Link between nasal carriage of Staphylococcus aureus and infected diabetic foot ulcers

Diabetes Metab. 2017 Apr;43(2):167-171. doi: 10.1016/j.diabet.2016.09.003. Epub 2016 Oct 5.

Abstract

Aims: 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.

Conclusion: These findings appear to provide new arguments in favour of the systematic detection of nasal S. aureus carriage to anticipate the management of DFI.

Keywords: Clonal complexes; Diabetic foot ulcer; Infection; Nasal carriage; Oligonucleotide array; Staphylococcus aureus.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Diabetic Foot / microbiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nose / microbiology*
  • Staphylococcal Infections / microbiology*
  • Staphylococcus aureus / isolation & purification*
  • Young Adult