Bacterial species distribution on the genital skin of hospitalized patients with stroke manifesting incontinence-associated dermatitis: A cross-sectional study.

AIM: To compare the isolated and identified bacterial species colonizing on the genital skin between patients with and without incontinence-associated dermatitis. METHODS: This cross-sectional study included 102 patients with stroke admitted to an acute hospital in Japan. Swabs were collected, and bacterial species found in swabs were isolated and identified using a selective agar medium and simple identification kits. In addition to demographic information, severity of incontinence-associated dermatitis and the total bacterial counts were measured. RESULTS: Incontinence-associated dermatitis was present in 53.9% of the participants. Staphylococcus aureus was found in 50% of the participants with incontinence-associated dermatitis and only 17.9% of those without incontinence-associated dermatitis (P = 0.0029). Bacterial species distribution by erythema and skin erosion, which denote severity of incontinence-associated dermatitis, was different, but not significant; additionally, the total number of bacterial colonies was equivalent. CONCLUSIONS: Bacterial species distribution differed between patients with and without incontinence-associated dermatitis, whereas the total number of bacterial colonies was equivalent. A high detection rate of S. aureus on genital skin sites potentially affects the presence of incontinence-associated dermatitis and its severity. Geriatr Gerontol Int 2023; 23: 537-542.

Selective detection of urease-producing bacteria on the genital skin surface in patients with incontinence-associated dermatitis.

We aimed to investigate the association between the presence of cutaneous urease-producing bacteria and the development of incontinence-associated dermatitis (IAD) using an original urea agar medium as a step toward developing advanced preventive measures. In previous clinical assessments, we developed an original urea agar medium to detect urease-producing bacteria via the medium's colour changes. In a cross-sectional study, specimens were collected via the swabbing technique at genital skin sites in 52 stroke patients hospitalised in a university hospital. The primary objective was to compare the presence of urease-producing bacteria between the IAD and no-IAD groups. Determining the bacterial count was the secondary objective. The prevalence of IAD was 48%. A significantly higher detection rate of urease-producing bacteria was observed in the IAD group than in the no-IAD group (P = .002) despite the total number of bacteria being equivalent between them. In conclusion, we discovered that there was a significant association between the presence of urease-producing bacteria and IAD development in hospitalised stroke patients.

[A Case of Hepatocellular Carcinoma with Haemobilia after Transcatheter Hepatic Arterial Embolization for Tumor Rupture].

A 79-year-old man was scheduled for surgery for hepatocellular carcinoma(HCC)after transcatheter hepatic arterial embolization for rupture. Two weeks before surgery, the patient came to our hospital with a chief complaint of back pain. First, we performed biliary drainage, under the diagnosis of HCC with obstructive jaundice due to haemobilia. Hepatectomy was performed when the patient's condition stabilized. It should be kept in mind that haemobilia may occur after TAE for HCC with bile duct tumor thrombus, and appropriate treatment should be performed when bleeding occurs.

Skin debris and micro-organisms on the periwound skin of pressure ulcers and the influence of periwound cleansing on microbial flora.

Many clinicians use the same solution, most often normal saline, to cleanse the periwound skin and the wound bed itself. However, skin debris such as water-insoluble proteins and lipids are not efficiently removed by normal saline solutions. To analyze the skin debris and micro-organisms found on the periwound skin of pressure ulcers and to evaluate the effect of periwound cleansing on the microbial flora, a descriptive study was conducted among 17 long-term care residents with Stage III and IV pressure ulcers. Skin debris from both the periwound area and normal skin was collected from all 17 residents. In addition, micro-organisms from the wound bed, periwound, and normal skin of five residents were collected before, immediately after, and 6 hours and 24 hours after periwound cleansing using a skin cleanser. All microbial species were identified by cultivation. Cholesterol and nitrogen-containing substances were found in greater quantity on the periwound than on normal skin (P = 0.0027 and P = 0.0054, respectively) and the number of isolated micro-organisms from the periwound area was larger than that from normal skin. Protein showed the highest correlation to the microbial count present on the periwound (r = 0.71, P = 0.0014). The microbial counts of all isolated micro-organisms decreased immediately after cleansing but the number of isolates with high microbial counts increased over time. In the wound bed, the number of isolates with decreasing microbial counts was larger than the number of isolates with increasing microbial counts. Both numbers returned to pre-cleansing values after 24 hours, suggesting that periwound cleansing only (without directly cleansing the wound bed) is effective at reducing the microbial counts in the wound bed for up to 24 hours. Further research is needed to evaluate the effects of periwound cleansing on healing time.