scholarly journals Risk factors for methicillin-resistant Staphylococcus aureus in diabetic foot infections

2014 ◽  
Vol 5 (1) ◽  
pp. 23575 ◽  
Author(s):  
Lawrence A. Lavery ◽  
Javier La Fontaine ◽  
Kavita Bhavan ◽  
Paul J. Kim ◽  
Jayme R. Williams ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistant ◽  
Diabetic Foot Infections

scholarly journals Diabetic Foot Infections: Local Prevalence of and Case–Control Study of Risk Factors for Methicillin-Resistant Staphylococcus aureus and Pseudomonas aeruginosa

2020 ◽  
Vol 7 (10) ◽  
Author(s):  
Justin J Kim ◽  
Alison Lydecker ◽  
Rohini Davé ◽  
Jacqueline T Bork ◽  
Mary-Claire Roghmann
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Diabetic Foot ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Case Control Study ◽  
Case Control ◽  
Methicillin Resistant ◽  
Diabetic Foot Infections ◽  
Control Study

Abstract We identified deep diabetic foot infections by culture and conducted a case–control study examining the risk factors for moderate to severe methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PsA) diabetic foot infections. Our MRSA prevalence was lower than literature values; PsA was higher. Gangrene may be predictive of Pseudomonas infection.

scholarly journals Risk factors for methicillin-resistant Staphylococcus aureus and extended-spectrum ß-lactamase producing Enterobacterales in patients with diabetic foot infections requiring hospital admission

2020 ◽  
Vol 33 (6) ◽  
pp. 430-435
Author(s):  
Victoria García Zafra ◽  
Alicia Hernández Torres ◽  
Elisa García Vázquez ◽  
Teresa Soria Cogollos ◽  
Manuel Canteras Jordana ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Prospective Observational Study ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistant ◽  
E Coli ◽  
Diabetic Foot Infections ◽  
Extended Spectrum ◽  
Esbl Producers

Purpose. Methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) may complicate the treatment of diabetic foot infections (DFIs). The aim of this study was to determine the risk factors for these pathogens in DFIs. Material and methods. This was a prospective observational study of 167 consecutive adult patients with DFIs. The diagnosis and severity of DFIs were based on the Infectious Disease Society of America (IDSA) classification system. Multivariate analyses were performed in order to identify risk factors for MRSA and ESBL-E infections. Results. S. aureus was the most isolated pathogen (n=82, 37.9 %) followed by Escherichia coli (n= 40, 18.5%). MRSA accounted for 57.3% of all S. aureus and 70% of Klebsiella pneumoniae and 25% of E. coli were ESBL producers, respectively. Deep ulcer [OR 8,563; 95% CI (1,068-4,727)], previous use of fluoroquinolones [OR 2,78; 95% CI (1,156-6,685)] and peripheral vasculopathy [OR 2,47; 95% CI (1.068-4.727)] were the independent predictors for MRSA infections; and osteomyelitis [OR 6,351; 95% CI (1,609-25,068)] and previous use of cephalosporins [OR 5,824; 95% CI (1,517-22,361)] for ESBL-E infections. Conclusions. MRSA and ESBL-E have adquired a great clinical relevance in DFIs. The availability of their risk factors is very convenient to choose the empirical treatment in severe forms.

Daptomycin for Methicillin-Resistant Staphylococcus aureus Diabetic Foot Infections

2014 ◽  
Vol 104 (2) ◽  
pp. 159-168 ◽  
Author(s):  
Warren S. Joseph ◽  
Thomas Quast ◽  
Alberto Cogo ◽  
Monica G. Crompton ◽  
Min Jung Yoon ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Clinical Success ◽  
Initial Therapy ◽  
Antibiotic Agent ◽  
Negative Effects ◽  
Methicillin Resistant ◽  
Diabetic Foot Infections ◽  
Antibiotic Drug

Background Diabetic foot infection (DFI) is a serious, difficult-to-treat infection, especially when caused by methicillin-resistant Staphylococcus aureus (MRSA). Vancomycin has been the standard treatment for MRSA infection, but lower response rates in MRSA skin infections have been reported. This analysis assessed the outcome and safety of daptomycin therapy in patients with a DFI caused by MRSA. Methods Using the Cubicin Outcomes Registry and Experience and the European Cubicin Outcomes Registry and Experience (2006–2009), 79 patients with MRSA DFI were identified and included in this analysis. Results In the 74 evaluable patients, daptomycin was administered at a median dose of 4.8 mg/kg primarily every 24 hours (85.1%) and for a median of 15.0 days. Overall, 77.0% of the patients (57 of 74) received initial therapy with activity against MRSA; however, of patients receiving daptomycin as second-line therapy (n = 31), only 45.2% were treated with an antibiotic agent active against MRSA. The overall clinical success and treatment failure rates were 89.2% and 10.8%, respectively. Success with daptomycin therapy was higher in patients who had surgery and in those whose initial therapy was daptomycin. Eleven patients had 14 adverse events, two of which were possibly related to daptomycin use and led to discontinuation. Conclusions In a large real-world cohort of patients with MRSA DFI, daptomycin therapy was shown to be generally well tolerated and effective. The use of an anti-MRSA antibiotic agent should be considered when implementing first-line antibiotic drug therapy for DFI in countries where MRSA is common to avoid inappropriate empirical treatment and potential negative effects on outcomes.

Correlation Between Patients With Methicillin-Resistant Staphylococcus aureus (MRSA) Nares Colonization and MRSA Diabetic Foot Infections

2020 ◽  
pp. 153473462096357
Author(s):  
Jacquelyn Brondo ◽  
Kathleen Morneau ◽  
Teri Hopkins ◽  
Linda Yang ◽  
Jose Cadena-Zuluaga ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Predictive Value ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Empiric Therapy ◽  
Inclusion Criteria ◽  
Methicillin Resistant ◽  
Diabetic Foot Infections ◽  
Prior Literature ◽  
Mrsa Infection

Infectious Diseases Society of America diabetic foot infection (DFI) guidelines indicate empiric methicillin-resistant Staphylococcus aureus (MRSA) coverage for patients with a history of MRSA infection, when local prevalence of MRSA is high, or infection is clinically severe. These recommendations may lead to overutilization of empiric MRSA coverage, which can result in serious consequences. A strong negative predictive value (NPV) has been reported in literature for pneumonia, and recently, for all anatomical sites of infection. While these findings are promising, further validation is needed before clinicians may confidently use MRSA nares to guide empiric therapy for DFIs. A retrospective electronic medical record review was completed between October 1, 2013 and October 1, 2019. Patients met inclusion criteria if they were at least 18, admitted with a DFI, had MRSA nares test results, and DFI cultures. Patients were excluded if pregnant or MRSA infection within 1 year prior to index admission for DFI. A total of 200 patients met inclusion criteria. The majority of study participants were male with a mean age of 63. NPV of MRSA nares for MRSA DFIs was determined to be 94% and positive predictive value 58%. Sensitivity and specificity were 56% and 94%, respectively. Results of this study are consistent with prior literature supporting strong correlation of NPV for MRSA nares. The DFIs evaluated suggest a strong NPV of MRSA nares for MRSA DFIs, which may allow for faster de-escalation of empiric anti-MRSA antibiotic therapy and lower risk of adverse events associated with anti-MRSA therapy.

scholarly journals DIABETIC FOOT INFECTIONS

2012 ◽  
Vol 19 (04) ◽  
pp. 475-481
Author(s):  
AYAZ GUL ◽  
JAVID IQBAL ◽  
ZIA UDDIN AFRIDI
Keyword(s):  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Detailed Knowledge ◽  
Type I ◽  
Cross Sectional ◽  
Methicillin Resistant ◽  
Surgical Department ◽  
Diabetic Foot Infections ◽  
Study Results

Objective: The objective of this study is to know the frequency of methicillin resistant Staphylococcus aureus and its antibioticsensitivity in diabetic foot infections in our setup. Design: Cross sectional descriptive study. Setting: Surgical Department, Khyber TeachingHospital, Peshawar. Period: January 2008 to January 2010. Materials and Methods: A total of 84 patients, including 64 males and 20 females.Patient's identity, age, gender and the bacterial isolate on culture and sensitivity report were noted on a standardized proforma and analyzed onSPSS version 16.0. Patients of 18 years and both gender with type I & II Diabetes mellitus, diabetic foot ulcers of Wagner Classification SystemGrade 1 to 5 of 3 weeks duration, with infection and with no evidence of healing were enrolled in the study. Results: The overall mean age ofpatients was 60.8 years + 6.5SD with 9.2 + 0.5% HbA1c level. Frequency of methicillin resistant Staphylococcus aureus was 28.57%. Methicillinsensitive Staphylococcal aureus (51.19%), Pseudomonas aeruginosa (48.80%) and Escherichia coli (46.42%) were the common organismcultured. Methicillin resistant Staphylococcus aureus showed 100% sensitivity to Vancomicin, Linezolid, Meropenem, Imepenem andPipracillin/tazobactam. Conclusions: There is an alarming trend of increase in methicillin resistant Staphylococcus aureus because ofindiscriminate use of antibiotics in our set up which should be discouraged and a detailed knowledge of bacterial susceptibility to antimicrobialagents is necessary.

Methicillin-Resistant Staphylococcus aureus Endocarditis from a Diabetic Foot Ulcer

2018 ◽  
Vol 108 (6) ◽  
pp. 528-531 ◽  
Author(s):  
Andrew J. Hale ◽  
Emily Vicks ◽  
Mary T. LaSalvia ◽  
John M. Giurini ◽  
Adolf W. Karchmer
Keyword(s):  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
The United States ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Methicillin Resistant ◽  
Diabetic Foot Infections

Diabetic foot infections are a common cause of morbidity and mortality in the United States, and successful treatment often requires an aggressive and prolonged approach. Recent work has elucidated the importance of appropriate therapy for a given severity of diabetic foot infection, and highlighted the ongoing risk such patients have for subsequent invasive life-threatening infection should diabetic foot ulcers fail to heal. The authors describe the case of a man with diabetes who had prolonged, delayed healing of a diabetic foot ulcer. The ulcer subsequently became infected by methicillin-resistant Staphylococcus aureus (MRSA). The infection was treated conservatively with oral therapy and minimal debridement. Several months later, he experienced MRSA bloodstream infection and complicating endocarditis. The case highlights the ongoing risk faced by patients when diabetic foot ulcers do not heal promptly, and emphasizes the need for aggressive therapy to promote rapid healing and eradication of MRSA.

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