Molecular epidemiology of diabetic foot ulcers

Abstract Introduction/Objective The study accessed the prevalence of Escherichia coli in diabetic diabetic foot infection(DFI) and diabetic foot osteomyelitis(DFOM).A single retrospective single centre was conducted on patients diagnosed with E.coli isolated from deep DFI and DFOM at Komfo Anokye Teaching Hospital over 2 year period. Methods/Case Report Phylogenetic backgrounds,virulence factors(VFs) and antibiotic resistance profiles were determined.Whole genome analysis of E.coli strains isolated from same periods were performed. From two years study period,35 E.coli strains isolated from 33 patients were analysed,73% were isolated from DFOM Results (if a Case Study enter NA) The majority of the strains belonged to the virulent B2 and D phylogenetic groups(82%).These isolates exhibited a significant higher average of VFs number greater than strains belonging to the other groups (p<0.0001).papG2 gene was significantly more detected in strains belonging to B2 phylogeny isolated from DFI compared to DFOM(p=0.003) The most prevalent antibiotic resistance pattern was observed for ampicillin(82%)cotrimoxazole(45%) and ciprofloxacin (33%).The genome analysis of strains isolated at two periods in DFOM showed a decrease of the genome size and this decrease was more important for the strains isolated at 9 months(versus 4 months) Conclusion Shared mutation on the putative acy-CoA dehydrogenase-encoding gene aidB was observed on both strains. E.coli isolated from DFOM werA shared highly genetically diverse with different pathogenicity traits.Their adaptation on the bone structure could require genome reduction and some important modifications in the balance virulence and resistance of the bacteria