PREVALENCE OF METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) COLONIZATION, RISK FACTORS AND ANTIBIOTIC SUSCEPTIBILITY PROFILE AMONG PATIENTS WITH ASYMPTOMATIC DIABETES MELLITUS TYPE 2

Abstract

INTRODUCTION
Infection is one of the major causes of increased morbidity and mortality in individuals with diabetes mellitus. One of the bacterial pathogens associated with these infections is the methicillin-resistant Staphylococcus aureus (MRSA). This is probably because diabetes mellitus is one of the significant risk factors for MRSA colonization. Colonization of the said organism may act as an endogenous reservoir which places carriers at a greater risk for future infection. This study aims to identify the prevalence and risk factors for MRSA nasal colonization among individuals with diabetes mellitus in our locality and to determine the antimicrobial susceptibility of this organism. This will guide clinicians in the prevention and proper treatment of MRSA-related infections.

METHODOLOGY
This is a prospective cross-sectional study which included adult Filipino patients with diabetes mellitus type 2. Nasal swab samples were obtained and analyzed for the presence of MRSA.

RESULTS
Among 103 diabetic patients screened for MRSA nasal colonization, the prevalence rate is 6.8%. History of antibiotic use showed a positive correlation with the presence of MRSA nasal colonization. The isolates exhibited resistance to benzylpenicillin/oxacillin (100%), clindamycin (42.9%), quinupristin/dalfopristin, vancomycin, and cotrimoxazole (14.3%).

CONCLUSION
The prevalence of MRSA in this population is higher compared with other Asian countries. Contrary to other studies, there were no diabetes related risk factors identified. In this population, history of antibiotic use plays a significant role in MRSA nasal colonization. Therefore, clinicians should have a high level of suspicion of possible MRSA caused infection in diabetic patients with history of antibiotic use. The presence of antimicrobial resistance to B-lactams, clindamycin, cotrimoxazole, and vancomycin should prompt clinicians to be cautious in prescribing such antibiotics especially in high risk patients wherein inappropriate or delayed treatment is detrimental.