Table_2_Distinct Skin Microbiome and Skin Physiological Functions Between Bedridden Older Patients and Healthy People: A Single-Center Study in Japan.docx

With the increase in the older populations, the number of bedridden older patients is becoming a matter of concern. Skin microbiome and skin physiological functions are known to change according to lifestyle and community; however, such changes in case of movement- and cleaning-restricted bedridden older patients have not yet been revealed. To address this issue, we analyzed skin microbiome and skin physiological functions, including pH, hydration, sebum level, and transepidermal water loss (TEWL), of bedridden older patients, compared with those of ambulatory older and young individuals. For this analysis, we enrolled 19 healthy young and 18 ambulatory older individuals from the community and 31 bedridden older patients from a single, long-term care hospital in Japan. The area of interest was set to the sacral (lower back) skin, where pressure injuries (PIs) and subsequent infection frequently occurs in bedridden older patients. We observed a higher number of gut-related bacteria, fewer commensals, higher skin pH, and lower TEWL on the sacral skin of bedridden older patients than on that of young or ambulatory older individuals. In addition, we observed that 4 of the 31 bedridden older patients developed PIs during the research period; a higher abundance of pathogenic skin bacteria were also observed inside the PI wounds. These findings imply distinct skin microbiome and skin physiological functions in bedridden older patients in comparison with healthy individuals and may suggest the need for more stringent cleaning of the skin of bedridden older patients in light of the closeness of skin and wound microbiome.

随着老年人口占比的不断提升，卧床老年患者的数量愈发受到关注。皮肤微生物组（skin microbiome）与皮肤生理功能已知会随生活方式与所处群落发生改变，但对于活动与清洁均受限制的卧床老年患者，这类变化尚未被揭示。为解决这一问题，本研究针对卧床老年患者的皮肤微生物组与皮肤生理功能展开分析，检测指标包括pH值、皮肤含水量、皮脂含量以及经表皮水分流失量（transepidermal water loss, TEWL），并与能自主行走的老年个体及青年个体进行对比。本次研究共招募了来自社区的19名健康青年、18名能自主行走的老年个体，以及来自日本某单一长期护理医院的31名卧床老年患者。本研究选取的检测部位为骶尾部（下背部）皮肤——该部位在卧床老年患者中常出现压力性损伤（pressure injuries, PIs）并继发感染。我们观察到，与青年个体或能自主行走的老年个体相比，卧床老年患者骶尾部皮肤中的肠道相关细菌丰度更高、共生菌数量更少，皮肤pH值更高，经表皮水分流失量则更低。此外，本研究发现31名卧床老年患者中有4名在研究期间出现了压力性损伤，且在这些压力性损伤创面内部检测到了丰度更高的致病性皮肤细菌。上述研究结果表明，与健康个体相比，卧床老年患者的皮肤微生物组与皮肤生理功能存在显著差异；同时鉴于皮肤与创面微生物组的紧密关联，本研究提示需对卧床老年患者的皮肤实施更为严格的清洁护理。