Gelatti LC, Bonamigo RR, Becker AP, Eidt LM, Ganassini L, d' Azevedo PA. Phenotypic, molecular and antimicrobial susceptibility assessment in isolates from chronic ulcers of cured leprosy patients: a case study in Southern Brazil.
An Bras Dermatol 2014;
89:404-8. [PMID:
24937812 PMCID:
PMC4056696 DOI:
10.1590/abd1806-4841.20142688]
[Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 06/20/2013] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND
One of the most stigmatizing physical sequelaeof leprosy in cured patients
is the development of chronic lower extremity ulcers. The bacterial
diversity present in ulcers is considered one of the factors that can delay
the healing process, as well as serve as a focus for severe secondary
infections.
OBJECTIVE
To identify the microbiota and antimicrobial resistance profile of bacteria
isolated from skin ulcers in patients cured of leprosy.
METHODS
After obtaining informed consent, material was collected from ulcers of 16
patients treated at the Outpatient Public Health Dermatology Clinic of Rio
Grande do Sul and Hospital Colônia Itapuã. Sampleswere
collected during dressing, and the material sent to the Microbiology
Laboratory of the Federal University of Health Sciences of Porto Alegre for
microbiological culture. Methicillin-resistant Staphylococcus aureus
(MRSA) was characterized by two molecular methods, including
detection of the mecA gene by PCR and SCCmecgene typing.
RESULTS
Cultures revealed microorganisms in all ulcers: Gram-negative bacilli in
80%, Gram-positive cocci in 63%, and mixed microflora in 36%.
Staphylococcus aureus and Pseudomonas aeruginosa were
the most prevalent bacteria. Assessment of the antimicrobial resistance
profile was notable for the presence of MRSA. Molecular analysis of this
isolate revealed presence of the mecA gene contained in a type IV
staphylococcal cassette chromosome mec (SCCmec).
CONCLUSIONS
In patients with leprosy, laboratory culture of skin ulcers is essential for
correct antibiotic selection and to control emerging pathogens, such as MRSA
carrying SCCmec type IV.
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