Department of Medical Biochemistry, University of Ghana Medical School, Korle Bu, Accra, Ghana.
Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana.
BMC Microbiol. 2021 Jan 5;21(1):4. doi: 10.1186/s12866-020-02070-5.
Buruli ulcer (BU) is a skin disease caused by Mycobacterium ulcerans and is the second most common mycobacterial disease after tuberculosis in Ghana and Côte d'Ivoire. M. ulcerans produces mycolactone, an immunosuppressant macrolide toxin, responsible for the characteristic painless nature of the infection. Secondary infection of ulcers before, during and after treatment has been associated with delayed wound healing and resistance to streptomycin and rifampicin. However, not much is known of the bacteria causing these infections as well as antimicrobial drugs for treating the secondary microorganism. This study sought to identify secondary microbial infections in BU lesions and to determine their levels of antibiotic resistance due to the prolonged antibiotic therapy required for Buruli ulcer.
Swabs from fifty-one suspected BU cases were sampled in the Amansie Central District from St. Peters Hospital (Jacobu) and through an active case surveillance. Forty of the samples were M. ulcerans (BU) positive. Secondary bacteria were identified in all sampled lesions (N = 51). The predominant bacteria identified in both BU and Non-BU groups were Staphylococci spp and Bacilli spp. The most diverse secondary bacteria were detected among BU patients who were not yet on antibiotic treatment. Fungal species identified were Candida spp, Penicillium spp and Trichodema spp. Selected secondary bacteria isolates were all susceptible to clarithromycin and amikacin among both BU and Non-BU patients. Majority, however, had high resistance to streptomycin.
Microorganisms other than M. ulcerans colonize and proliferate on BU lesions. Secondary microorganisms of BU wounds were mainly Staphylococcus spp, Bacillus spp and Pseudomonas spp. These secondary microorganisms were less predominant in BU patients under treatment compared to those without treatment. The delay in healing that are experienced by some BU patients could be as a result of these bacteria and fungi colonizing and proliferating in BU lesions. Clarithromycin and amikacin are likely suitable drugs for clearance of secondary infection of Buruli ulcer.
溃疡分枝杆菌病（BU）是一种由溃疡分枝杆菌引起的皮肤疾病，是加纳和科特迪瓦继肺结核之后第二常见的分枝杆菌病。溃疡分枝杆菌产生的 (mycolactone) 是一种免疫抑制剂大环内酯毒素，负责感染的无痛特征。在治疗前后，溃疡的二次感染与伤口愈合延迟以及对链霉素和利福平的耐药性有关。然而，对于导致这些感染的细菌以及治疗二次微生物的抗菌药物，人们知之甚少。本研究旨在确定 BU 病变中的二次微生物感染，并确定它们的抗生素耐药水平，因为 BU 需要长时间的抗生素治疗。
在 Amansie Central 区的圣彼得医院（Jacobu）和通过主动病例监测，从 51 例疑似 BU 病例中采集了拭子。其中 40 例样本为溃疡分枝杆菌阳性。在所有采样病变中都鉴定出了二级细菌（N=51）。在 BU 和非 BU 组中，鉴定出的主要细菌是葡萄球菌属和芽孢杆菌属。在尚未接受抗生素治疗的 BU 患者中，检测到最多样化的二级细菌。鉴定出的真菌物种包括 念珠菌属、青霉属和 Trichoderma 属。在 BU 和非 BU 患者中，所选二级细菌分离株均对克拉霉素和阿米卡星敏感。然而，大多数对链霉素的耐药性很高。
除了溃疡分枝杆菌外，还有其他微生物在 BU 病变中定植和增殖。BU 伤口的次要微生物主要是葡萄球菌属、芽孢杆菌属和假单胞菌属。与未接受治疗的患者相比，接受治疗的 BU 患者中的这些次要微生物较少。一些 BU 患者经历的愈合延迟可能是由于这些细菌和真菌在 BU 病变中定植和增殖所致。克拉霉素和阿米卡星可能是清除 BU 溃疡二次感染的合适药物。
