Research Article
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Year 2026, Volume: 18 Issue: 1, 62 - 67, 24.03.2026
https://doi.org/10.18521/ktd.1850416
https://izlik.org/JA62AL98ZB

Abstract

References

  • 1. Gnanamani A, Hariharan P, Paul-Satyaseela M. Staphylococcus aureus: overview of bacteriology, clinical diseases, epidemiology, antibiotic resistance and therapeutic approach [Internet]. In: Enany S, Crotty Alexander LE, editors. Frontiers in Staphylococcus aureus. London: IntechOpen; 2017. doi:10.5772/67338.
  • 2. Al-Mebairik NF, El-Kersh TA, Al-Sheikh YA, Marie MAM. A review of virulence factors, pathogenesis, and antibiotic resistance in Staphylococcus aureus. Reviews in Medical Microbiology. 2016;27(2):50–6. doi:10.1097/MRM.0000000000000067.
  • 3. Cheung GYC, Bae JS, Otto M. Pathogenicity and virulence of Staphylococcus aureus. Virulence. 2021;12(1):547–69. doi:10.1080/21505594.2021.1878688.
  • 4. Taylor TA, Tobin EH, Unakal CG. Staphylococcus aureus infection [Internet]. StatPearls Treasure Island (FL): StatPearls Publishing; 2025. [cited 2025 Dec 14] Available from: https://www.ncbi.nlm.nih.gov/books/NBK441868
  • 5. Tobin EH, Jogu P, Koirala J. Methicillin-resistant Staphylococcus aureus [Internet]. StatPearls Treasure Island (FL): StatPearls Publishing; 2025. [cited 2025 Dec 20] Available from: https://www.ncbi.nlm.nih.gov/books/NBK482221
  • 6. Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing. CLSI supplement M100. 35th ed. USA: CLSI; 2025.
  • 7. Bhoi P, Otta S, Swain B, Kar BR. Prevalence of nasal carriage of MRSA in diabetic patients attending the outpatient department. Int J Res Med Sci. 2020;8(4):1336–9. doi:10.18203/2320-6012.ijrms20201320.
  • 8. Alvarez S, Coffey R, Mathias PM, Algotar AM. Prediabetes [Internet]. StatPearls Treasure Island (FL): StatPearls Publishing; 2025. [cited 2025 Dec 14]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459332
  • 9. Akbari M, Hassan-Zadeh V. IL-6 signalling pathways and the development of type 2 diabetes. Inflammopharmacology. 2018;26(3):685–98. doi:10.1007/s10787-018-0458-0.
  • 10. Dulkadiroğlu E, Özden H, Demirci H. The evaluation of intracellular energy metabolism in prediabetic patients and patients newly diagnosed with type 2 diabetes mellitus. Turk J Med Sci. 2021;51(1):238–45. doi:10.3906/sag-1912-60.
  • 11. American Diabetes Association Professional Practice Committee. 2. Diagnosis and classification of diabetes: standards of care in diabetes-2024. Diabetes Care. 2024;47(Suppl 1):S20-42. doi:10.2337/dc24-S002.
  • 12. Akbari M, Hassan-Zadeh V. Hyperglycemia affects the expression of inflammatory genes in peripheral blood mononuclear cells of patients with type 2 diabetes. Immunol Investig. 2018;47(7):654–65. doi:10.1080/08820139.2018.1480031.
  • 13. Tsalamandris S, Antonopoulos AS, Oikonomou E, Papamikroulis GA, Vogiatzi G, Papaioannou S, et al. The role of inflammation in diabetes: current concepts and future perspectives. Eur Cardiol. 2019;14(1):50-9. doi:10.15420/ecr.2018.33.1.
  • 14. Casqueiro J, Casqueiro J, Alves C. Infections in patients with diabetes mellitus: a review of pathogenesis. Indian J Endocrinol Metab. 2012;16(Suppl 1):S27–36. doi:10.4103/2230-8210.94253.
  • 15. Wang Q, Nurxat N, Zhang L, Liu Y, Wang Y, Zhang L, et al. Diabetes mellitus promotes the nasal colonization of high virulent Staphylococcus aureus through the regulation of SaeRS two-component system. Emerg Microbes Infect. 2023;12(2):2276335. doi:10.1080/22221751.2023.2276335.
  • 16. Tsao S, Hsu C, Yin M. Meticillin-resistant Staphylococcus aureus infection in diabetic mice enhanced inflammation and coagulation. J Med Microbiol. 2006;55(Pt 4):379–85. doi:10.1099/jmm.0.46054-0.
  • 17. Cheong HS, Chang Y, Kim Y, Joo EJ, Kwon MJ, Wild SH, et al. Glycaemic status, insulin resistance, and risk of infection-related mortality: a cohort study. Eur J Endocrinol. 2023;188(2):197–205. doi:10.1093/ejendo/lvad011.
  • 18. Stacey HJ, Clements CS, Welburn SC, Jones JD. The prevalence of methicillin-resistant Staphylococcus aureus among diabetic patients: a meta-analysis. Acta Diabetol. 2019;56:907–21. doi:10.1007/s00592-019-01301-0.
  • 19. Wang SH, Sun ZL, Guo YJ, Yang BQ, Yuan Y, Wei Q, et al. Meticillin-resistant Staphylococcus aureus isolated from foot ulcers in diabetic patients in a Chinese care hospital: risk factors for infection and prevalence. J Med Microbiol. 2010;59(10):1219–24. doi:10.1099/jmm.0.020537-0.
  • 20. Abbas MM, Almasri M, Abu-Zant A, Sharef S, Mahajne S, Kananbi K. Prevalence of anterior nares colonization of Palestinian diabetic patients with Staphylococcus aureus or methicillin-resistant Staphylococcus aureus. Qual Assur Saf Crops Foods. 2023;15(4):32-41. doi:10.15586/qas.v15i4.1380.
  • 21. World Health Organization (WHO). World report on social determinants of health equity [Internet]. Geneva: World Health Organization; 2025. [cited 2025 Dec 20] Available from: https://www.who.int/publications/i/item/9789240107588
  • 22. Elgart JF, Torrieri R, Ré M, Salazar M, Espeche W, Angelini JM, et al. Prediabetes is more than a pre-disease: additional evidences supporting the importance of its early diagnosis and appropriate treatment. Endocrine. 2023;79(1):80-5. doi:10.1007/s12020-022-03249-8.
  • 23. Olsen K, Danielsen K, Wilsgaard T, Sangvik M, Sollid JU, Thune I, et al. Obesity and Staphylococcus aureus nasal colonization among women and men in a general population. PLoS One. 2013;8(5):e63716. doi:10.1371/journal.pone.0063716.
  • 24. Stanaway S, Johnson D, Moulik P, Gill G. Methicillin-resistant Staphylococcus aureus (MRSA) isolation from diabetic foot ulcers correlates with nasal MRSA carriage. Diabetes Res Clin Pract. 2007;75(1):47–50. doi:10.1016/j.diabres.2006.05.021.
  • 25. Campbell MP, Mott MD, Owen JR, Reznicek JE, Beck CA, Muthukrishnan G, et al. Low albumin level is more strongly associated with adverse outcomes and Staphylococcus aureus infection than hemoglobin A1C or smoking tobacco. J Orthop Res. 2022;40(11):2670–7. doi:10.1002/jor.25282.
  • 26. Karanika S, Zervou FN, Zacharioudakis IM, Paudel S, Mylonakis E. Risk factors for meticillin-resistant Staphylococcus aureus colonization in dialysis patients: a meta-analysis. J Hosp Infect. 2015;91(3):257–63. doi:10.1016/j.jhin.2015.07.014.
  • 27. Tamer A, Karabay O, Ekerbicer H. Staphylococcus aureus nasal carriage and associated factors in type 2 diabetic patients. Jpn J Infect Dis. 2006;59(1):10-4.
  • 28. Shih HI, Chang CM, Shen FC, Lee YJ, Wu CH, Hsu HC, et al. High prevalence nasal carriage of methicillin-resistant Staphylococcus aureus among long term care facility healthcare workers in relation to patient contact. Infect Prev Pract. 2021;3(1):100117. doi:10.1016/j.infpip.2021.100117.
  • 29. Westgeest AC, Hanssen JLJ, de Boer MGJ, Schippers EF, Lambregts MMC. Eradication of community-onset methicillin-resistant Staphylococcus aureus carriage: a narrative review. Clin Microbiol Infect. 2025;31(2):173–81. doi:10.1016/j.cmi.2024.01.003.

Nasal Carriage of Methicillin-Resistant Staphylococcus aureus in Prediabetes and Type 2 Diabetes Mellitus

Year 2026, Volume: 18 Issue: 1, 62 - 67, 24.03.2026
https://doi.org/10.18521/ktd.1850416
https://izlik.org/JA62AL98ZB

Abstract

Aim: Staphylococcus aureus (S. aureus) nasal colonization, especially with methicillin-resistant S. aureus (MRSA), is a significant risk factor for infection and transmission. While diabetes mellitus (DM) is a recognized risk factor, its association with prediabetes (preDM) is less apparent. This study investigated MRSA nasal carriage in DM and preDM and its relation to metabolic and anthropometric parameters.
Material and Methods: This cross-sectional study included 300 participants: 100 with type 2 DM, 100 with preDM and 100 non-diabetic controls attending General Internal Medicine clinics (May–August 2025). PreDM and DM were defined by American Diabetes Association (ADA) criteria and individuals with recent antibiotic use, acute infection, immunosuppression, dialysis or malignancy were excluded. Nasal swabs were cultured on blood agar, identified by MALDI-TOF and tested for methicillin resistance using oxacillin MIC per Clinical and Laboratory Standards Institute (CLSI M100 35th ed., 2025) standards. Clinical and laboratory parameters were assessed using nonparametric statistical tests, with significance set at p < 0.05. 
Results: MRSA nasal carriage was higher in DM patients than controls (8% vs 1%, p=0.035). DM was associated with greater waist circumference and poorer glycemic profiles. MRSA carriage showed weak positive correlations with body weight, fasting glucose, HbA1c and triglycerides, and a weak negative correlation with albumin. Prediabetes showed a nonsignificant increase compared with controls. 
Conclusion: Type 2 DM was associated with increased MRSA nasal carriage, whereas prediabetes was not; intermediate rates in prediabetes do not support routine MRSA screening in this group. These findings support a selective, risk-based approach rather than routine MRSA screening in prediabetic populations.

Ethical Statement

This study was approved by the Sivas Cumhuriyet University Health Sciences Research Ethics Committee (Date: 04 April 2025, number: 2025-04/105).

Supporting Institution

The authors received no financial support for this article.

Thanks

We would like to thank health technician Ayşe Gül ALTUN for her technical support in this study.

References

  • 1. Gnanamani A, Hariharan P, Paul-Satyaseela M. Staphylococcus aureus: overview of bacteriology, clinical diseases, epidemiology, antibiotic resistance and therapeutic approach [Internet]. In: Enany S, Crotty Alexander LE, editors. Frontiers in Staphylococcus aureus. London: IntechOpen; 2017. doi:10.5772/67338.
  • 2. Al-Mebairik NF, El-Kersh TA, Al-Sheikh YA, Marie MAM. A review of virulence factors, pathogenesis, and antibiotic resistance in Staphylococcus aureus. Reviews in Medical Microbiology. 2016;27(2):50–6. doi:10.1097/MRM.0000000000000067.
  • 3. Cheung GYC, Bae JS, Otto M. Pathogenicity and virulence of Staphylococcus aureus. Virulence. 2021;12(1):547–69. doi:10.1080/21505594.2021.1878688.
  • 4. Taylor TA, Tobin EH, Unakal CG. Staphylococcus aureus infection [Internet]. StatPearls Treasure Island (FL): StatPearls Publishing; 2025. [cited 2025 Dec 14] Available from: https://www.ncbi.nlm.nih.gov/books/NBK441868
  • 5. Tobin EH, Jogu P, Koirala J. Methicillin-resistant Staphylococcus aureus [Internet]. StatPearls Treasure Island (FL): StatPearls Publishing; 2025. [cited 2025 Dec 20] Available from: https://www.ncbi.nlm.nih.gov/books/NBK482221
  • 6. Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing. CLSI supplement M100. 35th ed. USA: CLSI; 2025.
  • 7. Bhoi P, Otta S, Swain B, Kar BR. Prevalence of nasal carriage of MRSA in diabetic patients attending the outpatient department. Int J Res Med Sci. 2020;8(4):1336–9. doi:10.18203/2320-6012.ijrms20201320.
  • 8. Alvarez S, Coffey R, Mathias PM, Algotar AM. Prediabetes [Internet]. StatPearls Treasure Island (FL): StatPearls Publishing; 2025. [cited 2025 Dec 14]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459332
  • 9. Akbari M, Hassan-Zadeh V. IL-6 signalling pathways and the development of type 2 diabetes. Inflammopharmacology. 2018;26(3):685–98. doi:10.1007/s10787-018-0458-0.
  • 10. Dulkadiroğlu E, Özden H, Demirci H. The evaluation of intracellular energy metabolism in prediabetic patients and patients newly diagnosed with type 2 diabetes mellitus. Turk J Med Sci. 2021;51(1):238–45. doi:10.3906/sag-1912-60.
  • 11. American Diabetes Association Professional Practice Committee. 2. Diagnosis and classification of diabetes: standards of care in diabetes-2024. Diabetes Care. 2024;47(Suppl 1):S20-42. doi:10.2337/dc24-S002.
  • 12. Akbari M, Hassan-Zadeh V. Hyperglycemia affects the expression of inflammatory genes in peripheral blood mononuclear cells of patients with type 2 diabetes. Immunol Investig. 2018;47(7):654–65. doi:10.1080/08820139.2018.1480031.
  • 13. Tsalamandris S, Antonopoulos AS, Oikonomou E, Papamikroulis GA, Vogiatzi G, Papaioannou S, et al. The role of inflammation in diabetes: current concepts and future perspectives. Eur Cardiol. 2019;14(1):50-9. doi:10.15420/ecr.2018.33.1.
  • 14. Casqueiro J, Casqueiro J, Alves C. Infections in patients with diabetes mellitus: a review of pathogenesis. Indian J Endocrinol Metab. 2012;16(Suppl 1):S27–36. doi:10.4103/2230-8210.94253.
  • 15. Wang Q, Nurxat N, Zhang L, Liu Y, Wang Y, Zhang L, et al. Diabetes mellitus promotes the nasal colonization of high virulent Staphylococcus aureus through the regulation of SaeRS two-component system. Emerg Microbes Infect. 2023;12(2):2276335. doi:10.1080/22221751.2023.2276335.
  • 16. Tsao S, Hsu C, Yin M. Meticillin-resistant Staphylococcus aureus infection in diabetic mice enhanced inflammation and coagulation. J Med Microbiol. 2006;55(Pt 4):379–85. doi:10.1099/jmm.0.46054-0.
  • 17. Cheong HS, Chang Y, Kim Y, Joo EJ, Kwon MJ, Wild SH, et al. Glycaemic status, insulin resistance, and risk of infection-related mortality: a cohort study. Eur J Endocrinol. 2023;188(2):197–205. doi:10.1093/ejendo/lvad011.
  • 18. Stacey HJ, Clements CS, Welburn SC, Jones JD. The prevalence of methicillin-resistant Staphylococcus aureus among diabetic patients: a meta-analysis. Acta Diabetol. 2019;56:907–21. doi:10.1007/s00592-019-01301-0.
  • 19. Wang SH, Sun ZL, Guo YJ, Yang BQ, Yuan Y, Wei Q, et al. Meticillin-resistant Staphylococcus aureus isolated from foot ulcers in diabetic patients in a Chinese care hospital: risk factors for infection and prevalence. J Med Microbiol. 2010;59(10):1219–24. doi:10.1099/jmm.0.020537-0.
  • 20. Abbas MM, Almasri M, Abu-Zant A, Sharef S, Mahajne S, Kananbi K. Prevalence of anterior nares colonization of Palestinian diabetic patients with Staphylococcus aureus or methicillin-resistant Staphylococcus aureus. Qual Assur Saf Crops Foods. 2023;15(4):32-41. doi:10.15586/qas.v15i4.1380.
  • 21. World Health Organization (WHO). World report on social determinants of health equity [Internet]. Geneva: World Health Organization; 2025. [cited 2025 Dec 20] Available from: https://www.who.int/publications/i/item/9789240107588
  • 22. Elgart JF, Torrieri R, Ré M, Salazar M, Espeche W, Angelini JM, et al. Prediabetes is more than a pre-disease: additional evidences supporting the importance of its early diagnosis and appropriate treatment. Endocrine. 2023;79(1):80-5. doi:10.1007/s12020-022-03249-8.
  • 23. Olsen K, Danielsen K, Wilsgaard T, Sangvik M, Sollid JU, Thune I, et al. Obesity and Staphylococcus aureus nasal colonization among women and men in a general population. PLoS One. 2013;8(5):e63716. doi:10.1371/journal.pone.0063716.
  • 24. Stanaway S, Johnson D, Moulik P, Gill G. Methicillin-resistant Staphylococcus aureus (MRSA) isolation from diabetic foot ulcers correlates with nasal MRSA carriage. Diabetes Res Clin Pract. 2007;75(1):47–50. doi:10.1016/j.diabres.2006.05.021.
  • 25. Campbell MP, Mott MD, Owen JR, Reznicek JE, Beck CA, Muthukrishnan G, et al. Low albumin level is more strongly associated with adverse outcomes and Staphylococcus aureus infection than hemoglobin A1C or smoking tobacco. J Orthop Res. 2022;40(11):2670–7. doi:10.1002/jor.25282.
  • 26. Karanika S, Zervou FN, Zacharioudakis IM, Paudel S, Mylonakis E. Risk factors for meticillin-resistant Staphylococcus aureus colonization in dialysis patients: a meta-analysis. J Hosp Infect. 2015;91(3):257–63. doi:10.1016/j.jhin.2015.07.014.
  • 27. Tamer A, Karabay O, Ekerbicer H. Staphylococcus aureus nasal carriage and associated factors in type 2 diabetic patients. Jpn J Infect Dis. 2006;59(1):10-4.
  • 28. Shih HI, Chang CM, Shen FC, Lee YJ, Wu CH, Hsu HC, et al. High prevalence nasal carriage of methicillin-resistant Staphylococcus aureus among long term care facility healthcare workers in relation to patient contact. Infect Prev Pract. 2021;3(1):100117. doi:10.1016/j.infpip.2021.100117.
  • 29. Westgeest AC, Hanssen JLJ, de Boer MGJ, Schippers EF, Lambregts MMC. Eradication of community-onset methicillin-resistant Staphylococcus aureus carriage: a narrative review. Clin Microbiol Infect. 2025;31(2):173–81. doi:10.1016/j.cmi.2024.01.003.
There are 29 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Article
Authors

Şeyma Taştemur 0000-0002-9013-6395

Tuba Doğan Karataş 0000-0002-2610-6562

Özlem Aldemir 0000-0002-9356-7510

Murtaza Öz 0000-0003-3415-5927

Submission Date December 29, 2025
Acceptance Date February 20, 2026
Publication Date March 24, 2026
DOI https://doi.org/10.18521/ktd.1850416
IZ https://izlik.org/JA62AL98ZB
Published in Issue Year 2026 Volume: 18 Issue: 1

Cite

APA Taştemur, Ş., Doğan Karataş, T., Aldemir, Ö., & Öz, M. (2026). Nasal Carriage of Methicillin-Resistant Staphylococcus aureus in Prediabetes and Type 2 Diabetes Mellitus. Konuralp Medical Journal, 18(1), 62-67. https://doi.org/10.18521/ktd.1850416
AMA 1.Taştemur Ş, Doğan Karataş T, Aldemir Ö, Öz M. Nasal Carriage of Methicillin-Resistant Staphylococcus aureus in Prediabetes and Type 2 Diabetes Mellitus. Konuralp Medical Journal. 2026;18(1):62-67. doi:10.18521/ktd.1850416
Chicago Taştemur, Şeyma, Tuba Doğan Karataş, Özlem Aldemir, and Murtaza Öz. 2026. “Nasal Carriage of Methicillin-Resistant Staphylococcus Aureus in Prediabetes and Type 2 Diabetes Mellitus”. Konuralp Medical Journal 18 (1): 62-67. https://doi.org/10.18521/ktd.1850416.
EndNote Taştemur Ş, Doğan Karataş T, Aldemir Ö, Öz M (March 1, 2026) Nasal Carriage of Methicillin-Resistant Staphylococcus aureus in Prediabetes and Type 2 Diabetes Mellitus. Konuralp Medical Journal 18 1 62–67.
IEEE [1]Ş. Taştemur, T. Doğan Karataş, Ö. Aldemir, and M. Öz, “Nasal Carriage of Methicillin-Resistant Staphylococcus aureus in Prediabetes and Type 2 Diabetes Mellitus”, Konuralp Medical Journal, vol. 18, no. 1, pp. 62–67, Mar. 2026, doi: 10.18521/ktd.1850416.
ISNAD Taştemur, Şeyma - Doğan Karataş, Tuba - Aldemir, Özlem - Öz, Murtaza. “Nasal Carriage of Methicillin-Resistant Staphylococcus Aureus in Prediabetes and Type 2 Diabetes Mellitus”. Konuralp Medical Journal 18/1 (March 1, 2026): 62-67. https://doi.org/10.18521/ktd.1850416.
JAMA 1.Taştemur Ş, Doğan Karataş T, Aldemir Ö, Öz M. Nasal Carriage of Methicillin-Resistant Staphylococcus aureus in Prediabetes and Type 2 Diabetes Mellitus. Konuralp Medical Journal. 2026;18:62–67.
MLA Taştemur, Şeyma, et al. “Nasal Carriage of Methicillin-Resistant Staphylococcus Aureus in Prediabetes and Type 2 Diabetes Mellitus”. Konuralp Medical Journal, vol. 18, no. 1, Mar. 2026, pp. 62-67, doi:10.18521/ktd.1850416.
Vancouver 1.Şeyma Taştemur, Tuba Doğan Karataş, Özlem Aldemir, Murtaza Öz. Nasal Carriage of Methicillin-Resistant Staphylococcus aureus in Prediabetes and Type 2 Diabetes Mellitus. Konuralp Medical Journal. 2026 Mar. 1;18(1):62-7. doi:10.18521/ktd.1850416

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