Prevalence, diversity, and antimicrobial susceptibility proles of methicillin-resistant Staphylococcus aureus among patients with diabetic foot infections in a referral hospital in Tehran, Iran

Fateh Rahimi; Sanaz Khashei; Mohammad Katouli

doi:10.21203/rs.3.rs-3174457/v1

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Prevalence, diversity, and antimicrobial susceptibility proles of methicillin-resistant Staphylococcus aureus among patients with diabetic foot infections in a referral hospital in Tehran, Iran

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Prevalence, diversity, and antimicrobial susceptibility proles of methicillin-resistant Staphylococcus aureus among patients with diabetic foot infections in a referral hospital in Tehran, Iran

Fateh Rahimi, Sanaz Khashei and Mohammad Katouli

Research Square, Vol.25 July 2023

Research Square Company

2023

DOI: https://doi.org/10.21203/rs.3.rs-3174457/v1

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Abstract

diabetic foot infection

MRSA

Antimicrobial susceptibility prole

SCCmec typing

ccr typing

PhP typing

The increasing incidence of methicillin-resistant Staphylococcus aureus (MRSA) is a major problem in the treatment of diabetic foot infections (DFIs). Due to the evolution of MRSA clones, and thereby inappropriate antibiotic therapy, typing of these strains in DFIs is needed to reduce their clonal dissemination in different regions. This study aimed to determine the prevalence, diversity, and antibiotic susceptibility profiles of MRSA isolated from patients with DFIs attending a referral hospital in Tehran, Iran during 2019–2020. Staphylococcal cassette chromosome mec (SCCmec) typing, ccr typing, PhP typing, and detection of Panton-Valentine Leukocidin (pvl) gene were done to explore the diversity of the strains. Antibiotic susceptibility profiles of the strains were also determined using the disk diffusion method and broth microdilution assay. Of the 238 S. aureus strains isolated, 73 were identified as MRSA. The highest antibiotic resistance was seen against ciprofloxacin (86%), followed by kanamycin and tobramycin (84%). Overall, MRSA strains were categorized into 29 antibiotypes. Also, 49.3% of strains were known as high-level oxacillin-resistant strains (MIC ≥ 256 μg/ml). SCCmec type III and type 3 ccr were detected in 86.3% of strains and they were classified as hospital-acquired (HA)-MRSA. PhP typing revealed the presence of 8 common types (CTs) and 11 single types (STs), with CT2 comprising 41.1% of the strains. Our data suggest that MRSA strains isolated from DFIs in this country could be diverse and resistant to clinically important antibiotics. In this context diabetic patients can serve as a reservoir for dissemination of these bacteria between community and clinical environments.

Details

Title: Prevalence, diversity, and antimicrobial susceptibility proles of methicillin-resistant Staphylococcus aureus among patients with diabetic foot infections in a referral hospital in Tehran, Iran
Authors: Fateh Rahimi (Corresponding Author) - University of Isfahan
Sanaz Khashei (Author) - Isfahan University of Medical Sciences
Mohammad Katouli (Author) - University of the Sunshine Coast, Queensland, Centre for Bioinnovation
Publication details: Research Square, Vol.25 July 2023
Publisher: Research Square Company
Date published: 2023
DOI: 10.21203/rs.3.rs-3174457/v1
ISSN: 2693-5015
Copyright note: This work is licensed under a Creative Commons Attribution 4.0 International License.
Grant note: This study was supported in part by an operating grant from University of Isfahan.
Organisation Unit: School of Science, Technology and Engineering; Centre for Bioinnovation
Language: English
Record Identifier: 99743798902621
Output Type: Preprint

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