Antibiotic Resistance Profiling and mecA Gene Detection in Diabetic Foot Infections: A Study from Ardabil City, Iran

Background and Aim: Diabetic foot infections (DFIs) are common complications for individuals suffering from diabetes. The aim of this study was to monitor the presence of the mecA gene in diabetic foot infections in diabetic patients in Ardabil city, northwest Iran. Materials and Methods: A total of eighty samples were collected from Imam Khomeini Hospital in Ardabil, Iran, between March and February 2023. Bacterial isolates were identified using conventional microbiological tests, and their antibiotic susceptibility was tested. The presence of the mecA gene was determined by PCR assay. Results & Conclusion: A total of 119 bacterial strains were isolated from 80 diabetic foot ulcer samples. The most common aerobic Gram-positive bacteria were Staphylococcus aureus (n=34) and coagulase-negative Staphylococcus spp. (n=21). Enterobacteriaceae included Escherichia coli (n=18), Citrobacter spp. (n=5), and Enterobacter spp. (n=5). Enterococcus spp. were found in 18 isolates. Gram-negative aerobic bacteria included Pseudomonas aeruginosa (n=8) and Acinetobacter spp. (n=5). The main anaerobic isolate was Bacteroides fragilis (n=5). Thirteen MRSA strains were detected, 12 of which carried the mecA gene; one strain was MRSA by cefoxitin testing but lacked mecA , suggesting alternative resistance mechanisms. All Gram-positive isolates were susceptible to linezolid, and all Enterobacteriaceae were sensitive to imipenem. S. aureus and B. fragilis were the predominant aerobic and anaerobic bacteria, respectively. These findings support the early use of combined antimtabicrobial therapy for diabetic foot infections.