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JSF-12, 13+14 MARTS, 2008
BIOFILM
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KONTAMINERING ?
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Quorum sensing: (QS)
Bakteriernes kommunikation
Virulensfaktorer
(Bakterierne bliver først virulente patogener, når de når et antal, hvor QSsystemet aktiverer virulensfaktorerne. Indtil da er de mere uskadelige
kolonisatorer)
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Antibiotika
Quorum sensing-inhibitorer
Biofilms in chronic wounds. James GA, Swogger E, Wolcott R, Pulcini ED, Secor P,
Sestrich J, Costerton JW, Wound Repair Regen. 2008 Jan-Feb;16(1):37-44.
Stewart PS.
Chronic wounds including diabetic foot ulcers, pressure ulcers, and venous leg ulcers
are a worldwide health problem. It has been speculated that bacteria colonizing chronic
wounds exist as highly persistent biofilm communities. This research examined chronic
and acute wounds for biofilms and characterized microorganisms inhabiting these
wounds. Chronic wound specimens were obtained from 77 subjects and acute wound
specimens were obtained from 16 subjects. Culture data were collected using standard
clinical techniques. Light and scanning electron microscopy techniques were used to
analyze 50 of the chronic wound specimens and the 16 acute wound specimens.
Molecular analyses were performed on the remaining 27 chronic wound specimens
using denaturing gradient gel electrophoresis and sequence analysis. Of the 50 chronic
wound specimens evaluated by microscopy, 30 were characterized as containing biofilm
(60%), whereas only one of the 16 acute wound specimens was characterized as
containing biofilm (6%). This was a statistically significant difference (p<0.001).
Molecular analyses of chronic wound specimens revealed diverse polymicrobial
communities and the presence of bacteria, including strictly anaerobic bacteria, not
revealed by culture. Bacterial biofilm prevalence in specimens from chronic wounds
relative to acute wounds observed in this study provides evidence that biofilms may be
abundant in chronic wounds.
Horrocks A: Prontosan wound irrigation and gel: management of chronic
wounds. Br J Nurs: 2006.
Chronic wounds present a challenge that is costly in terms of quality of life to
the patient and in financial terms for the NHS. Several factors contribute to
the development of a chronic wound, in particular the influence of bacteria as
a biofilm within the wound environment. Irrigating a wound with normal
saline has long been advocated as the most appropriate method of wound
irrigation but biofilms are now known to be resistant to this method of
cleansing. A small (10 patient) evaluation of the use of Prontosan in patients
whose duration of chronic wounds exceeded 1 year has demonstrated that
Prontosan wound irrigation and Prontosan gel are an appropriate alternative
for cleaning, moistening and decontaminating encrusted, contaminated and
chronic skin wounds, and can have a dramatic influence of the quality of life
for such patients. This article discusses the cause of chronicity within a
wound and discusses in depth three of the ten patients in the evaluation.