Abstract
Purpose: The bacterial manifestation in Skin ulcer is a common type of disease affecting patients' health and quality of life. Due to increases in antibiotic resistance, the difficulty of its management.
Methods: A prospective study was carried out on skin ulcers by collecting the results of bacterial culture sampled of 110 cases from January 2016 to December 2017 at our hospital. We analyzed the constituent ratios of ulcer surface bacteria, the change in the main infectious bacteria and the results of drug sensitivity testing for common bacteria. In addition, the characteristics of bacterial infection of skin ulcers were summarized.
Result: Out of 110 samples, 90 isolated bacteria were cultured. 61 samples were Gram-negative bacteria, mainly comprising Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter cloacae and Escherichia coli. In addition, 23 isolates were Gram-positive bacteria, mainly comprising Staphylococcus aureus and Enterococcus faecalis. The probability of a negative bacterial culture in 2017 was significantly lower than that in 2016 (16.7% vs. 40.0%, p < 0.01). Moreover, the probability of P. aeruginosa infection in 2017 was significantly higher than that in 2016 (31.7% vs. 14.0%, p < 0.01). P. aeruginosa was resistant to seven commonly used antibiotics. Both K. pneumoniae and E. coli had higher resistance to ampicillin. E. cloacae were not sensitive to piperacillin/tazobactam. Acinetobacter baumannii was resistant to all the tested drugs. S. aureus, E. faecalis and Staphylococcus epidermidis had high resistance to clindamycin. There was other drug resistance to reflect the higher rate of skin bacterial resistance.
Conclusion: Skin bacterial resistance rate is high. Gram-negative bacteria gradually account for the majority, and P. aeruginosa becomes the most important skin infection pathogen. These characteristics of bacterial infections of skin ulcers provide a significant reference for guiding the selection of antibiotics, better controlling infections of skin ulcers and accelerating the healing of skin ulcers.
Keywords: Skin ulcer, Infection Bacteria, Drug sensitivity.
References
- Mansilha A, Brand~ao D. Guidelines for treatment of patients with diabetes and infected ulcers. J Cardiovasc Surg (Torino). 2013;54(1 Suppl 1):193e200.
- Renner R, Sticherling M, Rüger R, et al. Persistence of bacteria like Pseudomonas aeruginosa in non-healing venous ulcers. Eur J Dermatol. 2012;22(6):751e757.
- Gjødsbøl K, Christensen JJ, Karlsmark T, et al. Multiple bacterial species reside in chronic wounds: a longitudinal study. Int Wound J. 2006;3(3):225e231.
- Bessa LJ, Fazii P, Di Giulio M, et al. Bacterial isolates from infected wounds and their antibiotic susceptibility pattern: some remarks about wound infection. Int Wound J. 2015;12:47e52.
- Coetzee E, Rode H, Kahn D. Pseudomonas aeruginosa burn wound infection in a dedicated paediatric burns unit. S Afr J Surg. 2013;51:50e53.
- Bowling FL, Dissanayake SU, Jude EB. Opportunistic pathogens in diabetic foot lesions. Curr Diabetes Rev. 2012;8(3): 195e199.
- Hurlow J, Bowler PG. Potential implications of biofilm in chronic wounds: a case series. J Wound Care. 2012;21: 109e110.
- Bowler PG, Welsby S, Towers V, et al. Multidrug-resistant organisms, wounds and topical antimicrobial protection. Int Wound J. 2012;9:387e396.
- Mulu, F. Moges, B. Tessema, and A. Kassu, “Pattern and multiple drug resistance of bacterial pathogens isolated from wound infection at University of Gondar Teaching Hospital, northwest Ethiopia,” Ethiopian Medical Journal, vol. 44, no. 2, pp. 125–131, 2006. · View at Scopus
- Biadglegne, B. Abera, A. Alem, and B. Anagaw, “Bacterial isolates from wound infection and their antimicrobial susceptibility pattern in Felege Hiwot Referral Hospital, North west Ethiopia,” Ethiopian Journal of Health Sciences, vol. 19, no. 3, pp. 173–177, 2009.
- Abraham and B. L. Wamisho, “Microbial susceptibility of bacteria isolated from open fracture wounds presenting to the err of black-lion hospital, Addis Ababa University, Ethiopia,” African Journal of Microbiology Research, vol. 3, no. 12, pp. 939–951, 2009. · View at Scopus
- Kibret and B. Abera, “Bacteriology and antibiogram of pathogens from wound infections at Dessie Laboratory, North East Ethiopia,” Tanzania Journal of Health Research, vol. 13, no. 4, pp. 1–11, 2011.
- Valarmathi, M. R. Pandian, and B. Senthilkumar, “Incidence and screening of wound infection causing microorganisms,” Journal of Academy Industry Research, vol. 1, no. 8, pp. 508–510, 2013.
- A. Wariso and C. O. Nwachukwu, “A survey of common pathogens in wound in patients at University of Port Harcourt Teaching Hospital (U.P.T.H.), Port Harcourt,” West African Journal of Medicine, vol. 22, no. 1, pp. 50–54, 2003. · View at Scopus
- Garba, Y. Lusa, E. Bawa, M. Tijjani, M. Aliyu, and U. Raji, “Antibiotics susceptibility pattern of Pseudomonas aeruginosa isolated from wounds in patients attending Ahmadu Bello University Teaching Hospital, Zaria, Nigeria,” Nigerian Journal of Basic and Applied Science, vol. 20, pp. 32–34, 2012.
- Giacometti, O. Cirioni, A. M. Schimizzi et al., “Epidemiology and microbi-ology of surgical wound infections,” Journal of Clinical Microbiology, vol. 38, no. 2, pp. 918–922, 2000.
- Shittu, D. Kolawole, and E. Oyedepo, “A study of wound infections in two health institutions in Ile-Ife, Nigeria,” African Journal of Biomedical Research, vol. 5, pp. 97–102, 2002.
- N. Ohalete, R. K. Obi, and M. C. EmeaKoroha, “Bacteriology of different wound infection and their antimicrobial susceptibility patterns in Imo state Nigeria,” World Journal of Pharmaceutical Sciences, vol. 13, no. 3, pp. 1155–1172, 2012.
- Bhat and S. Vasaikar, “Bacteriological profile and antibiogram of aerobic burn wound isolates in Mthatha, Eastern Cape, South Africa,” South Africa Journal of Epidemiology and Infectious, vol. 25, pp. 16–19, 2010.
- Shriyan, R. Sheetal, and N. Nayak, “Aerobic micro-organisms in post-operative wound infections and their antimicrobial susceptibility patterns,” Journal of Clinical and Diagnostic Research, vol. 4, no. 6, pp. 3392–3396, 2010.
- N. Nwachukwu, F. Orji, and U. Okike, “Antibiotic susceptibility patterns of bacterial isolates from surgical wounds in Abia State University Teaching Hospital (ABSUTH), Aba -Nigeria,” Research Journal of Medicine and Medical Sciences, vol. 4, pp. 575–579, 2009.
Corresponding Author
Dr Mahesh Chandra Sahu
Assistant Professor, Medical Research Laboratory
IMS and SUM Hospital, Bhubaneswar
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.