Qualitative bacteriology and leg ulcer healing

Abstract

This study investigated the bacterial profile of leg ulcers in 52 patients attending the Fremantle Hospital leg ulcer clinic. The aim was to identify whether the presence of specific bacterial groups delays healing, whether the bacterial flora changes as ulcers heal and, if so, whether these changes influence healing. The results show that the presence of any one specific bacterial group did not appear to delay healing, although the presence of four or more bacterial groups was associated with delayed healing. This was found to be statistically significant. It was noted that the bacterial flora does change as ulcers heal and that these changes were not related to changes in healing, with the exception of skin flora.

Association Between Microbial Bioburden and Healing Outcomes in Venous Leg Ulcers: A Review of the Evidence

“…10,14 Fewer studies comment on anaerobes and the rigor of anaerobic cultivation methods vary widely, but even these studies disagree on the association of anaerobes with healing. 24,34,35,37 Results for Streptococcus species are most consistent, with most studies showing association with ulcers of increased size, longer duration, and healing delay. 24,[34][35][36] Interestingly, the studies that did not find associations between bacterial populations and healing were more likely to exclude patients with clinical signs of infection in the study design (Table 1 vs. Table 2).…”

“…24,34,35,37 Results for Streptococcus species are most consistent, with most studies showing association with ulcers of increased size, longer duration, and healing delay. 24,[34][35][36] Interestingly, the studies that did not find associations between bacterial populations and healing were more likely to exclude patients with clinical signs of infection in the study design (Table 1 vs. Table 2). In all of the studies examined, clinical signs of infection were not defined, except for the report by Moffatt et al, which listed pain, odor, swelling, erythema, and confirmation by microbiological results without further definition.…”

“…24,34,35 However, there are studies that associate S. aureus both with delayed healing 14,36 and smaller, healing ulcers. 23,37 Similarly, Pseudomonas species have been associated both with larger ulcers and delayed healing, 24,[34][35][36]38 whereas other (although fewer) studies have found that ulcers harboring Pseudomonas were more likely to heal normally. 10,14 Fewer studies comment on anaerobes and the rigor of anaerobic cultivation methods vary widely, but even these studies disagree on the association of anaerobes with healing.…”

“…For the cultivation-based studies reviewed here, diversity is defined as the number of different species of bacteria cultured from an ulcer sample. As summarized in Tables 1 and 2, some studies have concluded that nonhealing ulcers were more likely to have a higher microbial diversity, 23,35 but others have shown that diversity could not be used to predict healing. 14,32 For studies using DNA sequencing data, more specific ecological concepts of diversity can be used.…”

Bacterial Agents in Diabetic Foot Infections and Their Biofilm Formation Rates

“…İlginç olarak yaradaki bakteri türünden çok, tür sayısı yara iyileşmesi ile daha çok ilişkilidir. Yara iyileşmesindeki gecikme, dört veya daha fazla bakteri türü varlığında, tür sayısı ile doğru orantılıdır (16) . Biyofilm çoğunlukla birden çok tür içeren mikroorganizma topluluklarından oluşur, bu nedenle mikrobiyal virülansın sinerjik etkisi sıklıkla yara komplikasyonları ile sonuçlanır (17,18) .…”