Clinical and microbiological features of host-bacterial interplay in chronic venous ulcers versus other types of chronic skin ulcers

Mara Mădălina Mihai; Mircea Ioan Popa; Alina Maria Holban; Irina Gheorghe-Barbu; Liliana Gabriela Popa; Mariana-Carmen Chifiriuc; Călin Giurcăneanu; Coralia Bleotu; Corina Ioana Cucu; Veronica Lazăr

doi:10.3389/fmicb.2023.1326904

Clinical and microbiological features of host-bacterial interplay in chronic venous ulcers versus other types of chronic skin ulcers

Front Microbiol. 2024 Feb 5:14:1326904. doi: 10.3389/fmicb.2023.1326904. eCollection 2023.

Affiliations

¹ Department of Oncologic Dermatology-"Elias" University Emergency Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
² Department of Botany-Microbiology, Faculty of Biology, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania.
³ Department of Microbiology-"Cantacuzino" Institute, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
⁴ Cellular and Molecular Department, "Ştefan S. Nicolau" Institute of Virology, Bucharest, Romania.

Abstract

Introduction: Chronic venous ulcers of the lower limbs develop in the context of advanced venous disease and have a significant impact on the patient's quality of life, being associated with depression and worrisome suicide rates, as well as with an economic burden caused by increased medical care costs and high epidemiological risks of healthcare associated infections and emergence of strains resistant to multiple classes of antibiotics and/ or antiseptics. Although numerous studies have investigated the composition of the chronic wounds microbiome, either by culture-dependent or independent methods, there are no data on the association between virulence and resistance profiles of strains isolated from venous ulcers and the clinical picture of this pathology. The elucidation of pathogenic mechanisms, at both phenotypic and molecular level, is crucial in the fight against these important human microbial agents, in order to develop novel biomarkers and discover new therapeutic targets.

Methods: In this study we aimed to characterize the phenotypic virulence profiles (including the ability to develop biofilms) of microorganisms isolated from chronic skin wounds and to correlate them with the clinical symptomatology. Considering the high incidence of Staphylococcus aureus infections in chronic ulcers, but also the ability of this species to develop multi-drug resistance, we performed an more in-depth study of the phenotypic and genotypic virulence profiles of methicillin-resistant Staphylococcus.

Results: The study revealed important differences regarding the clinical evolution and virulence profiles of microorganisms isolated from lower limb wounds, as well as between patients diagnosed with chronic venous ulcers and those with lesions of different etiology.

Keywords: bacterial virulence factors; bio-marker; chronic wound; host-microbiome; methicillin resistant Staphylococcus aureus (MRSA); tolerance at antimicrobials of biofilm cells.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. The study was supported by a grant of the Romanian Ministry of Research, Innovation and Digitization, CNCS/CCCDI—UEFISCDI, project number PN-III-P1-1.1-PD-2019-1225, within PNCDI III. Publication of this paper was supported by the University of Medicine and Pharmacy Carol Davila, through the institutional program Publish not Perish.