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A Fluorescence-based Method to Study Bacterial Gene Regulation in Infected Tissues
Published on: February 19, 2019
Representative Targeted Molecular And Genomic Characterization Of Virulence Genes In Staphylococcus aureus From
Shaymaa H Al-Kubaisy1, Rawaa A Hussein2, Mushtak T S Al-Ouqaili3
1Department of Microbiology, College of Medicine, University of Anbar.
Abstract:
Diabetic foot infections (DFIs) represent a major public health concern, and methicillin-resistant Staphylococcus aureus (MRSA) is among the most clinically significant pathogens. This study investigated the prevalence of virulence genes (cna and hlg), antimicrobial resistance profiles, and representative genomic features of multidrug-resistant S. aureus isolates recovered from patients with DFIs. A cross-sectional observational study was conducted on 125 patients with diabetic foot infections between January and December 2024. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method and cefoxitin screening according to Clinical and Laboratory Standards Institute (CLSI) guidelines, with S. aureus ATCC 25923 used as the quality-control strain. Vancomycin susceptibility was confirmed by minimum inhibitory concentration (MIC) testing. Polymerase chain reaction (PCR) was used to detect the virulence genes (cna and hlg) and blaOXA-group I genes. Whole-genome sequencing (WGS) was performed on two representative isolates, including one multidrug-resistant (MDR) isolate and one extensively drug-resistant (XDR) isolate, using a de novo sequencing approach to generate draft genome assemblies. Among 125 clinical specimens, bacterial growth was observed in 90 samples (72%), of which 45 isolates (50%) were identified as S. aureus. Among these isolates, 35/45 (77.78%) were classified as MRSA, and 36/45 (80%) were multidrug resistant. The hlg gene was detected in all isolates, whereas the cna gene was identified in 13/45 (28.89%) isolates. No blaOXA-group I genes were detected. Genomic analysis identified multiple resistance-associated genes, including blaZ, tet(38), norA, and vanT, together with CRISPR-Cas elements and plasmid-associated resistance determinants. These findings highlight the high prevalence of multidrug-resistant S. aureus in DFIs and support the importance of continued genomic surveillance of clinically relevant resistant strains.
Insights
Multidrug-resistant Staphylococcus aureus, including methicillin-resistant strains, is common in diabetic foot infections. Genomic analysis reveals significant antimicrobial resistance and virulence genes, emphasizing the need for ongoing surveillance.
Area of Science:
- Microbiology
- Genomics
- Infectious Diseases
Background:
- Diabetic foot infections (DFIs) are a significant public health issue.
- Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen in DFIs.
Purpose of the Study:
- To investigate the prevalence of virulence genes (cna, hlg) and antimicrobial resistance in S. aureus from DFIs.
- To characterize genomic features of multidrug-resistant (MDR) and extensively drug-resistant (XDR) S. aureus isolates from DFIs.
Main Methods:
- Cross-sectional study of 125 DFI patients.
- Antimicrobial susceptibility testing (Kirby-Bauer, MIC).
- Polymerase chain reaction (PCR) for virulence and resistance genes.
- Whole-genome sequencing (WGS) of representative MDR/XDR isolates.
Main Results:
- S. aureus identified in 50% of positive cultures (45/90).
- High prevalence of MRSA (77.78%) and MDR (80%) S. aureus isolates.
- hlg gene detected in all isolates; cna gene in 28.89%.
- WGS identified resistance genes (blaZ, tet(38), norA, vanT) and CRISPR-Cas elements.
Conclusions:
- High prevalence of multidrug-resistant S. aureus in DFIs.
- Genomic surveillance is crucial for understanding and managing resistant strains in DFIs.
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