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This study aimed to identify risk factors associated with methicillin\u2010resistant\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      (\n                      <jats:italic>S. aureus<\/jats:italic>\n                      ) (MRSA) infections and their epidemiology among patients with diabetic foot ulcers (DFUs).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 211 wound samples were collected from patients with DFUs in five educational hospitals in Tehran during 2017\u20132019. The presence of certain virulence markers (\u03b1\u2010haemolysin (\n                      <jats:italic>hl\u03b1<\/jats:italic>\n                      ), phenol\u2010soluble modulins (\n                      <jats:italic>psm\u03b1<\/jats:italic>\n                      ), accessory gene regulator (\n                      <jats:italic>agr<\/jats:italic>\n                      ), exfoliative toxin A, B (\n                      <jats:italic>eta etb<\/jats:italic>\n                      ) and toxic shock syndrome toxin\u20101 (\n                      <jats:italic>tsst-1<\/jats:italic>\n                      )) was investigated by polymerase chain reaction (PCR), and a multiplex PCR assay was used to screen for staphylococcal cassette chromosome (SCC\n                      <jats:italic>mec<\/jats:italic>\n                      ) types. Antibiotic susceptibility testing (AST) was performed by the Kirby\u2013Bauer disk diffusion method.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A significant proportion of patients with DFUs had Type 2 diabetes. Grading of DFUs revealed that Grade 4 was the most common grade among patients. The majority of patients were infected with\n                      <jats:italic>S. aureus<\/jats:italic>\n                      (45.3%) and\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                      (\n                      <jats:italic>E. coli<\/jats:italic>\n                      ) (29.4%). A total of 59\n                      <jats:italic>S. aureus<\/jats:italic>\n                      isolates were identified, of which 37 (62.7%) were MRSA, and 22 (37.2%) were methicillin\u2010susceptible\n                      <jats:italic>S. aureus<\/jats:italic>\n                      (MSSA). MRSA isolates were mostly positive for the\n                      <jats:italic>hl\u03b1<\/jats:italic>\n                      (57.6%) and\n                      <jats:italic>psm\u03b1<\/jats:italic>\n                      (50.8%) genes. The\n                      <jats:italic>tsst-<\/jats:italic>\n                      1 gene was detected in 8.5% of MRSA strains, while the\n                      <jats:italic>eta<\/jats:italic>\n                      (3.4%) and\n                      <jats:italic>etb<\/jats:italic>\n                      (5.1%) genes had the lowest prevalence in MRSA isolates. According to the results, SCC\n                      <jats:italic>mec<\/jats:italic>\n                      Type III (48.6%) was the most common subtype among MRSA isolates, followed by SCC\n                      <jats:italic>mec<\/jats:italic>\n                      II (16.2%). The antimicrobial susceptibility testing results revealed that linezolid (66.1%), gentamycin (66.1%) and mupirocin (62.7%) were the most effective antibiotics against MRSA isolates, respectively. In contrast, MRSA strains showed the highest resistance to cefoxitin and penicillin. Finally, the risk factors in patients with DFU in this study were diastolic hypertension, cardiovascular diseases, renal failure, neuropathy disease and hospitalization history.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings underscore the critical importance of a comprehensive understanding of patients\u2019 medical records and underlying conditions. In addition, accurate assessment of microbial prevalence and antibiotic susceptibility is essential for the effective management of DFUs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/cjid\/5695498","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T06:27:37Z","timestamp":1776061657000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk Factors Associated With Methicillin\u2010Resistant\n                    <i>Staphylococcus aureus<\/i>\n                    Infections in Patients With Diabetic Foot Ulcers in Tehran"],"prefix":"10.1155","volume":"2026","author":[{"given":"Haniyeh","family":"Khalili","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mona","family":"Mahrooghi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahin","family":"Najar-Peerayeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2016-3512","authenticated-orcid":false,"given":"Shabnam Zeighamy","family":"Alamdary","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hossein Najd","family":"Sepas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7523-7905","authenticated-orcid":false,"given":"Bita","family":"Bakhshi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,12]]},"reference":[{"key":"e_1_2_15_1_2","article-title":"Management of Diabetes Epidemic: Global Perspective","author":"Rao G. 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