Published: 2020-03-26

Prevalence of nasal carriage of MRSA in diabetic patients attending the outpatient department

Priyadarshini Bhoi, Sarita Otta, Bichitrananda Swain, Bikash Ranjan Kar


Background: Up to 30% of the human population is asymptomatically colonized with nasal Staphylococcus aureus. Study was done to determine the prevalence and risk factors for MRSA colonization as nasal carrier in a population of outpatients with diabetes.

Methods: The study enrolled patients with diabetes from whom nasal swabs were obtained and were analyzed for presence of MRSA.

Results: Out of the 402 patients evaluated, 254 (63.18%) were colonized with S. aureus and 164 (64.56%) of them were MRSA.

Conclusions: Diabetes have more propensity for MRSA colonization than non-diabetic patients. A better understanding of the epidemiology and risk factors for nasal MRSA colonization in the persons with diabetes may have significant implications for the treatment and prevention of MRSA infections.


MRSA colonization, Nasal carrier, Staphylococcus aureus

Full Text:



Jevons MP. Celbenin-resistant staphylococci. Br Med J. 1961;1:124-5.

Maranan MC, Moreira B, Boyle VS, Daum RS. Antimicrobial resistance in Staphylococci. Epidemiology, molecular mechanisms, and clinical relevance. Infect Dis Clin North Am. 1997;11:813-49.

Fridkin SK. Epidemiology of Gram-positive infections in the United States. Ninth Annual Meeting of the Society for Healthcare Epidemiology of America. San Francisco. 1999:19-22.

Eliopoulos GM. Vancomycin-resistant enterococci: Mechanism and clinical relevance. Infect Dis Clin North Am. 1997;11:851-65.

Hiramatsu K, Aritaka N, Hanaki H, Kawasaki S, Hosoda Y, Hori S, et al. Dissemination in Japanese hospitals of strains of Staphylococcus aureus heterogeneously resistant to vancomycin. Lancet. 1997;350:1670-73.

Parker MT, Lapage SP. Penicillinase production by Staphylococcus aureus strains from outbreaks of food poisoning. J Clin Pathol. 1957;10:313-6.

Haley RW, Hightower AW, Khabbaz RF, Thornsberry C, Martone WJ, Allen JR, et al. The emergence of methicillin-resistant Staphylococcus aureus infections in United States hospitals. Possible roles of the house staff-patient transfer circuit. Ann Intern Med. 1982;97:297-308.

Yamasaki F, Takeuchi S, Uehara Y, Matsushita M, Arise K, Morimoto N, et al. Prevalence and characteristics of methicillin-resistant Staphylococcus aureus in community residents of Japan. J Gen Fam Med. 2018;19:77-81.

Neidhart S, Zaatreh S, Klinder A, Redanz S, Spitzmuller R, Holtfreter S, et al. Predictors of colonization with Staphylococcus species among patients scheduled for cardiac and orthopedic interventions at tertiary care hospitals in north-eastern Germany a prevalence screening study. Eur J Clin Microbiol Infect Dis. 2018;37:633-41.

Oguzkaya AM, Artan C, Baykan Z. Prevalence and risk factors for Staphylococcus aureus and methicillin-resistant Staphylococcus aureus nasal carriage inpatients in a tertiary care hospital’s chest clinic in Turkey. Niger J Clin Pract. 2016;19:313-7.

Lu SY, Chang FY, Cheng CC, Lee KD, Huang YC. Methicillin-resistant Staphylococcus aureus nasal colonization among adult patients visiting emergency department in a medical center in Taiwan. PLoS One. 2011;6:18620.

Scerri J, Monecke S, Borg MA. Prevalence and characteristics of community carriage of methicillin-resistant Staphylococcus aureus in Malta. J Epidemiol Glob Health. 2013;3:165-73.

Tigabu A, Tiruneh M, Mekonnen F. Nasal carriage rate, antimicrobial susceptibility pattern, and associated factors of staphylococcus aureus with special emphasis on MRSA among urban and rural elementary school children in gondar, northwest ethiopia: a comparative cross-sectional study. Advances Preven Med. 2018;36:47-57.

Hidron AI, Kourbatova EV, Halvosa JS, Terrell BJ, McDougal LK, Tenover FC, et al. Risk factors for colonization with methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to an urban hospital: emergence of community associated MRSA nasal carriage. Clin Infect Dis. 2005;41:159-66.

Saxena AK, Panhotra BR, Venkateshappa CK, Sundaram DS, Naguib M, Uzzaman W, et al. The impact of nasal carriage of methicillin-resistant and methicillin-susceptible Staphylococcus aureus (MRSA and MSSA) on vascular access related septicemia among patients with type II diabetes on dialysis. Ren Fail. 2002;24:763-77.

Graham PL, Lin SX, Larson EL. A US population based survey of Staphylococcus aureus colonization. Ann Intern Med. 2006;144:318-25.

Baykam N, Esener H, Ergonul O, Kosker PZ, Cirkin T, Celikbas A et al. Methicillin-resistant Staphylococcus aureus on hospital admission in Turkey. Am J Infect Control. 2009;37:247-9.