Characterization of Methicillin-Resistant Staphylococcus Aureus Resistance and Hematological Profiles in Diabetic Foot Infections.

BACKGROUND

This study aimed to analyze the infection rate, drug-resistant phenotypes, and hematological index profiles of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) in patients with diabetic foot ulcers (DFUs). This study sought to provide insights for the early identification of MRSA infections and the optimization of antimicrobial strategies in patients with DFU.

METHODS

The clinical data of patients with DFUs hospitalized from January 2022 through June 2023 were retrospectively reviewed. The detection rate and drug resistance profile of S. aureus were analyzed using bacterial culture and drug sensitivity testing. Additionally, the differences in hematological indices between the MRSA and MSSA infection groups were compared.

RESULTS

A total of 1,385 patients with DFU underwent bacterial culture of secretions, with a positive rate of 50.25% (696/1,385) for pathogenic bacteria. The detection rate of S. aureus was 14.58% (202/1,385), out of which MRSA accounted for 38.12% (77/202). The MRSA group exhibited resistance to macrolides (clarithromycin: 64.94% vs. 36.00%; erythromycin: 70.13% vs. 39.20%; azithromycin: 66.23% vs. 38.40%), lincosamides (clindamycin: 68.83% vs. 31.20%), and quinolones (levofloxacin: 28.57% vs. 15.20%; moxifloxacin: 15.58% vs. 5.60%). These differences were statistically significant (all p < 0.05). Furthermore, hematological analysis revealed significant disparities between the two groups in erythrocyte mean corpuscular hemoglobin concentration (MCHC), D-dimer, albumin (ALB), alkaline phosphatase (ALP), and electrolytes (Na+, Cl-, Ca2+) (all p < 0.05).

CONCLUSIONS

This study examined the characteristics of DFU-associated MRSA infection, particularly its multidrug resistance features. MRSA infection demonstrated 100% sensitivity to vancomycin and linezolid. The findings suggest that combined detection of MCHC, D-dimer, ALB, ALP, Na+, Cl-, and Ca2+ may serve as a valuable reference for the early identification of DFU-associated MRSA infection in clinical settings. Clinicians should be mindful of MRSA infection risks in patients with DFU and develop individualized anti-infection regimens based on drug sensitivity profiles to improve prognosis.