title: [Current detection rates of multiresistant gram negative bacteria (3MRGN, 4MRGN) in patients with chronic leg ulcers].
abstract: BACKGROUND
  Due to the increasing problem of antibiotic resistance in gram-negative pathogens, the Commission for Hospital Hygiene and Infection Prevention (KRINKO) decided to establish a new clinically oriented definition of multi-resistance. Gram-negative pathogens with a multidrug-resistance (MRGN) are divided into those with resistance to three (3MRGN) or four (4MRGN) antibiotic groups.
  
  
  METHODS
  In this multicenter study which was done in ten dermatological wound clinics, the bacteriological swabs from up to 100 patients with chronic leg ulcers per center were analyzed according to the current classification KRINKO and evaluated.
  
  
  RESULTS
  Overall, the results of 970 patients (553 women, 417 men) could be evaluated. We found 681 gram-positive and 1155 gram-negative bacteria. Pseudomonas aeruginosa was with a detection-rate of 31.1% the most frequent gram-negative pathogen, followed by Proteus mirabilis with 13.7% and various enterobacteria with 28.6%. According to the current KRINKO classification,eight patients with 4MRGN and 34 patients with 3MRGN could be identified.
  
  
  CONCLUSIONS
  Our results demonstrate the current spectrum of bacteria in patients with chronic leg ulcers with a variety of gram-negative pathogens, some of which are classified as multi-drug resistant. As a clinical consequence some of the patients require individualized preventive measures and therapy.
authors.affiliation: Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstraße 55, 45122, Essen, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Jockenhöfer
authors.forename: H
authors.initials: H
authors.lastname: Gollnick
authors.forename: K
authors.initials: K
authors.lastname: Herberger
authors.forename: G
authors.initials: G
authors.lastname: Isbary
authors.forename: R
authors.initials: R
authors.lastname: Renner
authors.forename: M
authors.initials: M
authors.lastname: Stücker
authors.forename: E
authors.initials: E
authors.lastname: Valesky
authors.forename: U
authors.initials: U
authors.lastname: Wollina
authors.forename: M
authors.initials: M
authors.lastname: Weichenthal
authors.forename: S
authors.initials: S
authors.lastname: Karrer
authors.forename: B
authors.initials: B
authors.lastname: Ross
authors.forename: E
authors.initials: E
authors.lastname: Heintschel von Heinegg
authors.forename: J
authors.initials: J
authors.lastname: Dissemond
mesh_terms: D000328:Adult; D002908:Chronic Disease; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005858:Germany / Q000453:epidemiology; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D007871:Leg Ulcer / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D017192:Skin Diseases, Bacterial / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*