scholarly journals Anti-Microbial Dendrimers against Multidrug-Resistant P. aeruginosa Enhance the Angiogenic Effect of Biological Burn-wound Bandages

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Philippe Abdel-Sayed ◽  
Ariane Kaeppeli ◽  
Thissa Siriwardena ◽  
Tamis Darbre ◽  
Karl Perron ◽  
...  
Keyword(s):  
Healing Process ◽  
Multidrug Resistant ◽  
Burn Patients ◽  
Drug Resistant ◽  
Wound Infections ◽  
Significant Morbidity ◽  
Burn Wound ◽  
Skin Cells ◽  
Angiogenic Effect ◽  
Healing Processes

Abstract Multi-drug resistant Pseudomonas aeruginosa has increased progressively and impedes further regression in mortality in burn patients. Such wound infections serve as bacterial reservoir for nosocomial infections and are associated with significant morbidity and costs. Anti-microbial polycationic dendrimers G3KL and G3RL, able to kill multi-drug resistant P. aeruginosa, have been previously developed. The combination of these dendrimers with a class of biological bandages made of progenitor skin cells, which secrete growth factors, could positively impact wound-healing processes. However, polycations are known to be used as anti-angiogenic agents for tumor suppression. Since, neovascularization is pivotal in the healing of deep burn-wounds, the use of anti-microbial dendrimers may thus hinder the healing processes. Surprisingly, we have seen in this study that G3KL and G3RL dendrimers can have angiogenic effects. Moreover, we have shown that a dendrimer concentration ranging between 50 and 100 μg/mL in combination with the biological bandages can suppress bacterial growth without altering cell viability up to 5 days. These results show that antimicrobial dendrimers can be used in combination with biological bandages and could potentially improve the healing process with an enhanced angiogenesis.

scholarly journals Arginine Is a Critical Substrate for the Pathogenesis of Pseudomonas aeruginosa in Burn Wound Infections

mBio ◽  
2017 ◽  
Vol 8 (2) ◽  
Author(s):  
Jake Everett ◽  
Keith Turner ◽  
Qiuxian Cai ◽  
Vernita Gordon ◽  
Marvin Whiteley ◽  
...  
Keyword(s):  
Antimicrobial Agents ◽  
Hospital Setting ◽  
Multidrug Resistant ◽  
Burn Patients ◽  
Burn Wound ◽  
Burn Wounds ◽  
Resistant Strains ◽  
High Doses ◽  
Ubiquitous Presence

ABSTRACT Environmental conditions affect bacterial behavior and can greatly influence the course of an infection. However, the environmental cues that elicit bacterial responses in specific infection sites are relatively unknown. Pseudomonas aeruginosa is ubiquitous in nature and typically innocuous. However, it is also one of the most prevalent causes of fatal sepsis in burn wound patients. The aim of this study was to determine the impact of environmental factors, specifically the availability of arginine, on the pathogenesis of P. aeruginosa in burn wound infections. Comparison of burned versus noninjured tissue revealed that l-arginine (l-Arg) was significantly depleted in burn wounds as a consequence of elevated arginase produced by myeloid-derived suppressor cells. We also observed that l-Arg was a potent chemoattractant for P. aeruginosa, and while low concentrations of l-Arg increased P. aeruginosa’s swimming motility, high concentrations resulted in diminished swimming. Based on these observations, we tested whether the administration of exogenous l-Arg into the burn wound could attenuate the virulence of P. aeruginosa in thermally injured mice. Administration of l-Arg resulted in decreased P. aeruginosa spread and sepsis and increased animal survival. Taken together, these data demonstrate that the availability of environmental arginine greatly influences the virulence of P. aeruginosa in vivo and may represent a promising phenotype-modulating tool for future therapeutic avenues. IMPORTANCE Despite our growing understanding of the pathophysiology of burn wounds and the evolution of techniques and practices to manage infections, sepsis remains a significant medical concern for burn patients. P. aeruginosa continues to be a leader among all causes of bacteremic infections due to its tendency to cause complications in immunocompromised patients and its ubiquitous presence in the hospital setting. With the unforgiving emergence of multidrug-resistant strains, it is critical that alternative strategies to control or prevent septic infections in burn patients be developed in parallel with novel antimicrobial agents. In this study, we observed that administration of l-Arg significantly reduced bacterial spread and sepsis in burned mice infected with P. aeruginosa. Given the safety of l-Arg in high doses and its potential wound-healing benefits, this conditionally essential amino acid may represent a useful tool to modulate bacterial behavior in vivo and prevent sepsis in burn patients. IMPORTANCE Despite our growing understanding of the pathophysiology of burn wounds and the evolution of techniques and practices to manage infections, sepsis remains a significant medical concern for burn patients. P. aeruginosa continues to be a leader among all causes of bacteremic infections due to its tendency to cause complications in immunocompromised patients and its ubiquitous presence in the hospital setting. With the unforgiving emergence of multidrug-resistant strains, it is critical that alternative strategies to control or prevent septic infections in burn patients be developed in parallel with novel antimicrobial agents. In this study, we observed that administration of l-Arg significantly reduced bacterial spread and sepsis in burned mice infected with P. aeruginosa. Given the safety of l-Arg in high doses and its potential wound-healing benefits, this conditionally essential amino acid may represent a useful tool to modulate bacterial behavior in vivo and prevent sepsis in burn patients.

scholarly journals Carbapenemases: Transforming Acinetobacter baumannii into a Yet More Dangerous Menace

Biomolecules ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 720 ◽  
Author(s):  
Maria Soledad Ramirez ◽  
Robert A. Bonomo ◽  
Marcelo E. Tolmasky
Keyword(s):  
Acinetobacter Baumannii ◽  
Nosocomial Infections ◽  
Acquired Resistance ◽  
Clinical Manifestations ◽  
High Capacity ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
Wound Infections ◽  
Extensively Drug Resistant

Acinetobacter baumannii is a common cause of serious nosocomial infections. Although community-acquired infections are observed, the vast majority occur in people with preexisting comorbidities. A. baumannii emerged as a problematic pathogen in the 1980s when an increase in virulence, difficulty in treatment due to drug resistance, and opportunities for infection turned it into one of the most important threats to human health. Some of the clinical manifestations of A. baumannii nosocomial infection are pneumonia; bloodstream infections; lower respiratory tract, urinary tract, and wound infections; burn infections; skin and soft tissue infections (including necrotizing fasciitis); meningitis; osteomyelitis; and endocarditis. A. baumannii has an extraordinary genetic plasticity that results in a high capacity to acquire antimicrobial resistance traits. In particular, acquisition of resistance to carbapenems, which are among the antimicrobials of last resort for treatment of multidrug infections, is increasing among A. baumannii strains compounding the problem of nosocomial infections caused by this pathogen. It is not uncommon to find multidrug-resistant (MDR, resistance to at least three classes of antimicrobials), extensively drug-resistant (XDR, MDR plus resistance to carbapenems), and pan-drug-resistant (PDR, XDR plus resistance to polymyxins) nosocomial isolates that are hard to treat with the currently available drugs. In this article we review the acquired resistance to carbapenems by A. baumannii. We describe the enzymes within the OXA, NDM, VIM, IMP, and KPC groups of carbapenemases and the coding genes found in A. baumannii clinical isolates.

The Bacteriological Profile of Burn Wound Infections at a Tertiary Burns Center in Nepal

2019 ◽  
Vol 40 (6) ◽  
pp. 838-845 ◽  
Author(s):  
Ojas Jyoti Singh Pujji ◽  
Kiran Kishor Nakarmi ◽  
Basudha Shrestha ◽  
Shankar Man Rai ◽  
Steven Leonard Alexander Jeffery
Keyword(s):  
Traffic Accidents ◽  
Burn Injury ◽  
Road Traffic ◽  
Average Distance ◽  
Polymyxin B ◽  
Multidrug Resistant ◽  
Gram Negative Bacteria ◽  
Wound Infections ◽  
Burn Wound ◽  
Gram Negative

AbstractIn Nepal, burn is the third most common injury after falls and road traffic accidents. Infection is the leading cause of mortality in burn injury. A profile exploring predominant flora and antimicrobial sensitivity is important to facilitate treatment ahead of microbiology results and to aid prevention of multidrug-resistant organisms. The aim of this study was to document epidemiological and bacteriological data of burn wound infections at a tertiary level burns center in Nepal. Samples were collected from January 2017 to May 2017, over a period of 5 months. Patient notes were referred to and information regarding baseline characteristics and burn wound infection data was collected. A total of 76 patients were included in the study during the 5-month period, which resulted in 113 samples being included for review. Females were injured most with burns 70% (n = 53) compared with males 30% (n = 23). Only 6 (8%) of 77 patients lived locally in Kathmandu. The average distance traveled by patients was 233 km (median 208, range 0–765, SD 181). Average TBSA% of burn was 22% (median 20, range 3–50, SD 12). Gram-negative organisms predominated, with Acinetobacter spp. in 42 cases (55%), Pseudomonas aeruginosa in 26 cases (34%), and Enterobacter spp. in 16 cases (21%). Colistin, polymyxin B, and tigecycline were found to be most sensitive covering 108, 98, and 94 organisms. Gram-negative bacteria colonized the majority of burn wounds. Colistin, polymyxin B, and tigecycline were the most sensitive to gram-negative bacteria. Gram-positive Staphylococcus aureus was sensitive most to vancomycin and tigecycline.

scholarly journals Burn Wound Infections

2006 ◽  
Vol 19 (2) ◽  
pp. 403-434 ◽  
Author(s):  
Deirdre Church ◽  
Sameer Elsayed ◽  
Owen Reid ◽  
Brent Winston ◽  
Robert Lindsay
Keyword(s):  
Wound Care ◽  
Infectious Complications ◽  
Inhalation Injury ◽  
Trauma Patients ◽  
Burn Patients ◽  
Wound Infections ◽  
Burn Wound ◽  
Central Lines ◽  
Treatment And Prevention ◽  
Specialized Care

SUMMARYBurns are one of the most common and devastating forms of trauma. Patients with serious thermal injury require immediate specialized care in order to minimize morbidity and mortality. Significant thermal injuries induce a state of immunosuppression that predisposes burn patients to infectious complications. A current summary of the classifications of burn wound infections, including their diagnosis, treatment, and prevention, is given. Early excision of the eschar has substantially decreased the incidence of invasive burn wound infection and secondary sepsis, but most deaths in severely burn-injured patients are still due to burn wound sepsis or complications due to inhalation injury. Burn patients are also at risk for developing sepsis secondary to pneumonia, catheter-related infections, and suppurative thrombophlebitis. The introduction of silver-impregnated devices (e.g., central lines and Foley urinary catheters) may reduce the incidence of nosocomial infections due to prolonged placement of these devices. Improved outcomes for severely burned patients have been attributed to medical advances in fluid resuscitation, nutritional support, pulmonary and burn wound care, and infection control practices.

scholarly journals Evaluation of Biofilm Formation and Frequency of Multidrug-resistant and Extended Drug-resistant Strain in Pseudomonas aeruginosa Isolated from Burn Patients in Isfahan

2018 ◽  
Vol 7 (1) ◽  
pp. 61 ◽  
Author(s):  
HajiehGhasemian Safaei ◽  
Pourya Nasirmoghadas ◽  
Sima Yadegari ◽  
Sharareh Moghim ◽  
BahramNasr Esfahani ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Resistant Strain ◽  
Biofilm Formation ◽  
Multidrug Resistant ◽  
Burn Patients ◽  
Drug Resistant

scholarly journals Correlation of Hypernatremia to Success Rate of Skin Graft in Burn Patients Dr. Soetomo Hospital Burn Centre from 2014- 2018

2021 ◽  
Vol 4 (2) ◽  
pp. 44
Author(s):  
Ephora Wulandari ◽  
Lynda Hariani ◽  
Agus Santoso Budi
Keyword(s):  
Relative Risk ◽  
Skin Graft ◽  
Healing Process ◽  
Electrolyte Imbalance ◽  
Split Thickness Skin Graft ◽  
Wound Healing Process ◽  
Chemical Agent ◽  
Burn Patients ◽  
Burn Wound ◽  
Major Burn

Background : From collective data from 2014 – 2018 from Burn Centre in Dr. Soetomo Hospital, the rate of failed skin graft was 26%. This high number became a concerned because skin graft was the main procedure to close large burn wound. This event is affected by many problems, one of them is electrolyte imbalance. Hypernatremia was seen in major burn patients that causes the disruption of wound healing process of skin graft. Methods: A cross sectional study of patients with burns admitted to the Burn Centre of Dr. Soetomo Hospital between January 2014 and December 2018 were evaluated. Results : 143 subjects were involved in this study. 44 subjects are female (31%) and 99 subjects are male (69%). 66% of the burn injuries are caused by fire (93 subjects), 14% caused by electricity (20 subjects), 8% caused by scald (12 subjects), 6% caused by boiled oil (8 subjects), 4% caused by chemical agent (6 subjects) and 2% caused by blast injury (1 subject). 77% of all subjects (110 subjects) underwent split thickness skin graft less than 10% while 23% (33 subjects) underwent the procedure 10% or more than it. Hypernatremia is found in 16% of all subjects (23 subjects), 19% with hyponatremia (28 subjects) and majority of it, 65%, with normonatremia (92 subjects). From the study, it was found that the risk of failed skin graft was higher on hypernatremia subjects than normonatremia subjects, the relative risk was 6,06 to fail. This number was higher if the skin graft procedure took more than 10%. But, it was found the risk was higher on hyponatremia subjects than the rest of subjects, with the relative risk was 7,75 to fail. Conclusions: Hypernatremia caused high risk of failed skin graft on major burn patients

scholarly journals Enzymatically-crosslinked gelatin hydrogels containing paenipeptin and clarithromycin against carbapenem-resistant pathogen in murine skin wound infection

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sun Hee Moon ◽  
Yihong Kaufmann ◽  
Ryoichi Fujiwara ◽  
En Huang
Keyword(s):  
Wound Infection ◽  
Multidrug Resistant ◽  
Skin Wound ◽  
Drug Resistant ◽  
Wound Infections ◽  
Log Reduction ◽  
Carbapenem Resistant ◽  
Infected Wounds ◽  
Localized Delivery

Abstract Background The recent rise and spread of carbapenem-resistant pathogens pose an urgent threat to public health and has fueled the search for new therapies. Localized delivery of topical antibiotics is an alternative for the treatment of infected wounds caused by drug-resistant pathogens. In this study, we aimed to develop antimicrobial-loaded hydrogels for topical treatment of wound infections in a murine skin wound infection. Results Paenipeptin analogue 1, a linear lipopeptide, potentiated clarithromycin against multidrug-resistant Acinetobacter baumannii, Enterobacter cloacae, Escherichia coli, and Klebsiella pneumoniae. Enzymatically-crosslinked gelatin hydrogels were developed to encapsulate paenipeptin analogue 1 and clarithromycin. The encapsulated antimicrobials were gradually released from hydrogels during incubation, reaching 75.43 and 53.66% for paenipeptin and clarithromycin, respectively, at 24 h. The antimicrobial-loaded hydrogels containing paenipeptin and clarithromycin synergistically resulted in 5-log reduction in carbapenem-resistant A. baumannii within 6 h in vitro. Moreover, the antimicrobial-loaded hydrogels reduced 3.6- and 2.5-log of carbapenem-resistant A. baumannii when treated at 4 or 20 h post infection, respectively, in a murine skin wound infection. Conclusions Enzymatically-crosslinked gelatin hydrogels loaded with paenipeptin analogue 1 and clarithromycin exhibited potent therapeutic efficacy against carbapenem-resistant A. baumannii in murine skin wound infection.

scholarly journals Study of Biofilm Formation and Antibiotic Resistant Profile in Multidrug Resistant and Extensive Drug Resistance Pseudomonas Aeruginosa Isolated from Burn Wound Infections in Southwest Iran

2021 ◽  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Drug Resistance ◽  
Full Text ◽  
Biofilm Formation ◽  
Multidrug Resistant ◽  
Wound Infections ◽  
Burn Wound ◽  
Antibiotic Resistant ◽  
Extensive Drug Resistance ◽  
Southwest Iran

Abstract The full text of this preprint has been withdrawn by the authors due to author disagreement with the posting of the preprint. Therefore, the authors do not wish this work to be cited as a reference. Questions should be directed to the corresponding author.

Antibiotic resistance pattern of Acinetobacter baumannii from burns patients: increase in prevalence of blaOXA-24-like and blaOXA-58-like genes

2020 ◽  
Author(s):  
Niloofar Tafreshi ◽  
Laleh Babaeekhou ◽  
Maryam Ghane
Keyword(s):  
Acinetobacter Baumannii ◽  
Insertion Sequence ◽  
Treatment Options ◽  
Carbapenem Resistance ◽  
Multidrug Resistant ◽  
Resistance Pattern ◽  
Drug Resistant ◽  
Burn Wound ◽  
Beta Lactamases ◽  
First Time

Background and Objectives: Notwithstanding the increased prevalence of Acinetobacter baumannii drug-resistant isolates, treatment options are progressively limiting. This study aims to provide a recent report on antibiotic susceptibility in burn wound isolates of A. baumannii, and the importance of OXA beta-lactamases in carbapenem resistance. Materials and Methods: The susceptibility levels to different antimicrobial categories were determined among 84 A. baumannii isolates from burn wound infection between 2016 and 2018. Multiplex PCR was used to detect OXA beta-lactamases genes, including blaOXA-51, blaOXA-23, blaOXA-24 and blaOXA-58. ISAba-1 association with blaOXA-51, blaOXA-23 and blaOXA-58 was detected by PCR mapping. Results: All the isolates were determined as multidrug-resistant (MDR) and 69% as extensively drug-resistant (XDR). Different carbapenems MIC ranges (MIC50 and MIC90) were observed among the isolates harboring blaOXA-like genes and isolates with the OXA-24-like enzyme showed higher carbapenems MIC ranges. The prevalence of blaOXA-51-like, blaOXA-23-like, blaOXA-24-like and blaOXA-58-like were 100%, 53.57%, 41.66% and 30.95%, respectively. ISAba-1 insertion sequence was found to be upstream to blaOXA-23-like and blaOXA-58-like genes in 23 out of 45 (71.1%) blaOXA-23-like-positive and 4 out of 23 (15.3) blaOXA-58-like-positive isolates, respectively. Conclusion: Resistance to carbapenems as the last resort for treatment of A. baumannii infections is growing. This study, for the first time in Iran, has observed the increased frequency of blaOXA-24-like and blaOXA-58-like genes and found an association between ISAba-1 and blaOXA-58-like gene, which signifies the possible risk of increased diversity in OXA beta-lactamases and growth in carbapenem resistance

scholarly journals New Nanotechnologies for the Treatment and Repair of Skin Burns Infections

2020 ◽  
Vol 21 (2) ◽  
pp. 393 ◽  
Author(s):  
Eliana B. Souto ◽  
André F. Ribeiro ◽  
Maria I. Ferreira ◽  
Maria C. Teixeira ◽  
Andrea A. M. Shimojo ◽  
...  
Keyword(s):  
Tissue Engineering ◽  
Wound Dressing ◽  
Systemic Exposure ◽  
Mortality Rates ◽  
Wound Infections ◽  
Risk Of Infection ◽  
Significant Morbidity ◽  
Burn Wound ◽  
Skin Integrity ◽  
Systemic Antibiotics

Burn wounds are highly debilitating injuries, with significant morbidity and mortality rates worldwide. In association with the damage of the skin integrity, the risk of infection is increased, posing an obstacle to healing and potentially leading to sepsis. Another limitation against healing is associated with antibiotic resistance mainly due to the use of systemic antibiotics for the treatment of localized infections. Nanotechnology has been successful in finding strategies to incorporate antibiotics in nanoparticles for the treatment of local wounds, thereby avoiding the systemic exposure to the drug. This review focuses on the most recent advances on the use of nanoparticles in wound dressing formulations and in tissue engineering for the treatment of burn wound infections.

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