The Clinical Significance of Bacterial Growth in Venous Leg Ulcers

Abstract

The importance of pathogenic bacteria in venous leg ulcers was analysed in a randomized open trial divided into 2 parts. During the first 2-week period the effects of physiological saline and dextranomer beads were compared. During the following 8 weeks the effect of porcine skin, aluminium foil and a double layer bandage were compared. The assessment of the results of treatment was based on the area and volume of the ulcer measured by stereophotogrammetry and the bacteriological findings. Staphylococcus aureus was the commonest isolated species. Mixed cultures comprising Staph. aureus and gram-negative bacteria were the next commonest finding. There was a low frequency of isolation of anaerobic bacteria. The bacteriological findings were similar in the different treatment groups. The nature of the bacterial isolates and the colonization estimated by a contact-transfer procedure bore no relationship to the clinical assessment as to whether the ulcer was clean or purulent. Healing of the ulcer was not influenced by the bacteria present. The findings seem to indicate that as a rule the bacteria in the ulcers are saprophytic and will disappear when the favourable environment for their growth is lost.

Molecular Microbiology: New Dimensions for Cutaneous Biology and Wound Healing

“…For example, Schraibman (1990) was able to isolate b-hemolytic streptococci from 18% of chronic leg ulcers using selective streptococci media to culture the samples, which is significantly higher than that reported in other studies in which selective media were not used (Eriksson et al, 1984). In addition, several of the studies did not appropriately assess the presence of anaerobes by using a www.jidonline.org 45 long incubation time.…”

“…The most common aerobic bacteria cultured from venous ulcers include S. aureus, S. epidermidis, Streptococcus spp., Enterococcus spp., P. aeruginosa, and Proteus mirabilis (Table 2) (Eriksson et al, 1984;Gilchrist and Reed, 1989;Hansson et al, 1995;Brook and Frazier, 1998;Davies et al, 2007). The most common anaerobes isolated from these wounds are Peptococcus spp, Peptostreptococcus spp., Finegoldia spp., and Bacteroides spp.…”

The Beneficial Toxicity Paradox of Antimicrobials in Leg Ulcer Healing Impaired by a Polymicrobial Flora: A Proof-of-Concept Study

“…The role of bacteria in the pathogenesis of chronic leg ulcers and bedsores is unclear and disputed [1, 2, 3, 4, 5, 6, 7, 8, 9, 10]. Delayed healing has been reported to be linked to the influence of some or all recovered microorganisms even when clinical infection was not evidenced.…”

Bactericidal and Cytotoxic Effects of Chloramine-T on Wound Pathogens and Human Fibroblasts In Vitro

“…6 Although resistance toward antiseptics has been reported, it is to a significantly lesser extent than reported with antibiotic usage. 7 The cell membrane targets disabled by antiseptic agents have a broad spectrum of activity that includes bacteria, viruses, fungi, and protozoa. 8 Some broad-spectrum antiseptics can impact all types of bacteria found in wounds, including grampositive, gram-negative, and even some antibiotic-resistant strains.…”