Abstract

Background and objectives: There is no data regarding the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) complicated skin and soft tissue infections (cSSTI) in the Kingdom of Bahrain despite its rapidly growing existence worldwide. This study aims to ascertain its prevalence at Bahrain Defence Force Hospital between 2010 and 2015. Since Bahrain is considered one of the top ranking countries with Diabetes Mellitus (DM), we aim to establish the percentage of patients with DM in MRSA cSSTI. Diabetic foot infections constitute a major complication of DM and contribute to the risk of amputation. We intend to identify the rate of MRSA cSSTI infections in the foot and the rate of amputation in patients with and without DM.
Methods: Retrospective cohort study of an electronic medical chart review of in- and outpatients who had documented swab collection for cSSTI.
Results: Out of 16,189 swabs collected, 702 were positive for MRSA cSSTI. The prevalence rate of MRSA in cSSTI was 4.3%. Out of 439 patients, 43% were positive for DM. There were higher odds of MRSA cSSTI occurring in the foot in patients with DM (OR = 5.2, 95% CI 3.1 to 8.6; P < 0.0001) compared to patients without DM (RR = 3.6, 95% CI 2.4 to 5.4; P < 0.0001). There were higher odds of patients with DM foot MRSA cSSTI undergoing amputation (OR = 46.1, 95% CI 2.7 to 786.1; P < 0.05) compared to patients without DM (RR = 25.1, 95% CI 1.6 to 395.9, P < 0.05).
Conclusion: This will be the benchmark study for the prevalence of MRSA in cSSTI in Bahrain to establish the awareness of its association with DM and its disease burden.

Keywords: Bahrain, MRSA, cSSTI, Prevalence, Diabetes, Foot, Amputation