## 4 Discussion  
An increase in morbidity and death is associated with DFI when blood sugar is uncontrolled and poor self-care is performed [2,38]. Diabetic foot infection (DFI) is caused by one or more bacteria and is one of the most notable consequences of diabetes, according to [PERSON] et al. [1] and [PERSON] et al. [3]. Acute DFI is caused by Gram-positive cocc that live in an aerobic environment, such as _S. aureus_. Diabetic foot ulcers (DFUs) are commonly caused by _S. aureus_. In diabetic foot infection, _S. aureus_ is an important pathogen, either alone or as part of an integrated infection [39]. MRSA infection is becoming more common in both hospitals and the population [40, 41, 42]. In diabetic patients, swabs taken from foot ulcers are usually infected with MRSA [43,44]. Based on the results obtained in the current study, out of 250 patients with DM (type II), 48 (19.2%) _S. aureus_ isolates were isolated; 26/250 (10.4%) were classified as MSSA isolates and 22/250 (8.8%) as MRSA isolates. _S. aureus_ is the predominant causal bacterium in diabetic foot ulcers, according to multiple studies, and [PERSON] et al. [2] found _S. aureus_ in 38.7% of patients suffering from DFIs. A high incidence of Gram-positive bacteria has been seen in DFI in numerous studies [45,46]. _S. aureus_ is the most common cause of skin infections in particular, and is actually a normal skin flora. There has been evidence of Gram-negative microorganisms, Enterobacteriaceae such as _E. coli_, _Proteus_ species, and anaerobes in other research [47,48]. \begin{table}
\begin{tabular}{c c c c c c c c c c c c c} \hline \hline \multirow{2}{*}{**Antimicrobial Agent**} & \multicolumn{3}{c}{**No. of Isolates**} & \multicolumn{3}{c}{**Essential**} & \multicolumn{3}{c}{**Categorical**} & \multirow{2}{*}{**Very Major Error**} & \multirow{2}{*}{**Major Error**} & \multirow{2}{*}{**Minor Error**} \\ \cline{2-2} \cline{4-2}  
Among the four bacteria evaluated by [PERSON] et al. [49], _S. aureus_ accounted for 42%, followed by _Escherichia coli_ (36%) and coagulase-negative _S. aureus_ (25%), and _Pseudomonas aeruginosa_ and _Klebsiella pneumonia_ each accounted for 7%. Additionally, MRSA's presence in 6% of _S. aureus_ isolates and its representation of 31.6% of them is reason for concern, considering the pathogen's clinical relevance. This incidence is lower than the 15-30% rate commonly used to describe MRSA in DFUs [50], which may be explained by the low prevalence of MRSA in the country [51; 52; 53]. Several alternative MRSA investigative techniques have been established, including selective chromogenic media, PCR tests, and, more recently, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) [54; 55]. MRSA identification can be divided into two main categories: performance/efficacy criteria and convenience/efficiency requirements. High performance and efficacy are benefits of PCR, and qPCR techniques take only a few hours [56; 57]. MALDI-TOF MS, on the other hand, has the possibility to be an effective and easy type of screening test for MRSA characterization, because it is already regularly used in several microbiology laboratories; undoubtedly, the discovery of resistance to antibiotics using MALDI-TOF MS is receiving more and more attention [55]. The MALDI-TOF MS approach for identifying microorganisms mainly depends on the analysis of mass spectra that indicate particular molecular fingerprints of microbes, typically proteins [13]. The mass spectrum profile (MSP), a collection of signals utilized for the detection of _S. aureus_, is mostly composed of conserved ribosomal proteins, which represent approximately 50% of the total number of signals [58]. The high percentage of cellular proteins suggested that _S. aureus_ identification was very repeatable and reliable, as evidenced by the score values seen in our investigations. In this investigation, the MALDI-TOF MS methodology validated higher scores (\(\geq\)2.0) for _Staphylococcus_ spp.