Bakterielle Kolonisation chronischer Wunden

Abstract

In this retrospective investigation, we documented the bacterial colonization of 79 patients with chronic wounds, who had been treated between January 2002 and May 2003 in an outpatient wound healing clinic of a university dermatology program. We isolated 106 facultative pathogenic bacterial strains of which 56 were Staphylococcus aureus, 19 Pseudomonas aeruginosa, 11 Escherichia coli, 4 Proteus mirabilis, 4 Enterobacter cloacae, 2 Serratia marcescens, 2 Streptococcus group G und 8 further species. 68 of these bacterial strains were gram-positive and 46 gram-negative. Moreover we identified one patient with Candida parapsilosis. Therefore, 70.8% of all patients showed Staphylococcus aureus in their chronic wounds. Determination of the specific resistances showed 17 patients to be colonized with oxacillin- resistant Staphylococcus aureus (ORSA) strain; this corresponds to 21.5% of all patients. Consequently, 30.4% of all Staphylococcus aureus isolates were ORSA strains. All of the ORSA isolates were sensitive to vancomycin. Sensitivity to tetracycline was documented in 15, to amikacin in 13, to clindamycin in 7, to gentamicin and erythromycin in 6 of the ORSA-positive patients. In the case of trimethoprim/sulfamethoxazole, 10 were sensitive and 3 were intermediate in sensitivity. Beside the obligate resistance to oxacillin, penicillin G, ampicillin, cefuroxime and imipenem, none of the ORSA was sensitive to ofloxacin. The results of our investigations demonstrate the actual spectrum of bacterial colonization in chronic wounds of patients in an university dermatologic wound clinic and underline the growing problem of ORSA.

pH Influence on Antibacterial Efficacy of Common Antiseptic Substances

“…whether wound pH affects the activity and efficacy of antimicrobial agents. As chronic wounds are frequently colonized by different kinds of microorganisms, the most prominent being S. aureus and P. aeruginosa [12,24], an antimicrobial treatment is often necessary to avoid or eliminate wound infection. Hence, it is of interest to investigate the influence of the pH on the performance of antimicrobial substances.…”

“…Contamination and infection of wounds can disrupt the regular healing sequence and result in a chronic inflammation, which hinders reepithelization [8,9,10]. Most chronic wounds are polymicrobial, and infections generally involve mixed populations of aerobic and anaerobic bacteria [11,12]. Staphylococcus aureus is considered to be the most problematic germ in traumatic, surgical and burn wound infections [12,13], but other microorganisms such as Pseudomonas aeruginosa , Escherichia coli and Klebsiella pneumoniae may also play a role in chronic wound infection [13].…”

“…Most chronic wounds are polymicrobial, and infections generally involve mixed populations of aerobic and anaerobic bacteria [11,12]. Staphylococcus aureus is considered to be the most problematic germ in traumatic, surgical and burn wound infections [12,13], but other microorganisms such as Pseudomonas aeruginosa , Escherichia coli and Klebsiella pneumoniae may also play a role in chronic wound infection [13]. Hence, an antimicrobial treatment, based on systemic and topical antibiotics or using antiseptic substances, is often necessary to avoid or to eliminate wound infection.…”

“…This study uses both ADT and MLN to investigate the influence of the pH on the activity and the efficacy of common antiseptic substances, such as silver nitrate, polihexanide, chlorhexidine, octenidine and PVP-iodine. S. aureus and P. aeruginosa , the most prominent bacteria in wound infection [12,24], have been used as model organisms. Moreover, the antibiotics vancomycin and gentamycin were included in the study for comparison.…”

Antimicrobial Impact of Cold Atmospheric Pressure Plasma on Medical Critical Yeasts and Bacteria Cultures

“…Microorganisms influence the balance of degradation and reconstructive processes during wound healing by amplifying and/or perpetuating a proinflammatory environment that hinders reepithelization [5,6]. As a specific example, Staphylococcus aureus is considered to be the most problematic bacterium in traumatic, surgical and burn wound infections, primarily based on the knowledge that its incidence is high in these and other types of wounds [7,8]. Other bacteria such as Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae may also play a role in chronic wound infection [8].…”