Nagase Satoshi, Ogai Kazuhiro, Urai Tamae, Shibata Kana, Matsubara Emi, Mukai Kanae, Matsue Miki, Mori Yumiko, Aoki Miku, Arisandi Defa, Sugama Junko, Okamoto Shigefumi
Department of Clinical Laboratory Science, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan.
Wellness Promotion Science Center, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan.
Front Med (Lausanne). 2020 Apr 8;7:101. doi: 10.3389/fmed.2020.00101. eCollection 2020.
With the increase in the older populations, the number of bedridden older patients is becoming a matter of concern. Skin microbiome and skin physiological functions are known to change according to lifestyle and community; however, such changes in case of movement- and cleaning-restricted bedridden older patients have not yet been revealed. To address this issue, we analyzed skin microbiome and skin physiological functions, including pH, hydration, sebum level, and transepidermal water loss (TEWL), of bedridden older patients, compared with those of ambulatory older and young individuals. For this analysis, we enrolled 19 healthy young and 18 ambulatory older individuals from the community and 31 bedridden older patients from a single, long-term care hospital in Japan. The area of interest was set to the sacral (lower back) skin, where pressure injuries (PIs) and subsequent infection frequently occurs in bedridden older patients. We observed a higher number of gut-related bacteria, fewer commensals, higher skin pH, and lower TEWL on the sacral skin of bedridden older patients than on that of young or ambulatory older individuals. In addition, we observed that 4 of the 31 bedridden older patients developed PIs during the research period; a higher abundance of pathogenic skin bacteria were also observed inside the PI wounds. These findings imply distinct skin microbiome and skin physiological functions in bedridden older patients in comparison with healthy individuals and may suggest the need for more stringent cleaning of the skin of bedridden older patients in light of the closeness of skin and wound microbiome.
随着老年人口的增加，卧床老年患者的数量正成为一个令人担忧的问题。已知皮肤微生物群和皮肤生理功能会根据生活方式和社区环境而发生变化；然而，行动和清洁受限的卧床老年患者的此类变化尚未得到揭示。为了解决这个问题，我们分析了卧床老年患者的皮肤微生物群和皮肤生理功能，包括pH值、水合作用、皮脂水平和经表皮水分流失（TEWL），并与能走动的老年人和年轻人进行了比较。在这项分析中，我们招募了19名来自社区的健康年轻人、18名能走动的老年人以及31名来自日本一家单一长期护理医院的卧床老年患者。感兴趣的区域设定为骶部（下背部）皮肤，卧床老年患者在此部位经常发生压力性损伤（PIs）及随后的感染。我们观察到，与年轻人或能走动的老年人相比，卧床老年患者骶部皮肤的肠道相关细菌数量更多、共生菌更少、皮肤pH值更高且TEWL更低。此外，我们观察到31名卧床老年患者中有4人在研究期间发生了压力性损伤；在压力性损伤伤口内还观察到致病性皮肤细菌的丰度更高。这些发现表明，与健康个体相比，卧床老年患者具有独特的皮肤微生物群和皮肤生理功能，并且鉴于皮肤与伤口微生物群的紧密关系，可能意味着需要对卧床老年患者的皮肤进行更严格的清洁。
