{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T16:16:03Z","timestamp":1789229763119,"version":"build-2803163510"},"reference-count":107,"publisher":"Microbiology Society","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,4]]},"abstract":"<jats:p>\n                  <jats:bold>Background.<\/jats:bold>\n                  <jats:italic>Pseudomonas aeruginosa<\/jats:italic> is an invasive organism that frequently causes severe tissue damage in diabetic foot ulcers.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Gap statement.<\/jats:bold> The characterisation of P. aeruginosa strains isolated from diabetic foot infections has not been carried out in Tunisia.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Purpose.<\/jats:bold> The aim was to determine the prevalence of <jats:italic>P. aeruginosa<\/jats:italic> isolated from patients with diabetic foot infections (DFIs) in Tunisia and to characterize their resistance, virulence and molecular typing.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Methods.<\/jats:bold> Patients with DFIs admitted to the diabetes department of the International Hospital Centre of Tunisia, from September 2019 to April 2021, were included in this prospective study. <jats:italic>P. aeruginosa<\/jats:italic> were obtained from the wound swabs, aspiration and soft tissue biopsies during routine clinical care and were confirmed by matrix-assisted laser desorption\/ionization time-of-flight mass spectrometry. Antimicrobial susceptibility testing, serotyping, integron and OprD characterization, virulence, biofilm production, pigment quantification, elastase activity and molecular typing were analysed in all recovered <jats:italic>P. aeruginosa<\/jats:italic> isolates by phenotypic tests, specific PCRs, sequencing, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Results.<\/jats:bold> Sixteen <jats:italic>P. aeruginosa<\/jats:italic> isolates (16.3\u200a%) were recovered from 98\u2009samples of 78 diabetic patients and were classified into 6 serotypes (O:11 the most frequent), 11 different PFGE patterns and 10 sequence types (three of them new ones). The high-risk clone ST235 was found in two isolates. The highest resistance percentages were observed to netilmicin (69\u200a%) and cefepime (43.8\u200a%). Four multidrug-resistant (MDR) isolates (25\u200a%) were detected, three of them being carbapenem-resistant. The ST235-MDR strain harboured the In51 class 1 integron (<jats:italic>intI1 +aadA6+orfD+qacED1-sul1<\/jats:italic>). According to the detection of 14 genes involved in virulence or quorum sensing, 5 virulotypes were observed, including 5 <jats:italic>exoU<\/jats:italic>-positive, 9 <jats:italic>exoS<\/jats:italic>-positive and 2 <jats:italic>exoU\/exoS<\/jats:italic>-positive strains. The <jats:italic>lasR<\/jats:italic> gene was truncated by IS<jats:italic>Ppu21<\/jats:italic> insertion sequence in one isolate, and a deletion of 64\u2009bp in the <jats:italic>rhlR<\/jats:italic> gene was detected in the ST235-MDR strain. Low biofilm, pyoverdine and elastase production were detected in all <jats:italic>P. aeruginosa<\/jats:italic>; however, the <jats:italic>lasR<\/jats:italic>-truncated strain showed a chronic infection phenotype characterized by loss of serotype-specific antigenicity, high production of phenazines and high biofilm formation.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Conclusions.<\/jats:bold> Our study demonstrated for the first time the prevalence and the molecular characterization of <jats:italic>P. aeruginosa<\/jats:italic> strains from DFIs in Tunisia, showing a high genetic diversity, moderate antimicrobial resistance, but a high number of virulence-related traits, highlighting their pathological importance.<\/jats:p>","DOI":"10.1099\/jmm.0.001851","type":"journal-article","created":{"date-parts":[[2024,7,4]],"date-time":"2024-07-04T15:17:26Z","timestamp":1720106246000},"source":"Crossref","is-referenced-by-count":4,"title":["Molecular characterization of 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