains. The prevalence of MRSA was alarmingly high (as also suggested by others), as evaluated by the presence of the mup gene among strains, highlighting the importance of appropriate clinical management of MRSA infections in patients with diabetic foot ulcers. In this group of patients, screening of ulcer samples before antimicrobial therapy would enable informed choices regarding the selection of antimicrobial agents (e.g. octenidine, authorized for the treatment of chronic wounds) maximizing the chances of positive therapy.
authors.affiliation: Microbiology Department, Jagiellonian University Medical College, 18 Czysta Street, 31-121 Krakow, Poland.. monika.pobiega@gmail.com.
authors.forename: Monika
authors.initials: M
authors.lastname: Pobiega
authors.forename: Iwona
authors.initials: I
authors.lastname: Myjak
authors.forename: Monika
authors.initials: M
authors.lastname: Pomorska-Wesolowska
authors.forename: Dorota
authors.initials: D
authors.lastname: Romaniszyn
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Ziolkowski
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Chmielarczyk
authors.forename: Joanna
authors.initials: J
authors.lastname: Macig
authors.forename: Anna
authors.initials: A
authors.lastname: Szczypta
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Wójkowska-Mach
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000235:genetics; D017719:Diabetic Foot / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D024881:Drug Resistance, Bacterial / Q000235:genetics; D005098:Exotoxins / Q000235:genetics; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009154:Mutation; D009687:Nuclear Proteins / Q000235:genetics; D010641:Phenotype; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D014774:Virulence; D014946:Wound Infection / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D005098:Exotoxins; C115217:LukE protein, Staphylococcus aureus; D009687:Nuclear Proteins; C480380:mupA protein, Staphylococcus aureus