Ackam Nancy, Opoku-Boadi Abigail, Agbavor Bernadette, Adjei Jonathan Kofi, Agbanyo Abigail, Oppong Michael Ntiamoah, Wiafe-Akenten Charity, Sylverken Augustina, Obiri-Danso Kwasi, Wansbrough-Jones Mark, Amoako Yaw Ampem, Phillips Richard Odame
Kumasi Centre for Collaborative Research into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Department of Theoretical and Applied Biology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
J Clin Tuberc Other Mycobact Dis. 2024 Jul 26;36:100468. doi: 10.1016/j.jctube.2024.100468. eCollection 2024 Aug.
Previous studies have demonstrated secondary microbial infection of Buruli ulcer (BUD) lesions before, during and after treatment. However, there is limited data on the bacterial diversity across treatment and their influence on clinical outcome. The present study aimed to investigate the relationship between bacterial diversity within BUD lesions and clinical outcome in affected individuals.
We investigated the bacterial diversity within lesions of individuals with PCR confirmed BUD from 5 endemic districts within central Ghana. Samples were collected longitudinally from lesions over treatment period. Microbiological analyses including isolation of bacteria, and species identification were performed using the VITEK 2 compact.
Out of 36 participants included, 80.5 % presented with ulcers on the lower limbs. Higher bacterial diversity was observed in ulcers compared to other clinical forms of BUD. There was a significant association between bacterial diversity and clinical outcome ( = 0.002). ESBL producing bacteria and MRSA were isolated in slow healing BUD lesions.
Higher diversity of secondary organisms colonizing BUD lesions may have an impact on clinical outcome in affected individuals. There is the need for the development of treatment guidelines for simultaneous management of and other potential pathogens within lesions to improve clinical outcome.
先前的研究已证明在布氏杆菌溃疡（BUD）病变治疗前、治疗期间及治疗后存在继发性微生物感染。然而，关于不同治疗阶段细菌多样性及其对临床结局影响的数据有限。本研究旨在调查BUD病变内细菌多样性与受影响个体临床结局之间的关系。
我们调查了来自加纳中部5个流行地区经PCR确诊为BUD的个体病变内的细菌多样性。在治疗期间从病变处纵向采集样本。使用VITEK 2 compact进行包括细菌分离和菌种鉴定在内的微生物学分析。
在纳入的36名参与者中，80.5%的人下肢出现溃疡。与BUD的其他临床形式相比，溃疡中观察到更高的细菌多样性。细菌多样性与临床结局之间存在显著关联（P = 0.002）。在愈合缓慢的BUD病变中分离出产ESBL细菌和耐甲氧西林金黄色葡萄球菌（MRSA）。
定植于BUD病变的继发性生物体的更高多样性可能会影响受影响个体的临床结局。需要制定治疗指南，以便同时处理病变内 的细菌和其他潜在病原体，从而改善临床结局。 （注：原文中“ ”部分缺失具体内容）
