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Bacterial superinfection in zoonotic cutaneous leishmaniasis
Monir Doudi1, Mahbubeh Setorki, Manizheh Narimani
1Department of Microbiology, Falavarjan Branch, Islamic Azad University, Isfahan, Iran. monirdoudi@yahoo.com
Background:
Zoonotic Cutaneous Leishmaniasis (ZCL) is a polymorphic disease. It is generally accepted that bacterial superinfection may play a role in the clinical appearance of the lesions and may delay or prevent the healing process. However, the pattern of bacterial pathogens involved has rarely been investigated.
Material/Methods:
The aim of this study was to identify the bacterial species contaminating the suspected ZCL and their susceptibility to commonly used antibiotics. Microscopic examination of stained smears and cultures were used to differentiate ZCL from non-ZCL lesions in a rural area north of Isfahan, Iran from July to December 2009. Bacteria were isolated from the lesions and identified and antibiotic susceptibility was determined by standard microbiological techniques.
Results:
The results show that 602 (68%) of 855 patients were positive for ZCL, of which 83.4% with volcano-shape, 8.8% psoriasiform, 6.6% popular form and 1.2% with other atypical forms of ZCL. The bacteria were isolated from 66.8% of ZCL (70% of volcano-shape, 60% of psoriasiform and 25% of popular form) and 64.7% of non-ZCL lesions. The most common species were Staphylococcus aureus (41.7%) and S. epidermidis (28%) followed by Bacillus sp. Streptococcus pyogenes, Escherichia coli, Klebsiella sp., Proteus sp., Enterobacter sp. and Pseudomonas aeroginosa. Ciprofloxacin, Erythromycin, Cefazolin and Clindamycin were the most effective antibiotics.
Conclusions:
Bacterial superinfection appears to be very common in ZCL, but its prevalence is not different from that of non-ZCL lesions and it has little effect on the clinical appearance of anthroponotic cutaneous Leishmaniasis (ACL). Local lesion care and management of bacterial superinfection must be considered in the treatment of ZCL.
Insights
Bacterial superinfections are common in Zoonotic Cutaneous Leishmaniasis (ZCL) lesions, similar to other skin conditions. Effective antibiotics like ciprofloxacin and erythromycin are identified for treating these bacterial co-infections.
Area of Science:
- Microbiology
- Dermatology
- Infectious Diseases
Background:
- Zoonotic Cutaneous Leishmaniasis (ZCL) presents with varied clinical forms.
- Bacterial superinfection is suspected to influence ZCL lesion appearance and healing.
- The specific bacterial pathogens involved in ZCL remain under-investigated.
Purpose of the Study:
- To identify bacterial species contaminating ZCL lesions.
- To determine the antibiotic susceptibility patterns of these bacteria.
- To compare bacterial prevalence in ZCL versus non-ZCL lesions.
Main Methods:
- Microscopic examination and cultures of lesion smears from suspected ZCL cases.
- Isolation, identification, and antibiotic susceptibility testing of bacterial pathogens.
- Study conducted in a rural area north of Isfahan, Iran (July-December 2009).
Main Results:
- 602 of 855 patients (68%) were diagnosed with ZCL, showing diverse clinical forms (e.g., volcano-shape).
- Bacteria were isolated from 66.8% of ZCL lesions and 64.7% of non-ZCL lesions.
- Staphylococcus aureus and S. epidermidis were the most prevalent bacteria; ciprofloxacin, erythromycin, cefazolin, and clindamycin showed high efficacy.
Conclusions:
- Bacterial superinfection is frequent in ZCL but not significantly different from non-ZCL lesions.
- Bacterial superinfection has minimal impact on the clinical presentation of ZCL.
- Management of bacterial superinfection is crucial for ZCL treatment alongside local lesion care.
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