Gelatti Luciane Cristina, Bonamigo Renan Rangel, Becker Ana Paula, Eidt Letícia Maria, Ganassini Letícia, d' Azevedo Pedro Alves
Faculdade Serra da Mesa, Uruaçu, GO, Brazil.
Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
An Bras Dermatol. 2014 May-Jun;89(3):404-8. doi: 10.1590/abd1806-4841.20142688.
One of the most stigmatizing physical sequelae of 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.
To identify the microbiota and antimicrobial resistance profile of bacteria isolated from skin ulcers in patients cured of leprosy.
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. Samples were 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.
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).
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.
治愈的麻风病患者最具污名化的身体后遗症之一是慢性下肢溃疡的形成。溃疡中存在的细菌多样性被认为是可能延迟愈合过程以及成为严重继发性感染病灶的因素之一。
鉴定从治愈的麻风病患者皮肤溃疡中分离出的细菌的微生物群和抗菌药物耐药谱。
在获得知情同意后，从南里奥格兰德州公共卫生皮肤科门诊和伊塔普阿殖民地医院治疗的16例患者的溃疡中采集材料。在换药时采集样本，并将材料送至阿雷格里港联邦健康科学大学微生物实验室进行微生物培养。耐甲氧西林金黄色葡萄球菌（MRSA）通过两种分子方法进行鉴定，包括通过PCR检测mecA基因和SCCmec基因分型。
培养显示所有溃疡中均有微生物：80%为革兰氏阴性杆菌，63%为革兰氏阳性球菌，36%为混合菌群。金黄色葡萄球菌和铜绿假单胞菌是最常见的细菌。抗菌药物耐药谱评估显示存在MRSA。对该分离株的分子分析显示存在包含在IV型葡萄球菌盒式染色体mec（SCCmec）中的mecA基因。
对于麻风病患者，皮肤溃疡的实验室培养对于正确选择抗生素和控制新出现的病原体（如携带IV型SCCmec的MRSA）至关重要。
