Distinct Skin Microbiome and Skin Physiological Functions Between Bedridden Older Patients and Healthy People: A Single-Center Study in Japan
Distinct Skin Microbiome and Skin Physiological Functions Between Bedridden Older Patients and Healthy People: A Single-Center Study in Japan
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DOI：
10.3389/fmed.2020.00101
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发表时间：
2020-04-08
影响因子：
3.9
通讯作者：
Okamoto, Shigefumi
中科院分区：
文献类型：
--
作者：
Nagase, Satoshi;Ogai, Kazuhiro;Okamoto, Shigefumi
随着老年人口的增加，卧床不起的老年患者的数量正在成为一个令人关注的问题。已知皮肤微生物组和皮肤生理功能会根据生活方式和社区而改变;然而，在运动和清洁受限的卧床不起的老年患者的情况下，这种变化尚未被揭示。为了解决这个问题，我们分析了卧床不起的老年患者的皮肤微生物组和皮肤生理功能，包括pH值、水合作用、皮脂水平和经表皮水分丢失（TEWL），并与非卧床的老年人和年轻人进行了比较。在这项分析中，我们招募了来自社区的19名健康年轻人和18名非卧床老年人，以及来自日本一家长期护理医院的31名卧床不起的老年患者。感兴趣的区域被设置为骶骨（下背部）皮肤，在卧床不起的老年患者中经常发生压力损伤（PI）和随后的感染。我们观察到更多的肠道相关的细菌，更少的细菌，更高的皮肤pH值，和更低的TEWL的骶骨皮肤卧床不起的老年患者比年轻或走动的老年人。此外，我们观察到31例卧床不起的老年患者中有4例在研究期间发生PI;在PI伤口内也观察到较高丰度的致病性皮肤细菌。这些发现意味着与健康个体相比，卧床不起的老年患者具有不同的皮肤微生物组和皮肤生理功能，并且可能表明鉴于皮肤和伤口微生物组的紧密性，需要对卧床不起的老年患者的皮肤进行更严格的清洁。
With the increase in the older populations, the number of bedridden older patients is becoming a matter of concern. Skin microbiome and skin physiological functions are known to change according to lifestyle and community; however, such changes in case of movement- and cleaning-restricted bedridden older patients have not yet been revealed. To address this issue, we analyzed skin microbiome and skin physiological functions, including pH, hydration, sebum level, and transepidermal water loss (TEWL), of bedridden older patients, compared with those of ambulatory older and young individuals. For this analysis, we enrolled 19 healthy young and 18 ambulatory older individuals from the community and 31 bedridden older patients from a single, long-term care hospital in Japan. The area of interest was set to the sacral (lower back) skin, where pressure injuries (PIs) and subsequent infection frequently occurs in bedridden older patients. We observed a higher number of gut-related bacteria, fewer commensals, higher skin pH, and lower TEWL on the sacral skin of bedridden older patients than on that of young or ambulatory older individuals. In addition, we observed that 4 of the 31 bedridden older patients developed PIs during the research period; a higher abundance of pathogenic skin bacteria were also observed inside the PI wounds. These findings imply distinct skin microbiome and skin physiological functions in bedridden older patients in comparison with healthy individuals and may suggest the need for more stringent cleaning of the skin of bedridden older patients in light of the closeness of skin and wound microbiome.