The Clinical Significance of Bacterial Growth in Venous Leg Ulcers

Eriksson, G; Eklund, Anders-Erik; Kallings, Lars Olof

doi:10.3109/13813458409087138

Cited by 16 publications

(28 citation statements)

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“…(i) Anaerobes are not regarded as being detrimental to normal wound healing (70,80,150,217). (ii) Compared with aerobic and facultative microorganisms, the culture, isolation, and identification of anaerobic bacteria is more time-consuming, labor-intensive, and expensive and is often deemed to be too demanding for many diagnostic microbiology laboratories.…”

Section: Microbial Colonizationmentioning

confidence: 99%

“…One school of thought is that the density of microorganisms is the critical factor in determining whether a wound is likely to heal (100,102,151,196,202). However, a second school of thought argues that the presence of specific pathogens is of primary importance in delayed healing (59,130,149,181,216,217), while yet others have reported microorganisms to be of minimal importance in delayed healing (4,70,80,95,98,214,237).…”

Section: Introductionmentioning

confidence: 99%

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Wound Microbiology and Associated Approaches to Wound Management

2001

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The majority of dermal wounds are colonized with aerobic and anaerobic microorganisms that originate predominantly from mucosal surfaces such as those of the oral cavity and gut. The role and significance of microorganisms in wound healing has been debated for many years. While some experts consider the microbial density to be critical in predicting wound healing and infection, others consider the types of microorganisms to be of greater importance. However, these and other factors such as microbial synergy, the host immune response, and the quality of tissue must be considered collectively in assessing the probability of infection. Debate also exists regarding the value of wound sampling, the types of wounds that should be sampled, and the sampling technique required to generate the most meaningful data. In the laboratory, consideration must be given to the relevance of culturing polymicrobial specimens, the value in identifying one or more microorganisms, and the microorganisms that should be assayed for antibiotic susceptibility. Although appropriate systemic antibiotics are essential for the treatment of deteriorating, clinically infected wounds, debate exists regarding the relevance and use of antibiotics (systemic or topical) and antiseptics (topical) in the treatment of nonhealing wounds that have no clinical signs of infection. In providing a detailed analysis of wound microbiology, together with current opinion and controversies regarding wound assessment and treatment, this review has attempted to capture and address microbiological aspects that are critical to the successful management of microorganisms in wounds

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Section: Microbial Colonizationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Wound Microbiology and Associated Approaches to Wound Management

2001

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“…This has facilitated a shift from conventional phenotypic methods for the detection of pathogens in clinical samples to the increased use of molecular approaches for both taxonomic and phylogenetic analysis (13). Conventional analysis of chronic wound communities has relied on traditional bacteriological culture methods (5,6,11,12,16,18), thereby completely missing the unculturable population that may be present (53) and thus strengthening the need for the application of such molecular techniques to wound ecology studies.…”

mentioning

confidence: 99%

Use of 16S Ribosomal DNA PCR and Denaturing Gradient Gel Electrophoresis for Analysis of the Microfloras of Healing and Nonhealing Chronic Venous Leg Ulcers

Davies

Hill

Wilson³

et al. 2004

J Clin Microbiol

133

130

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The bacterial microfloras of 8 healing and 10 nonhealing chronic venous leg ulcers were compared by using a combination of cultural analysis and denaturing gradient gel electrophoresis (DGGE) of PCR-amplified 16S rRNA gene products. Cultural analysis of the microflora revealed that the majority of both wound types carried the aerobes Staphylococcus and Pseudomonas spp. (89 and 80%, respectively). Sequencing of 16S ribosomal DNAs selected on the basis of DGGE profiling allowed the identification of strains not detected by cultural means. Of considerable interest was the finding that more than 40% of the sequences represented organisms not cultured from the wound from which they were amplified. DGGE profiles also revealed that all of the wounds possessed one apparently common band, identified by sequencing as Pseudomonas sp. The intensity of this PCR signal suggested that the bacterial load of nonhealing wounds was much higher for pseudomonads compared to healing wounds and that it may have been significantly underestimated by cultural analysis. Hence, the present study shows that DGGE could give valuable additional information about chronic wound microflora that is not apparent from cultural analysis alone.

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“…Unfortunately, few conclusions can be drawn, mostly from the descriptive culture data, due to insufficient details in the results. For example, of the studies with multiple sampling time points, some concluded that the bacterial communities remained relatively the same, [29][30][31]38 whereas others reported wide variations with time; 16,32,35 however, there is no objective measure of the relative extent of variation in the different studies, making these conclusions subjective. Also, these studies included minimal information on changes in patient/ulcer characteristics (such as clinical signs and symptoms of infection) that could aid in further interpretation of differences between samples at various time points.…”

Section: Microbial Diversitymentioning

confidence: 99%

“…As summarized in Table 1, several studies have shown no association between any specific bacterial species and healing outcomes. 16,[29][30][31][32][33] Among studies that show associations, there are conflicting conclusions on the relevance of many of the commonly isolated species, such as Staphylococcus aureus and Pseudomonas species, as well as anaerobes ( Table 2). Most studies of S. aureus show no association with healing delay or increased ulcer size.…”

Section: Presence Of Pathogenic Organismsmentioning

confidence: 99%

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

Tuttle

2015

Advances in Wound Care

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The Clinical Significance of Bacterial Growth in Venous Leg Ulcers

Cited by 16 publications

References 0 publications

Wound Microbiology and Associated Approaches to Wound Management

Wound Microbiology and Associated Approaches to Wound Management

Use of 16S Ribosomal DNA PCR and Denaturing Gradient Gel Electrophoresis for Analysis of the Microfloras of Healing and Nonhealing Chronic Venous Leg Ulcers

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

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