Abstract
Background: An acute wound infection might be caused by external damage to the skin including abrasions, lacerations, bites, burns, accidents, war injuries and surgical incisions. When a wound fails to heal within a week, it should be considered a chronic type. Complement system potent inflammatory cascade in wound infection, is important and altered wound healing. Complement activation leads to the generation of many potent effectors including anaphylatoxin C5a. C5a has induced synthesis of TNF-α and IL-1β in macrophage and monocyte which are all together the goal of the present paper. Methodology: This study was conducted in Al-Kindy and Al-Wasity hospitals in Baghdad on 200 patients suffering from wounds. One hundred patients were with acute wounds infection and the other 100 patients considered as control wounds i.e. without infection. The procedure method was followed according to manufacturer’s instructions (Elabscience, USA) utilizing C5a ELISA kit for conducting the test. Blood samples were taken at 24, 48, 72, 96 and 120 hours of hospitalization of the patients. Results: It was found that the highest concentration of C5a was found at 120 hours after patients hospitalization who were with wound infection, and the mean value of C5a was 4898 pg/ml. 4661 pg/ml of C5a was recorded among patients with acute-phase infection compared to 4387 pg/ml concentration of the same complement among control group without wound infection at 96 hours post residence in hospital. Conclusions: Gram-positive bacteria were more prevalent causing wound infections. Dermacoccus nishinomiyaensis, Kocuria rosea and Kocuria kristinae were isolated for the first time in this locality. A complement 5a (C5a) revealed a very high concentration in acute-phase of wound infections. It was found that C5a was serially elevated with time of hospitalization of wounded and infected patients. C5a was highly elevated with wound infection by Gram-negative bacteria compared to infections by Gram-negatives.
Highlights
Wound infection is invasive with pathogen to a level that invokes local and systemic response host
The present study showed that complement 5a (C5a) concentration was increased with time of residence of patient with wound infections e.g., the C5a concentration was 4113 pg/ml at the end of the second day of residence, and this value was elevated to be 4898 pg/ml at 120 hours of hospitalization (Figure 2)
The present study revealed that Staphylococcus aureus was more prevalent causing acute-phase wound infection and the frequency of isolation was 28.6% This result was almost similar to that obtained by Nagoba and others who found that the incidence of this bacteria was 28.12% [14] [15] and Yin (2013) who showed Staphylococcus aureus was responsible for the majority of skin and soft tissue infection
Summary
Wound infection is invasive with pathogen to a level that invokes local and systemic response host. The wounds are commonly colonized by Staphylococcus aureus within the first week and later by Pseudomonas aeruginosa and other Enterobacteriaceae like Escherichia coli, Klebsiella sp, and Proteus mirabilis All these events usually lead to stimulation of innate immune system and play a role in acute inflammation [2]. Complement system potent inflammatory cascade in wound infection, is important and altered wound healing. Results: It was found that the highest concentration of C5a was found at 120 hours after patients hospitalization who were with wound infection, and the mean value of C5a was 4898 pg/ml. 4661 pg/ml of C5a was recorded among patients with acute-phase infection compared to 4387 pg/ml concentration of the same complement among control group without wound infection at 96 hours post residence in hospital. A complement 5a (C5a) revealed a very high concentration in acute-phase of wound
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