The microbiology of infected and noninfected leg ulcers
The microbiology of infected and noninfected leg ulcers
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DOI：
10.1046/j.1365-4362.1999.00738.x
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发表时间：
1999-08-01
影响因子：
3.6
通讯作者：
Davies, BJ
中科院分区：
文献类型：
--
作者：
Bowler, PG;Davies, BJ
方法对根据临床体征确定为感染的小腿溃疡进行需氧和厌氧微生物的拭子培养，并采用严格的分离鉴定技术进行需氧和厌氧微生物的检测。结果44例小腿溃疡患者共培养出220株细菌，30例未感染的小腿溃疡患者共培养出110株细菌。统计分析表明，每个感染溃疡的厌氧菌平均数量(特别是消化链球菌)显著增加。和普雷沃特拉菌(Prevoella spp.)非感染性溃疡组分别为2.5和1.3(P<；0.05)。此外，在感染的小腿溃疡中，厌氧菌占总微生物组成的49%，而在非感染的小腿溃疡中，这一比例为36%。两组创面平均需氧菌数差异无统计学意义(P>；0.05)。这项研究未能证明常见的兼性病原体与伤口感染之间存在明显的相关性。铜绿假单胞菌的分离率普遍较低，虽然金黄色葡萄球菌在两种创面中都是常见的菌株，但在非感染的小腿溃疡中更常见。结论本研究证实了小腿溃疡存在复杂的需氧-厌氧菌群，感染伤口中厌氧菌的存在，以及特定需氧病原菌的存在与伤口感染之间的相关性较差。鉴于这些发现，微生物协同作用在慢性创面感染发病机制中的作用可能比任何特定潜在病原体的单独参与更具有临床重要性。
Background A clinical study was undertaken to investigate and compare specifically the aerobic and anaerobic microbiology of infected and noninfected leg ulcers.Methods Leg ulcers, defined as being infected on the basis of clinical signs, were swab sampled and investigated for aerobic and anaerobic microorganisms using stringent isolation and identification techniques.Results Two hundred and twenty isolates were cultured from 44 infected leg ulcers, in comparison with 110 isolates from 30 noninfected leg ulcers. Statistical analysis indicated a significantly greater mean number of anaerobic bacteria per infected ulcer (particularly Peptostreptococcus spp. and Prevotella spp.) in comparison with the noninfected ulcer group (2.5 vs. 1.3, respectively) (P < 0.05). Also, anaerobes represented 49% of the total microbial composition in infected leg ulcers compared with 36% in noninfected leg ulcers. The mean numbers of aerobes per wound in the two ulcer groups were not statistically different (P > 0.05). The study failed to demonstrate a clear correlation between commonly implicated facultative pathogens and wound infection. The isolation rate of Pseudomonas aeruginosa was generally low and, although Staphylococcus aureus was a frequent isolate in both wound types, it was more prevalent in noninfected leg ulcers.Conclusions This study has demonstrated the complex aerobic-anaerobic microflora which exists in leg ulcers, the prevalence of anaerobes in infected wounds, and a poor correlation between the presence of specific aerobic pathogens and wound infection. In view of these findings, the role of microbial synergistic interactions in the pathogenesis of chronic wound infection may be of greater clinical importance than the isolated involvement of any specific potential pathogen.