Distinct Skin Microbiome and Skin Physiological Functions Between Bedridden Older Patients and Healthy People: A Single-Center Study in Japan

Abstract

With the increase in the older populations, the number of bedridden older patients is becoming a matter of concern. Skin microbiome and skin physiological functions are known to change according to lifestyle and community; however, such changes in case of movement-and cleaning-restricted bedridden older patients have not yet been revealed. To address this issue, we analyzed skin microbiome and skin physiological functions, including pH, hydration, sebum level, and transepidermal water loss (TEWL), of bedridden older patients, compared with those of ambulatory older and young individuals. For this analysis, we enrolled 19 healthy young and 18 ambulatory older individuals from the community and 31 bedridden older patients from a single, long-term care hospital in Japan. The area of interest was set to the sacral (lower back) skin, where pressure injuries (PIs) and subsequent infection frequently occurs in bedridden older patients. We observed a higher number of gut-related bacteria, fewer commensals, higher skin pH, and lower TEWL on the sacral skin of bedridden older patients than on that of young or ambulatory older individuals. In addition, we observed that 4 of the 31 bedridden older patients developed PIs during the research period; a higher abundance of pathogenic skin bacteria were also observed inside the PI wounds. These findings imply distinct skin microbiome and skin physiological functions in bedridden older patients in comparison with healthy individuals and may suggest the need for more stringent cleaning of the skin of bedridden older patients in light of the closeness of skin and wound microbiome.

Recovery Dynamics of Intestinal Bacterial Communities of CCl4-Treated Mice with or without Mesenchymal Stem Cell Transplantation over Different Time Points

“…PERMANOVA, SIMPER, and PAM clustering analyses have been used in a variety of studies [ 32 – 34 ]. In the current study, the differences in bacterial communities between the MSC and CCl 4 groups at designated times (i.e., 48 h, 1 w, and 2 w) were determined by the three analyses, and the relevant results showed the largest difference between the MSC and CCl 4 groups occurred at 48 h. As the most obvious difference of survival percentages of mice between the MSC and CCl 4 groups occurred from 48 h to 1 w, it implied that the change of intestinal bacterial communities was associated with this obvious difference.…”

Stability of Skin Microbiome at Sacral Regions of Healthy Young Adults, Ambulatory Older Adults, and Bedridden Older Patients After 2 Years

“…In a previous study by Nagase et al (2020), the sacral region, where PIs frequently occur, was found to be contaminated with gut-related bacteria such as Bacteroides species (spp. ), Enterococcus spp., and Klebsiella spp.…”

“…), Enterococcus spp., and Klebsiella spp. Moreover, the wound microbiome just after PI occurrence was very close to the skin microbiome around the PI, implying that the underlying skin microbiome may be a cause of wound infection (Konya et al, 2005; Nagase et al, 2020; Smith et al, 2010).…”

“…In addition to the microbial changes of the sacral skin in bedridden older patients, in the previous study, the skin physiological functions, namely, SC hydration, skin pH, and transepidermal water loss (TEWL), were measured, and the skin pH in the sacral region of bedridden older patients was significantly higher than that of the healthy participants (Nagase et al, 2020). To treat the higher rate of gut-related bacteria and higher skin pH in the sacral region of bedridden older patients, an intensive skin care regimen with mildly acidic detergents or skin care products was proposed (Nagase et al, 2020).…”

“…It is important to answer this question so that a proper skin care strategy can be developed for such patients. In the present study, therefore, we analyzed the changes in microbiome composition and skin condition by recruiting the same participants that were used in the 2017 study (Nagase et al, 2020). For comparison, we also recruited the same healthy young and ambulatory older adults as in the 2017 study.…”