Effect of secondary infection on epithelialisation and total healing of cutaneous leishmaniasis lesions

Cutaneous leishmaniasis (CL) generally presents with a single or several localised cutaneous ulcers without involvement of mucous membranes. Ulcerated lesions are susceptible to secondary contamination that may slow the healing process. This study verified the influence of non-parasitic wound infect...

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Bibliographic Details
Published in:Memórias do Instituto Oswaldo Cruz 2017-09, Vol.112 (9), p.640-646
Main Authors: Antonio, Liliane de Fátima, Lyra, Marcelo Rosandiski, Saheki, Maurício Naoto, Schubach, Armando de Oliveira, Miranda, Luciana de Freitas Campos, Madeira, Maria de Fátima, Lourenço, Maria Cristina da Silva, Fagundes, Aline, Ribeiro, Érica Aparecida Dos Santos, Barreto, Leonardo, Pimentel, Maria Inês Fernandes
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Child
Coinfection - microbiology
cutaneous leishmaniasis
Female
Humans
Kaplan-Meier Estimate
Leishmaniasis, Cutaneous - microbiology
Male
Middle Aged
opportunistic infection
PARASITOLOGY
Prospective Studies
TROPICAL MEDICINE
Wound Healing
wound infection
Young Adult
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Summary:Cutaneous leishmaniasis (CL) generally presents with a single or several localised cutaneous ulcers without involvement of mucous membranes. Ulcerated lesions are susceptible to secondary contamination that may slow the healing process. This study verified the influence of non-parasitic wound infection on wound closure (epithelialisation) and total healing. Twenty-five patients with a confirmed diagnosis of CL and ulcerated lesions underwent biopsy of ulcer borders. One direct microbial parameter (germ identification in cultures) and four indirect clinical parameters (secretion, pain, burning sensation, pruritus) were analysed. FINDINGS Biopsies of ten lesions showed secondary infection by one or two microorganisms (Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus faecalis, Streptococcus pyogenes and Candida parapsilosis). "Secretion" and "burning sensation" influenced epithelialisation time but not total healing time. Positive detection of germs in the ulcer border and "pain" and "pruritus" revealed no influence on wound closure. Our borderline proof of clinical CL ulcer infection inhibiting CL wound healing supports the need to follow antimicrobial stewardship in CL ulcer management, which was recently proposed for all chronic wounds.
ISSN:0074-0276
1678-8060
1678-8060
0074-0276
DOI:10.1590/0074-02760160557