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Updated: Jan 23, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Methicillin-resistant Staphylococcus aureus pneumonia in diabetics: a single-center, retrospective analysis
Qiu-Rui Zhang1,2, Hong Chen1,2, Bing Liu1,2
1Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Background:
Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia is an important issue with significant morbidity and mortality in clinical practice, especially in diabetes mellitus (DM). Studies focusing on S. aureus pneumonia in DM is limited, we sought to make a relatively comprehensive exploration of clinical characteristics, antimicrobial resistance, and risk factors for mortality of S. aureus pneumonia in DM and non-diabetics mellitus (non-DM).
Methods:
A retrospective study was conducted in Ruijin Hospital from 2014 to 2017. The characteristics of DM and non-DM patients were assessed, including demographics, comorbidities, using of invasive mechanical ventilation, Hemoglobin A1c (HbA1C), confusion, urea, respiratory rate, blood pressure, age ≥65 years (CURB-65) score, length of hospital stay, clinical outcomes, antimicrobial susceptibility. Independent risk factors for mortality were identified by univariate and multivariate logistic regression analysis.
Results:
A total of 365 patients with S. aureus pneumonia were included in our study, including 144 with DM and 221 non-DM. DM patients were more susceptible to MRSA infection (65.3% vs. 56.1%, P > 0.05), suffered from much severer pneumonia with a higher CURB-65 score, invasive mechanical ventilation rate (46.5% vs. 28.1%, P < 0.01) and mortality rates (30.6% vs. 23.1%, P > 0.05); almost all DM patients had higher antimicrobial resistance than non-DM patients, the DM group had a higher co-infection rate (47.2% vs. 45.7%, P > 0.05), and Acinetobacter baumannii was the most common bacterium in DM, while Klebsiella pneumoniae ranked first in patients with non-DM. Independent risk factors for pneumonia-related mortality were MRSA and CURB-65. Higher HbA1c levels were linked to a higher MRSA infection and co-infection rate and more severe pneumonia, leading to an increase in mortality.
Conclusions:
DM patients with poor glucose control are more susceptible to MRSA infection. They suffer from higher antimicrobial resistance, a higher co-infection rate, and much severer pneumonia than non-DM. MRSA itself is an independent risk factor for mortality in all patients.
Insights
Diabetes mellitus (DM) patients with poor glucose control face higher risks of Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia, increased severity, and mortality. MRSA is a key risk factor for pneumonia deaths in all patients.
Area of Science:
- Infectious Diseases
- Endocrinology
- Critical Care Medicine
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia poses significant clinical challenges, particularly in patients with diabetes mellitus (DM).
- Limited research exists on S. aureus pneumonia specifically within the DM population.
- This study comprehensively explores clinical characteristics, antimicrobial resistance, and mortality risk factors in DM versus non-DM patients with S. aureus pneumonia.
Purpose of the Study:
- To compare the clinical characteristics of S. aureus pneumonia in patients with and without diabetes mellitus.
- To investigate antimicrobial resistance patterns in S. aureus pneumonia between diabetic and non-diabetic patients.
- To identify independent risk factors for mortality in S. aureus pneumonia, with a focus on the impact of diabetes.
Main Methods:
- A retrospective study was conducted from 2014 to 2017, analyzing data from 365 patients with S. aureus pneumonia.
- Patient characteristics, comorbidities, invasive mechanical ventilation use, Hemoglobin A1c (HbA1c), CURB-65 scores, and clinical outcomes were assessed.
- Univariate and multivariate logistic regression analyses were employed to identify independent risk factors for mortality.
Main Results:
- DM patients (n=144) exhibited higher susceptibility to MRSA (65.3%) compared to non-DM patients (n=221, 56.1%).
- Diabetic patients presented with more severe pneumonia, evidenced by higher CURB-65 scores, increased invasive mechanical ventilation rates (46.5% vs. 28.1%), and higher mortality rates (30.6% vs. 23.1%).
- Higher HbA1c levels correlated with increased MRSA and co-infection rates, more severe pneumonia, and elevated mortality risk. MRSA and CURB-65 were identified as independent mortality risk factors.
Conclusions:
- Diabetic patients with poor glycemic control are more prone to MRSA pneumonia, experiencing greater antimicrobial resistance and co-infection rates.
- MRSA pneumonia is associated with increased severity and mortality in diabetic patients compared to non-diabetic individuals.
- Methicillin-resistant Staphylococcus aureus (MRSA) is confirmed as an independent risk factor for pneumonia-related mortality across all patient groups.
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