We aimed to investigate the association between the presence of cutaneous urease‐producing bacteria and the development of incontinence‐associated dermatitis (IAD) using an original urea agar medium as a step toward developing advanced preventive measures. In previous clinical assessments, we developed an original urea agar medium to detect urease‐producing bacteria via the medium's colour changes. In a cross‐sectional study, specimens were collected via the swabbing technique at genital skin sites in 52 stroke patients hospitalised in a university hospital. The primary objective was to compare the presence of urease‐producing bacteria between the IAD and no‐IAD groups. Determining the bacterial count was the secondary objective. The prevalence of IAD was 48%. A significantly higher detection rate of urease‐producing bacteria was observed in the IAD group than in the no‐IAD group (P = .002) despite the total number of bacteria being equivalent between them. In conclusion, we discovered that there was a significant association between the presence of urease‐producing bacteria and IAD development in hospitalised stroke patients.

Introduction: Compression therapy is important in oedema control in lymphoedema. However, some patients have difficulties starting compression therapy because standard self-care education does not enable them to fully understand lymphoedema and recognise it as their problem. To overcome this, real-time image-sharing education, using a combination of indocyanine green lymphography (ICG) and ultrasonography, may be used to educate patients. In this case study, real-time image-sharing education promoted decision-making and behaviour change in a patient with lower extremity lymphoedema so she would wear elastic stockings. Case: A 51-year-old woman with a BMI of 31.7 kg/m2 and secondary lower extremity lymphoedema following cervical cancer surgery did not adhere to self-care instructions regarding wearing elastic stockings for 5 years. The oedema worsened, her limb circumference increased and she had two episodes of cellulitis within a year. Because the patient had a negative attitude towards elastic stockings, real-time image-sharing education was used to promote recognition of illness using ICG and an understanding of the condition of lymphoedema using ultrasonography. After the images were shared and explained, the patient discussed her recognition and understanding of lymphoedema, then decided to use compression stockings. She continued to wear them for 4 months, and her limb circumference decreased. Conclusion: Real-time image-sharing education using ICG and ultrasonography as self-care support for a lymphoedema patient who would not start compression therapy could result in behavioural changes and the patient starting and continuing to wear elastic stockings.

Background: Aspiration pneumonia (AP), which is a major cause of death in the elderly, does present with typical symptoms in the early stages of onset, thus it is difficult to detect and treat at an early stage. In this study, we identified biomarkers that are useful for the detection of AP and focused on salivary proteins, which may be collected non-invasively. This is because expectorating saliva is often difficult for elderly people, so we collected salivary proteins from the buccal mucosa.Methods: We collected samples from the buccal mucosa of six patients with AP and six control patients (no AP) in an acute-care hospital. Following protein precipitation using trichloroacetic acid and washing with acetone, the samples were analyzed by liquid chromatography and tandem mass spectrometry (LC-MS/MS). We also determined the number of cytokines and chemokines in non-precipitated samples from buccal mucosa.Results: Comparative quantitative analysis of LC-MS/MS spectra revealed 179 and 181 proteins that were significantly higher and lower in abundance, respectively, in the AP group compared with the control group. We identified eight proteins (chloride intracellular channel protein 3, b-defensin 4A, protein S100-A7A, Purkinje cell protein 4-like protein 1, glutamine synthetase, protein S100-A7, cytosolic 5'-nucleotidase 3A, pyridoxal kinase) that were detected in all of the AP samples with high coverage, indicating that these proteins are promising AP biomarker candidates. In addition, the abundance of C-reactive protein (CRP) in oral samples was highly correlated with serum CRP levels, suggesting that oral CRP levels may be used as a surrogate to predict serum CRP in AP patients. A multiplex cytokine/chemokine assay revealed that MCP-1 tended to be low, indicating unresponsiveness of MCP-1 and its downstream immune pathways in AP.Conclusion: Our findings suggest that oral salivary proteins, which are obtained non-invasively, can be utilized for the detection of AP.

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Aim To compare the isolated and identified bacterial species colonizing on the genital skin between patients with and without incontinence‐associated dermatitis. Methods This cross‐sectional study included 102 patients with stroke admitted to an acute hospital in Japan. Swabs were collected, and bacterial species found in swabs were isolated and identified using a selective agar medium and simple identification kits. In addition to demographic information, severity of incontinence‐associated dermatitis and the total bacterial counts were measured. Results Incontinence‐associated dermatitis was present in 53.9% of the participants. Staphylococcus aureus was found in 50% of the participants with incontinence‐associated dermatitis and only 17.9% of those without incontinence‐associated dermatitis (P = 0.0029). Bacterial species distribution by erythema and skin erosion, which denote severity of incontinence‐associated dermatitis, was different, but not significant; additionally, the total number of bacterial colonies was equivalent. Conclusions Bacterial species distribution differed between patients with and without incontinence‐associated dermatitis, whereas the total number of bacterial colonies was equivalent. A high detection rate of S. aureus on genital skin sites potentially affects the presence of incontinence‐associated dermatitis and its severity. Geriatr Gerontol Int 2023; 23: 537–542.