Antibiotic susceptibility and resistance of bacterial pathogens in chronic leg ulcers: a retrospective cohort study

Antimicrobial resistance has recently become a significant challenge in the medical field, affecting among others the management of chronic wounds. It is also frequently observed in dermatology, studies showing that up to 100% of chronic leg ulcers (CLU) are at some point colonized with bacterial pathogens. The aim of our study was to describe the spectrum of bacterial colonization and their antibiotic susceptibility in patients with CLU from a tertiary referral center from Romania. A total of 150 patients with at least one CLU and with a microbiological culture performed from the lesions, were included in the study. 9 bacterial species and 217 strains were identified. The most frequent bacterial pathogen was Staphylococcus aureus (42.4%), followed by Pseudomonas aeruginosa (23,04%) and Proteus spp. (13,82%). High resistance to oxacillin, erythromycin and clindamycin were found among methicillin-resistant Staphylococcus aureus strains, contrary to methicillin-susceptible Staphylococcus aureus strains that depicted high resistance to ampicillin, clindamycin and erythromycin. Pseudomonas spp., Klebsiella spp. and E. coli strains showed resistance to ciprofloxacin. In summary, these findings underline the importance of bacterial profiling and their antibiotic susceptibility in CLU. Due to the emergence of resistant bacterial strains, swab tests should be performed whenever suspecting infections in CLU before the initiation of antibiotics.