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. 2024 Feb 5:14:1326904.
doi: 10.3389/fmicb.2023.1326904. eCollection 2023.

Clinical and microbiological features of host-bacterial interplay in chronic venous ulcers versus other types of chronic skin ulcers

Mara Mădălina Mihai  1   2 , Mircea Ioan Popa  3 , Alina Maria Holban  2 , Irina Gheorghe-Barbu  2 , Liliana Gabriela Popa  1 , Mariana-Carmen Chifiriuc  2 , Călin Giurcăneanu  1 , Coralia Bleotu  2   4 , Corina Ioana Cucu  1 , Veronica Lazăr  2
Affiliations

Clinical and microbiological features of host-bacterial interplay in chronic venous ulcers versus other types of chronic skin ulcers

Mara Mădălina Mihai et al. Front Microbiol. .

Abstract

Introduction: Chronic venous ulcers of the lower limbs develop in the context of advanced venous disease and have a significant impact on the patient's quality of life, being associated with depression and worrisome suicide rates, as well as with an economic burden caused by increased medical care costs and high epidemiological risks of healthcare associated infections and emergence of strains resistant to multiple classes of antibiotics and/ or antiseptics. Although numerous studies have investigated the composition of the chronic wounds microbiome, either by culture-dependent or independent methods, there are no data on the association between virulence and resistance profiles of strains isolated from venous ulcers and the clinical picture of this pathology. The elucidation of pathogenic mechanisms, at both phenotypic and molecular level, is crucial in the fight against these important human microbial agents, in order to develop novel biomarkers and discover new therapeutic targets.

Methods: In this study we aimed to characterize the phenotypic virulence profiles (including the ability to develop biofilms) of microorganisms isolated from chronic skin wounds and to correlate them with the clinical symptomatology. Considering the high incidence of Staphylococcus aureus infections in chronic ulcers, but also the ability of this species to develop multi-drug resistance, we performed an more in-depth study of the phenotypic and genotypic virulence profiles of methicillin-resistant Staphylococcus.

Results: The study revealed important differences regarding the clinical evolution and virulence profiles of microorganisms isolated from lower limb wounds, as well as between patients diagnosed with chronic venous ulcers and those with lesions of different etiology.

Keywords: bacterial virulence factors; bio-marker; chronic wound; host-microbiome; methicillin resistant Staphylococcus aureus (MRSA); tolerance at antimicrobials of biofilm cells.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Adherence patterns to HeLa cell substrate. (A) No adherence; (B) Diffuse aggregative adherence in a strain of Pseudomonas aeruginosa; (C) Diffuse adherence in a strain of Staphylococcus aureus; (D) Aggregative localized adherence, in a strain of Escherichia coli; (E) Aggregative localized adherence, in a strain of Staphylococcus aureus; (F) Aggregative localized adherence, in a strain of methicillin-resistant Staphylococcus aureus; (G) Aggregative diffuse adherence, in a strain of methicillin-resistant Staphylococcus aureus; (H) Aggregative diffuse adherence, in a strain of Klebsiella pneumoniae; (I) Aggregative diffuse adherence, in a strain of methicillin-resistant Staphylococcus aureus. Source: Mihai et al. (2014). Published with the permission of authors.
Figure 2
Figure 2
Detection of the production of different virulence factors in 8 bacterial strains analyzed. (A) Virulence factor: caseinase, medium: agar with addition of 15% casein; (B) Virulence factor: DNase, medium: DNase; (C) Virulence factor: esculinase, medium: agar supplemented with 1% esculin and iron citrate; (D) Virulence factor: hemolysins, medium: agar supplemented with 5% sheep blood. Bacterial strains tested: no. 207 Pseudomonas aeruginosa, no. 208 P. aeruginosa, no. 209 Escherichia coli, no. 210 Staphylococcus aureus, no. 211 MRSA, no. 212 Klebsiella pneumoniae, no. 213 P. aeruginosa.
Figure 3
Figure 3
Detection of the production of different virulence factors in 8 bacterial strains analyzed. (A) Virulence factor: gelatinase; medium: agar with the addition of 3% gelatin; (B) Virulence factor: lecithinase, medium: agar with the addition of 2.5% egg yolk; (C) Virulence factor: lipase, medium: agar supplemented with 1% Tween 80; (D) Virulence factor: amylase, medium: agar with 1% starch added, flooded with Lugol solution. Bacterial strains tested: no. 104 Staphylococcus aureus, no. 108 Pseudomonas aeruginosa, no. 114 MRSA, no. 117 S. aureus, no. 118 S. aureus, no. 120 S. aureus, no. 131 S. aureus, no. 134 MRSA.
Figure 4
Figure 4
Favorable evolution of a patient diagnosed with chronic venous leg ulcer. (A) Initial clinical aspect of the wound. (B) Clinical aspect at 2 months. (C) Clinical aspect at 6 months.
Figure 5
Figure 5
Distribution by species of the isolated bacterial strains (number of strains, %).
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References

    1. Alqatawni A., Sharma A. L., Attilus B., Tyagi M., Daniel R. (2020). Shedding light on the role of extracellular vesicles in HIV infection and wound healing. Viruses 12:584. doi: 10.3390/v12060584, PMID: - DOI - PMC - PubMed
    1. Angel D. E., Lloyd P., Carville K., Santamaria N. (2011). The clinical efficacy of two semi-quantitative wound-swabbing techniques in identifying the causative organism(s) in infected cutaneous wounds. Int. Wound J. 8, 176–185. doi: 10.1111/j.1742-481X.2010.00765.x, PMID: - DOI - PMC - PubMed
    1. Baba T., Takeuchi F., Kuroda M., Yuzawa H., Aoki K., Oguchi A., et al. . (2002). Genome and virulence determinants of high virulence community-acquired MRSA. Lancet 359, 1819–1827. doi: 10.1016/S0140-6736(02)08713-5 - DOI - PubMed
    1. Bianchi T., Wolcott R. D., Peghetti A., Leaper D., Cutting K., Polignano R., et al. . (2016). Recommendations for the management of biofilm: a consensus document. J. Wound Care 25, 305–317. doi: 10.12968/jowc.2016.25.6.305, PMID: - DOI - PubMed
    1. Bleotu C. C. M., Dracea O., Iordache C., Delcaru C., Lazar V. (2010). In vitro modulation of adherence and invasion ability of enteroinvasive Escherichia coli by different viruses. IJABPT. 1:5.

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