Nasal Colonization of Methicillin Resistant Staphylococcus aureus and its Plausibleassociation with Infected Foot Ulcers in Diabetic Patients

Diabetic Foot ulceration is one of the major devastating complication of diabetes. Diabetic foot ulcers (DFUs) infected with multidrug resistant bacterial strains is often associated with prolonged hospital stay, increased treatment cost, significant morbidity and mortality. DFU infected with Methicillin Resistant Staphylococcus aureus (MRSA) if untreated may lead to amputation.

Materials & Method: Type 2 diabetic Subjects (Mean age 56 years)(n=27) with infected foot ulcers were included in his study.After wound debridement, samples were taken from the base of the ulcer using sterile cotton swabs and nasal swabs were also collected from the study subjects and were processed as per standard Microbiological methods.

Results: The overall isolation rate of S. aureus in DFU was 18.5%. Among the S. aureus isolates screened for MRSA, all the isolates from the DFU ulcers (n=4) and those isolated from the nares (n=3) of the diabetic subjects were found to be MRSA.Of note, 3 of the study subjects in whom MRSA was isolated from the DFU samples were found to harbour MRSA in their nares. Nevertheless, allthe isolateswere susceptible to linezolid, netillin, gentamicin and amikacin.No significant statistical difference was observed in the antimicrobial resistance percentage among the DFU and nasal isolates.

Conclusion: Our study results imply that, screening for MRSA colonisation would better predict a patient’s probability of MRSA infection and guide the clinicians in antimicrobial treatment decision making.