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1.
Medicine (Baltimore) ; 99(15): e19746, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32282735

RESUMO

RATIONALE: Toxic shock syndrome (TSS) typically is an acute onset multi-organ infection caused by TSS toxin-1 producing Staphylococcus aureus. Herein we describe a highly unusual case report. PATIENT CONCERNS: A male patient self-referred to the University of Minnesota Hospital with a chronic history of S aureus infection with accompanying fever, hypotension, and nonhealing, football-sized lesion on his leg. DIAGNOSIS: An unusual case presentation of TSS/hyperimmunoglobulin E syndrome is described. The patient had a leg wound from which TSS toxin-1 S aureus was isolated. The patient exhibited characteristic skewing of T cells to those with variable region, ß-chain T cell receptor-2. Other patients have been seen with related presentations. INTERVENTIONS: The following therapeutic regimen was instituted: vigorous antibacterial scrubs several times daily plus intravenous Ancef 3 days each month; intravenous infusions of immunoglobulin G infusions (28 gm) every 3 weeks; and weekly subcutaneous injections of recombinant granulocyte colony-stimulating factor. OUTCOME: Improvement was obvious within 3 months: no further cellulitic episodes occurred; the patient regained 95 pounds in 9 months; blanching and cyanosis of fingers disappeared within 3 months as did intractable pain although mild hypesthesias continued for 2 years; erythroderma resolved, and repeat skin biopsies performed after 2 years no longer demonstrated T cell receptor skewing. Although IgE levels have not completely returned to normal, the patient remains in excellent health. LESSONS: We propose that staphylococcal TSST-1 was responsible for the serious problems suffered by this patient as suggested by the following features: rapid onset of chronic, life-threatening, disorder that began with an episode of staphylococcal sepsis; the extraordinary elevation of IgE levels in this previously non-atopic individual; the acquired severe granulocyte chemotactic defect that accompanied this hyperimmunoglobulinemia ("Job Syndrome") with its accompanying wound-healing defect; and the striking diffuse erythroderma, including palmar erythema ("Red Man Syndrome") with hypotension and fever that also characterizes TSS.


Assuntos
Síndrome de Job/microbiologia , Choque Séptico/microbiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/isolamento & purificação , Administração Intravenosa , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Cefazolina/administração & dosagem , Cefazolina/uso terapêutico , Fator Estimulador de Colônias de Granulócitos/administração & dosagem , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Humanos , Imunoglobulina G/administração & dosagem , Imunoglobulina G/uso terapêutico , Infusões Intravenosas , Injeções Subcutâneas , Síndrome de Job/diagnóstico , Síndrome de Job/etiologia , Perna (Membro)/patologia , Masculino , Pessoa de Meia-Idade , Choque Séptico/diagnóstico , Choque Séptico/etiologia , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/patologia , Resultado do Tratamento , Ferimentos e Lesões/microbiologia
2.
J Agric Food Chem ; 68(6): 1621-1633, 2020 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-31967468

RESUMO

Collagen peptides can promote wound healing and are closely related to microbiome colonization. We investigated the relationship among collagen peptides, wound healing, and wound microflora colonization by administering the murine wound model with Salmo salar skin collagen peptides (Ss-SCPs) and Tilapia nilotica skin collagen peptides (Tn-SCPs). We analyzed the vascular endothelial growth factor (VEGF), fibroblast growth factors (ß-FGF), pattern recognition receptor (NOD2), antimicrobial peptides (ß-defence14, BD14), proinflammatory (TNF-α, IL-6, and IL-8) and anti-inflammatory (IL-10) cytokines, macrophages, neutrophil infiltration levels, and microbial communities in the rat wound. The healing rates of the Ss-SCP- and Tn-SCP-treated groups were significantly accelerated, associated with decreased TNF-α, IL-6, and IL-8 and upregulated BD14, NOD2, IL-10, VEGF, and ß-FGF. Accelerated healing in the collagen peptide group shows that the wound microflora such as Leuconostoc, Enterococcus, and Bacillus have a positive effect on wound healing (P < 0.01). Other microbiome species such as Stenotrophomonas, Bradyrhizobium, Sphingomonas, and Phyllobacterium had a negative influence and decreased colonization (P < 0.01). Altogether, these studies show that collagen peptide could upregulate wound NOD2 and BD14, which were implicated in microflora colonization regulation in the wound tissue and promoted wound healing by controlling the inflammatory reaction and increasing wound angiogenesis and collagen deposition.


Assuntos
Colágeno/química , Proteínas de Peixes/química , Microbiota/efeitos dos fármacos , Proteína Adaptadora de Sinalização NOD2/genética , Peptídeos/administração & dosagem , Pele/química , Ferimentos e Lesões/fisiopatologia , beta-Defensinas/genética , Administração Cutânea , Animais , Bactérias/classificação , Bactérias/efeitos dos fármacos , Bactérias/genética , Bactérias/isolamento & purificação , Ciclídeos , Fatores de Crescimento de Fibroblastos/genética , Fatores de Crescimento de Fibroblastos/imunologia , Humanos , Interleucina-10/genética , Interleucina-10/imunologia , Masculino , Camundongos , Proteína Adaptadora de Sinalização NOD2/imunologia , Peptídeos/química , Ratos , Ratos Sprague-Dawley , Salmo salar , Fator de Necrose Tumoral alfa/genética , Fator de Necrose Tumoral alfa/imunologia , Fator A de Crescimento do Endotélio Vascular/genética , Fator A de Crescimento do Endotélio Vascular/imunologia , Cicatrização/efeitos dos fármacos , Ferimentos e Lesões/tratamento farmacológico , Ferimentos e Lesões/imunologia , Ferimentos e Lesões/microbiologia , beta-Defensinas/imunologia
3.
Am J Vet Res ; 81(1): 84-90, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31887087

RESUMO

OBJECTIVE: To investigate in vitro effects of triclosan coating of suture materials on the growth of clinically relevant bacteria isolated from wounds in dogs. SAMPLE: 6 types of suture material and 10 isolates each of methicillin-susceptible Staphylococcus pseudintermedius, methicillin-resistant S pseudintermedius, Escherichia coli, and AmpC ß-lactamase and extended-spectrum ß-lactamase-producing E coli from clinical wound infections. PROCEDURES: Isolates were cultured on Mueller-Hinton agar with 3 types of triclosan-coated suture, uncoated counterparts of the same suture types, and positive and negative controls. Zones of inhibition (ZOIs) were measured after overnight incubation. Sustained antimicrobial activity assays were performed with susceptible isolates. The ZOI measurements and durations of sustained antimicrobial activity were compared among suture types and isolates by statistical methods. Suture surface characteristics and bacterial adherence were evaluated qualitatively with scanning electron microscopy. RESULTS: ZOIs were generated only by triclosan-coated materials; triclosan-coated suture had sustained antimicrobial activity (inhibition) for 3 to 29 days against all tested pathogens. The ZOIs around triclosan-coated suture were significantly greater for S pseudintermedius isolates than for E coli isolates. Bacterial adherence to uncoated polyglactin-910 was greatest, followed by triclosan-coated polyglactin-910, and then uncoated monofilament sutures, with least adherence to coated monofilament sutures. CONCLUSIONS AND CLINICAL RELEVANCE: Surface characteristics of suture materials may be as important or more important than triclosan coating for microbial inhibition; however, triclosan coating appeared to affect bacterial adherence for multifilament sutures. Triclosan-coated, particularly monofilament, sutures inhibited pathogens commonly isolated from wounds of dogs, including multidrug-resistant bacteria. Further studies are required to assess clinical efficacy of triclosan-coated suture materials in vivo.


Assuntos
Bactérias/efeitos dos fármacos , Suturas/veterinária , Triclosan/farmacologia , Ferimentos e Lesões/veterinária , Animais , Anti-Infecciosos Locais/administração & dosagem , Anti-Infecciosos Locais/farmacologia , Bactérias/isolamento & purificação , Bactérias/ultraestrutura , Aderência Bacteriana/efeitos dos fármacos , Cães , Meticilina/farmacologia , Microscopia Eletrônica de Varredura , Poliglactina 910 , Propriedades de Superfície , Suturas/microbiologia , Triclosan/administração & dosagem , Ferimentos e Lesões/microbiologia
4.
ACS Appl Mater Interfaces ; 11(37): 33734-33747, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31436081

RESUMO

Due to insufficient biomedical functions of hydrogels for wound management, the exploitation of available methods to expand the biomedical functions of hydrogels always becomes the cutting-edge research. Here, we report on the use of the silver-ethylene interaction and 3D printing technique to develop the antibacterial superporous polyacrylamide (PAM)/hydroxypropyl methylcellulose (HPMC) hydrogel dressings. Experiments demonstrated that the silver-ethylene interaction played significant roles in mediating the formation, dispersion, and cross-linking of silver nanoparticles (AgNPs) in the hydrogel matrix as well as the cross-linking of the PAM networks. At the same time, such organometallic complexes also controlled the release of AgNPs to balance the cytocompatibility and antibacterial activity of the AgNP-cross-linked hydrogels. On the other hand, the use of 3D printed templates and HPMC as the pore-making materials demonstrated could tailor hydrogels into 91.4% porosity and the formed pores into open channels, endowing hydrogels with rapid water uptake rate and 14 times dead-weight of uptake capacity. Furthermore, experiments showed that the regular large pores arisen from 3D printed templates could buffer the swelling of superporous hydrogel dressings, thus decreasing the detachment risk of dressings from wounds. In vivo experiments demonstrated that the AgNP-cross-linked superporous hydrogel dressings could promote the healing of the infected wounds and restrain scar tissue formation.


Assuntos
Antibacterianos , Bandagens , Etilenos , Hidrogéis , Impressão Tridimensional , Prata , Infecção dos Ferimentos , Ferimentos e Lesões , Animais , Antibacterianos/química , Antibacterianos/farmacocinética , Antibacterianos/farmacologia , Linhagem Celular , Etilenos/química , Etilenos/farmacocinética , Etilenos/farmacologia , Hidrogéis/química , Hidrogéis/farmacocinética , Hidrogéis/farmacologia , Ratos , Ratos Sprague-Dawley , Prata/química , Prata/farmacocinética , Prata/farmacologia , Infecção dos Ferimentos/tratamento farmacológico , Infecção dos Ferimentos/microbiologia , Ferimentos e Lesões/tratamento farmacológico , Ferimentos e Lesões/microbiologia
5.
mSphere ; 4(4)2019 08 28.
Artigo em Inglês | MEDLINE | ID: mdl-31462413

RESUMO

Nursing home residents are at a greater risk of developing pressure injuries that develop into an open wound, which can become colonized with bacteria. Understanding the factors that influence microbial colonization of open wounds can lead to the prevention of infections. The relationship between bacteria found in urine and those in open wounds is currently unknown. To determine if bacterial species colonizing open wounds are also found in the urine, we conducted a pilot study with nursing home residents, comparing bacterial species present in the urine with those present in wounds between the umbilicus and mid-thigh. To identify microbial species that were present in both urine and open wound at one time point in one patient, standard clinical bacteriologic culture techniques followed by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) were used, as well as 16S rRNA-encoding gene amplicon sequencing. We found some bacterial species detected in urine were also detected in open wounds in one individual at one time point, using both culture-dependent and -independent techniques. Bacterial species that were more often detected, using culture-dependent and -independent methods, at both sites included Enterococcus faecalis, Proteus mirabilis, Escherichia coli, and Providencia stuartii This pilot study provides evidence that bacterial species identified within the urine can also be identified in open wounds in the same patient at one point in time. Further studies are needed to investigate if these species are of the same lineage and if the urinary microbiota are able to seed colonization of open wounds below the umbilicus.IMPORTANCE Older adults, specifically those in nursing facilities, are more susceptible to developing chronic open nonhealing wounds. Chronic open nonhealing wounds severely impact an individual's quality of life and can lead to other comorbidities, such as infection. Recent evidence suggests that the open wound bacterial community can influence wound healing and repair. It is important to understand all sources of open wound contamination to improve preventative infection measures and treatment protocols. In this pilot study, we investigated if bacterial species isolated from urine can also be isolated from open wounds located between the levels of the umbilicus and mid-thigh in the same patient at the same point in time. A growing body of evidence suggests that urine can harbor a microbial community, even in asymptomatic individuals, and older adults are more prone to urinary incontinence. This is the first study to investigate bacterial species concordance between these two anatomical sites. We found, using both culture-dependent and -independent methods, that the same bacterial species can colonize both the urine and wound in one patient at one point in time. Further studies are needed to investigate if these species are of the same lineage and if the urinary microbiota are able to seed colonization of these types of open wounds.


Assuntos
Bactérias/isolamento & purificação , Infecções Bacterianas/urina , Microbiota , Casas de Saúde/estatística & dados numéricos , Ferimentos e Lesões/microbiologia , Idoso , Bactérias/classificação , Infecções Bacterianas/microbiologia , Técnicas Bacteriológicas , Humanos , Masculino , Projetos Piloto , Qualidade de Vida , RNA Ribossômico 16S/genética , Células-Tronco
6.
Eur J Clin Microbiol Infect Dis ; 38(10): 1901-1906, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31292789

RESUMO

Erysipelas is a common skin infection causing significant morbidity. At present there are no established procedures for bacteriological sampling. Here we investigate the possibility of using cultures for diagnostic purposes by determining the perianal colonization with beta-hemolytic streptococci (BHS) in patients with erysipelas. Patients with erysipelas and a control group of patients with fever without signs of skin infection were prospectively included and cultures for BHS were taken from the tonsils, the perianal area, and wounds. BHS were grouped according to Lancefield antigen, species-determined, and emm-typed. Renewed cultures were taken after four weeks from patients with erysipelas and a positive culture for BHS. 25 patients with erysipelas and 25 with fever were included. In the group with erysipelas, 11 patients (44%) were colonized with BHS, ten patients were colonized in the perianal area, and one patient in the throat. In contrast, only one patient in the control group was colonized (p = 0.005 for difference). All of the patients with erysipelas colonized with BHS had an erythema located to the lower limb. The BHS were then subjected to MALDI-TOF MS and most commonly found to be Streptococcus dysgalactiae. Renewed cultures were taken from nine of the 11 patients with BHS and three of these were still colonized. Streptococcus dysgalactiae colonizes the perianal area in a substantial proportion of patients with erysipelas. The possibility of using cultures from this area as a diagnostic method in patients with erysipelas seems promising.


Assuntos
Portador Sadio/microbiologia , Erisipela/microbiologia , Streptococcus/isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Canal Anal/microbiologia , Portador Sadio/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tonsila Palatina/microbiologia , Períneo/microbiologia , Prevalência , Estudos Prospectivos , Ferimentos e Lesões/microbiologia , Adulto Jovem
7.
Mater Sci Eng C Mater Biol Appl ; 103: 109741, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31349480

RESUMO

Wounds infected with methicillin-resistant Staphylococcus aureus (MRSA) biofilm represent a high risk in patients with diabetes. Nitric oxide (NO) has shown promise in dispersing biofilm and wound healing. For an effective treatment of MRSA biofilm-infected wounds, however, NO needs to be supplied to the biofilm matrix in a sustainable manner due to a short half-life and limited diffusion distance of NO. In this study, polyethylenimine/diazeniumdiolate (PEI/NONOate)-doped PLGA nanoparticles (PLGA-PEI/NO NPs) with an ability to bind to the biofilm matrix are developed to facilitate the NO delivery to MRSA biofilm-infected wound. In simulated wound fluid, PLGA-PEI/NO NPs show an extended NO release over 4 days. PLGA-PEI/NO NPs firmly bind to the MRSA biofilm matrix, resulting in a greatly enhanced anti-biofilm activity. Moreover, PLGA-PEI/NO NPs accelerate healing of MRSA biofilm-infected wounds in diabetic mice along with complete biofilm dispersal and reduced bacterial burden. These results suggest that the biofilm-binding NO-releasing NPs represent a promising NO delivery system for the treatments of biofilm-infected chronic wounds.


Assuntos
Antibacterianos/farmacologia , Complicações do Diabetes/tratamento farmacológico , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Nanopartículas/química , Infecções Cutâneas Estafilocócicas/tratamento farmacológico , Ferimentos e Lesões/tratamento farmacológico , Animais , Antibacterianos/química , Antibacterianos/metabolismo , Compostos Azo/química , Biofilmes/efeitos dos fármacos , Complicações do Diabetes/microbiologia , Diabetes Mellitus Experimental/complicações , Diabetes Mellitus Experimental/microbiologia , Liberação Controlada de Fármacos , Masculino , Staphylococcus aureus Resistente à Meticilina/patogenicidade , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos ICR , Óxido Nítrico/farmacocinética , Polietilenoimina/química , Copolímero de Ácido Poliláctico e Ácido Poliglicólico/química , Infecções Cutâneas Estafilocócicas/complicações , Cicatrização/efeitos dos fármacos , Ferimentos e Lesões/complicações , Ferimentos e Lesões/microbiologia , Ferimentos e Lesões/patologia
8.
Int J Syst Evol Microbiol ; 69(8): 2268-2276, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31125302

RESUMO

Two unusual catalase-negative, Gram-stain-positive, Vagococcus-like isolates that were referred to the CDC Streptococcus Laboratory for identification are described. Strain SS1994T was isolated from ground beef and strain SS1995T was isolated from a human foot wound. Comparative 16S rRNA gene sequence analysis of isolates SS1994T and SS1995T against Vagococcus type strain sequences supported their inclusion in the genus Vagococcus. Strain SS1994T showed high sequence similarity (>97.0 %) to the two most recently proposed species, Vagococcus martis (99.2 %) and Vagococcus teuberi (99.0 %) followed by Vagococcus penaei (98.8 %), strain SS1995T (98.6 %), Vagococcus carniphilus (98.0 %), Vagococcus acidifermentans (98.0 %) and Vagococcus fluvialis (97.9 %). The 16S rRNA gene sequence of strain SS1995T was most similar to V. penaei (99.1 %), followed by SS1994T (98.6 %), V. martis (98.4 %), V. teuberi (98.1 %), V. acidifermentans (97.8 %), and both V. carniphilus and V. fluvialis (97.5 %). A polyphasic taxonomic study using conventional biochemical and the rapid ID 32 STREP system, MALDI-TOF MS, cell fatty acid analysis, pairwise sequence comparisons of the 16S rRNA, rpoA, rpoB, pheS and groL genes, and comparative core and whole genome sequence analyses revealed that strains SS1994T and SS1995T were two novel Vagococcus species. The novel taxonomic status of the two isolates was confirmed with core genome phylogeny, average nucleotide identity <84 % and in silico DNA-DNA hybridization <28 % to any other Vagococcus species. The names Vagococcusbubulae SS1994T=(CCUG 70831T=LMG 30164T) and Vagococcusvulneris SS1995T=(CCUG 70832T=LMG 30165T) are proposed.


Assuntos
Enterococcaceae/classificação , Pé/microbiologia , Filogenia , Carne Vermelha/microbiologia , Ferimentos e Lesões/microbiologia , Animais , Técnicas de Tipagem Bacteriana , Composição de Bases , Bovinos , DNA Bacteriano/genética , Enterococcaceae/isolamento & purificação , Ácidos Graxos/química , Genes Bacterianos , Humanos , Masculino , Hibridização de Ácido Nucleico , RNA Ribossômico 16S/genética , Análise de Sequência de DNA
9.
J Infect Chemother ; 25(10): 816-819, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31003955

RESUMO

We report a case of necrotizing skin infection caused by Yokenella regensburgei in an immunosuppressed patient with orthotopic liver transplantation. Initial bacterial culture identification was suggestive of Hafnia alvei. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) confirmed identification of Y. regensburgei. Necrotizing fasciitis is potentially fatal and requires aggressive management, including early diagnosis, appropriate antibiotic selection, and operative debridement.


Assuntos
Enterobacteriaceae/isolamento & purificação , Fasciite Necrosante/microbiologia , Hospedeiro Imunocomprometido , Pele/lesões , Ferimentos e Lesões/microbiologia , Amputação , Antibacterianos/uso terapêutico , Desbridamento , Enterobacteriaceae/imunologia , Fasciite Necrosante/imunologia , Fasciite Necrosante/terapia , Feminino , Rejeição de Enxerto/imunologia , Rejeição de Enxerto/prevenção & controle , Humanos , Imunossupressores/efeitos adversos , Perna (Membro) , Cirrose Hepática Alcoólica/imunologia , Cirrose Hepática Alcoólica/cirurgia , Transplante de Fígado/efeitos adversos , Pessoa de Meia-Idade , Pele/microbiologia , Pele/patologia , Resultado do Tratamento , Ferimentos e Lesões/imunologia , Ferimentos e Lesões/terapia
10.
Colloids Surf B Biointerfaces ; 179: 17-27, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-30928801

RESUMO

Antimicrobial resistance is becoming more and more serious and has become a potential hazard to human life and health. The fabrication of some new antibacterial substances against resistant bacteria is demanded. With the wide application and research of carbon nanomaterials, nitrogen-doped carbon quantum dots (NCQDs) were synthesized by a one-step chemical route herein. The particle size of NCQDs in the range of 2-5 nm were characterized by transmission electron microscopy (TEM), atomic force microscopy, and dynamic light scattering. The functional groups and optical properties of NCQDs were investigated by UV-vis absorption spectroscopy, X-ray photoelectron spectroscopy and Fourier transform infrared spectroscopy. Disk-diffusion tests showed that the NCQDs had specific antibacterial activity against Staphylococcus. TEM showed that the NCQDs could destroy the cell structure of Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) but could not combat Escherichia coli. The antibacterial mechanism may be that positively charged NCQDs firstly interacted with the negatively charged bacteria, and then specifically anchored on some specific sites on the surface of Staphylococcus. The NCQDs were applied to treat wounds infected with MRSA and showed the same therapeutic effect as vancomycin. Photomicrographs of hematoxylin-eosin-stained histological sections showed that the NCQDs at concentrations effectively killing S. aureus and MRSA caused negligible toxicity to the main rat organs, including heart, liver, spleen, lung, and kidney. Thus, the NCQDs can be developed as a promising antibacterial agent for Staphylococcus. And the NCQDs are likely to treat local infections caused by Staphylococcus clinically, especially S. aureus and MRSA.


Assuntos
Antibacterianos/uso terapêutico , Carbono/química , Nitrogênio/química , Pontos Quânticos/química , Staphylococcus aureus/efeitos dos fármacos , Ferimentos e Lesões/tratamento farmacológico , Ferimentos e Lesões/microbiologia , Animais , Antibacterianos/farmacologia , Proteína C-Reativa/metabolismo , Escherichia coli/efeitos dos fármacos , Células HeLa , Humanos , Contagem de Leucócitos , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Espectroscopia Fotoeletrônica , Pontos Quânticos/ultraestrutura , Ratos Sprague-Dawley , Testes de Toxicidade , Cicatrização/efeitos dos fármacos , Ferimentos e Lesões/sangue
11.
Int J Low Extrem Wounds ; 18(1): 31-41, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30836811

RESUMO

Chronic nonhealing wounds are a severe burden to health care systems worldwide, causing millions of patients to have lengthy hospital stays, high health care costs, periods of unemployment, and reduced quality of life. Moreover, treating chronic nonhealing wounds effectively and reasonably in countries with limited medical resources can be extremely challenging. With many outstanding questions surrounding chronic nonhealing wounds, in this review, we offer changes to the microbiome as a potentially ignored mechanism important in the formation and treatment of chronic wounds. Our analysis helps bring a whole new understanding to wound formation and healing and provides a potential breakthrough in the treatment of chronic nonhealing wounds in the future.


Assuntos
Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde , Microbiota/fisiologia , Ferimentos e Lesões/microbiologia , Ferimentos e Lesões/fisiopatologia , Doença Crônica/economia , Feminino , Hospitalização/economia , Humanos , Masculino , Prognóstico , Medição de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Falha de Tratamento , Ferimentos e Lesões/terapia
12.
Sensors (Basel) ; 19(5)2019 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-30813559

RESUMO

The spread of antimicrobial resistance calls for chronic wound management devices that can engage with the wound exudate and signal infection by prompt visual effects. Here, the manufacture of a two-layer fibrous device with independently-controlled exudate management capability and visual infection responsivity was investigated by sequential free surface electrospinning of poly(methyl methacrylate-co-methacrylic acid) (PMMA-co-MAA) and poly(acrylic acid) (PAA). By selecting wound pH as infection indicator, PMMA-co-MAA fibres were encapsulated with halochromic bromothymol blue (BTB) to trigger colour changes at infection-induced alkaline pH. Likewise, the exudate management capability was integrated via the synthesis of a thermally-crosslinked network in electrospun PAA layer. PMMA-co-MAA fibres revealed high BTB loading efficiency (>80 wt.%) and demonstrated prompt colour change and selective dye release at infected-like media (pH > 7). The synthesis of the thermally-crosslinked PAA network successfully enabled high water uptake (WU = 1291 ± 48 - 2369 ± 34 wt.%) and swelling index (SI = 272 ± 4 - 285 ± 3 a.%), in contrast to electrospun PAA controls. This dual device functionality was lost when the same building blocks were configured in a single-layer mesh of core-shell fibres, whereby significant BTB release (~70 wt.%) was measured even at acidic pH. This study therefore demonstrates how the fibrous configuration can be conveniently manipulated to trigger structure-induced functionalities critical to chronic wound management and monitoring.


Assuntos
Infecção dos Ferimentos/diagnóstico , Ferimentos e Lesões/microbiologia , Alanina/análogos & derivados , Alanina/química , Curativos Biológicos , Azul de Bromotimol/química , Cor , Farmacorresistência Bacteriana/fisiologia , Humanos , Concentração de Íons de Hidrogênio , Nanopartículas/química , Ácidos Polimetacrílicos/química , Água/química , Cicatrização/fisiologia , Infecção dos Ferimentos/microbiologia
13.
J Ethnopharmacol ; 236: 354-365, 2019 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-30878545

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Oil extracted from Parrotiopsis jacquemontiana stem traditionally used for wound healing, body aches and dermatitis. In this study we have evaluated oil for its phytoconstituents, antioxidant, antimicrobial and wound healing activities. METHODS: Phytochemical characterization of oil was determined by standard qualitative procedures, gas chromatography mass spectrometry technique (GC-MS) and Fourier transform infra-red spectroscopy (FT-IR). The in vitro antioxidant aptitude was determined by scavenging of DPPH radical, hydroxyl ion, nitric oxide, inhibition of ß-carotene bleaching assay and iron chelation power assay. The antimicrobial potential of oil was investigated by disc diffusion method against multidrug resistant (MDR) bacterial isolates and fungal strains. Wound healing was performed in vivo with determination of wound contraction rates, histopathology, hemostatic potential and hydroxyproline estimation. RESULTS: GC-MS analysis indicated that oil was constituted mainly of 2, 6-dimethyl-8-oxoocta-2, 6-dienoic acid, methyl ester (18.2%), syringol (17.8%), catechol (12.4%), guaiacol (5.2%), p-cresol (5.4%) and phenol, 2-propyl- (3.7%). FT-IR analysis revealed several important functional groups in its chemical composition especially phenolic O-H compound stretching. Scavenging of DPPH radical, hydroxyl ion, nitric oxide, inhibition of ß-carotene oxidation and iron chelation power assays indicated strong antioxidant activities of oil. Further it efficiently inhibited growth of multidrug resistant isolates of Staphylococcus aureus, S. lugdenesis, Klebsiella pneumoniae, Escherichia coli, Coagulase -ve staphylococci and Pseudomonas aeruginosa. The minimum inhibitory concentrations ranged between (32-256) (µg/mL) of oil. The oil also strongly inhibited the growth of various fungal isolates with low level of minimum inhibitory concentrations (64-256) µg/mL. Remarkable rate for wound closure and epithelization, hemostatic potential and marked increase (p < 0.05) in hydroxyproline content was observed for oil during wound healing in rat. CONCLUSION: The results suggested that oil can be used as a potential source of wound healing therapeutics.


Assuntos
Anti-Infecciosos/farmacologia , Antioxidantes/farmacologia , Hamamelidaceae/química , Óleos Voláteis/farmacologia , Ferimentos e Lesões/tratamento farmacológico , Administração Cutânea , Animais , Anti-Infecciosos/química , Anti-Infecciosos/isolamento & purificação , Anti-Infecciosos/uso terapêutico , Antioxidantes/química , Antioxidantes/isolamento & purificação , Antioxidantes/uso terapêutico , Artemia , Bactérias/efeitos dos fármacos , Bandagens , Modelos Animais de Doenças , Fungos/efeitos dos fármacos , Cromatografia Gasosa-Espectrometria de Massas , Medicina Tradicional , Testes de Sensibilidade Microbiana , Óleos Voláteis/química , Óleos Voláteis/isolamento & purificação , Óleos Voláteis/uso terapêutico , Paquistão , Componentes Aéreos da Planta/química , Ratos , Ratos Sprague-Dawley , Pele/efeitos dos fármacos , Pele/lesões , Pele/patologia , Espectroscopia de Infravermelho com Transformada de Fourier , Testes de Toxicidade , Cicatrização/efeitos dos fármacos , Ferimentos e Lesões/microbiologia , Ferimentos e Lesões/patologia
14.
BMC Infect Dis ; 19(1): 103, 2019 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-30704410

RESUMO

BACKGROUND: War-wounded civilians in Middle East countries are at risk of post-traumatic osteomyelitis (PTO). We aimed to describe and compare the bacterial etiology and proportion of first-line antibiotics resistant bacteria (FLAR) among PTO cases in civilians from Syria, Iraq and Yemen admitted to the reconstructive surgical program of Médecins Sans Frontières (MSF) in Amman, Jordan, and to identify risk factors for developing PTO with FLAR bacteria. METHODS: We retrospectively analyzed the laboratory database of the MSF program. Inclusion criteria were: patients from Iraq, Yemen or Syria, admitted to the Amman MSF program between October 2006 and December 2016, with at least one bone biopsy sample culture result. Only bone samples taken during first orthopedic surgery were included in the analysis. To assess factors associated with FLAR infection, logistic regression was used to estimate odds ratio (ORs) and 95% confidence intervals (CI). RESULTS: 558 (76.7%) among 727 patients included had ≥1 positive culture results. 318 were from Iraq, 140 from Syria and 100 from Yemen. Median time since injury was 19 months [IQR 8-40]. Among the 732 different bacterial isolates, we identified 228 Enterobacteriaceae (31.5%), 193 Staphylococcus aureus (26.3%), 99 Pseudomonas aeruginosa (13.5%), and 21 Acinetobacter baumanii (2.8%). Three hundred and sixty four isolates were FLAR: 86.2% of Enterobacteriaceae, 53.4% of Pseudomonas aeruginosa, 60.5% of S. aureus and 45% of Acinetobacter baumannii. There was no difference in bacterial etiology or proportion of FLAR according to the country of origin. In multivariate analysis, a FLAR infection was associated with an infection of the lower extremity, with a time since the injury ≤12 months compared with time > 30 months and with more than 3 previous surgeries. CONCLUSIONS: Enterobacteriaceae were frequently involved in PTO in war wounded civilians from Iraq, Yemen and Syria between 2006 and 2016. Proportion of FLAR was high, particularly among Enterobacteriaceae, regardless of country of origin.


Assuntos
Conflitos Armados , Farmacorresistência Bacteriana Múltipla , Osteomielite/epidemiologia , Ferimentos e Lesões/epidemiologia , Acinetobacter baumannii/isolamento & purificação , Adulto , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Bases de Dados Factuais , Enterobacteriaceae/isolamento & purificação , Feminino , Humanos , Masculino , Oriente Médio/epidemiologia , Osteomielite/tratamento farmacológico , Osteomielite/microbiologia , Pseudomonas aeruginosa/isolamento & purificação , Estudos Retrospectivos , Staphylococcus aureus/isolamento & purificação , Ferimentos e Lesões/complicações , Ferimentos e Lesões/tratamento farmacológico , Ferimentos e Lesões/microbiologia , Adulto Jovem
15.
Biomed Res Int ; 2019: 4360525, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30800668

RESUMO

Staphylococcus is one of the most frequently isolated genera of opportunistic bacteria in animals and human beings. Staphylococci in mammals mostly inhabit the skin and mucous membranes. The objectives of the study were to investigate the distribution of staphylococcal species in healthy and sick cats in order to find diagnostic markers. The risk factors associated with colonization were also explored. Isolates from healthy (n=520) and sick cats (n=67) were identified at the species level using matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS). Swabs from conjunctival sacs, nares, skin, anus, and wounds were investigated using this technique. The diversity of the Staphylococcus species was high: 26 and 17 species in healthy and sick cats, respectively, and predominantly coagulase-negative staphylococci (CoNS) were isolated. The most frequently observed were S. felis and S. epidermidis in healthy cats, whereas S. felis and S. haemolyticus were most often found in sick animals. S. aureus strains were only isolated from healthy cats, whereas the only coagulase-positive Staphylococcus (CoPS) which occurred in the sick cats group was S. pseudintermedius. The sick, more frequently than the healthy animals, were colonized with S. pseudintermedius and S. haemolyticus and the relationship was statistically significant. Mostly, regardless of the state of their health, similar Staphylococcus species were isolated from cats; therefore, particular attention should be paid during the interpretation of diagnostic results.


Assuntos
Infecções Estafilocócicas/etiologia , Staphylococcus/isolamento & purificação , Canal Anal/microbiologia , Animais , Gatos , Coagulase/metabolismo , Aparelho Lacrimal/microbiologia , Prevalência , Pele/microbiologia , Staphylococcus/metabolismo , Ferimentos e Lesões/microbiologia
16.
J Infect Public Health ; 12(4): 594-597, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30635251

RESUMO

Sepsis related to Candida famata (C. famata) fungemia is extremely rare in immunocompetent patients. Moreover, septic shock has not been reported due to this yeast. A previously healthy young multi-trauma male, presented septic shock from C. famata, after he had been admitted in the Intensive Care Unit (ICU) due to haemorrhagic shock. Risk factors for candidemia in ICU patients are the presence of a central venous catheter (CVC), Total Parenteral Nutrition (TPN), use of broad-spectrum antimicrobials, immunosuppression and the length of ICU stay. The presence of CVCs, prior use of antibiotics, prolonged hospitalization, disruption of skin flora and immunocompromised states have been identified as predisposing risk factors for C. famata fungemia. It is worth noting that the present case concerns a non-immunocompromised patient, but long ICU stay and brain injury may indicate a state of immunoparalysis. Identification of the yeast was performed by partial amplification and sequencing of the 26S ribosomal DNA gene [hypervariable region D1/D2; partial sequencing of the act1 gene confirmed the identity of the strain as Debaryomyces hansenii (GenBank submission ID: 1688297)] The patient quickly recovered from sepsis after initiation of amphotericin B and was discharged on the 60th day.


Assuntos
Candidemia/complicações , Imunocompetência , Unidades de Terapia Intensiva , Choque Séptico/microbiologia , Ferimentos e Lesões/complicações , Adulto , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Candidemia/tratamento farmacológico , Cuidados Críticos , Debaromyces/genética , Humanos , Masculino , Fatores de Risco , Resultado do Tratamento , Ferimentos e Lesões/microbiologia
17.
Macromol Biosci ; 19(4): e1800453, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30645044

RESUMO

The increasing occurrence of bacterial infection at the wound sites is a serious global problem, demanding the rapid development of new antibacterial materials for wound dressing to avoid the abuse of antibiotics and thereby antibiotic resistance. In this work, the authors first report on antibacterial N-halamine polymer nanomaterials based on a strategic copolymerization of 3-allyl-5,5-dimethylhydantoin (ADMH) and methyl methacrylate (MMA), which exhibits in vitro and in vivo antimicrobial efficacy against pathogenic bacteria including Staphylococcus aureus and Escherichia coli. Particularly, when a biological evaluation is run for wound therapy, the N-halamine polymer nanomaterials exhibit a powerful antibacterial efficiency and wound healing ability after a series of histological examination of mouse wound. After the evaluation of biological and chemical surroundings, the proposed four-stage mechanism suggests that, with unique antibacterial NCl bonds, the N-halamine polymer nanomaterials can disrupt the bacterial membrane, as a result causing intracellular content leaked out and thereby cell death. Based on the synergistic action of antibacterial and wound therapy, the N-halamine polymer nanomaterials are expected to be promising as wound dressing materials in medical healing and biomaterials.


Assuntos
Aminas , Antibacterianos , Bandagens , Membrana Celular/metabolismo , Infecções por Escherichia coli , Escherichia coli/metabolismo , Nanoestruturas , Ácidos Polimetacrílicos , Infecções Estafilocócicas , Staphylococcus aureus/metabolismo , Infecção dos Ferimentos , Aminas/química , Aminas/farmacologia , Animais , Antibacterianos/química , Antibacterianos/farmacologia , Infecções por Escherichia coli/metabolismo , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/patologia , Infecções por Escherichia coli/terapia , Camundongos , Nanoestruturas/química , Nanoestruturas/uso terapêutico , Ácidos Polimetacrílicos/química , Ácidos Polimetacrílicos/farmacologia , Infecções Estafilocócicas/metabolismo , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/patologia , Infecções Estafilocócicas/terapia , Infecção dos Ferimentos/metabolismo , Infecção dos Ferimentos/microbiologia , Infecção dos Ferimentos/patologia , Infecção dos Ferimentos/terapia , Ferimentos e Lesões/metabolismo , Ferimentos e Lesões/microbiologia , Ferimentos e Lesões/patologia , Ferimentos e Lesões/terapia
18.
J Am Assoc Nurse Pract ; 31(6): 337-343, 2019 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-30681650

RESUMO

BACKGROUND AND PURPOSE: Prosthetic joint infection (PJI) is a serious complication resulting from total knee arthroplasty (TKA) or total hip arthroplasty (THA). In this study, patients with a PJI are compared with patients with an uncomplicated postoperative course to identify relevant risk factors for PJI. METHODS: A matched case-control study was performed with patients undergoing fast-track, elective unilateral TKA or THA. The following data were collected: demographics, surgery-related characteristics (perioperative blood loss, use of cement, body temperature), and postoperative characteristics (hematoma formation, wound leakage, blood transfusion, length of stay [LOS]). CONCLUSIONS: When the PJI group was compared with the control group, there was significantly more wound leakage during hospital stay (88% vs. 36%, p = .001) and early wound dressing changes in the first 3 days after surgery (88% vs. 40%, p = .002). Hematoma formation was observed more in the PJI patients group (44% vs. 10%, p = .005). A trend test revealed a significant association between the total number of wound dressing changes and development of PJI (p < .001); 72% of PJI patients had a length of stay of ≥4 days compared with 34% of controls (odds ratio 10.5; 95% CI [2.1-52.3]; p = .004). IMPLICATIONS FOR PRACTICE: Early postoperative wound drainage and hematoma formation directly correlate with PJI. This resulted in a significantly higher number of dressing changes and longer LOS. The nurse practitioner has a central role in postoperative care and is the first to recognize signs of an adverse postoperative clinical course.


Assuntos
Membros Artificiais/normas , Drenagem/efeitos adversos , Infecção dos Ferimentos/diagnóstico , Ferimentos e Lesões/microbiologia , Idoso , Artroplastia de Quadril/métodos , Artroplastia de Quadril/estatística & dados numéricos , Artroplastia do Joelho/métodos , Artroplastia do Joelho/estatística & dados numéricos , Membros Artificiais/microbiologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco , Infecção dos Ferimentos/fisiopatologia , Ferimentos e Lesões/fisiopatologia
19.
Infect Disord Drug Targets ; 19(2): 193-206, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30345928

RESUMO

BACKGROUND: A polyherbal formulation (Herboheal) traditionally indicated for woundcare was investigated for its anti-virulence potential against the notorious pathogen Staphylococcus aureus. OBJECTIVE: This study aimed at evaluating anti-virulence potential of Herboheal formulation against S. aureus in vitro as well as in vivo, followed by studying its effect on target bacterium's gene expression at the whole transcriptome level. METHODS: In vitro efficacy of the test formulation was evaluated using broth dilution assay, whereas in vivo efficacy was assayed employing the nematode Caenorhabditis elegans as the model host. Molecular targets of the test formulation in S. aureus were elucidated through whole transcriptome analysis. RESULTS: This formulation could exert inhibitory effect on bacterial growth and quorum sensingregulated pigment (staphyloxanthin) production at ≥ 0.025% v/v. It not only could inhibit S. aureus biofilm formation, but also eradicated pre-formed biofilm effectively. This formulation could modulate antibiotic susceptibility of S. aureus, enhanced its susceptibility to human serum heavily, while compromising its haemolytic potential. Herboheal-treated bacteria expressed notably lesser virulence towards the nematode worm Caenorhabditis elegans. Even repeated exposure of S. aureus to this polyherbal formulation did not give rise to resistant phenotype. Whole transcriptome analysis revealed genes associated with hemolysis, virulence, enzyme activity, transport, basic cellular processes, quorum sensing, and transcriptional regulators as the major targets of Herboheal in S. aureus. CONCLUSION: This study validates the traditional use of Herboheal formulation in wound-care by demonstrating its efficacy against one of the pathogenic bacteria most commonly involved in wound infections.


Assuntos
Antibacterianos/farmacologia , Proteínas de Bactérias/genética , Preparações de Plantas/farmacologia , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus aureus/efeitos dos fármacos , Ferimentos e Lesões/tratamento farmacológico , Animais , Biofilmes/efeitos dos fármacos , Caenorhabditis elegans , Perfilação da Expressão Gênica , Humanos , Fitoterapia , Percepção de Quorum/efeitos dos fármacos , Virulência , Sequenciamento Completo do Genoma , Ferimentos e Lesões/microbiologia , Xantofilas/metabolismo
20.
Trop Med Int Health ; 24(3): 339-347, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30549385

RESUMO

OBJECTIVE: To evaluate the molecular epidemiology and to georeference Staphylococcus aureus isolated from wounds and nares of patients seen at Basic Health Units (BHUs) of a Brazilian city. METHODS: Observational, cross-sectional study conducted from 2010 to 2013. A total of 119 S. aureus strains isolated from the wounds and nares of 88 patients were studied. The isolates were characterised by identifying virulence genes encoding enterotoxins A-E, haemolysins α, ß and δ, exfoliatins A, B and D, biofilm production, Panton-Valentine Leukocidin and toxic shock syndrome toxin 1, and by pulsed-field gel electrophoresis (PFGE), multilocus sequence and spa typing. RESULTS: Eighteen methicillin-resistant Staphylococcus aureus (MRSA) (6 SCCmec type II and 12 SCCmec type IV) and 101 (85%) MSSA were identified. PFGE typing resulted in the formation of eight clusters, with STs 1, 5, 8, 30, 188, 1176 and 1635 and spa type t002 being the predominant types among MSSA. The 18 MRSA belonged to STs 5, 8 and 1176 and spa types t002 and t062. CONCLUSION: The results demonstrate widespread dissemination of MSSA and MRSA clones carrying haemolysin, biofilm and toxin genes. Kernel density estimation revealed the highest density of S. aureus in the 4, 5 and 8 BHUs.


Assuntos
Staphylococcus aureus Resistente à Meticilina/genética , Infecções Estafilocócicas/epidemiologia , Ferimentos e Lesões/microbiologia , Idoso , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular , Infecções Estafilocócicas/microbiologia
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