Link between nasal carriage of Staphylococcus aureus and infected diabetic foot ulcers - 31/03/17

Doi : 10.1016/j.diabet.2016.09.003

C. Dunyach-Remy ^a,^b, C. Courtais-Coulon ^b, C. DeMattei ^c, N. Jourdan ^d, S. Schuldiner ^e, A. Sultan ^f, C. Carrière ^g, S. Alonso ^c, A. Sotto ^a,^h, J.-P. Lavigne ^a,^b,^⁎
^a U1047, National Institute of Health and Medical Research, Montpellier University, Faculty of Medicine, 30908 Nîmes cedex 02, France
^b Department of Microbiology, University Hospital Carémeau, 30029 Nîmes cedex 9, France
^c Department of Biostatistics, Epidemiology, Public Health and Medical Information, University Hospital Carémeau, 30029 Nîmes cedex 9, France
^d Department of Endocrinology, University Hospital Carémeau, 30029 Nîmes cedex 9, France
^e Department of Diabetology, University Hospital Nîmes, 30240 Le Grau du Roi, France
^f Department of Endocrinology, University Hospital Lapeyronie, 34295 Montpellier cedex 5, France
^g Department of Bacteriology, University Hospital Arnaud de Villeneuve, 34295 Montpellier cedex 5, France
^h Department of Infectious Diseases, Nîmes University Hospital Caremeau, 30029 Nîmes cedex 9, France

^⁎Corresponding author. Department of Microbiology, University Hospital of Caremeau, Place of Professor-Robert-Debré, 30029 Nîmes cedex 09, France. Tel.: +33 4 66 68 32 02; fax: +33 4 66 68 42 54.

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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.

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

Abbreviations : CC, DFI, DFU, IDSA, IWGDF, MRSA, NPV, PPV

Plan

Introduction

Materials and methods

Study design

Microbiology methods

Oligonucleotide DNA arrays and genotyping

Statistical analysis

Results

Study population and microbiological characteristics

Nasal carriage of S. aureus

Link between S. aureus isolated from nares and DFUs

Resistance and virulence profiles

Discussion

Contribution statement

Funding

Disclosure of interest

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Vol 43 - N° 2

P. 167-171 - avril 2017 Retour au numéro

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Link between nasal carriage of Staphylococcus aureus and infected diabetic foot ulcers - 31/03/17

Abstract

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Methods

Results

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