title: Methicillin-resistant Staphylococcus aureus (MRSA) isolation from diabetic foot ulcers correlates with nasal MRSA carriage.
abstract: Methicillin-resistant Staphylococcus aureus is increasingly isolated from diabetic foot ulcers, and may be associated with an adverse prognosis. We have explored the relationship between MRSA isolation from foot ulcers and nasal MRSA carriage. Over a 12 month period, 65 consecutively attending patients with diabetic foot ulceration were recruited. Demographic information was collected, and the ulcer and nose swabbed bacteriologically using standard techniques. The patients were mean age 61 year, diabetes duration 14 year, and HbA1c 8.5%. There were 61% male and 85% with type 2 diabetes. Ulcers were neuropathic in 55%, ischaemic in 14% and neuroischaemic in 31%. MRSA was isolated from 12 (19%) ulcers, and 11 (17%) had nasal carriage. Of the MRSA positive ulcer patients 7/12 (58%) had nasal MRSA carriage, compared with 4/53 (8%) with MRSA negative ulcers (p<0.0003). We conclude that nasal MRSA carriage in diabetic patients is a significant risk factor for foot ulcer MRSA infection.
authors.affiliation: Department of Diabetes and Endocrinology, University Hospital Aintree, Liverpool L9 1AE, United Kingdom.
authors.forename: Stephen
authors.initials: S
authors.lastname: Stanaway
authors.forename: Deborah
authors.initials: D
authors.lastname: Johnson
authors.forename: Probal
authors.initials: P
authors.lastname: Moulik
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Gill
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003922:Diabetes Mellitus, Type 1 / Q000382:microbiology / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000382:microbiology / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000503:physiopathology; D017719:Diabetic Foot / Q000382:microbiology*; D003929:Diabetic Neuropathies / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D009297:Nasal Mucosa / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*
chemical_list: D006442:Glycated Hemoglobin