A patient with diabetes has a history of foot ulcer and, specifically, a recurre

Question

A patient with diabetes has a history of foot ulcer and, specifically, a recurrent diabetic foot infection (DFI). Despite treatment and apparent success of the treatment the infection continues to reappear. The initial microbiological investigation has identified Staphylococcus aureus in this infection. Diagnostic laboratory serotyping and clonal complex (CC) analysis has grouped this S. aureusisolate with S. aureus strains that actually are more commonly isolated from patients with respiratory infections. Further simple analysis by PCR has revealed the presence of non-typical virulence factors.

Describe a research plan you would undertake to identify the molecular mechanisms (that is: the surface structures, the metabolic pathways and the stress response pathways) used by this specific S. aureus isolate for its colonization, persistence, and to act as a recurrent cause of DFI disease.

Explanation / Answer

Recurrent Diabetic Foot infection leading to ulcers creates open wounds which can be the perfect gateways for S. aureus to enter the body through blood stream. S. aureus attaches to host tissue surface, overcomes immune components by competing with other commensal microbes. The bacteria also keeps on replicating constantly to maintain its niche and exclude other strains. Thus, mild skin infections are strongly linked to the production of cytolytic toxins, phenol soluble modulins (exfoliative toxins), and facilitate the transmission of S.aureus. Superficial soft tissue infections also provide selective pressure for agr function and toxin production in bacteria promoting colonization.

Bacteria S.aureus can adapt environment pressure to overcome antibiotic therapy and can cause severe skin infections due to enhanced mechanism of transmission, persistence and virulence.

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