Layegh Pouran, Ghazvini Kiarash, Moghiman Toktam, Hadian Fatemeh, Zabolinejad Naghmeh, Pezeshkpour Fakhrozaman
Cutaneous Leishmaniasis Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Microbiology and Virology Research Center, Qaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Indian J Dermatol. 2015 Mar-Apr;60(2):211. doi: 10.4103/0019-5154.152560.
The colonization of aerobic and anaerobic microbial agents on cutaneous leishmaniasis (CL) lesions, especially acute erosive ulcerative ones, has been mentioned in previous studies showing controversial results on the healing course of lesions with the use of antibiotics.
The purpose of this study was to evaluate the prevalence of secondary bacterial infections in CL lesions and the effect of its elimination on the lesions' improvement rate.
This cross-sectional clinical trial was performed on 84 acute CL patients. The required skin samples were taken. Cultivation for bacteria was conducted. Patients with positive culture results were divided into two groups. Both groups received standard anti-leishmania treatment, whereas only one group was treated with cephalexin 40-50 mg/kg/day for 10 days. The improvement rate was evaluated in the following visits based on changes in the lesions' induration size.
Among the 84 studied patients, 22.6% had a negative culture result whereas the result was positive in 77.4%. The most common pathogenic germs were Staphylococcus aureus (52.3%) and Staphylococcus epidermidis (9.5%); 34/5% of the positive lesions received antibiotic treatment. Finally, among the lesions with a 75-100% improvement rate, no significant difference was observed between the antibiotic-treated and -untreated groups (36.1% vs. 63.9%, respectively, P = 0.403).
The most common pathogen was S. aureus and, as a primary outcome, the simultaneous treatment for microbial agents did not have any considerable effect on the improvement rate of CL lesions.
先前的研究提到过皮肤利什曼病（CL）皮损，尤其是急性糜烂溃疡性皮损上需氧和厌氧微生物的定植情况，这些研究显示使用抗生素对皮损愈合过程的影响存在争议。
本研究旨在评估CL皮损中继发性细菌感染的患病率及其清除对皮损改善率的影响。
对84例急性CL患者进行了这项横断面临床试验。采集所需的皮肤样本并进行细菌培养。培养结果呈阳性的患者被分为两组。两组均接受标准的抗利什曼原虫治疗，而只有一组接受头孢氨苄治疗，剂量为40 - 50mg/kg/天，持续10天。在随后的随访中，根据皮损硬结大小的变化评估改善率。
在84例研究患者中，22.6%的培养结果为阴性，77.4%为阳性。最常见的致病病菌是金黄色葡萄球菌（52.3%）和表皮葡萄球菌（9.5%）；34.5%的阳性皮损接受了抗生素治疗。最后，在改善率达到75% - 100%的皮损中，抗生素治疗组和未治疗组之间未观察到显著差异（分别为36.1%和63.9%，P = 0.403）。
最常见的病原体是金黄色葡萄球菌，作为主要结果，同时治疗微生物制剂对CL皮损的改善率没有任何显著影响。
