Selective detection of urease‐producing bacteria on the genital skin surface in patients with incontinence‐associated dermatitis

Abstract

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.

The multi‐factorial modes of action of urease in the pathogenesis of incontinence associated dermatitis

“… 30 , 31 , 32 A 2023 study of incontinent adult patients with IAD by Kota et al showed a significant correlation between urease expressing bacterial on the skin of the patients and IAD incidence. 33 The most frequently associated pathogens in IAD infections include Candida albicans ( C. albicans ) from the gastrointestinal tract, and S. aureus , from the perineal skin 2 , 19 , 34 The elevated pH (from ammonia) also enhances the activity of faecal enzymes including proteases and lipases. 4 , 19 , 26 , 36 Ammonia is a caustic chemical which at sufficiently high concentrations, can cause chemical burns.…”