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8%) strains. DNA array analysis revealed that 12.9% (n??1) of isolates were edinB positive. In ten strains, edin-B and etD genes were found to be associated. Genes encoding PVL were detected in 11 MRSA isolates (15%) and in one MSSA isolate (8.3%). All these strains belonged to the CC80-MRSA (European community MRSA Clone). A 6-month follow-up of the patients harbouring these strains demonstrated that all of them had a poor outcome (amputations). This study highlighted the extremely high rate of MDRO (58.5%) in DFI from Algerian patients. The prevalence of MDRO was especially striking for S.�aureus (85.9% of MRSA among staphylococci), Klebsiella pneumonia (83.8%) and Escherichia coli (60%). This PF-06463922 molecular weight burden of resistance might be directly associated with DFI because a national survey highlighted that the MRSA rate is 35% in Algeria, increasing Bafilomycin A1 in vitro to 40.7% for hospitalized patients (www.sante.dz/aarn/documents/pdf/rapport11.pdf). The same trend was found for K. pneumoniae (52.5% were resistant to cefotaxime) and E.?coli (13.4%). Another surprising feature was the predominance of Gram-positive cocci as S.?aureus is considered to be the most frequently isolated and virulent pathogen in DFI from western countries [15-17]. However, some recent studies have shown that Gram-negative organisms are the most frequent isolates in DFI from patients living in warm climates, especially in India [18-20]. As noted by Lipsky et?al. [4], there is no clear explanation for this predominance. The increasing prevalence of antibiotic-resistant bacteria in DFUs, particularly MRSA, both as colonizers or pathogens [6-8], is problematic. MRSA has emerged as a serious and commonly occurring problem in diabetic patients with foot ulcers [5, 7]. MRSA requires targeted antibiotic treatment and has been associated with a poor outcome in many reports [9, 10, 21]. In this study, we focused for the first time on S.?aureus isolated from DFIs in Annaba University Hospital (Algeria). Even though Gram-negative bacilli as a group were the most prevalent bacteria isolated in our study, FMO5 S.?aureus was the most common isolate (Table?1), accounting for 30.7% of all microorganisms, and 85.9% of S.?aureus were methicillin resistant, in agreement with other studies [5, 15, 17, 22, 23]. However, the rate of methicillin resistance is particularly high, ranging from 15 to 30% around the world [24]. While the MRSA prevalence rate is clearly high in Annaba Hospital (62.5% of all S.?aureus isolated in 2011 were MRSA), it is significantly lower than in strains isolated from DFIs (p?