Nasal Methicillin-Resistant Staphylococcus aureus Colonization in Patients with Type 1 Diabetes in Taiwan.

Chun-Ya Kang,Wei-Chi Wu,Yih-Shiou Hwang,Chi-Chun Lai,Kun-Jen Chen,Eugene Yu-Chuan Kang,Wei-Che Lo,Yhu-Chering Huang,Laura Liu,Fu-Sung Lo

doi:10.3390/microorganisms9061296

Abstract

Nasal methicillin-resistant Staphylococcus aureus (MRSA) colonies are an essential reservoir of infection, especially for patients with diabetes. However, data on MRSA colonization in patients with type 1 diabetes are limited. We investigated the epidemiology of MRSA colonization in patients with type 1 diabetes. This prospective cross-sectional study was conducted in a medical center (Chang Gung Memorial Hospital) in Taiwan from 1 July to 31 December 2020. Nasal sampling and MRSA detection were performed. The molecular characteristics of MRSA isolates were tested, and factors associated with MRSA colonization were analyzed. We included 245 patients with type 1 diabetes; nasal MRSA colonization was identified in 13 (5.3%) patients. All isolates belonged to community-associated MRSA genetic strains; the most frequent strain was clonal complex 45 (53.8%), followed by ST59 (30.8%) (a local community strain). MRSA colonization was positively associated with age ≤ 10 years, body mass index < 18 kg/m2, and diabetes duration < 10 years; moreover, it was negatively associated with serum low-density lipoprotein cholesterol ≥ 100 mg/dL. No independent factor was reported. The nasal MRSA colonization rate in type 1 diabetes is approximately 5% in Taiwan. Most of these colonizing strains are community strains, namely clonal complex 45 and ST59.

Highlights

Univariate analysis revealed that methicillin-resistant Staphylococcus aureus (MRSA) colonization was positively associated with age ≤ 10 years (OR: 14.44, 95% confidence intervals (95% CIs): 4.24–49.18), body mass index < 18 kg/m2 (OR: 7.10, 95% CI: 2.21–22.79), and diabetes duration < 10 years (OR: 8.86, 95% CI: 2.61–30.01) and negatively associated with age > 10 years (OR: 0.07, 95% CI: 0.02–0.44), diabetes duration ≥ 10 years (OR: 0.12, 95% CI: 0.03–0.39), and elevated low-density lipoprotein cholesterol (LDL-C) (OR: 0.27, 95% CI: 0.08–0.89), which was defined as serum
We investigated the epidemiology of nasal MRSA carriage in 245 patients with type 1 diabetes
The results suggested that the characteristics of patients with type 1 diabetes were similar to those of the community population in the aspect of MRSA colonization, though the patients with type 1 diabetes may be exposed to healthcare facilities more frequently

Summary

Introduction

Staphylococcus aureus is an essential cutaneous pathogen of serious infections in humans and causes a wide range of diseases [1,2]. It is vital to understand the pathogenesis of S. aureus infections and develop new approaches to prevent the disease. Via its adhesive and invasive ability, S. aureus can harbor in human tissue and create biofilms [3,4], as well as secret several virulence factors that can impair human immunity [5]. Colonizing strains are endogenous reservoirs for S. aureus infections, with anterior nares being one of the principal carriage sites [6], and the host’s characteristics could influence the colonization [3]

Methods

Discussion

Conclusion