Are diabetic foot ulcers complicated by MRSA osteomyelitis associated with worse prognosis? Outcomes of a surgical series.
OBJECTIVE
The aim of this study was to compare the outcomes of surgical treatment of osteomyelitis caused by methicillin-resistant Staphylococcus aureus (MRSA) with cases caused by methicillin-sensitive Staphylococcus aureus (MSSA).


METHODS
We abstracted data of a series of 185 consecutive patients with diabetes and foot osteomyelitis undergoing surgery within the first 12 h after admission at a single hospital. Bone infection was confirmed by histopathological studies. Only cases where Staphylococcus aureus was isolated from bone specimens were included in this analysis. We analysed several variables between the two groups: MRSA vs. MSSA.


RESULTS
MRSA bone infection was associated with higher body temperature (P = 0.02) and white blood cell count (P = 0.02) than MSSA. Patients with MRSA infections underwent a greater number of surgical procedures (P = 0.03). Limb salvage was achieved in 93.6% of the patients, with no statistically significant difference in limb salvage rates between MRSA and MSSA-related osteomyelitis.


CONCLUSIONS
From our experience, where treatment is based on early and aggressive surgical treatment, MRSA bone infections are not associated with worse prognosis.
Aragón-Sánchez
J
J
Diabetic Foot Unit, La Paloma Hospital, Las Palmas de Gran Canaria, Canary Islands, Spain. javiaragon@telefonica.net
Lázaro-Martínez
J L
JL
Quintana-Marrero
Y
Y
Hernández-Herrero
M J
MJ
García-Morales
E
E
Cabrera-Galván
J J
JJ
Beneit-Montesinos
J V
JV
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017719:Diabetic Foot / Q000382:microbiology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D010019:Osteomyelitis / Q000150:complications* / Q000382:microbiology / Q000601:surgery; D013203:Staphylococcal Infections / Q000150:complications*; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D016896:Treatment Outcome