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Clinical Significance of Antibiotic Resistance01:25

Clinical Significance of Antibiotic Resistance

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Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within...
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Staphylococcal Skin Infections01:29

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Staphylococcus aureus is a Gram-positive coccus that resides harmlessly on the skin and mucous membranes of healthy individuals. When the skin barrier is breached, it can shift from a commensal to an opportunistic pathogen. This transition is facilitated by surface adhesins, such as clumping factor B and S. aureus surface protein G (SasG), which bind to structural proteins, including loricrin and cytokeratin, in the damaged epidermis. Protein A, another key factor, binds the Fc region of...
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Factors Affecting the Risk of Infection01:26

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The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
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Mechanism of Antibiotic Resistance in MRSA01:25

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Antibiotic resistance in bacteria arises when microorganisms evolve the ability to withstand drugs designed to kill them or inhibit their growth, rendering once-effective treatments useless. This phenomenon, driven by genetic change and selection under antibiotic exposure, poses a profound threat to modern medicine. Mechanisms include drug-inactivating enzymes (e.g., β-lactamases), efflux pumps that eject antibiotics, mutations altering antibiotic targets, decreased drug uptake, and...
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Therapeutic Drug Monitoring: Affecting Factors01:29

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Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
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Drug Toxicity: Risk factors01:24

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Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
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Risk Factors Associated With Methicillin-Resistant Staphylococcus aureus Infections in Patients With Diabetic Foot

Haniyeh Khalili1, Mona Mahrooghi1, Shahin Najar-Peerayeh1

  • 1Faculty of Medical Sciences, Department of Bacteriology, Tarbiat Modares University, Tehran, Iran, modares.ac.ir.

The Canadian Journal of Infectious Diseases & Medical Microbiology = Journal Canadien Des Maladies Infectieuses Et De La Microbiologie Medicale
|April 15, 2026
PubMed
Summary

Diabetic foot ulcer infections are often caused by Staphylococcus aureus, with methicillin-resistant S. aureus (MRSA) being a significant concern. Identifying risk factors and antibiotic resistance patterns is crucial for effective treatment of diabetic foot ulcers (DFUs).

Keywords:
MRSAMSSAStaphylococcus aureusdiabetic foot ulcers

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Diabetology

Background:

  • Diabetic foot ulcers (DFUs) are a serious complication of diabetes mellitus, leading to high rates of morbidity and mortality.
  • Methicillin-resistant Staphylococcus aureus (MRSA) is a prevalent pathogen in DFU infections, necessitating research into its epidemiology and risk factors.

Purpose of the Study:

  • To identify risk factors associated with MRSA infections in patients with DFUs.
  • To determine the prevalence and characteristics of MRSA and methicillin-susceptible S. aureus (MSSA) in DFU patients.
  • To investigate the antibiotic susceptibility patterns of S. aureus isolates from DFUs.

Main Methods:

  • Collected 211 wound samples from DFU patients over two years (2017-2019).
  • Utilized polymerase chain reaction (PCR) to detect virulence genes (e.g., hla, psmα, agr, eta, etb, tsst-1) and staphylococcal cassette chromosome (SCCmec) types.
  • Performed antibiotic susceptibility testing (AST) using the Kirby-Bauer disk diffusion method.

Main Results:

  • S. aureus was identified in 45.3% of DFU cases, with 62.7% of these being MRSA.
  • The most common MRSA virulence genes were hla (57.6%) and psmα (50.8%). SCCmec Type III was the predominant subtype (48.6%).
  • MRSA showed high resistance to cefoxitin and penicillin but susceptibility to linezolid, gentamycin, and mupirocin. Risk factors included hypertension, cardiovascular disease, renal failure, neuropathy, and prior hospitalization.

Conclusions:

  • Understanding patient medical history and underlying conditions is vital for managing DFUs.
  • Accurate assessment of microbial prevalence and antibiotic susceptibility is essential for effective DFU treatment strategies.