International Journal of Microbiological Research 4 (2): 147-151, 2013 ISSN 2079-2093 © IDOSI Publications, 2013 DOI: 10.5829/idosi.ijmr.2013.4.2.74134 Corresponding Author: Mohammadreza Sharif, 5th Km-Qotb-e Ravandi Boulevard, P.O.Box: 87155.111, Kashan, Iran. Tel: +98 913 5339790, Fax: +98 361 5579028. 147 Risk Factors of Methicillin-Resistant Staphylococcus aureus Colonization in Diabetic Outpatients, A Prospective Cohort Study Javad Alizargar, Mohammadreza Sharif and Alireza Sharif 1 2 3 Kashan University of Medical Sciences, Kashan, Iran 1 Department of Pediatrics, Kashan University of Medical Sciences, Kashan, Iran 2 Department of Infectious Disease, Kashan University of Medical Sciences, Kashan, Iran 3 Abstract: Methicillin-resistant Staphylococcus aureus (MRSA) colonization in anterior nares of diabetic patients may cause morbidity and mortality. Study the epidemiology and risk factor of MRSA colonization may lead to better management of diabetic patients. Swabs were taken from anterior nares of 494 diabetic patients. Demographic characteristics and risk factors entered checklists. Antibiotic susceptibility of Staphylococcus aureus (S. aureus) was determined by disk diffusion method..From these 494 patients, 210 (42.5%) had positive nasal colonization of S. aureus. from 210 positive nasal colonization, 122 (57%) were MRSA (24.7% off all DM patients). The resistance rate of erythromycin, ciprofloxacin, clarithromycin was 81.9, 71.3 and 65.5%. Vancomycin resistance rate was 1.6 %. Our results showed the high prevalence of MRSA infection in diabetic patients. High antibiotic resistance of MRSA isolates may be a future challenge especially when we consider observing vancomycin resistance. Key words: Staphylococcus aureus Methicillin-Resistant Staphylococcus aureus Diabetes Complications Multiple Drug Resistance INTRODUCTION diabetic patients are not well defined and it confides to Staphylococcus aureus (S. aureus) is an important [6, 12]. pathogen that threat human being. Its ability to become Finding out the potent risk factors and epidemiology resistant is a threat that needs attention [1, 2]. Because its of MRSA infections may be helpful in managing diabetic habitat is moist squamous epithelium of the anterior nares, patients. In this investigation we supposed to make the most S. aureus infections assume to come from nasal risk factors leading to MRSA colonization clear and carriage [3]. Eradication of S. aureus from the anterior demonstrating its epidemiology with studying the nares has been proven to affect reducing S. aureus outpatients coming to Shahid Beheshty endocrinology infections [4, 5]. clinic in the last 5 years. Methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus differ in resistance to MATERIALS AND METHODS beta-lactam antibiotics; and MRSA often shows degree of resistance to other antibiotics nowadays [6]. This study is a prospective cohort one that was Diabetic Mellitus (DM) is amongst the most conducted in the endocrinology clinic of Shahid prevalent chronic diseases. DM is a risk factor for MRSA Behesty hospital, a central teaching hospital in Kashan, colonization and MRSA colonization in diabetic patient Iran and patients admitted in this clinic had DM based can lead to mortality and morbidity, especially when the on American Diabetes Association guidelines [13] and problem of multidrug resistance s hows itself [7-11]. confirmed with the Following criteria: A medical record The pattern and epidemiology of MRSA infection in indicating either fasting plasma glucose level more than several investigations, to the best of our knowledge