International Journal of General Medicine (Dec 2020)
Antimicrobial Susceptibility Testing and Phenotypic Detection of MRSA Isolated from Diabetic Foot Infection
Abstract
Khanda Anwar,1 Dlsoz Hussein,2 Jamal Salih3,4 1Microbiology Department, College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan Region, Iraq; 2Microbiology Department, Central Public Health Laboratory 1, Sulaymaniyah, Kurdistan Region, Iraq; 3Physiology Department, College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan Region, Iraq; 4Diabetes and Endocrine Centre, Sulaymaniyah, IraqCorrespondence: Jamal SalihPhysiology Department, College of Medicine, University of Sulaimani, New–Street-27, Zone 209, P.O. Box: 334, Sulaimaniyah, Kurdistan Region, IraqTel +00964-7702441985Email [email protected]: Diabetic foot infection (DFI) is a common and costly complication of diabetes that may be caused by various bacteria with multi-resistant genes. The aim of this study is to evaluate the efficacy of phenotypic methods for identification of methicillin-resistant Staphylococcus aureus (MRSA) with genotypic detection of MRSA-related genes.Methods: In this cross-sectional study, swab samples were collected from patients with DFI from hospitals in Sulaimani/Iraq in April–July 2019. All the samples were processed for microbiological assessment and further MRSA phenotypic and genotypic testing.Results: A total of 46 swab samples were collected from diabetic foot ulcers of 29 males and 17 females. Most samples (93.5%) showed positive growth, with higher proportions of monomicrobial (23; 53.5%) than mixed-bacterial infections (20; 46.5%) and S. aureus as the predominant pathogen. Conventional methods of MRSA detection, such as cefoxitin disc diffusion, can predict methicillin resistance in 45.8% of the cases. Real-time/conventional PCR showed that 41.6% of Staphylococcus aureus were positive for the mecA gene, while none of the isolates was positive for PVL.Conclusion: Staphylococcus aureus was the predominant pathogen in DFI. Although cefoxitin and oxacillin disc diffusion methods can help in the prediction of MRSA, real-time PCR is a reliable method for MRSA detection and confirmation.Keywords: diabetic foot, infection, MRSA, genotypic detection
