Department of Microbiology, Falavarjan Branch, Islamic Azad University, Isfahan, Iran.
Med Sci Monit. 2012 Sep;18(9):BR356-61. doi: 10.12659/msm.883345.
BACKGROUND: Zoonotic Cutaneous Leishmaniasis (ZCL) is a polymorphic disease. It is generally accepted that bacterial superinfection may play a role in the clinical appearance of the lesions and may delay or prevent the healing process. However, the pattern of bacterial pathogens involved has rarely been investigated. MATERIAL/METHODS: The aim of this study was to identify the bacterial species contaminating the suspected ZCL and their susceptibility to commonly used antibiotics. Microscopic examination of stained smears and cultures were used to differentiate ZCL from non-ZCL lesions in a rural area north of Isfahan, Iran from July to December 2009. Bacteria were isolated from the lesions and identified and antibiotic susceptibility was determined by standard microbiological techniques. RESULTS: The results show that 602 (68%) of 855 patients were positive for ZCL, of which 83.4% with volcano-shape, 8.8% psoriasiform, 6.6% popular form and 1.2% with other atypical forms of ZCL. The bacteria were isolated from 66.8% of ZCL (70% of volcano-shape, 60% of psoriasiform and 25% of popular form) and 64.7% of non-ZCL lesions. The most common species were Staphylococcus aureus (41.7%) and S. epidermidis (28%) followed by Bacillus sp. Streptococcus pyogenes, Escherichia coli, Klebsiella sp., Proteus sp., Enterobacter sp. and Pseudomonas aeroginosa. Ciprofloxacin, Erythromycin, Cefazolin and Clindamycin were the most effective antibiotics. CONCLUSIONS: Bacterial superinfection appears to be very common in ZCL, but its prevalence is not different from that of non-ZCL lesions and it has little effect on the clinical appearance of anthroponotic cutaneous Leishmaniasis (ACL). Local lesion care and management of bacterial superinfection must be considered in the treatment of ZCL.
背景:动物源皮肤利什曼病(ZCL)是一种多态性疾病。一般认为,细菌的继发感染可能在病变的临床表现中起作用,并可能延迟或阻碍愈合过程。然而,涉及的细菌病原体模式很少被研究过。
材料/方法:本研究的目的是确定污染疑似 ZCL 的细菌种类及其对常用抗生素的敏感性。2009 年 7 月至 12 月,在伊朗伊斯法罕北部的一个农村地区,使用染色涂片和培养的显微镜检查来区分 ZCL 与非 ZCL 病变。从病变中分离细菌并进行鉴定,并通过标准微生物技术确定抗生素敏感性。
结果:结果表明,855 例患者中有 602 例(68%)为 ZCL 阳性,其中 83.4%为火山形,8.8%为银屑病形,6.6%为流行形,1.2%为其他非典型 ZCL 形。ZCL(火山形的 70%、银屑病形的 60%和流行形的 25%)和非 ZCL 病变的 66.8%中分离出细菌。最常见的细菌是金黄色葡萄球菌(41.7%)和表皮葡萄球菌(28%),其次是芽孢杆菌、化脓性链球菌、大肠杆菌、克雷伯菌、变形杆菌、肠杆菌和铜绿假单胞菌。环丙沙星、红霉素、头孢唑林和克林霉素是最有效的抗生素。
结论:细菌继发感染似乎在 ZCL 中非常常见,但它的流行率与非 ZCL 病变没有不同,对人源皮肤利什曼病(ACL)的临床表现影响不大。在治疗 ZCL 时,必须考虑局部病变护理和细菌继发感染的管理。
Med Sci Monit. 2012-9
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