{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:21:40Z","timestamp":1753878100222,"version":"3.41.2"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T00:00:00Z","timestamp":1678924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To assess annual change in prevalence of methicillin resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (MRSA) from tissue and wound swab samples from foot ulcers (DFUs) in people with diabetes between 2005 and 2021.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis of everyone with MRSA positive wound or tissue swabs taken from our specialist multidisciplinary foot clinic between July 2005 and July 2021.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 406 MRSA positive isolates from DFU swabs were identified from 185 individuals attending the foot clinic. There were 22 hospital\u2010acquired infections (HAIs) and 159 community\u2010acquired infections (CAIs). Fifty\u2010two per cent (<jats:italic>n<\/jats:italic>\u00a0=\u200937) of these individuals from 2010 to 2021 (<jats:italic>n<\/jats:italic>\u00a0=\u200971) had presence of at least three risk factors for MRSA. The total number of swabs sent was 6312 from 1916 individuals living with diabetes. Annual MRSA DFU prevalence peaked in 2008 at 14.6% (<jats:italic>n<\/jats:italic>\u00a0=\u200938), decreased in 2013 to 5.2% (<jats:italic>n<\/jats:italic>\u00a0=\u200920) and did not exceed 4% (<jats:italic>n<\/jats:italic>\u00a0=\u20096) from 2015 to 2021. Hospital MRSA was lowest in 2021 (<jats:italic>n<\/jats:italic>\u00a0=\u2009211), a 76% fall from 2007 (<jats:italic>n<\/jats:italic>\u00a0=\u2009880). Incidence of MRSA HAI from 2015 to 2021 ranged from 5.4% (<jats:italic>n<\/jats:italic>\u00a0=\u200914) in 2020 to 11.5% (<jats:italic>n<\/jats:italic>\u00a0=\u200941) in 2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Prevalence of MRSA in DFU infections treated as outpatients is decreasing in line with falls in hospital acquired blood\u2010borne infections and with overall hospital MRSA incidence. This is likely a reflection of the combination of interventions, including stringent antibiotic prescribing and decolonisation strategies. Reduction in prevalence should have positive impact on outcomes in people living with diabetes, reducing the complication of osteomyelitis and necessity for long\u2010term antibiotic administration.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.15081","type":"journal-article","created":{"date-parts":[[2023,3,8]],"date-time":"2023-03-08T14:19:40Z","timestamp":1678285180000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Reduction in the prevalence of methicillin\u2010resistant <i>Staphylococcus aureus<\/i> in tissue and wound swab samples taken from outpatients attending a specialist diabetic foot clinic 2005\u20132021"],"prefix":"10.1111","volume":"40","author":[{"given":"James","family":"Moore","sequence":"first","affiliation":[{"name":"Department of Medicine Norfolk &amp; Norwich University Hospitals NHS Foundation Trust  Norwich UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Gooday","sequence":"additional","affiliation":[{"name":"Foot Clinic, Elsie Bertram Diabetes Centre Norfolk &amp; Norwich University Hospitals NHS Foundation Trust  Norwich UK"},{"name":"Norwich Medical School University of East Anglia  Norwich UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reham","family":"Soliman","sequence":"additional","affiliation":[{"name":"Department of Microbiology Norfolk &amp; Norwich University Hospitals NHS Foundation Trust  Norwich UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3619-9579","authenticated-orcid":false,"given":"Ketan","family":"Dhatariya","sequence":"additional","affiliation":[{"name":"Department of Medicine Norfolk &amp; Norwich University Hospitals NHS Foundation Trust  Norwich UK"},{"name":"Foot Clinic, Elsie Bertram Diabetes Centre Norfolk &amp; Norwich University Hospitals NHS Foundation Trust  Norwich UK"},{"name":"Norwich Medical School University of East Anglia  Norwich UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,3,16]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_2_14_3_1","unstructured":"NHS Digital.National Diabetes Inpatient Audit England and Wales 2017.2018."},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13973"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14773"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.3947\/ic.2018.50.1.11"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-021-06516-7"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-5491.2003.00860.x"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-5491.1999.00132.x"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1086\/424846"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis346"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.2165\/11538070-000000000-00000"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0891-5520(20)30638-3"},{"volume-title":"Methicillin Resistant Staphylococcus aureus. StatPearls","year":"2022","author":"Siddiqui AH","key":"e_1_2_14_14_1"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2006.05.021"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-0295"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-019-01301-0"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/1534734614550311"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens11060701"},{"key":"e_1_2_14_20_1","unstructured":"Public Health England.Annual epidemiological commentary: Gram\u2010negative bacteraemia MRSA bacteraemia MSSA bacteraemia andC. difficileinfections up to and including financial year April 2020 to March 2021.2021."},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2014.12.016"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz720"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.7139"},{"issue":"21","key":"e_1_2_14_24_1","first-page":"1970","article-title":"National burden of invasive methicillin\u2010resistant Staphylococcus aureus infections, United States, 2011","volume":"173","author":"Dantes R","year":"2013","journal-title":"JAMA Intern Med"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens10080937"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-019437"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.15081","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dme.15081","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.15081","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T06:18:04Z","timestamp":1694845084000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.15081"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,16]]},"references-count":25,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1111\/dme.15081"],"URL":"https:\/\/doi.org\/10.1111\/dme.15081","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"type":"print","value":"0742-3071"},{"type":"electronic","value":"1464-5491"}],"subject":[],"published":{"date-parts":[[2023,3,16]]},"assertion":[{"value":"2022-07-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e15081"}}