Potential role of anaerobic cocci in impaired human wound healing

Wall, Ivan; Davies, C.; Hill, Katja E.; Wilson, Matthew; Stephens, Philip J.; Harding, Keith; Thomas, David W.

doi:10.1046/j.1524-475x.2002.t01-1-10602.x

Cited by 52 publications

(31 citation statements)

References 69 publications

(65 reference statements)

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“…They also release short-chain fatty acids that have been shown to inhibit proliferation of fibroblasts, keratinocytes, and endothelial cells (Heerdt et al, 1997). Short-chain fatty acids may also be the causative agent of the malodor associated with anaerobic organisms, and may also contribute to hyperlipidemia associated with very large wounds, which slows wound healing in diabetic and nondiabetic patients (Wall et al, 2002).…”

Section: Pressure Ulcersmentioning

confidence: 99%

Molecular Microbiology: New Dimensions for Cutaneous Biology and Wound Healing

Martin

Zenilman

Lazarus

2010

Journal of Investigative Dermatology

139

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The role of bacteria in the pathogenesis of chronic, nonhealing wounds is unclear. All wounds are colonized with bacteria, but differentiating colonizers from invading organisms is difficult, if not impossible, at the present time. Furthermore, robust new molecular genomic techniques have shown that only 1% of bacteria can be grown in culture; anaerobes are especially difficult to identify using standard culture methods. Recent studies utilizing microbial genomic methods have demonstrated that chronic wounds are host to a wide range of microorganisms. New techniques also show that microorganisms are capable of forming highly organized biofilms within the wound that differ dramatically in gene expression and phenotype from bacteria that are typically seen in planktonic conditions. The aim of this review is to present a concise description of infectious agents as defined by new molecular techniques and to summarize what is known about the microbiology of chronic wounds in order to relate them to the pathophysiology and therapy of chronic wounds.

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Section: Pressure Ulcersmentioning

confidence: 99%

Molecular Microbiology: New Dimensions for Cutaneous Biology and Wound Healing

Martin

Zenilman

Lazarus

2010

Journal of Investigative Dermatology

139

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“…These wounds harbour a diverse microflora, which contributes both directly and indirectly to their non-healing phenotype (Stephens et al, 2003;Wall et al, 2002). Much attention has recently been focused on the ability of the bacteria within chronic wounds to form and exist within a biofilm (James et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Detection and identification of specific bacteria in wound biofilms using peptide nucleic acid fluorescent in situ hybridization (PNA FISH)

et al. 2009

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Biofilms provide a reservoir of potentially infectious micro-organisms that are resistant to antimicrobial agents, and their importance in the failure of medical devices and chronic inflammatory conditions is increasingly being recognized. Particular research interest exists in the association of biofilms with wound infection and non-healing, i.e. chronic wounds. In this study, fluorescent in situ hybridization (FISH) was used in combination with confocal laser scanning microscopy (CLSM) to detect and characterize the spatial distribution of biofilm-forming bacteria which predominate within human chronic skin wounds (Pseudomonas aeruginosa, Staphylococcus aureus, Streptococcus sp. and Micrococcus sp.). In vitro biofilms were prepared using a constant-depth film fermenter and a reconstituted human epidermis model. In vivo biofilms were also studied using biopsy samples from non-infected chronic venous leg ulcers. The specificity of peptide nucleic acid (PNA) probes for the target organisms was confirmed using mixed preparations of planktonic bacteria and multiplex PNA probing. Identification and location of individual bacterial species within multi-species biofilms demonstrated that P. aeruginosa was predominant. CLSM revealed clustering of individual species within mixed-species biofilms. FISH analysis of archive chronic wound biopsy sections showed bacterial presence and allowed bacterial load to be determined. The application of this standardized procedure makes available an assay for identification of single-or multi-species bacterial populations in tissue biopsies. The technique provides a reliable tool to study bacterial biofilm formation and offers an approach to assess targeted biofilm disruption strategies in vivo.

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“…Previous studies have shown that when optimal specimen collection, transport, and culture techniques are used, multiple organisms are usually recovered from DFIs (6,14,23,29,30,45,55). Furthermore, some studies suggest that the interactions of organisms within these polymicrobial mixtures lead to the production of virulence factors, such as hemolysins, proteases, and collagenases, as well as short-chain fatty acids, that cause inflammation, impede wound healing, and contribute to the chronicity of the infection (5,52,53,56). In such mixtures, biofilms that impede the penetration of antimicrobial agents into the infected site may also form (25).…”

mentioning

confidence: 99%

Bacteriology of Moderate-to-Severe Diabetic Foot Infections and In Vitro Activity of Antimicrobial Agents

Citron¹,

Goldstein

Merriam³

et al. 2007

J Clin Microbiol

420

319

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While foot infections in persons with diabetes are initially treated empirically, therapy directed at known causative organisms may improve the outcome. Many studies have reported on the bacteriology of diabetic foot infections (DFIs) over the past 25 years, but the results have varied and have often been contradictory. A number of studies have found that Staphylococcus aureus is the main causative pathogen (12,34,35), but two recent investigations reported a predominance of gram-negative aerobes (20, 47). The role of anaerobes is particularly unclear, because in many studies specimens were not collected or cultured properly to recover these organisms. Among those that did use appropriate methods, some report that anaerobes play a minimal role (2,7,15,21,46), while others suggest that Bacteroides fragilis is the predominant anaerobe isolated (1,3,17,57).These discrepancies could be partly due to differences in the causative organisms occurring over time, geographical variations, or the types and severity of infection included in the studies (1,20,47,51). In addition, some studies used a relatively small number of specimens, failed to report recent or concomitant antibiotic therapy, did not ensure that the specimen collection techniques would exclude superficial or colonizing organisms, or even make clear whether or not the wound was clinically infected. Also, laboratory processing of the samples may have been inadequate to grow anaerobes or fastidious organisms, and protocols that classify potential pathogens (e.g., coagulase-negative staphylococci [CoNS] or Corynebacterium species) as colonizers may have been used (4,46,49).While S. aureus and beta-hemolytic streptococci are widely recognized as pathogens in early DFIs, the role of other frequently isolated organisms is less clear to both the clinician and the microbiology laboratory. Previous studies have shown that when optimal specimen collection, transport, and culture techniques are used, multiple organisms are usually recovered from DFIs (6,14,23,29,30,45,55). Furthermore, some studies suggest that the interactions of organisms within these polymicrobial mixtures lead to the production of virulence factors, such as hemolysins, proteases, and collagenases, as well as short-chain fatty acids, that cause inflammation, impede wound healing, and contribute to the chronicity of the infection (5,52,53,56). In such mixtures, biofilms that impede the penetration of antimicrobial agents into the infected site may also form (25). Thus, the presence of multiple species can have important clinical implications that should not be overlooked (5, 23).

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Potential role of anaerobic cocci in impaired human wound healing

Cited by 52 publications

References 69 publications

Molecular Microbiology: New Dimensions for Cutaneous Biology and Wound Healing

Molecular Microbiology: New Dimensions for Cutaneous Biology and Wound Healing

Detection and identification of specific bacteria in wound biofilms using peptide nucleic acid fluorescent in situ hybridization (PNA FISH)

Bacteriology of Moderate-to-Severe Diabetic Foot Infections and In Vitro Activity of Antimicrobial Agents

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