The prevalence of methicillin-resistant Staphylococcus aureus among diabetic patients: a meta-analysis

Abstract

Aims Diabetic patients have multiple risk factors for colonisation with methicillin-resistant Staphylococcus aureus (MRSA), a nosocomial pathogen associated with significant morbidity and mortality. This meta-analysis was conducted to estimate the prevalence of MRSA among diabetic patients. Methods The MEDLINE, Embase, BIOSIS, and Web of Science databases were searched for studies published up to May 2018 that reported primary data on the prevalence of MRSA in 10 or more diabetic patients. Two authors independently assessed study eligibility and extracted the data. The main outcomes were the pooled prevalence rates of MRSA colonisation and infection among diabetic populations. Results Eligible data sets were divided into three groups containing data about the prevalence of MRSA colonisation or in diabetic foot or other infections. From 23 data sets, the prevalence of MRSA colonisation among 11577 diabetics was 9.20% (95% CI, 6.26–12.63%). Comparison of data from 14 studies that examined diabetic and non-diabetic patients found that diabetics had a 4.75% greater colonisation rate ( P < 0.0001). From 41 data sets, the prevalence of MRSA in 10994 diabetic foot infection patients was 16.78% (95% CI, 13.21–20.68%). Among 2147 non-foot skin and soft-tissue infections, the MRSA prevalence rate was 18.03% (95% CI, 6.64–33.41). Conclusions The prevalence of MRSA colonisation among diabetic patients is often higher than among non-diabetics; this may make targeted screening attractive. In the UK, many diabetic patients may already be covered by the current screening policies. The prevalence and impact of MRSA among diabetic healthcare workers requires further research. The high prevalence of MRSA among diabetic foot infections may have implications for antimicrobial resistance, and should encourage strategies aimed at infection prevention or alternative therapies. Electronic supplementary material The online version of this article (10.1007/s00592-019-01301-0) contains supplementary material, which is available to authorized users.

A retrospective analysis of the microbiology of diabetic foot infections at a Scottish tertiary hospital

“…Antimicrobial resistance is a common finding in DFIs, with meta-analyses estimating the global prevalence of methicillin-resistant S. aureus in DFIs to be 15-30% [8,9]. Previous studies in the UK have reported higher rates, ranging from 19.9 to 57.9% [16][17][18][19].…”

“…The microorganisms most commonly isolated from DFIs are aerobic Gram positive bacteria, predominantly Staphylococci [7,8]. The prevalence of methicillin resistant Staphylococcus aureus (MRSA) in DFIs is considered to be 15-30% [8,9]. Other bacterial genera commonly found in DFIs include Streptococci, Enterococci, Enterobacteriaceae, and Pseudomonas [3].…”

Methicillin-Resistant Staphylococcus aureus Diabetic Foot Crossed Infection: A Case Report

“…These infections are favored when there are abnormalities in defense mechanisms, when the patients have a chronic disease such as DM, and also when there are interruptions in the continuity of skin, such as ulcers [ 11 , 19 , 20 ]. Diabetic patients have multiple risk factors for colonization with methicillin-resistant Staphylococcus aureus (MRSA), a nosocomial pathogen associated with significant morbidity and mortality rates [ 7 , 10 ].…”

“…Approximately 15–30% of the human population is colonized with Staphylococcus aureus [ 9 ]. Nevertheless, according to the meta-analysis by Stacey et al patients with diabetes have a 4.75% higher colonization rate than non-diabetic people [ 10 ]. Importantly, this bacterium causes a wide range of clinical infections (e.g., bacteremia, endocarditis, skin and soft tissue, osteoarticular, pulmonary, and device-related infections).…”

“…Importantly, this bacterium causes a wide range of clinical infections (e.g., bacteremia, endocarditis, skin and soft tissue, osteoarticular, pulmonary, and device-related infections). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in DFI is 16.78% [ 10 ]. However, subsequent studies have reported higher rates in accordance with geographic variables [ 6 , 7 , 9 ].…”