The Persistence of Staphylococcus aureus in Pressure Ulcers: A Colonising Role

Abstract

Decubitus pressure ulcers (PU) are a major complication of immobilised patients. Staphylococcus aureus is one of the most frequently detected microorganisms in PU samples; however, its persistence and role in the evolution of these wounds is unknown. In this study, we analysed S. aureus strains isolated from PU biopsies at inclusion and day 28. Eleven S. aureus (21.1%) were detected in 52 patients at inclusion. Only six PUs (11.5%) continued to harbour this bacterium at day 28. Using a whole genome sequencing approach (Miseq®, Illumina), we confirmed that these six S. aureus samples isolated at D28 were the same strain as that isolated at inclusion, with less than 83 bp difference. Phenotypical studies evaluating the growth profiles (Infinite M Mano, Tecan®) and biofilm formation (Biofilm Ring Test®) did not detect any significant difference in the fitness of the pairs of S. aureus. However, using the Caenorhabditis elegans killing assay, a clear decrease of virulence was observed between strains isolated at D28 compared with those isolated at inclusion, regardless of the clinical evolution of the PU. Moreover, all strains at inclusion were less virulent than a control S. aureus strain, i.e., NSA739. An analysis of polymicrobial communities of PU (by metabarcoding approach), in which S. aureus persisted, demonstrated no impact of Staphylococcus genus on PU evolution. Our study suggested that S. aureus presented a colonising profile on PU with no influence on wound evolution.

Relative Abundance and Detection of Pseudomonas aeruginosa from Chronic Wound Infections Globally

“…Germany contributed four studies [ 46 , 47 , 48 , 49 ], and three separate studies were conducted within Denmark [ 50 , 51 , 52 ], Italy [ 53 , 54 , 55 ], the United Kingdom [ 56 , 57 , 58 ], Poland [ 59 , 60 , 61 ], and Turkey [ 62 , 63 , 64 ]. France [ 65 ], Portugal [ 66 ], the Republic of Slovenia [ 67 ], and Sweden [ 68 ] each contributed a single investigation. S. aureus was the most frequently encountered pathogen in Europe followed by P. aeruginosa , which was the most prevalent organism in three studies [ 61 , 65 , 67 ] and the second most abundant pathogen in the majority of the remaining studies.…”

“…France [ 65 ], Portugal [ 66 ], the Republic of Slovenia [ 67 ], and Sweden [ 68 ] each contributed a single investigation. S. aureus was the most frequently encountered pathogen in Europe followed by P. aeruginosa , which was the most prevalent organism in three studies [ 61 , 65 , 67 ] and the second most abundant pathogen in the majority of the remaining studies. The only studies that corresponded to France and Slovenia reported P. aeruginosa as the common organism isolated from wound infections [ 65 , 67 ].…”

“…S. aureus was the most frequently encountered pathogen in Europe followed by P. aeruginosa , which was the most prevalent organism in three studies [ 61 , 65 , 67 ] and the second most abundant pathogen in the majority of the remaining studies. The only studies that corresponded to France and Slovenia reported P. aeruginosa as the common organism isolated from wound infections [ 65 , 67 ]. A study by Kwiecińska-Piróg et al evaluated a large collection of 1142 bacterial cultures from wound infections in Poland and found that P. aeruginosa was the second most common pathogen and was associated with 35% of the positive wound cultures [ 59 ].…”

Staphylococcus aureus in Polymicrobial Skinand Soft Tissue Infections: Impact of Inter-Species Interactionsin Disease Outcome

“…The most common organisms identified in PUs are S. aureus, Proteus mirabilis, P. aeruginosa, and E. faecalis [53]. In chronically infected PUs, S. aureus has been found together with P. aeruginosa, E. coli, P. mirabilis, Enterobacter cloacae, and E. faecalis (Table 1) [29,47,48].…”