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Background <p>Methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) is one of the most common organisms isolated in diabetic foot infections (DFIs), and MRSA infection is presumed to be associated with a higher risk of adverse limb outcomes. However, the relationship between MRSA infection and the risk of lower-extremity amputation in patients with DFIs has not been clearly established, prompting a thoroughevaluation.</p> Methods <p>PubMed, EBSCO, and ScienceDirect were searched using PRISMA guidelines to identify studies reporting MRSA infection and amputation outcomes in DFIs. Data were extracted to construct an individual 2 × 2 contingency table. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated using a random effects meta-analysis applying the Mantel-Haenszel method. Statistical heterogeneity was assessed using the <i>I²</i> statistic across studies.</p> Results <p>A total of 24 studies were included in the systematic review; however, only 4 provided data suitable for meta-analysis. The amputation rates reported in these studies varied significantly. In a pooled random-effects analysis, there was no significant association between lower-extremity amputation and MRSA infections (OR = 0.83, 95% CI = 0.29 to 2.33), and substantial heterogeneity was observed (<i>I²</i> = 89%).</p> Conclusion <p>MRSA infection was not independently associated with amputation in patients with DFIs. However, the variability and limited sample sizes of the existing studies hinder definitive conclusions. These findings indicate that DFIs should be considered a multifaceted condition influenced by comorbidities, vascular health, and infection severity, rather than solely by MRSA.</p>

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Association of Methicillin-Resistant Staphylococcus aureus with Amputation Risk in Diabetic Foot Infections: A Systematic Review and Meta-Analysis

  • 期刊论文

  • 发表日期：

    2026年6月19日

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  • John Ashley Flores,
  • Ian Dave Balanditan,
  • Angela Mae Cuartelon,
  • Sofia Alexis Dayrit,
  • Jan Clarence Salinas,
  • Caleb Tiam-Lee,
  • Raphael Enrique Tiongco

摘要

Background

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common organisms isolated in diabetic foot infections (DFIs), and MRSA infection is presumed to be associated with a higher risk of adverse limb outcomes. However, the relationship between MRSA infection and the risk of lower-extremity amputation in patients with DFIs has not been clearly established, prompting a thoroughevaluation.

Methods

PubMed, EBSCO, and ScienceDirect were searched using PRISMA guidelines to identify studies reporting MRSA infection and amputation outcomes in DFIs. Data were extracted to construct an individual 2 × 2 contingency table. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated using a random effects meta-analysis applying the Mantel-Haenszel method. Statistical heterogeneity was assessed using the I² statistic across studies.

Results

A total of 24 studies were included in the systematic review; however, only 4 provided data suitable for meta-analysis. The amputation rates reported in these studies varied significantly. In a pooled random-effects analysis, there was no significant association between lower-extremity amputation and MRSA infections (OR = 0.83, 95% CI = 0.29 to 2.33), and substantial heterogeneity was observed (I² = 89%).

Conclusion

MRSA infection was not independently associated with amputation in patients with DFIs. However, the variability and limited sample sizes of the existing studies hinder definitive conclusions. These findings indicate that DFIs should be considered a multifaceted condition influenced by comorbidities, vascular health, and infection severity, rather than solely by MRSA.