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Association of PVL Gene in MSSA and MRSA Strains among Diabetic Ulcer Patients from Odisha, India
Swatishree Pany1, Bayasis M Sharma1, Shibani K Sen2
1Microbiology Division, 29727ICMR- Regional Medical Research Centre, Bhubaneswar, Odisha, India.
Abstract:
Staphylococcus aureus has emerged as an important pathogen among diabetic foot ulcers in patients with diabetes. Infections with S. aureus in diabetic ulcers need surveillance of resistant microbial profile to provide the basis for empirical therapy for the reduction of lower extremities amputation. Panton valentine leucocidin (PVL) is considered as one of the major virulence gene of S. aureus which is responsible for destruction of white blood cells and tissue necrosis. This pore forming cytotoxin gene is carried out by both methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) strains. The present study described the prevalence of PVL gene in MSSA and MRSA strains isolated from diabetic ulcer patients treated during November, 2019 to January, 2021 from a tertiary care hospital, Odisha. Infected tissue and blood samples from these patients were collected aseptically and sub-cultured using different media and standard techniques. The isolated genomic DNA of MSSA and MRSA strains were subjected to PCR assay for the detection of PVL gene. Two hundred ten S. aureus out of 402 diabetic ulcer patients were isolated having 59.52% MSSA and 40.47% MRSA strains. Wagner's grade III and grade IV ulcers were most prevalent in these ulcer patients. The prevalence of PVL gene in MSSA strains was more in comparison to MRSA strains. Forty five resistance patterns were observed from the antibiogram profiles of S. aureus. The present study highlighted that PVL gene could not be a marker for the detection of MRSA and MSSA strains in diabetic ulcer patients.
Insights
The Panton Valentine leucocidin (PVL) gene is prevalent in Staphylococcus aureus from diabetic foot ulcers. This study found PVL gene prevalence was higher in methicillin-susceptible S. aureus (MSSA) than methicillin-resistant S. aureus (MRSA), indicating PVL is not a reliable marker for MRSA detection.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Diabetes Complications
Background:
- Staphylococcus aureus is a significant pathogen in diabetic foot ulcers (DFUs), necessitating surveillance of antimicrobial resistance for effective empirical therapy.
- The Panton Valentine leucocidin (PVL) is a key virulence factor in S. aureus, contributing to tissue necrosis and white blood cell destruction.
- PVL-encoding genes are found in both methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) strains.
Purpose of the Study:
- To determine the prevalence of the PVL gene in MSSA and MRSA strains isolated from patients with diabetic foot ulcers.
- To investigate the potential of the PVL gene as a marker for differentiating MSSA and MRSA in the context of DFU infections.
Main Methods:
- Isolation and identification of S. aureus from infected tissue and blood samples of diabetic ulcer patients.
- Determination of MSSA and MRSA status.
- Polymerase chain reaction (PCR) assay for the detection of the PVL gene in isolated strains.
- Antibiogram profiling to observe resistance patterns.
Main Results:
- Out of 402 diabetic ulcer patients, 210 S. aureus strains were isolated (59.52% MSSA, 40.47% MRSA).
- Wagner's grade III and IV ulcers were most common.
- The PVL gene showed a higher prevalence in MSSA strains compared to MRSA strains.
- Forty-five distinct resistance patterns were observed.
Conclusions:
- The PVL gene prevalence was higher in MSSA than MRSA strains isolated from diabetic foot ulcers.
- The PVL gene is not a reliable marker for distinguishing between MRSA and MSSA in diabetic ulcer patients.
- Understanding the microbial profile, including virulence factors like PVL, is crucial for managing DFU infections and preventing amputations.
