MRSA and diabetic foot wounds: contaminating or infecting organisms?

Although infection is a well-recognized barrier to healing, evidence has emerged that wound colonization with methicillin-resistant Staphylococcus aureus (MRSA) has the same effect, which has been quantified as increasing the time to healing twofold. MRSA is a concern for those with diabetic foot ulcers based on evidence of impaired healing when it is present in the wound. However, many studies have found the bacterial content of diabetic foot ulcers to be polymicrobial, which necessitates MRSA being placed in this environmental context. Multiple variables contribute to the development of infection, including the host response, tissue perfusion, ulcer depth, ulcer location, and an adequate source of nutrition. In view of these factors, it is difficult to attribute infection to one bacterial species.