从糖尿病足溃疡中分离出的革兰氏阳性细菌的毒性特征

Rebecca A. Keogh, Savannah Huyvaert, Garrett D Moore, Alexander R. Horswill, K. Doran
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摘要

包括糖尿病足溃疡(DFUs)在内的糖尿病伤口感染是全球关注的主要健康问题,也是非创伤性截肢的主要原因。糖尿病足溃疡中的感染细菌种类繁多,由于广泛的抗生素耐药性和生物膜的形成,抗生素治疗往往失败。确定DFU中的细菌种类及其毒力潜力对于提供治疗方案至关重要。在这里,我们从科罗拉多大学安舒茨医学中心糖尿病患者的清创组织中分离出细菌。最常见的细菌是革兰氏阳性菌,包括粪肠球菌、金黄色葡萄球菌和无乳链球菌(又称 B 群链球菌 (GBS))。大多数组织都分离出一种以上的菌种,其中粪肠球菌和 GBS 经常与金黄色葡萄球菌一起出现在多微生物感染中。金黄色葡萄球菌是最容易形成生物膜的菌种,而粪肠球菌和 GBS 分离物几乎不形成生物膜。不同菌株对抗生素的敏感性各不相同,金黄色葡萄球菌对青霉素的耐药性较高,GBS 对克林霉素的耐药性较高,而粪肠球菌对万古霉素的耐药性处于中等水平。最后,我们利用小鼠糖尿病伤口感染模型发现,与单一感染的小鼠相比,金黄色葡萄球菌的存在导致 GBS 和粪肠球菌的恢复率明显更高。
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Virulence Characteristics of Gram-positive Bacteria Isolated from Diabetic Foot Ulcers
Diabetic wound infections including diabetic foot ulcers (DFUs) are a major global health concern and a leading cause of non-traumatic amputations. Numerous bacterial species establish infection in DFUs, and treatment with antibiotics often fails due to widespread antibiotic resistance and biofilm formation. Determination of bacterial species that reside in DFU and their virulence potential is critical to inform treatment options. Here, we isolate bacteria from debridement tissues from patients with diabetes at the University of Colorado Anschutz Medical Center. The most frequent species were Gram-positive including Enterococcus faecalis, Staphylococcus aureus, and Streptococcus agalactiae, also known as Group B Streptococcus (GBS). Most tissues had more than one species isolated with E. faecalis and GBS frequently occurring in polymicrobial infection with S. aureus. S. aureus was the best biofilm producing species with E. faecalis and GBS isolates exhibiting little to no biofilm formation. Antibiotic susceptibility varied amongst strains with high levels of penicillin resistance amongst S. aureus, clindamycin resistance amongst GBS and intermediate vancomycin resistance amongst E. faecalis. Finally, we utilized a murine model of diabetic wound infection and found that the presence of S. aureus led to significantly higher recovery of GBS and E. faecalis compared to mice challenged in mono-infection.
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3.30
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15 weeks
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