Bacterial colonization and healing of venous leg ulcers

Abstract

The aim of the study was to evaluate a possible influence of selected bacterial species on healing of venous leg ulcers. Fifty-nine patients with venous leg ulcers were followed via frequent semiquantitative culture of bacteria from the ulcer surface and determination of the ulcer area over a period of 180 days. Occurrences of cellulitis were treated with systemic antibiotics. There was a significant difference in relative areas on days 90 and 180 when ulcers with growth of Pseudoomonus ueruginosu were compared to those without (p=0.0080 and 0.0133, respectively). Ulcers with P. ueruginosa were characterized to a great extent by enlargement in contrast to those without. Ulcers with growth of Stuphyiococcus uureus or haemolytic streptococci healed significantly more slowly than those without when relative areas were compared on day 180 (p=0.0079 and 0.0492, respectively). Complete healing within the observation period of 180 days was observed in 10.5'%~ of patients with P. aeruginosa and 35% of those without (p=0.0631), in 21.6% of patients with S. uureus and 62.5% of those without (p=0.0278), and in 10.5'%, of patients with haemolytic streptococci and 35% of those without ( p = 0.0631). The initial areas of ulcers colonized with P. aeruginosu or S. uureus were significantly larger than those without, but no significant correlation between initial areas and ulcer healing was revealed. Conclusion: Our results suggest that P. aeruginosa in venous leg ulcers can induce ulcer enlargement and/or cause a healing delay. The results also suggest a healing delay caused by S. uureus and haemolytic streptococci. However, conclusions have to be treated with caution since P. ueruginosu was found in combination with haemolytic streptococci in 15.3% of the patients.

Prevalence and antibiotic susceptibility of bacteria from acute and chronic wounds in Malaysian subjects

“…In this study, higher occurrence rates of S. aureus and P. aeruginosa were observed in chronic wounds than in acute wounds. Madsen et al [32] and Zhao et al [33] reported that wounds infected with S. aureus and P. aeruginosa were generally slower to heal. Athanasopoulos et al [34] and Edwards et al [35] postulated that the extracellular adherence protein (Eap) of S. aureus may play a pivotal role in impaired wound healing by impeding the inflammatory state and inhibiting angiogenesis in the proliferative stage.…”

Nonrandom Distribution of Pseudomonas aeruginosa and Staphylococcus aureus in Chronic Wounds

“…A number of studies have demonstrated that P. aeruginosa is frequently present in chronic wounds (12,17) and have provided evidence that the bacteria are located in aggregates enclosed in extracellular polymeric matrix material as found in biofilms (17). Furthermore, chronic wounds that harbored P. aeruginosa were larger than those that did not, and the healing process also seemed to be more severely hindered for those wounds (12,14,20).…”

Nano-Engineered Biomaterials for Tissue Regeneration: What Has Been Achieved So Far?

“…Chronic wounds are defined as lesions that present impaired (i.e., slow) wound healing (Kirsner and Eaglstein, 1993). Among possible causes for such impaired healing is the persistent inflammation within the actual wound, caused by bacteria colonization, for example (Ehrlich, 1998;Fukai et al, 2005), which is exacerbated in diabetic patients (Lookingbill et al, 1978;Madsen et al, 1996;Robson, 1997;Sibbald et al, 2000;Baltzis et al, 2014;Eming et al, 2014). This permanent inflammatory state results in early degradation of newly forming tissue, creating a neverending loop of wound healing (Rogers et al, 1995;Yager et al, 1996;Kahari and Saarialho-Kere, 1997;Trengove et al, 1999;Liu et al, 2009).…”