Virulence and Drug-Resistance of Staphylococcus aureus Strains Isolated from Venous Ulcers in Polish Patients

• Published in: International journal of environmental research and public health 2021-04, Vol.18 (9), p.4662
• Main Authors: Gajda, Mateusz, Załugowicz, Emilia, Pomorska-Wesołowska, Monika, Bochenek, Tomasz, Gryglewska, Barbara, Romaniszyn, Dorota, Chmielarczyk, Agnieszka, Wójkowska-Mach, Jadwiga
• Format: Article
• Language: English
• Subjects: Ambulatory care; Antibiotics; Antimicrobial agents; Biofilms; Chromosomes; Collaboration; Diabetes; Drug resistance; Enzymes; Genes; Genetic analysis; Laboratories; Leg ulcers; Long term health care; Methicillin; Microbiomes; Microorganisms; Multidrug resistance; Patients; Phenotyping; Polymerase chain reaction; Population; Protein A; Skin; Staphylococcus aureus; Staphylococcus infections; Strains (organisms); Streptogramin B; Ulcers; Virulence
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph18094662

Infected chronic venous ulcers (VUs) represent a major health problem. We analysed the aerobic microbiome in the VUs, the virulence, and drug-resistance of (SA) strains. Swabs from 143 outpatients and inpatients Polish subjects were collected. SA strains were tested for drug sensitivity using a phenotyping method and for methicillin-resistant SA (MRSA) and macrolide-lincosamide-streptogramin B (MLSB) resistance using PCR. We analysed virulence genes, the genetic similarity of strains, and performed Staphylococcal cassette chromosome typing and Staphylococcal protein A typing. SA was isolated as a single one in 34.9% of cases, 31.5% paired with another pathogen, and 33.6% combined with at least two other strains. The majority of SA isolates (68.5%) possessed the virulence lukE gene. Drug resistance was significantly common in hospitalised than in ambulatory patients (OR 3.8; 95%CI 1.8-7.91). MLSB (altogether in 19.6% isolates) were observed mostly in non-hospitalised patients (OR 9.1; 95%CI 1.17-71.02), while MRSA was detected in 11.9% of strains equally. Hospitalisation and patient's age group (aged > 78.0 or < 54.5 years) were significant predictors of the multi-drug resistant SA (MDR-SA). Over 30% of the infected VUs were associated with multi-species biofilms and presence of potentially highly pathogenic microorganisms. Elderly hospitalised patients with chronic venous ulcers are prone to be infected with a MDR-SA.