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Clonal repetitive element polymerase chain reaction patterns of Pseudomonas aeruginosa in diabetic foot ulcers, Iran

Niloofar Ghahari1, Arezoo Mirzaei1, Bahram Nasr Esfahani1

  • 1Department of Bacteriology and Virology, Faculty of Medicine, Isfahan University of Medical Science, Isfahan, Iran.

IJID Regions
|February 10, 2025
PubMed
Abstract

Insights

Pseudomonas aeruginosa is prevalent in diabetic foot infections, often showing multidrug resistance and biofilm formation. Hospital hygiene surveillance is crucial to control the spread of these resistant strains.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Genetics

Background:

  • Diabetic foot infections (DFU) are a significant clinical challenge.
  • Pseudomonas aeruginosa is a key pathogen complicating DFU treatment.
  • Understanding P. aeruginosa prevalence and resistance is vital for effective DFU management.

Purpose of the Study:

  • To determine the prevalence of P. aeruginosa in diabetic foot ulcers.
  • To assess the antimicrobial resistance, biofilm formation, and virulence gene profiles of P. aeruginosa isolates.
  • To investigate the clonality and hospital-associated dissemination of P. aeruginosa strains in DFU.

Main Methods:

  • Collected samples from 66 DFU patients.
  • Assessed P. aeruginosa prevalence, antimicrobial susceptibility, and biofilm production using disk diffusion and crystal violet assays.
  • Utilized polymerase chain reaction to detect resistance and virulence genes (blaTEM, blaSHV, toxA, alg44, mucA) and repetitive element polymerase chain reaction for clonality analysis.

Main Results:

  • High resistance rates observed for ciprofloxacin (58.6%), tobramycin (57.1%), and imipenem (55.1%).
  • Multidrug resistance (62.5%) and strong biofilm production (41.3%) were common.
  • Prevalence of virulence genes toxA (82%), alg44 (93.1%), mucA (75.8%) and blaTEM (65.5%) were significant; blaSHV was absent (0%).
  • Clonal relationships were identified among isolates from the same hospital.

Conclusions:

  • P. aeruginosa strains in DFU exhibit significant multidrug resistance and biofilm-forming capabilities.
  • The presence of specific virulence genes contributes to the pathogenicity of these strains.
  • Hospital-associated clonal spread highlights the need for enhanced infection control and surveillance of hygiene practices to prevent dissemination.
Keywords:
Beta-lactamaseDiabeticFoot ulcerPseudomonas aeruginosamucAtoxA

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