title: Staphylococcus aureus Toxins and Diabetic Foot Ulcers: Role in Pathogenesis and Interest in Diagnosis.
abstract: Infection of foot ulcers is a common, often severe and costly complication in diabetes. Diabetic foot infections (DFI) are mainly polymicrobial, and Staphylococcus aureus is the most frequent pathogen isolated. The numerous virulence factors and toxins produced by S. aureus during an infection are well characterized. However, some particular features could be observed in DFI. The aim of this review is to describe the role of S. aureus in DFI and the implication of its toxins in the establishment of the infection. Studies on this issue have helped to distinguish two S. aureus populations in DFI: toxinogenic S. aureus strains (harboring exfoliatin-, EDIN-, PVL- or TSST-encoding genes) and non-toxinogenic strains. Toxinogenic strains are often present in infections with a more severe grade and systemic impact, whereas non-toxinogenic strains seem to remain localized in deep structures and bone involving diabetic foot osteomyelitis. Testing the virulence profile of bacteria seems to be a promising way to predict the behavior of S. aureus in the chronic wounds.
authors.affiliation: Institut National de la Sant&#233; Et de la Recherche M&#233;dicale U1047, Universit&#233; de Montpellier, UFR de M&#233;decine, N&#238;mes 30908, France. catherine.remy@chu-nimes.fr.|Service de Microbiologie, Centre Hospitalo-Universitaire Car&#233;meau, N&#238;mes 30029, France. catherine.remy@chu-nimes.fr.
authors.forename: Catherine
authors.initials: C
authors.lastname: Dunyach-Remy
authors.affiliation: Institut National de la Sant&#233; Et de la Recherche M&#233;dicale U1047, Universit&#233; de Montpellier, UFR de M&#233;decine, N&#238;mes 30908, France. ngbachristelle@hotmail.fr.
authors.forename: Christelle
authors.initials: C
authors.lastname: Ngba Essebe
authors.affiliation: Institut National de la Sant&#233; Et de la Recherche M&#233;dicale U1047, Universit&#233; de Montpellier, UFR de M&#233;decine, N&#238;mes 30908, France. albert.sotto@chu-nimes.fr.|Service des Maladies Infectieuses et Tropicales, Centre Hospitalo-Universitaire Car&#233;meau, N&#238;mes 30029, France. albert.sotto@chu-nimes.fr.
authors.forename: Albert
authors.initials: A
authors.lastname: Sotto
authors.affiliation: Institut National de la Sant&#233; Et de la Recherche M&#233;dicale U1047, Universit&#233; de Montpellier, UFR de M&#233;decine, N&#238;mes 30908, France. jean.philippe.lavigne@chu-nimes.fr.|Service de Microbiologie, Centre Hospitalo-Universitaire Car&#233;meau, N&#238;mes 30029, France. jean.philippe.lavigne@chu-nimes.fr.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Lavigne
mesh_terms: D001427:Bacterial Toxins / Q000378:metabolism*; D017719:Diabetic Foot / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy; D054884:Host-Pathogen Interactions; D006801:Humans; D010019:Osteomyelitis / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy; D011379:Prognosis; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy; D013211:Staphylococcus aureus / Q000378:metabolism / Q000472:pathogenicity*; D014774:Virulence; D037521:Virulence Factors / Q000378:metabolism*; D014946:Wound Infection / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy
chemical_list: D001427:Bacterial Toxins; D037521:Virulence Factors
keywords: Staphylococcus aureus; diabetic foot infection; toxins