Waldemar L Olszewski1,2, Marzanna Zaleska1, Ewa Stelmach1, Ewa Swoboda-Kopec3, Pradeep Jain4, Karoon Agrawal5, Sashi Gogia6, Arun Gogia6, Piotr Andziak2, Marek Durlik2,7. 1. 1Department of Surgical Research Transplantation and Human Epigenetics, Medical Research Center, Polish Academy of Sciences, Warsaw, Poland. 2. 2Department of Transplantation Surgery, Central Clinical Hospital, Ministry of Internal Affairs, Warsaw, Poland. 3. 3Department of Microbiology, Medical University, Warsaw, Poland. 4. 4Institute of Medical Sciences, Benaras Hindu University, Varanasi, India. 5. 5Department of Burns, Plastic and Maxillofacial Surgery, Safdarjang Hospital and VM Medical College, New Delhi, India. 6. 6Amla Mediquip/Sanwari Bai Surgical Centre, New Delhi, India. 7. 7Department of Surgical Research and Transplantology, Medical Research Center, Polish Academy of Sciences, Warsaw, Poland.
Abstract
BACKGROUND: Infections and inflammation of the lower limb skin, soft tissues, and vessels are more common than in other body regions. The aim was to determine whether cryptic bacteria dwelling in deep tissues are the cause. METHODS: We performed bacteriologic studies of specimens harvested from arteries of amputated ischemic legs, leg varices, and tissue fluid/lymph and lymphatics in lymphedema. RESULTS: Calf arteries contained isolates in 61% and femoral arteries in 36%, whereas normal cadaveric organ donors' arteries in 11%. Bacterial deoxyribonucleic acid (DNA) was detected in 70%. The majority of isolates belonged to the coagulase-negative staphylococci and Staphylococcus aureus; however, highly pathogenic bacteria were also detected. All were sensitive to all antibiotics except penicillin. Saphenous vein varices contained bacterial cells in 40% and controls 4%; bacterial DNA was found in 69%. The majority of bacteria were S. epidermidis and S. aureus susceptible to all antibiotics except penicillin, Lymph and epifascial lymphatics limb contained bacteria in 60% and 33% samples, respectively and controls in 7%. Most were S. epidermidis susceptible to all antibiotics except penicillin. CONCLUSION: Cryptic bacteria are present in lower limb tissues and may play a pathologic role in surgical site infections. Proper antibacterial prophylaxis should be considered when planning surgical interventions.
BACKGROUND: Infections and inflammation of the lower limb skin, soft tissues, and vessels are more common than in other body regions. The aim was to determine whether cryptic bacteria dwelling in deep tissues are the cause. METHODS: We performed bacteriologic studies of specimens harvested from arteries of amputated ischemic legs, leg varices, and tissue fluid/lymph and lymphatics in lymphedema. RESULTS:Calf arteries contained isolates in 61% and femoral arteries in 36%, whereas normal cadaveric organ donors' arteries in 11%. Bacterial deoxyribonucleic acid (DNA) was detected in 70%. The majority of isolates belonged to the coagulase-negative staphylococci and Staphylococcus aureus; however, highly pathogenic bacteria were also detected. All were sensitive to all antibiotics except penicillin. Saphenous vein varices contained bacterial cells in 40% and controls 4%; bacterial DNA was found in 69%. The majority of bacteria were S. epidermidis and S. aureus susceptible to all antibiotics except penicillin, Lymph and epifascial lymphatics limb contained bacteria in 60% and 33% samples, respectively and controls in 7%. Most were S. epidermidis susceptible to all antibiotics except penicillin. CONCLUSION: Cryptic bacteria are present in lower limb tissues and may play a pathologic role in surgical site infections. Proper antibacterial prophylaxis should be considered when planning surgical interventions.
Authors: P Del Giudice; N van der Mee-Marquet; F David-Rubin; F Le Duff; K Benchia; E Counillon; A S Domelier; R Quentin Journal: Clin Infect Dis Date: 2006-08-22 Impact factor: 9.079
Authors: Grzegorz Szczêsny; Bozenna Interewicz; Ewa Swoboda-Kopeć; Waldemar L Olszewski; Andrzej Górecki; Piotr Wasilewski Journal: J Trauma Date: 2008-10
Authors: Stephanie M Hamilton; Clifford R Bayer; Dennis L Stevens; Richard L Lieber; Amy E Bryant Journal: J Infect Dis Date: 2008-12-01 Impact factor: 5.226