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Emergence of community-acquired methicillin-resistant Staphylococcus aureus EMRSA-15 clone as the predominant cause of diabetic foot ulcer infections in Portugal

2019-10-10Artigo científico Acesso restrito
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dc.contributor.authorSilva, Vanessa
dc.contributor.authorAlmeida, Francisco
dc.contributor.authorCarvalho, José António
dc.contributor.authorCastro, Ana Paula
dc.contributor.authorFerreira, Eugénia
dc.contributor.authorManageiro, Vera
dc.contributor.authorTejedor-Junco, María Teresa
dc.contributor.authorCaniça, Manuela
dc.contributor.authorIgrejas, Gilberto
dc.contributor.authorPoeta, Patrícia
dc.date.accessioned2020-04-22T21:17:12Z
dc.date.available2020-04-22T21:17:12Z
dc.date.issued2019-10-10
dc.description.abstractMethicillin-resistant Staphylococcus aureus (MRSA) are often found in infected diabetic foot ulcers, in which the prevalence may reach 40%. These complications are one of the main causes of morbidity in diabetic patients. The objectives of this study were to investigate the prevalence and antimicrobial resistance of MRSA strains in infected diabetic foot ulcers and to characterize their genetic lineages. Samples collected from 42 type 2 diabetic patients, presenting infected foot ulcers, were seeded onto ORSAB plates with 2 mg/L of oxacillin for MRSA isolation. Susceptibility to 14 antimicrobial agents was tested by the Kirby-Bauer disk diffusion method. The presence of resistance genes, virulence factors, and the immune evasion cluster system was studied by PCR. All isolates were characterized by MLST, accessory gene regulator (agr), spa, and staphylococcal chromosomal cassette mec (SCCmec) typing. Twenty-five MRSA strains were isolated. All isolates showed resistance to penicillin and cefoxitin. Sixteen isolates showed phenotypic resistance to erythromycin being 7 co-resistant to clindamycin. Resistance to trimethoprim-sulfamethoxazole was found in 2 isolates harboring the dfrA and dfrG genes. The IEC genes were detected in 80% of isolates, 16 of which were ascribed to IEC-type B. Isolates were assigned to 12 different spa types. The MLST analysis grouped the isolates into 7 sequence types being the majority (68%) ascribed to SCCmec type IV. In this study, there was a high prevalence of the EMRSA-15 clone presenting multiple resistances in diabetic foot ulcers making these infections complicated to treat leading to a higher morbidity and mortality in diabetic patients.pt_PT
dc.description.sponsorshipThis work was funded by the R&D Project CAREBIO2 - Comparative assessment of antimicrobial resistance in environmental biofilms through proteomics - towards innovative theranostic biomarkers, with reference NORTE-01-0145-FEDER-030101 and PTDC/SAU-INF/30101/2017, financed by the European Regional Development Fund (ERDF) through the Northern Regional Operational Program (NORTE 2020) and the Foundation for Science and Technology (FCT). This work was supported by the Associate Laboratory for Green Chemistry-LAQV which is financed by national funds from FCT/ MCTES (UID/QUI/50006/2019). Vanessa Silva is supported by national funds through FCT/MCTES and by the European Social Fund through POCH/FSE under the PhD grant SFRH/BD/137947/2018.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationEur J Clin Microbiol Infect Dis. 2020 Jan;39(1):179-186. doi: 10.1007/s10096-019-03709-6. Epub 2019 Oct 10pt_PT
dc.identifier.doi10.1007/s10096-019-03709-6pt_PT
dc.identifier.issn0934-9723
dc.identifier.urihttp://hdl.handle.net/10400.18/6492
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringer/ European Society of Clinical Microbiologypt_PT
dc.relation.publisherversionhttps://link.springer.com/article/10.1007/s10096-019-03709-6pt_PT
dc.subjectCA-MRSApt_PT
dc.subjectDiabetic Foot Ulcerspt_PT
dc.subjectEMRSA-15pt_PT
dc.subjectInfectionpt_PT
dc.subjectMethicillin-resistant Staphylococcus aureuspt_PT
dc.subjectResistência aos Antimicrobianospt_PT
dc.titleEmergence of community-acquired methicillin-resistant Staphylococcus aureus EMRSA-15 clone as the predominant cause of diabetic foot ulcer infections in Portugalpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage186pt_PT
oaire.citation.issue1pt_PT
oaire.citation.startPage179pt_PT
oaire.citation.titleEuropean journal of clinical microbiology & infectious diseasespt_PT
oaire.citation.volume39pt_PT
rcaap.embargofctDe acordo com política editorial da revista.pt_PT
rcaap.rightsembargoedAccesspt_PT
rcaap.typearticlept_PT

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