{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T05:04:13Z","timestamp":1779944653762,"version":"3.53.1"},"reference-count":31,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Funda\u00e7\u00e3o Paulista Contra a Hansen\u00edase"},{"DOI":"10.13039\/501100013994","name":"Brazilian Society of Dermatology","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100013994","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Chronic ulcers are characterized by impaired tissue repair and frequently harbor antimicrobial-resistant microorganisms, worsening clinical outcomes. The objective of this study is to identify microbial agents in chronic ulcers treated at the Lauro de Souza Lima Institute Wound Care Outpatient Clinic and to evaluate their antimicrobial susceptibility profiles and \u03b2-lactamase production. Samples (swab and biopsy) from patients treated at the Lauro de Souza Lima Institute were analyzed. Susceptibility was assessed by disk diffusion. ESBL and AmpC production were confirmed by PCR targeting blaTEM, blaSHV, blaCTX-M1, and blaCMY-2. In Staphylococcus spp., oxacillin and clindamycin resistance were evaluated and confirmed by mecA and ermAC. From 33 patients (mean age 63.4 years), 116 isolates were obtained, mainly Pseudomonas aeruginosa (27%), Proteus mirabilis (18%), and Staphylococcus aureus (13%). P. aeruginosa showed high resistance, with 48% MDR and 29% PDR. Among Enterobacterales, 19% were ESBL producers and 17% AmpC, with 56% carrying blaCMY-2. In Staphylococcus, 33% were oxacillin-resistant and 50% expressed MLSb phenotype. P. aeruginosa was identified as the most prevalent pathogen, with frequent MDR\/PDR phenotypes. Resistance genes exhibited a discrepancy between genotypic and phenotypic profiles, suggesting the presence of unexpressed resistance that may be inducible during treatment.<\/jats:p>","DOI":"10.3390\/microorganisms14061199","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T11:02:51Z","timestamp":1779793371000},"page":"1199","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Microbial Profile and Antimicrobial Resistance Patterns in Chronic Lower Limb Ulcers: Evidence from a Brazilian Dermatology Referral Center"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1683-1907","authenticated-orcid":false,"given":"Silas Matheus Brosco de Toledo","family":"Piza","sequence":"first","affiliation":[{"name":"Microbiology Laboratory, Instituto Lauro de Souza Lima (ILSL), Bauru 17034-971, SP, Brazil"},{"name":"Molecular Biology Laboratory, Instituto Lauro de Souza Lima (ILSL), Bauru 17034-971, SP, Brazil"},{"name":"Department of Tropical Diseases, Botucatu Medical School, S\u00e3o Paulo State University (UNESP), Botucatu 18618-689, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina Maldonado Poz","family":"Bernardo","sequence":"additional","affiliation":[{"name":"Wound Clinic, Instituto Lauro de Souza Lima (ILSL), Bauru 17034-971, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia Alessandra de Lima","family":"Ramos","sequence":"additional","affiliation":[{"name":"Wound Clinic, Instituto Lauro de Souza Lima (ILSL), Bauru 17034-971, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9079-2723","authenticated-orcid":false,"given":"Maria de Lourdes Ribeiro de Souza da","family":"Cunha","sequence":"additional","affiliation":[{"name":"Department of Tropical Diseases, Botucatu Medical School, S\u00e3o Paulo State University (UNESP), Botucatu 18618-689, SP, Brazil"},{"name":"Electron Microscopy Center, Institute of Biosciences of Botucatu, S\u00e3o Paulo State University (UNESP), Botucatu 18618-689, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia Sammarco","family":"Rosa","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, Instituto Lauro de Souza Lima (ILSL), Bauru 17034-971, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ant\u00f4nio Carlos Ceribelli","family":"Martelli","sequence":"additional","affiliation":[{"name":"Wound Clinic, Instituto Lauro de Souza Lima (ILSL), Bauru 17034-971, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7377-7652","authenticated-orcid":false,"given":"Luiza","family":"Pinheiro-Hubinger-Stauffer","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, Instituto Lauro de Souza Lima (ILSL), Bauru 17034-971, SP, Brazil"},{"name":"Molecular Biology Laboratory, Instituto Lauro de Souza Lima (ILSL), Bauru 17034-971, SP, Brazil"},{"name":"Department of Tropical Diseases, Botucatu Medical School, S\u00e3o Paulo State University (UNESP), Botucatu 18618-689, SP, Brazil"},{"name":"Electron Microscopy Center, Institute of Biosciences of Botucatu, S\u00e3o Paulo State University (UNESP), Botucatu 18618-689, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1111\/j.1600-0625.2008.00786.x","article-title":"The skin: An indispensable barrier","volume":"17","author":"Proksch","year":"2008","journal-title":"Exp. 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