title: Link between nasal carriage of Staphylococcus aureus and infected diabetic foot ulcers.
abstract: OBJECTIVE
  Nasal carriage of Staphylococcus aureus in diabetic patients may be a risk factor for diabetic foot lesion infections. The aims of this study were to compare the genotypic profiles of S. aureus strains isolated from nares and diabetic foot ulcers (DFUs) using microarray technology.
  
  
  METHODS
  Patients were included if they were admitted for diabetic foot infection (DFI) at any of three diabetology departments of Montpellier and Nîmes University Hospitals between 1 September 2010 to 30 June 2012. All S. aureus isolates were analyzed using oligonucleotides arrays; S. aureus resistance and virulence genes were determined and each isolate was affiliated to a clonal complex.
  
  
  RESULTS
  The prevalence of S. aureus nasal carriage among the 276 included patients was 39.5% (n=109), while 36.6% (n=101) had S. aureus at both sites (nares and foot wounds) and, of these patients, 65.3% of patients harboured the same strain at both sites. In addition, the spread of the methicillin-resistant S. aureus (MRSA) ST398 clone in DFI and its tropism for bone were also further confirmed.
  
  
  CONCLUSIONS
  These findings appear to provide new arguments in favour of the systematic detection of nasal S. aureus carriage to anticipate the management of DFI.
authors.affiliation: U1047, National Institute of Health and Medical Research, Montpellier University, Faculty of Medicine, 30908 Nîmes cedex 02, France; Department of Microbiology, University Hospital Carémeau, 30029 Nîmes cedex 9, France.
authors.forename: C
authors.initials: C
authors.lastname: Dunyach-Remy
authors.affiliation: Department of Microbiology, University Hospital Carémeau, 30029 Nîmes cedex 9, France.
authors.forename: C
authors.initials: C
authors.lastname: Courtais-Coulon
authors.affiliation: Department of Biostatistics, Epidemiology, Public Health and Medical Information, University Hospital Carémeau, 30029 Nîmes cedex 9, France.
authors.forename: C
authors.initials: C
authors.lastname: DeMattei
authors.affiliation: Department of Endocrinology, University Hospital Carémeau, 30029 Nîmes cedex 9, France.
authors.forename: N
authors.initials: N
authors.lastname: Jourdan
authors.affiliation: Department of Diabetology, University Hospital Nîmes, 30240 Le Grau du Roi, France.
authors.forename: S
authors.initials: S
authors.lastname: Schuldiner
authors.affiliation: Department of Endocrinology, University Hospital Lapeyronie, 34295 Montpellier cedex 5, France.
authors.forename: A
authors.initials: A
authors.lastname: Sultan
authors.affiliation: Department of Bacteriology, University Hospital Arnaud de Villeneuve, 34295 Montpellier cedex 5, France.
authors.forename: C
authors.initials: C
authors.lastname: Carrière
authors.affiliation: Department of Biostatistics, Epidemiology, Public Health and Medical Information, University Hospital Carémeau, 30029 Nîmes cedex 9, France.
authors.forename: S
authors.initials: S
authors.lastname: Alonso
authors.affiliation: U1047, National Institute of Health and Medical Research, Montpellier University, Faculty of Medicine, 30908 Nîmes cedex 02, France; Department of Infectious Diseases, Nîmes University Hospital Caremeau, 30029 Nîmes cedex 9, France.
authors.forename: A
authors.initials: A
authors.lastname: Sotto
authors.affiliation: U1047, National Institute of Health and Medical Research, Montpellier University, Faculty of Medicine, 30908 Nîmes cedex 02, France; Department of Microbiology, University Hospital Carémeau, 30029 Nîmes cedex 9, France. Electronic address: jean.philippe.lavigne@chu-nimes.fr.
authors.forename: J-P
authors.initials: JP
authors.lastname: Lavigne
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017719:Diabetic Foot / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D055815:Young Adult
keywords: Clonal complexes; Diabetic foot ulcer; Infection; Nasal carriage; Oligonucleotide array; Staphylococcus aureus