MICROBIOLOGY IN CHRONIC WOUNDS

Chronic leg wounds are colonized by diverse microbial communities, including resident and transient flora, which significantly influence healing outcomes. Staphylococcus aureus and Pseudomonas aeruginosa are frequently implicated, with polymicrobial infections contributing to delayed healing and antimicrobial resistance. Aim: To investigate the microbiological agents in chronic leg wounds. Materials and Methods: A prospective study was conducted at the University Clinic for Dermatovenerology and the Institute of Microbiology and Parasitology, Ss. Cyril and Methodius University, Skopje, following ethics approval and written informed consent. One hundred adult patients with chronic wounds localized on the lower extremities (>4 weeks duration, >1 cm²) were included. Exclusion criteria encompassed malignancy, inflammatory dermatoses, burns, recent antibiotic therapy, and acute infections. Clinical evaluation, patient questionnaires, and wound swab samples were collected for microbial isolation and identification. Results: Among 106 chronic wounds, microbial growth was observed in 67 samples. Staphylococcus aureus (MSSA 35.8%, MRSA 7.5%) was the most frequently isolated pathogen, followed by Pseudomonas aeruginosa (19.4%), Enterobacter spp. (19.4%), and Escherichia coli (17.9%). Polymicrobial infections were detected in 29.8% of cases, with MSSA combined with P. aeruginosa or Enterobacter species being the most common associations. Conclusion: Chronic leg wounds are frequently colonized by a heterogeneous mix of microorganisms, with S. aureus and P. aeruginosa predominating. Polymicrobial infections pose challenges for treatment and may influence healing outcomes. Comprehensive microbiological evaluation is essential for guiding targeted antimicrobial therapy.