Clonal repetitive element polymerase chain reaction patterns of Pseudomonas aeruginosa in diabetic foot ulcers, Iran

Abstract

Objectives

Pseudomonas aeruginosa has gained attention in diabetic foot infections, which complicate treatment. Further research is essential to understand the prevalence and clinical impact of P. aeruginosa in diabetic foot ulcers (DFU) and to develop effective management strategies.

Methods

Samples were collected from 66 patients with DFU. The prevalence of P. aeruginosa, its antimicrobial profile, and biofilm formation were assessed by disk diffusion and crystal violet assays. The prevalence of resistance and virulence genes, including bla_TEM, bla_SHV, toxA, alg44, and mucA, was assessed using polymerase chain reaction. Finally, the clonality of the isolates was assessed by repetitive element polymerase chain reaction.

Results

The highest levels of resistance were seen against ciprofloxacin, tobramycin, and imipenem, with 58.6%, 57.1%, and 55.1%, respectively. A total of 41.3% and 62.5% of the isolates were strong biofilm-producers and multidrug-resistant, respectively. The prevalence of toxA, alg44, and mucA, were reported to be 82%,93.1%, and 75.8%, respectively, and for β-lactamase genes, such as bla_TEM and bla_SHV, were 65.5% and 0%. Among the 28 isolates, 14 GTG types showed clonal relationships with certain strains.

Conclusion

These findings suggest that all clonal types were associated with the same hospital, emphasizing the need for epidemiologic surveillance of hygiene practices within healthcare facilities to mitigate strain dissemination.