Virulence factors and clonal diversity of Staphylococcus aureus in colonization and wound infection with emphasis on diabetic foot infection

Abstract

Foot ulcer is a common complication in diabetic subjects and infection of these wounds contributes to increased rates of morbidity and mortality. Diabetic foot infections are caused by a multitude of microbes and Staphylococcus aureus, a major nosocomial and community-associated pathogen, significantly contributes to wound infections as well. Staphylococcus aureus is also the primary pathogen commonly associated with diabetic foot osteomyelitis and can cause chronic and recurrent bone infections. The virulence capability of the pathogen and host immune factors can determine the occurrence and progression of S. aureus infection. Pathogen-related factors include complexity of bacterial structure and functional characteristics that provide metabolic and adhesive properties to overcome host immune response. Even though, virulence markers and toxins of S. aureus are broadly similar in different wound models, certain distinguishing features can be observed in diabetic foot infection. Specific clonal lineages and virulence factors such as TSST-1, leukocidins, enterotoxins, and exfoliatins play a significant role in determining wound outcomes. In this review, we describe the role of specific virulence determinants and clonal lineages of S. aureus that influence wound colonization and infection with special reference to diabetic foot infections.

Topical Application of Ozonated Oils for the Treatment of MRSA Skin Infection in an Animal Model of Infected Ulcer

“…This feature can be useful for the topical use of ozone to treat infected DFU. Although S. aureus is the pathogen most frequently isolated from DFU, these lesions are often polymicrobial [ 45 ]. Therefore, it is important to consider both microbiological and clinical features to select the appropriate antibiotic therapy [ 13 ].…”

Determinants of Murine Skin Microbiota Composition in Homeostasis and Wound Healing

“…In a clinical setting, it has been thought that skin wounds are characterised by major colonisation of Gram-negative bacteria, such as Pseudomonas aeruginosa [34], and often display an over-representation of Staphylococci [32]. Here, we report that wound microbiome (which was not certified by peer review) is the author/funder.…”

Regulation of virulence and β-lactamase gene expression in Staphylococcus aureus isolates: cooperation of two-component systems in bloodstream superbugs

“…Regarding virulence genes, edin genes were detected in a single isolate of CC30. Several studies performed in different countries have been reported this toxin in other MRSA genetic backgrounds such as CC30 and C22 [ 15 , 38 ]. This demonstrated consistency with the previous studies.…”

“…CC30 and CC22 were the only clones that were positive for exfoliative toxins etA , etB genes. These toxins are responsible for staphylococcal scalded skin syndrome [ 38 , 39 ]. The prevalence of these genes might be due to the specific geographic region.…”