title: Prevalence and risk factors for methicillin-resistant Staphylococcus aureus colonization in a diabetic outpatient population: a prospective cohort study.
abstract: BACKGROUND
  Diabetes mellitus is a risk factor for methicillin-resistant Staphylococcus aureus (MRSA) colonization and infection. We attempted to determine the prevalence and risk factors for MRSA colonization in a population of outpatients with diabetes.
  
  
  METHODS
  This prospective cohort study enrolled patients with diabetes. Anterior nares cultures were obtained from patients with diabetes admitted to outpatient endocrinology and metabolism clinics, and risk factors for MRSA colonization were analyzed.
  
  
  RESULTS
  Out of the 304 patients evaluated, 127 (41.9%) were colonized with S aureus and 30 (9.9%) were colonized with MRSA. Overall, 23.6% of all S aureus isolates were MRSA. In multivariate analysis, factors independently associated with an increased risk of MRSA colonization included the presence of connective tissue disease (odds ratio, 7.075; 95% confidence interval, 2.157-23.209; P = .001) and insulin therapy (odds ratio, 3.910; 95% confidence interval, 1.652-9.251; P = .002).
  
  
  CONCLUSIONS
  The prevalence of MRSA colonization in our sample of diabetic outpatients was 9.9%. Independent risk factors for MRSA colonization were the presence of connective tissue disease and insulin use. A better understanding of the epidemiology and risk factors for nasal MRSA colonization in the persons with diabetes may have significant implications for the treatment and prevention of MRSA infections.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey. sayinkutlu@yahoo.com
authors.forename: Selda Sayin
authors.initials: SS
authors.lastname: Kutlu
authors.forename: Nural
authors.initials: N
authors.lastname: Cevahir
authors.forename: Serife
authors.initials: S
authors.lastname: Akalin
authors.forename: Fulya
authors.initials: F
authors.lastname: Akin
authors.forename: Selmin
authors.initials: S
authors.lastname: Dirgen Caylak
authors.forename: Mehmet
authors.initials: M
authors.lastname: Bastemir
authors.forename: Koray
authors.initials: K
authors.lastname: Tekin
mesh_terms: D000328:Adult; D000368:Aged; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D015331:Cohort Studies; D048909:Diabetes Complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D009666:Nose / Q000382:microbiology; D010045:Outpatients; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology