Community-associated methicillin-resistant Staphylococcus aureus infection of diabetic foot ulcers in an eastern diabetic foot center in a tertiary hospital in China: a retrospective study
Abstract Background Diabetic foot concerns are a major public health problem. Methicillin-resistant Staphylococcus aureus (MRSA) plays a significant role in diabetic foot ulcers. Community-associated MRSA has become notorious for skin and skin soft tissue infections over the last two decades. This s...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-023-08631-z |
| _version_ | 1797453763458367488 |
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| author | Yixin Chen Jie Yang Ying Wang Jiaxing You Weifen Zhu Chao Liu Yi Luan Lin Li Hong Li |
| author_facet | Yixin Chen Jie Yang Ying Wang Jiaxing You Weifen Zhu Chao Liu Yi Luan Lin Li Hong Li |
| author_sort | Yixin Chen |
| collection | DOAJ |
| description | Abstract Background Diabetic foot concerns are a major public health problem. Methicillin-resistant Staphylococcus aureus (MRSA) plays a significant role in diabetic foot ulcers. Community-associated MRSA has become notorious for skin and skin soft tissue infections over the last two decades. This study investigated MRSA infection in diabetic foot patients at a tertiary hospital, focusing on the epidemiology and characteristics of community-associated MRSA. Methods A total of 149 patients with diabetic foot infection whose culture results indicated Staphylococcus aureus as the source were selected. Epidemiological investigations, clinical characteristics, laboratory index records, antibiotic susceptibility analysis, and clinical outcome tracking were performed in all cases. Based on oxacillin resistance using the Vitek Compact 2 system, cases were divided into methicillin-sensitive Staphylococcus aureus and MRSA groups. Subgroup analysis of the MRSA group was performed in accordance with the Centers for Disease Control definition: community-associated MRSA and hospital-associated MRSA. Results The MRSA group (n = 41, 27.5%) had a longer duration of ulcers and hospital stay and higher hospitalization costs than the methicillin-sensitive Staphylococcus aureus group (n = 108, 72.5%). According to the classification criteria of Infectious Diseases Society of America, the severity of infection in the community-associated MRSA group was higher than that in the hospital-associated MRSA group. The analysis of antimicrobial susceptibility of 41 MRSA isolates showed that the resistance rates to erythromycin, clindamycin, quinolone, gentamicin, tetracycline, and rifampicin were 78.0%, 68.3%, 31.7%, 17.1%, 9.8%, and 2.4%, respectively. All the MRSA strains were sensitive to linezolid, tigecycline, and vancomycin. The resistance rates to quinolones and gentamycin in the community-associated MRSA group (both 0%) were lower than those in the hospital-associated MRSA group. Conclusion Emergence of MRSA in diabetic foot ulcer was associated with a prolonged wound duration and increased consumption of medical resources. Community-associated MRSA strains predominated among MRSA isolates from diabetic foot wounds and caused more severe infections. |
| first_indexed | 2024-03-09T15:27:33Z |
| format | Article |
| id | doaj.art-b795ee2f1479415d8b2b48b3235fe4d1 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-03-09T15:27:33Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-b795ee2f1479415d8b2b48b3235fe4d12023-11-26T12:27:01ZengBMCBMC Infectious Diseases1471-23342023-10-012311910.1186/s12879-023-08631-zCommunity-associated methicillin-resistant Staphylococcus aureus infection of diabetic foot ulcers in an eastern diabetic foot center in a tertiary hospital in China: a retrospective studyYixin Chen0Jie Yang1Ying Wang2Jiaxing You3Weifen Zhu4Chao Liu5Yi Luan6Lin Li7Hong Li8Department of Endocrinology, Zhejiang University School of Medicine Sir Run Run Shaw HospitalDepartment of Orthopedics, Zhejiang University School of Medicine Sir Run Run Shaw HospitalWound and Ostomy Care Clinic, Zhejiang University School of Medicine Sir Run Run Shaw HospitalDepartment of Orthopedics, Zhejiang University School of Medicine Sir Run Run Shaw HospitalDepartment of Endocrinology, Zhejiang University School of Medicine Sir Run Run Shaw HospitalDepartment of Orthopedics, Zhejiang University School of Medicine Sir Run Run Shaw HospitalDepartment of Cardiology, Zhejiang University School of Medicine Sir Run Run Shaw HospitalDepartment of Endocrinology, Zhejiang University School of Medicine Sir Run Run Shaw HospitalDepartment of Endocrinology, Zhejiang University School of Medicine Sir Run Run Shaw HospitalAbstract Background Diabetic foot concerns are a major public health problem. Methicillin-resistant Staphylococcus aureus (MRSA) plays a significant role in diabetic foot ulcers. Community-associated MRSA has become notorious for skin and skin soft tissue infections over the last two decades. This study investigated MRSA infection in diabetic foot patients at a tertiary hospital, focusing on the epidemiology and characteristics of community-associated MRSA. Methods A total of 149 patients with diabetic foot infection whose culture results indicated Staphylococcus aureus as the source were selected. Epidemiological investigations, clinical characteristics, laboratory index records, antibiotic susceptibility analysis, and clinical outcome tracking were performed in all cases. Based on oxacillin resistance using the Vitek Compact 2 system, cases were divided into methicillin-sensitive Staphylococcus aureus and MRSA groups. Subgroup analysis of the MRSA group was performed in accordance with the Centers for Disease Control definition: community-associated MRSA and hospital-associated MRSA. Results The MRSA group (n = 41, 27.5%) had a longer duration of ulcers and hospital stay and higher hospitalization costs than the methicillin-sensitive Staphylococcus aureus group (n = 108, 72.5%). According to the classification criteria of Infectious Diseases Society of America, the severity of infection in the community-associated MRSA group was higher than that in the hospital-associated MRSA group. The analysis of antimicrobial susceptibility of 41 MRSA isolates showed that the resistance rates to erythromycin, clindamycin, quinolone, gentamicin, tetracycline, and rifampicin were 78.0%, 68.3%, 31.7%, 17.1%, 9.8%, and 2.4%, respectively. All the MRSA strains were sensitive to linezolid, tigecycline, and vancomycin. The resistance rates to quinolones and gentamycin in the community-associated MRSA group (both 0%) were lower than those in the hospital-associated MRSA group. Conclusion Emergence of MRSA in diabetic foot ulcer was associated with a prolonged wound duration and increased consumption of medical resources. Community-associated MRSA strains predominated among MRSA isolates from diabetic foot wounds and caused more severe infections.https://doi.org/10.1186/s12879-023-08631-zCommunity-associated methicillin-resistant Staphylococcus aureusDiabetic foot ulcerAnti-microbial susceptibility pattern |
| spellingShingle | Yixin Chen Jie Yang Ying Wang Jiaxing You Weifen Zhu Chao Liu Yi Luan Lin Li Hong Li Community-associated methicillin-resistant Staphylococcus aureus infection of diabetic foot ulcers in an eastern diabetic foot center in a tertiary hospital in China: a retrospective study BMC Infectious Diseases Community-associated methicillin-resistant Staphylococcus aureus Diabetic foot ulcer Anti-microbial susceptibility pattern |
| title | Community-associated methicillin-resistant Staphylococcus aureus infection of diabetic foot ulcers in an eastern diabetic foot center in a tertiary hospital in China: a retrospective study |
| title_full | Community-associated methicillin-resistant Staphylococcus aureus infection of diabetic foot ulcers in an eastern diabetic foot center in a tertiary hospital in China: a retrospective study |
| title_fullStr | Community-associated methicillin-resistant Staphylococcus aureus infection of diabetic foot ulcers in an eastern diabetic foot center in a tertiary hospital in China: a retrospective study |
| title_full_unstemmed | Community-associated methicillin-resistant Staphylococcus aureus infection of diabetic foot ulcers in an eastern diabetic foot center in a tertiary hospital in China: a retrospective study |
| title_short | Community-associated methicillin-resistant Staphylococcus aureus infection of diabetic foot ulcers in an eastern diabetic foot center in a tertiary hospital in China: a retrospective study |
| title_sort | community associated methicillin resistant staphylococcus aureus infection of diabetic foot ulcers in an eastern diabetic foot center in a tertiary hospital in china a retrospective study |
| topic | Community-associated methicillin-resistant Staphylococcus aureus Diabetic foot ulcer Anti-microbial susceptibility pattern |
| url | https://doi.org/10.1186/s12879-023-08631-z |
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