Abstract
Users of prosthetic devices face the accumulation of potentially drug-resistant pathogenic bacteria on the skin/prosthesis interface. In this study, we took surface swabs of the skin/prosthesis interface of eleven disabled athletes to identify microorganisms present. In addition to determining their antimicrobial resistance profile, we assessed their sensitivity to Manuka honey and Garlic extract (allicin). Eleven volunteers were directed to swab the skin at the skin/prosthesis interface. After initial isolation of microorganisms, we employed the following general microbiological methods: Gram stain, Catalase test, Oxidase test, lactose fermenting capability, haemolytic capability, Staphaurex, mannitol fermenting capability, Streptex; API Staph, 20E, Candida, and BBL crystal identification system tests. Once identified, isolates were analysed for their sensitivity to penicillin, erythromycin, ampicillin, vancomycin, ceftazidime, ciprofloxacin, gentamicin, and colistin-sulphate. Isolates were also analysed for their sensitivity to allicin (Garlic Extract (GE)) and Manuka honey (Medihoney™) (MH). Eleven isolates were identified: Bacillus cereus, Staphylococcus haemolyticus, Staphylococcus aureus, Micrococcus luteus, Pseudomonas oryzihabitans, Micrococcus spp., Bacillus subtilis, Group D Streptococcus, Pantoea spp., Enterobacter cloacae, and Bergeyella zoohelcum. All isolates were resistant to 1 unit of penicillin and 10 μg of ampicillin. Bergeyella zoohelcum was observed to have the widest range of resistance with observed resistance against five of the eight antimicrobials employed in this study. This study highlights the prevalence of uncommon drug-resistant microorganisms on the skin within a vulnerable population, highlighting the potential for MH or GE intervention.
Highlights
Bergeyella zoohelcum was observed to have the widest range of resistance with observed resistance five of the eight antimicrobials employed in this study
Some of the isolated organisms could be considered endogenous bacteria, these results suggest that there are a variety of bacteria that are present on the skin and prosthetic devices of prosthesis users, including endogenous skin bacteria, endogenous gastrointestinal bacteria, and exogenous bacteria
Results of this study suggests there is a requirement for comprehensive bacterial identification and increased antimicrobial susceptibility testing on strains not routinely identified in wound infections; here, we isolated the more common microorganisms such as Staphylococcus, alongside those which are less common, such as B. zoohelcum is commonly linked to cat and dog bites, with only five cases of infection reported worldwide [65], though this may be due to the fastidious growth requirements related to variants of the microorganism, leading to systematic underreporting
Summary
It is estimated that there were more than 27,000 amputations in the UK between. 2015–2018, with around 176 leg, toe, or foot amputations carried out each week within the UK [1]. The World Health Organisation estimates that the disabled community will continue to rise in proportion with the increase in life expectancy and associated ageing health difficulties [2]. There are many amputees that face common problems associated with the use of prostheses, such as malodour and continued infections [3,4]. Amputations are common with the prevalence of chronic wounds caused by vascular diseases such as diabetes mellitus [5], whereby the wounds cannot heal due to inflammation imbalances and infection [6], making recurrent infections especially problematic and leading to a continued
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