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. aureus isolate 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

Finding the chronic wounds, those are colonized by microorganisms is based on the clinical symptoms and diagnostics. The Staphylococcus origin of bacteria is very common in any infections origin, as it is an opportunistic pathogen, they are ubiquitous and they are always present for the respiratory infections. IN case of diabetic patients the foot ulcers and the non-curing nature of it is very common.

Here we will discuss how we can find out the surface structures, the metabolic pathways and the stress response pathways of these type of Staph aureus in DFI. There are two societies named the Infectious Diseases Society of America (IDSA) and the International Working Group on the Diabetic Foot (IWGDF), they have developed research based clinical criteria for classifying the severity of DFI.

In case of DFI with Staph aureus wound healing is hindered by various mechanisms, especially by a low growth factor activity, a reduced cellular proliferation, also there is a high protease level which could be measured by elevated inflammatory markers.

virulence potential of strains in DFI, especially the staphylococcal enterotoxins A, B, C, D, E, G, H, I, J, K, and Q, toxic shock syndrome toxin 1, exfoliative toxins A and B, PVL, LukDE leukocidin, - and two -hemolysins, adhesive matrix molecules, epidermal cell differentiation inhibitor and capsular types 5 and 8 can be determined by multiplex PCR.

Diagnosing metabolic pathways analytical biochemistry detection of nucleotides was performed, this specific method is very useful, which is a process of ion-pairing–liquid chromatography–mass spectrometry. Here we can take the approach of finding out the level of translation and the proteomic analysis to detect the specific proteins and enzymes. Even the pulse based protein extracts are useful identifying specific proteins.  Using software DELTA 2D we can identify the cytoplasmic proteins, which would give us the necessary information.

For stress relate aspects the bacterial species could be diagnosed with the identification of reactive oxygen species (ROI) of that sample. This regulatory response relies on molecular sentinels to detect oxidative stress is cuses because of the oxidative stress, this diagnosis and proper identification would be helpful. Here also need to mention that DNA microarray analysis

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