title: Nonrandom distribution of Pseudomonas aeruginosa and Staphylococcus aureus in chronic wounds.
abstract: The spatial organization of Pseudomonas aeruginosa and Staphylococcus aureus in chronic wounds was investigated in the present study. Wound biopsy specimens were obtained from patients diagnosed as having chronic venous leg ulcers, and bacterial aggregates in these wounds were detected and located by the use of peptide nucleic acid-based fluorescence in situ hybridization and confocal laser scanning microscopy (CLSM). We acquired CLSM images of multiple regions in multiple sections cut from five wounds containing P. aeruginosa and five wounds containing S. aureus and measured the distance of the bacterial aggregates to the wound surface. The distance of the P. aeruginosa aggregates to the wound surface was significantly greater than that of the S. aureus aggregates, suggesting that the distribution of the bacteria in the chronic wounds was nonrandom. The results are discussed in relation to our recent finding that swab culturing techniques may underestimate the presence of P. aeruginosa in chronic wounds and in relation to the hypothesis that P. aeruginosa bacteria located in the deeper regions of chronic wounds may play an important role in keeping the wounds arrested in a stage dominated by inflammatory processes.
authors.affiliation: Department of International Health, Faculty of Health Sciences, University of Copenhagen, Copenhagen N DK-2200, Denmark.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Fazli
authors.forename: Thomas
authors.initials: T
authors.lastname: Bjarnsholt
authors.forename: Klaus
authors.initials: K
authors.lastname: Kirketerp-Møller
authors.forename: Bo
authors.initials: B
authors.lastname: Jørgensen
authors.forename: Anders Schou
authors.initials: AS
authors.lastname: Andersen
authors.forename: Karen A
authors.initials: KA
authors.lastname: Krogfelt
authors.forename: Michael
authors.initials: M
authors.lastname: Givskov
authors.forename: Tim
authors.initials: T
authors.lastname: Tolker-Nielsen
mesh_terms: D002908:Chronic Disease; D017753:Ecosystem; D006801:Humans; D017404:In Situ Hybridization, Fluorescence / Q000379:methods; D018613:Microscopy, Confocal; D020135:Peptide Nucleic Acids / Q000235:genetics; D011552:Pseudomonas Infections / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000235:genetics / Q000302:isolation & purification*; D013045:Species Specificity; D013203:Staphylococcal Infections / Q000382:microbiology; D013211:Staphylococcus aureus / Q000235:genetics / Q000302:isolation & purification*; D014647:Varicose Ulcer / Q000382:microbiology*; D014946:Wound Infection / Q000382:microbiology*
chemical_list: D020135:Peptide Nucleic Acids