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Wu X, Chen W, Rong R, Pan B, Hu X, Zheng L, Alimu A, Chu C, Tu Y, Zhang Z, Ye Y, Gu M, Sheng P. Application of the New Irrigation Protocol to Reduce Recurrence Rate in the Management Of Periprosthetic Joint Infection. Orthop Surg 2024; 16:577-584. [PMID: 38238252 PMCID: PMC10925507 DOI: 10.1111/os.13948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 10/24/2023] [Accepted: 10/24/2023] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE Irrigation is a conventional treatment for acute and chronic periprosthetic joint infections (PJI). However, there has been no unified standard for irrigation during surgery for PJI in the past, and the efficacy is uncertain. The purpose of this study is to create a new irrigation protocol to enhance the infection control rate and reduce the postoperative recurrence rate of PJI patients. METHODS We conducted a single-institution retrospective review with a total of 56 patients who underwent revision total hip or knee arthroplasties due to PJI from January 2011 to January 2022. Conventional irrigation (CI) was used in 32 cases, and standard operating procedure of irrigation (SOPI) was used in 24. The CI protocol carries out an empirical irrigation after debridement, which is quite random. Our SOPI protocol clearly stipulates the soaking concentration and time of hydrogen peroxide and povidone-iodine. The irrigation is carried out three times, and tissue samples are taken from multiple parts before and after irrigation, which are sent for microbial culture. The important statistical indicators were the rate of positive microbiological culture and postoperative recurrence rate with an average follow-up of 24 average months. RESULTS The drainage volume was lower in the SOPI group than in the CI group on postoperative day 3 (p < 0.01) and 7 (p = 0.016). In addition, the percentage of positive microbiological cultures after the third irrigation was less than that before (p < 0.01) and after (p < 0.01) the first irrigation. The most common causative organism was Staphylococcus aureus, which was detected in 25.0% and 12.5% of the SOPI and CI groups, respectively. The failure rate at the final follow-up was 8.3% and 31.3% (p = 0.039) for the SOPI and CI groups, respectively. CONCLUSION Compared with the traditional CI method, SOPI standardized the soaking time of hydrogen peroxide and povidone-iodine, increased the frequency of and irrigation, and proved that microorganisms were almost completely removed through the microbial culture of multiple tissues. SOPI has the potential to become a standardized irrigation process worthy of promotion, effectively reducing the postoperative recurrence rate of PJI patients.
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Affiliation(s)
- Xiaoyu Wu
- Department of Joint SurgeryThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Orthopaedics and TraumatologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Weishen Chen
- Department of Joint SurgeryThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Orthopaedics and TraumatologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Rong Rong
- Department of Nosocomial InfectionThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
| | - Baiqi Pan
- Department of Joint SurgeryThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Orthopaedics and TraumatologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Xuantao Hu
- Department of Joint SurgeryThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Orthopaedics and TraumatologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Linli Zheng
- Department of Joint SurgeryThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Orthopaedics and TraumatologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Aerman Alimu
- Department of Joint SurgeryThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Orthopaedics and TraumatologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Chenghan Chu
- Department of Joint SurgeryThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Orthopaedics and TraumatologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Yucheng Tu
- Department of Joint SurgeryThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Orthopaedics and TraumatologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Ziji Zhang
- Department of Joint SurgeryThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Orthopaedics and TraumatologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Yongyu Ye
- Department of Spinal SurgeryGuangdong Provincial People's HospitalGuangzhouChina
| | - Minghui Gu
- Department of Joint SurgeryThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Orthopaedics and TraumatologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Puyi Sheng
- Department of Joint SurgeryThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Orthopaedics and TraumatologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
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Li LG, Zhao HX, Wang HY, Ding LF, Wang YH, Wang Y, Tian SQ. The value of sequential application of hydrogen peroxide, povidone-iodine and physiological saline in reducing postoperative infections after total knee arthroplasty: A prospective, randomized, controlled study. Knee 2024; 47:53-62. [PMID: 38244239 DOI: 10.1016/j.knee.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 11/30/2023] [Accepted: 12/28/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND Currently, in the field of total joint arthroplasty (TJA), there are no studies that have demonstrated the value of the sequential application of hydrogen peroxide, povidone-iodine, and physiological saline during the surgical procedure in decreasing postoperative infections in total knee arthroplasty (TKA), and in decreasing the incidence of periprosthetic joint infections (PJI) in particular. This study aimed to assess the efficacy of the sequential application of hydrogen peroxide, povidone-iodine, and physiological saline in reducing postoperative infections in TKA. METHODS The study prospectively included 4743 patients, with Group A (2371, 49.9%) receiving sequential intraoperative application of hydrogen peroxide, povidone-iodine, and physiological saline irrigation of the incision, and Group B (2372, 50.1%) receiving intraoperative application of physiological saline irrigation of the incision only, to collect the patients' baseline data and clinical characteristics, and to statistically assess the incidence of superficial infections and the PJI during the follow up period to evaluate the clinical value of the study. RESULTS The baseline levels of patients in Groups A and B were comparable. There were 132 (2.8%) lost visits during the study period. The incidence of superficial infections within 30 days after surgery was 0.22% in Group A and 1.17% in Group B, the difference between the two groups was statistically significant (P = 0.007). The incidence of PJI was 0.17% in Group A and 1.26% in Group B, the difference between the two groups was statistically significant (P = 0.0121). CONCLUSION Sequential application of hydrogen peroxide, povidone-iodine, and physiological saline to irrigate incision in TKA can significantly reduce the incidence of postoperative superficial infections and PJI. The scientific and rational application of this therapy intraoperatively greatly reduces the incidence of PJI and postoperative superficial infections, which is of great benefit to the patient's prognosis.
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Affiliation(s)
- Liang-Gang Li
- Department of Orthopedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Heng-Xin Zhao
- Department of Orthopedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Hong-Yu Wang
- Department of Orthopedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Lan-Feng Ding
- Department of Orthopedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Yuan-He Wang
- Department of Orthopedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Yan Wang
- Department of Gynecology, The Women and Children's Hospital of Qingdao, Qingdao, People's Republic of China.
| | - Shao-Qi Tian
- Department of Orthopedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China.
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Qi Y, Qin Q, Liao G, Tong L, Jin C, Wang B, Fang W. Unveiling the super tolerance of Candida nivariensis to oxidative stress: insights into the involvement of a catalase. Microbiol Spectr 2024; 12:e0316923. [PMID: 38206032 PMCID: PMC10846165 DOI: 10.1128/spectrum.03169-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/30/2023] [Indexed: 01/12/2024] Open
Abstract
Yeast cells involved in fermentation processes face various stressors that disrupt redox homeostasis and cause cellular damage, making the study of oxidative stress mechanisms crucial. In this investigation, we isolated a resilient yeast strain, Candida nivariensis GXAS-CN, capable of thriving in the presence of high concentrations of H2O2. Transcriptomic analysis revealed the up-regulation of multiple antioxidant genes in response to oxidative stress. Deletion of the catalase gene Cncat significantly impacted H2O2-induced oxidative stress. Enzymatic analysis of recombinant CnCat highlighted its highly efficient catalase activity and its essential role in mitigating H2O2. Furthermore, over-expression of CnCat in Saccharomyces cerevisiae improved oxidative resistance by reducing intracellular ROS accumulation. The presence of multiple stress-responsive transcription factor binding sites at the promoters of antioxidative genes indicates their regulation by different transcription factors. These findings demonstrate the potential of utilizing the remarkably tolerant C. nivariensis GXAS-CN or enhancing the resistance of S. cerevisiae to improve the efficiency and cost-effectiveness of industrial fermentation processes.IMPORTANCEEnduring oxidative stress is a crucial trait for fermentation strains. The importance of this research is its capacity to advance industrial fermentation processes. Through an in-depth examination of the mechanisms behind the remarkable H2O2 resistance in Candida nivariensis GXAS-CN and the successful genetic manipulation of this strain, we open the door to harnessing the potential of the catalase CnCat for enhancing the oxidative stress resistance and performance of yeast strains. This pioneering achievement creates avenues for fine-tuning yeast strains for precise industrial applications, ultimately leading to more efficient and cost-effective biotechnological processes.
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Affiliation(s)
- Yanhua Qi
- Institute of Biological Science and Technology, Guangxi Academy of Sciences, Nanning, Guangxi, China
| | - Qijian Qin
- Institute of Biological Science and Technology, Guangxi Academy of Sciences, Nanning, Guangxi, China
| | - Guiyan Liao
- Institute of Biological Science and Technology, Guangxi Academy of Sciences, Nanning, Guangxi, China
| | - Lige Tong
- Institute of Biological Science and Technology, Guangxi Academy of Sciences, Nanning, Guangxi, China
| | - Cheng Jin
- State Key Laboratory of Mycology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
| | - Bin Wang
- Institute of Biological Science and Technology, Guangxi Academy of Sciences, Nanning, Guangxi, China
| | - Wenxia Fang
- Institute of Biological Science and Technology, Guangxi Academy of Sciences, Nanning, Guangxi, China
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Ajayan KV, Chaithra PJ, Sridharan K, Sruthi P, Harikrishnan E, Harilal CC. Synergistic influence of iodine and hydrogen peroxide towards the degradation of harmful algal bloom of Microcystis aeruginosa. ENVIRONMENTAL RESEARCH 2023; 237:116926. [PMID: 37598850 DOI: 10.1016/j.envres.2023.116926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/03/2023] [Accepted: 08/17/2023] [Indexed: 08/22/2023]
Abstract
Cyanobacterial blooming due to the influence of temperature and increased nutrients in ponds/lakes aided by the runoff from agricultural lands, is a serious environmental issue. The presence of cyanotoxins in water may poison the health of aquatic organisms, animals, and humans. In this study, we focus on chemical assisted degradation of Microcystis aeruginosa- an alga that is of special relevance owing to its consistent blooming, especially in tropical regions. The study aims to ascertain the individual iodine (I) and hydrogen peroxide (H2O2) and their combination (hereinafter referred to as IH) effects on the degradation of Microcystis aeruginosa. As expected, the collected pond water revealed the presence of metal ions viz., Ni, Zn, Pb, Cu and Mn, which enriched the blooming of M. aeruginosa. Interestingly, a complete rupture of the cells - pigment loss, biochemical degradation and oxidative damage-was observed by the IH solution after exposure for ∼9 h under ambient conditions. In comparison to control (original water without chemicals), the addition IH completely eliminated the pigments phycocyanin (99.5%) and allophycocyanin (98%), and degraded ∼81% and 91% of carbohydrates and proteins, respectively due to the synergistic action of I and H. Superior degradation of algae through a simple and eco-friendly approach presented in this study could be explored more effectively towards its large-scale applicability.
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Affiliation(s)
- K V Ajayan
- Biomass Laboratory, Environmental Science Division, Department of Botany, University of Calicut, Tenjipalam, Malappuram, Kerala, 673 635, India.
| | - P J Chaithra
- Department of Environmental Science, University of Calicut, Tenjipalam, Malappuram, Kerala, 673635, India
| | - Kishore Sridharan
- Department of Nanoscience and Technology, University of Calicut, Tenjipalam, Malappuram, Kerala, 673635, India
| | - P Sruthi
- PG Department of Botany, Payyanur College, Kannur University, Edat, 670327, Kerala, India
| | - E Harikrishnan
- PG Department of Botany, Payyanur College, Kannur University, Edat, 670327, Kerala, India
| | - C C Harilal
- Biomass Laboratory, Environmental Science Division, Department of Botany, University of Calicut, Tenjipalam, Malappuram, Kerala, 673 635, India; Department of Environmental Science, University of Calicut, Tenjipalam, Malappuram, Kerala, 673635, India.
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Mu W, Ji B, Cao L. Single-stage revision for chronic periprosthetic joint infection after knee and hip arthroplasties: indications and treatments. ARTHROPLASTY 2023; 5:11. [PMID: 36864484 PMCID: PMC9979399 DOI: 10.1186/s42836-023-00168-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/16/2023] [Indexed: 03/04/2023] Open
Abstract
Single-stage revision for chronic periprosthetic joint infection has been introduced 40 years ago. This option is gaining more and more attention as well as popularity. It is a reliable treatment for the chronic periprosthetic joint infection after knee and hip arthroplasties when implemented by an experienced multi-disciplinary team. However, its indications and corresponding treatments remain controversial. This review focused on the indications and specific treatments related to the option, with an attempt to help surgeons to use this method with more favorable outcomes.
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Affiliation(s)
- Wenbo Mu
- grid.412631.3Department of Orthopedics, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011 Xinjiang China ,grid.13394.3c0000 0004 1799 3993Department of Pharmacognosy, School of Pharmacy, Xinjiang Medical University, Urumqi, 830011 Xinjiang China
| | - Baochao Ji
- grid.412631.3Department of Orthopedics, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011 Xinjiang China
| | - Li Cao
- Department of Orthopedics, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, Xinjiang, China.
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Farhan-Alanie OM, Kennedy JW, Meek RMD, Haddad FS. Is it time to reconsider the use of hydrogen peroxide in hip and knee arthroplasty? Bone Joint J 2023; 105-B:97-98. [PMID: 36722068 DOI: 10.1302/0301-620x.105b2.bjj-2022-1090.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
| | | | - R M D Meek
- Queen Elizabeth University Hospital, Glasgow, UK
| | - Fares S Haddad
- University College London Hospitals NHS Foundation Trust, London, UK.,The Bone and Joint Journal, London, UK
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Caid M, Valk J, Danoff J. Irrigation Solutions in Total Joint Arthroplasty. Spartan Med Res J 2022; 7:37502. [PMID: 36128028 PMCID: PMC9448655 DOI: 10.51894/001c.37502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/02/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Despite advancements in the field of adult reconstruction, prosthetic joint infection (PJI) remains a common and devastating complication of total joint arthroplasty. Eradication of these infections can often prove difficult, and they remain a source of considerable morbidity and mortality. This clinical review paper will focus on some of the more commonly used irrigation solutions; povidone-iodine (PI), chlorhexidine (CHG), acetic acid (AA), hydrogen peroxide (HP), antibiotic irrigations, taurolidine, and polyhexanide-betaine (PB). SUMMARY OF THE EVIDENCE Significant research has been performed on the prevention of PJI, including use of intraoperative joint irrigation solutions. Several solutions have been theorized to aid in infection prevention, but no evidence-based practice guidelines in this area of orthopaedics have been established. There is a paucity of prospective randomized control trials to compare the efficacy of these joint irrigation solutions. CONCLUSIONS The authors present a review regarding seven major categories of commonly used intraoperative joint irrigation solutions. The current literature fails to demonstrate a clear consensus for a preferred solution and concentration for povidone-iodine, chlorhexidine, hydrogen peroxide, acetic acid, antibiotic irrigations, taurolidine, and polyhexanide-betaine. Prospective, randomized control trials directly comparing these different irrigation solutions are needed.
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López-Fernández AM, Moisescu EE, de Llanos R, Galindo F. Development of a Polymeric Film Entrapping Rose Bengal and Iodide Anion for the Light-Induced Generation and Release of Bactericidal Hydrogen Peroxide. Int J Mol Sci 2022; 23:ijms231710162. [PMID: 36077560 PMCID: PMC9478968 DOI: 10.3390/ijms231710162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
A series of poly(2-hydroxyethyl methacrylate) (PHEMA) thin films entrapping photosensitizer Rose Bengal (RB) and tetrabutylammonium iodide (TBAI) have been synthetized. The materials have been characterized by means of Thermogravimetric Analysis (TGA), Attenuated Total Reflectance Fourier Transform Infrared Spectroscopy (ATR-FTIR) and UV-vis Absorption spectroscopy. Irradiation of the materials with white light led to the generation of several bactericidal species, including singlet oxygen (1O2), triiodide anion (I3-) and hydrogen peroxide (H2O2). 1O2 production was demonstrated spectroscopically by reaction with the chemical trap 2,2'-(anthracene-9,10-diylbis(methylene))dimalonic acid (ABDA). In addition, the reaction of iodide anion with 1O2 yielded I3- inside the polymeric matrix. This reaction is accompanied by the formation of H2O2, which diffuses out the polymeric matrix. Generation of both I3- and H2O2 was demonstrated spectroscopically (directly in the case of triiodide by the absorption at 360 nm and indirectly for H2O2 using the xylenol orange test). A series of photodynamic inactivation assays were conducted with the synthesized polymers against Gram-negative bacteria Escherichia coli and Pseudomonas aeruginosa. Complete eradication (7 log10 CFU/mL) of both bacteria occurred after only 5 min of white light irradiation (400-700 nm; total energy dose 24 J/cm2) of the polymer containing both RB and TBAI. The control polymer without embedded iodide (only RB) showed only marginal reductions of ca. 0.5 log10 CFU/mL. The main novelty of the present investigation is the generation of three bactericidal species (1O2, I3- and H2O2) at the same time using a single polymeric material containing all the elements needed to produce such a bactericidal cocktail, although the most relevant antimicrobial activity is shown by H2O2. This experimental approach avoids multistep protocols involving a final step of addition of I-, as described previously for other assays in solution.
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Affiliation(s)
- Ana M. López-Fernández
- Departamento de Química Inorgánica y Orgánica, Universitat Jaume I, Av. V. Sos Baynat s/n, 12071 Castellón, Spain
| | - Evelina E. Moisescu
- Departamento de Química Inorgánica y Orgánica, Universitat Jaume I, Av. V. Sos Baynat s/n, 12071 Castellón, Spain
| | - Rosa de Llanos
- Unidad Predepartamental de Medicina, Universitat Jaume I, Av. V. Sos Baynat s/n, 12071 Castellón, Spain
- Correspondence: (R.d.L.); (F.G.)
| | - Francisco Galindo
- Departamento de Química Inorgánica y Orgánica, Universitat Jaume I, Av. V. Sos Baynat s/n, 12071 Castellón, Spain
- Correspondence: (R.d.L.); (F.G.)
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Cell Toxicity Study of Antiseptic Solutions Containing Povidone–Iodine and Hydrogen Peroxide. Diagnostics (Basel) 2022; 12:diagnostics12082021. [PMID: 36010371 PMCID: PMC9407558 DOI: 10.3390/diagnostics12082021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 12/03/2022] Open
Abstract
The increasing incidence of periprosthetic joint infections (PJIs) has led to a growing interest in developing strategies to prevent and treat this severe complication. The surgical site’s application of antiseptic solutions to eliminate contaminating bacteria and eradicate the bacterial biofilm has been increasing over time. Even though it has been proven that combining antimicrobials could enhance their activities and help overcome acquired microbial resistance related to the topical use of antibiotics, the toxicity of integrated solutions is not well described. This study aimed to evaluate the cytotoxicity of solutions containing povidone–iodine (PI) and hydrogen peroxide (H2O2), alone or in combination, after 1.3 and 5 min of exposure. Chondrocytes, tenocytes, and fibroblast-like synoviocytes were used for cytotoxicity analysis. Trypan blue stain (0.4% in PBS) was applied to evaluate the dead cells. All solutions tested showed a progressive increase in toxicity as exposure time increased except for PI at 0.3%, which exhibited the lowest toxicity. The combined solutions reported a reduced cellular killing at 3 and 5 min than H2O2 at equal concentrations, similar results to PI solutions.
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Augmenting Azoles with Drug Synergy to Expand the Antifungal Toolbox. Pharmaceuticals (Basel) 2022; 15:ph15040482. [PMID: 35455479 PMCID: PMC9027798 DOI: 10.3390/ph15040482] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 03/25/2022] [Accepted: 03/26/2022] [Indexed: 12/23/2022] Open
Abstract
Fungal infections impact the lives of at least 12 million people every year, killing over 1.5 million. Wide-spread use of fungicides and prophylactic antifungal therapy have driven resistance in many serious fungal pathogens, and there is an urgent need to expand the current antifungal arsenal. Recent research has focused on improving azoles, our most successful class of antifungals, by looking for synergistic interactions with secondary compounds. Synergists can co-operate with azoles by targeting steps in related pathways, or they may act on mechanisms related to resistance such as active efflux or on totally disparate pathways or processes. A variety of sources of potential synergists have been explored, including pre-existing antimicrobials, pharmaceuticals approved for other uses, bioactive natural compounds and phytochemicals, and novel synthetic compounds. Synergy can successfully widen the antifungal spectrum, decrease inhibitory dosages, reduce toxicity, and prevent the development of resistance. This review highlights the diversity of mechanisms that have been exploited for the purposes of azole synergy and demonstrates that synergy remains a promising approach for meeting the urgent need for novel antifungal strategies.
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Drug-dependent growth curve reshaping reveals mechanisms of antifungal resistance in Saccharomyces cerevisiae. Commun Biol 2022; 5:292. [PMID: 35361876 PMCID: PMC8971432 DOI: 10.1038/s42003-022-03228-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 03/07/2022] [Indexed: 11/15/2022] Open
Abstract
Microbial drug resistance is an emerging global challenge. Current drug resistance assays tend to be simplistic, ignoring complexities of resistance manifestations and mechanisms, such as multicellularity. Here, we characterize multicellular and molecular sources of drug resistance upon deleting the AMN1 gene responsible for clumping multicellularity in a budding yeast strain, causing it to become unicellular. Computational analysis of growth curve changes upon drug treatment indicates that the unicellular strain is more sensitive to four common antifungals. Quantitative models uncover entwined multicellular and molecular processes underlying these differences in sensitivity and suggest AMN1 as an antifungal target in clumping pathogenic yeasts. Similar experimental and mathematical modeling pipelines could reveal multicellular and molecular drug resistance mechanisms, leading to more effective treatments against various microbial infections and possibly even cancers. Combined growth curve experiments and quantitative modeling reveal antifungal responses of planktonic yeast, providing a future framework to examine antimicrobial drug resistance.
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Christopher ZK, Deckey DG, Pollock JR, Spangehl MJ. Antiseptic Irrigation Solutions Used in Total Joint Arthroplasty: A Critical Analysis Review. JBJS Rev 2022; 10:01874474-202203000-00005. [PMID: 35231016 DOI: 10.2106/jbjs.rvw.21.00225] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
» There are limited data that directly compare the efficacy of antiseptic irrigation solutions used for the prevention and treatment of periprosthetic joint infections in orthopaedic procedures; there is a notable lack of prospective data. » For prevention of periprosthetic joint infections, the strongest evidence supports the use of low-pressure povidone-iodine. » For the treatment of periprosthetic joint infections, delivering multiple solutions sequentially may be beneficial.
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Kashef N, Hamblin MR. In Vitro Potentiation of Antimicrobial Photodynamic Inactivation by Addition of Potassium Iodide. Methods Mol Biol 2022; 2451:607-619. [PMID: 35505037 DOI: 10.1007/978-1-0716-2099-1_32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The current increase in antibiotic resistance worldwide and the emergence of microbial strains that are resistant to all known antibiotics have stimulated research into novel strategies such as aPDI that are thought to be unlikely to lead to the development of resistance. Although many studies have reported in vitro aPDI killing of microorganisms by a range of different photosensitizers, there are still limitations to the effectiveness of aPDI, and recurrence of bacterial growth may occur in animal studies after completion of the illumination. In this chapter we cover a novel and relatively simple method to improve the efficacy of aPDI against Gram-positive Staphylococcus aureus, Gram-negative Escherichia coli, and fungal yeast Candida albicans by the addition of potassium iodide, a nontoxic inorganic salt. Under some circumstances up to six-logs additional killing can be obtained.
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Affiliation(s)
- Nasim Kashef
- Department of Microbiology, School of Biology, College of Science, University of Tehran, Tehran, Iran
| | - Michael R Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, South Africa.
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Reduced Susceptibility and Increased Resistance of Bacteria against Disinfectants: A Systematic Review. Microorganisms 2021; 9:microorganisms9122550. [PMID: 34946151 PMCID: PMC8706950 DOI: 10.3390/microorganisms9122550] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 01/22/2023] Open
Abstract
Disinfectants are used to reduce the concentration of pathogenic microorganisms to a safe level and help to prevent the transmission of infectious diseases. However, bacteria have a tremendous ability to respond to chemical stress caused by biocides, where overuse and improper use of disinfectants can be reflected in a reduced susceptibility of microorganisms. This review aims to describe whether mutations and thus decreased susceptibility to disinfectants occur in bacteria during disinfectant exposure. A systematic literature review following PRISMA guidelines was conducted with the databases PubMed, Science Direct and Web of Science. For the final analysis, 28 sources that remained of interest were included. Articles describing reduced susceptibility or the resistance of bacteria against seven different disinfectants were identified. The important deviation of the minimum inhibitory concentration was observed in multiple studies for disinfectants based on triclosan and chlorhexidine. A reduced susceptibility to disinfectants and potentially related problems with antibiotic resistance in clinically important bacterial strains are increasing. Since the use of disinfectants in the community is rising, it is clear that reasonable use of available and effective disinfectants is needed. It is necessary to develop and adopt strategies to control disinfectant resistance.
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Use of Adjunct Antiseptic Agents in Periprosthetic Joint Infections. J Am Acad Orthop Surg 2021; 29:e1151-e1158. [PMID: 34520439 DOI: 10.5435/jaaos-d-21-00154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 08/05/2021] [Indexed: 02/01/2023] Open
Abstract
Periprosthetic joint infection is a leading cause for failure of contemporary total hip arthroplasty and total knee arthroplasty projected to nearly double in the next decade and reach an economic burden of $1.85 billion in the United Sates by 2030. Although multiple treatments for periprosthetic joint infection have been described, a thorough débridement and joint lavage to decrease bacterial bioburden and to remove biofilm remains a critical component of treatment. Various adjunct antiseptic agents such as chlorhexidine, povidone-iodine, hydrogen peroxide, acetic acid, and chlorine compounds are currently in off-label use in this capacity. Each antiseptic agent, however, has a distinct mechanism of action and targets different organisms, and some combinations of agents may lead to tissue toxicity. In this review, currently available adjunct antiseptic washes will be described in detail based on their mechanism of action and the evidence for their use will be reviewed. Furthermore, this review puts forward an evidence-based treatment algorithm based on the specific causative organism.
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16
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Siddiqi A, Abdo ZE, Rossman SR, Kelly MA, Piuzzi NS, Higuera CA, Schwarzkopf R, Springer BD, Chen AF, Parvizi J. What Is the Optimal Irrigation Solution in the Management of Periprosthetic Hip and Knee Joint Infections? J Arthroplasty 2021; 36:3570-3583. [PMID: 34127346 DOI: 10.1016/j.arth.2021.05.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/16/2021] [Accepted: 05/19/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Thorough irrigation and debridement using an irrigation solution is a well-established treatment for both acute and chronic periprosthetic joint infections (PJIs). In the absence of concrete data, identifying the optimal irrigation agent and protocol remains challenging. METHODS A thorough review of the current literature on the various forms of irrigations and their additives was performed to evaluate the efficacy and limitations of each solution as pertaining to pathogen eradication in the treatment of PJI. As there is an overall paucity of high-quality literature comparing irrigation additives to each other and to any control, no meta-analyses could be performed. The literature was therefore summarized in this review article to give readers concise information on current irrigation options and their known risks and benefits. RESULTS Antiseptic solutions include povidone-iodine, chlorhexidine gluconate, acetic acid, hydrogen peroxide, sodium hypochlorite, hypochlorous acid, and preformulated commercially available combination solutions. The current literature suggests that intraoperative use of antiseptic irrigants may play a role in treating PJI, but definitive clinical studies comparing antiseptic to no antiseptic irrigation are lacking. Furthermore, no clinical head-to-head comparisons of different antiseptic irrigants have identified an optimal irrigation solution. CONCLUSION Further high-quality studies on the optimal irrigation additive and protocol for the management of PJI are warranted to guide future evidence-based decisions.
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Affiliation(s)
- Ahmed Siddiqi
- A Division of Ortho Alliance NJ, Orthopaedic Institute of Central Jersey, Manasquan, NJ; Department of Orthopedic Surgery, Hackensack Meridian Health, Hackensack Meridian School of Medicine, Hackensack, NJ; Department of Orthopedic Surgery, Jersey Shore University Medical Center, Neptune, NJ
| | - Zuhdi E Abdo
- Department of Orthopedics, Rutgers New Jersey Medical School, Newark, NJ
| | - Stephen R Rossman
- Department of Orthopedic Surgery, Hackensack Meridian Health, Hackensack Meridian School of Medicine, Hackensack, NJ
| | - Michael A Kelly
- Department of Orthopedic Surgery, Hackensack Meridian Health, Hackensack Meridian School of Medicine, Hackensack, NJ
| | - Nicolas S Piuzzi
- Department of Orthopedic Surgery, Cleveland Clinic Foundation, Cleveland, OH
| | - Carlos A Higuera
- Department of Orthopedic Surgery, Cleveland Clinic Florida, Weston, FL
| | - Ran Schwarzkopf
- Department of Orthopedics, New York University Langone Medical Center, New York, NY
| | - Bryan D Springer
- Department of Orthopedics, Atrium Musculoskeletal Institute, OrthoCarolina Hip and Knee Center, Charlotte, NC
| | - Antonia F Chen
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA
| | - Javad Parvizi
- Department of Orthopedics, Rothman Orthopedics, Philadelphia, PA
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Siddiqi A, Abdo ZE, Springer BD, Chen AF. Pursuit of the ideal antiseptic irrigation solution in the management of periprosthetic joint infections. J Bone Jt Infect 2021; 6:189-198. [PMID: 34109103 PMCID: PMC8182666 DOI: 10.5194/jbji-6-189-2021] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/07/2021] [Indexed: 12/23/2022] Open
Abstract
Irrigation and debridement in the treatment of periprosthetic joint infection
(PJI) serve an integral role in the eradication of bacterial burden and
subsequent re-infection rates. Identifying the optimal irrigation agent,
however, remains challenging, as there is limited data on superiority.
Direct comparison of different irrigation solutions remains difficult
because of variability in treatment protocols. While basic science studies
assist in the selection of irrigation fluids, in vitro results do not directly
translate into clinical significance once implemented in vivo. Dilute
povidone iodine, hydrogen peroxide, chlorhexidine gluconate, acetic acid,
sodium hypochlorite, hypochlorous acid, and preformed combination solutions
all have potential against a broad spectrum of PJI pathogens with their own
unique advantages and disadvantages. Future clinical studies are needed to
identify ideal irrigation solutions with optimal bactericidal properties and
low cytotoxicity for PJI treatment.
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Affiliation(s)
- Ahmed Siddiqi
- Orthopaedic Institute of Central Jersey, a division of Ortho Alliance NJ, 2315 Route 34 South Manasquan, NJ 08736, USA.,Hackensack Meridian School of Medicine, Department of Orthopedic Surgery, Hackensack, NJ, USA.,Jersey Shore University Medical Center, Department of Orthopedic Surgery, Neptune, NJ, USA
| | - Zuhdi E Abdo
- Rutgers New Jersey Medical School, Department of Orthopedics, Newark, NJ, 07103, USA
| | - Bryan D Springer
- OrthoCarolina Hip and Knee Center, Department of Orthopedics Atrium Musculoskeletal Institute, Charlotte, NC, 28207, USA
| | - Antonia F Chen
- Brigham & Women's Hospital, Department of Orthopedics, Boston, MA, 02115, USA
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18
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Mu W, Xu B, Guo W, Ji B, Wahafu T, Cao L. Outcome of Irrigation and Debridement With Topical Antibiotics Delivery for the Management of Periprosthetic Joint Infection Occurring Within 3 Months Since the Primary Total Joint Arthroplasty. J Arthroplasty 2021; 36:1765-1771. [PMID: 33358609 DOI: 10.1016/j.arth.2020.11.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/21/2020] [Accepted: 11/23/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Irrigation and debridement with modular component exchange is appealing for surgeons to treat early-stage periprosthetic joint infection (PJI). However, the indication, perioperative protocol, and success rate remain controversial. This study is the first one to present results of debridement, antibiotics, and implant retention (DAIR) with integrated MIT (modular component exchange, povidone-iodine and topical antibiotics delivery) protocol for treating PJI occurring within 3 months since the primary total joint arthroplasty. METHODS We retrospectively analyzed patients who received DAIR with MIT protocol in our department between January 2011 and May 2018. Topical antibiotics were delivered in all cases. Topical antibiotics infusion was applied for those infected with multidrug-resistant bacteria, fungus, polymicrobial infection, and culture negative one. Failure was defined as additional surgical intervention for infection after DAIR; persistent sinus tract, drainage or excessive joint pain; need for suppressive antibiotics therapy due to the infection; infection relapse with the same pathogen; reinfection with different microorganism; and infection-related death. RESULTS A total of 73 patients with a mean age of 63.30 ± 10.97 years were included in this study, including 43 men and 30 women. There are 41 knees and 32 hips. Thirty patients had sinus tract. With a mean follow-up of 63.79 ± 18.57 months, there were 9 failures in total with an overall success rate of 87.67%. The success rate was 88.57% and 86.84% for those receiving topical antibiotics infusion postoperatively and those without. CONCLUSIONS DAIR with a standard MIT protocol is a viable and safe option for PJI occurring within 3 months since the primary total joint arthroplasty. LEVEL OF EVIDENCE Level 4, therapeutic study.
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Affiliation(s)
- Wenbo Mu
- Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Boyong Xu
- Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Wentao Guo
- Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Baochao Ji
- Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Tuerhongjiang Wahafu
- Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Li Cao
- Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
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Gardezi M, Roque D, Barber D, Spake CS, Glasser J, Berns E, Antoci V, Born C, Garcia DR. Wound Irrigation in Orthopedic Open Fractures: A Review. Surg Infect (Larchmt) 2021; 22:245-252. [PMID: 32589513 PMCID: PMC9639236 DOI: 10.1089/sur.2020.075] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Management of open fractures remains a major clinical challenge because of the higher energy involved in the injury, the greater local trauma, tissue necrosis, and extensive contamination. Even though early surgical debridement was thought to be critical, limited available operative techniques have minimized surgery in favor of early antibiotic administration. No clear agreement on the surgical approach, debridement, or irrigation technique exists. Surgeons continue to argue about the use of various fluids, the appropriate pressure of irrigation, antiseptics, and other factors. The current work reviews the available data and summarizes the capabilities of modern orthopedic irrigation solutions. Methods: To delineate available research on the topic, the PubMed database was queried for the most common techniques, fluid variables, and chemical adjuvants utilized in current open fracture and wound irrigation methodologies. Modes of delivery, volume, pressure, temperature, timing, solution type, and additives are evaluated in the context of known outcomes to determine which solutions may be preferable. Results: Various methods have been described with their own advantages as well as limitations. Particular solutions may apply to specific clinical scenarios, presence of implants, and degree of tissue contamination. Desired irrigation solutions are isotonic, non-toxic, non-hemolytic, transparent, sterilizable, efficient in removing debris and pathogens, as well as affordable; however, no current irrigant achieves all these desired characteristics. Conclusions: Despite being crucial for the healing of open fractures, there is no clear gold standard for irrigation. Although there are some novel irrigation solutions, there has been a paucity of research on finding new, safer, and more effective irrigation solutions that will promote wound healing and reduce infection.
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Affiliation(s)
- Mursal Gardezi
- The Diane N. Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
- Department of Orthopaedics, The Warren Alpert School of Medicine, Brown University, Providence, USA
| | - Daniel Roque
- The Diane N. Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
- Department of Orthopaedics, The Warren Alpert School of Medicine, Brown University, Providence, USA
| | - Douglas Barber
- The Diane N. Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
- Department of Orthopaedics, The Warren Alpert School of Medicine, Brown University, Providence, USA
| | - Carole S.L. Spake
- The Diane N. Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
- Department of Orthopaedics, The Warren Alpert School of Medicine, Brown University, Providence, USA
| | - Jillian Glasser
- The Diane N. Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
- Department of Orthopaedics, The Warren Alpert School of Medicine, Brown University, Providence, USA
| | - Ellis Berns
- The Diane N. Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
- Department of Orthopaedics, The Warren Alpert School of Medicine, Brown University, Providence, USA
| | - Valentin Antoci
- The Diane N. Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
- Department of Orthopaedics, The Warren Alpert School of Medicine, Brown University, Providence, USA
| | - Christopher Born
- The Diane N. Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
- Department of Orthopaedics, The Warren Alpert School of Medicine, Brown University, Providence, USA
| | - Dioscaris R. Garcia
- The Diane N. Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
- Department of Orthopaedics, The Warren Alpert School of Medicine, Brown University, Providence, USA
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Abstract
Topical antibacterials are commonly used for superficial pyodermas such as impetigo and treatment or prevention of infections following minor cuts, abrasions, burns, and surgical wounds. Several antibiotics and antiseptics are available for use in different indications. One of the major uses of topical antibacterials is acne in which benzoyl peroxide is the drug of the first choice either singly or in combination with antibiotics or retinoids. Mupirocin and fusidic acid are the two most commonly used antibiotics for the treatment of superficial pyodermas and eradication of staphylococcal carrier state. Bacterial resistance to topical antibiotics is a growing concern and topical antiseptics such as gentian violet are getting renewed interest as alternatives. Incidence of contact dermatitis is a limiting factor for the use of several topical antibacterials. Although many botanical products have demonstrated in vitro activities against skin pathogens, their clinical utilities remain to be established by good-quality clinical trials.
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Affiliation(s)
- Debabrata Bandyopadhyay
- Department of Dermatology, Venereology, and Leprosy, Medical College and Hospitals, Kolkata, 88, College Street, Kolkata, West Bengal, India
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21
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Roshdy H, Seaoud E, Elbelbesy R. Low-budget, single-session elimination of CIED pocket infection. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2020; 44:129-134. [PMID: 33283878 DOI: 10.1111/pace.14133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/29/2020] [Accepted: 12/22/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND The dramatic increase in the use of cardiovascular implantable electronic devices (CIED) was associated with an increased rate of CIED infection, which has a high management cost. AIM OF THE STUDY To test the safety and efficacy of a single-session protocol, aiming to reuse the infected pocket side and the same device and leads in patients with CIED pocket infection. PATIENTS AND METHODS We included patients with isolated pocket infection between January 2015 and November 2019. The Patient was prepared by taking a swab for culture and sensitivity before the procedure. The pocket was debrided and the capsule was removed, the pocket was rinsed with povidone-iodine and hydrogen peroxide mixture, then packed with gauze sponge soaked with povidone-iodine. The device was debrided using ultrasonic irrigation and sterilized using gas plasma. The device was reimplanted and the wound was closed in layers. RESULTS During the period of the study, we had 12 patients with isolated pocket infection. Nine presented with erosion, two with impending erosion, and one with a chronic sinus. Patient's age was 61.5 ± 7.64 years. The infection was diagnosed 14.2 ± 8.22 weeks post device implantation. They were admitted for 7.6 ± 1.54 days postprocedure. The follow-up duration was 26.5 ± 15 (1.7-52) months. Only one patient (8%) had a recurrence of the infection after 50 days of the procedure. CONCLUSION Our protocol was successful in treating 92% of device-related pocket infection without the need to replace the device or the pocket side.
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Affiliation(s)
- Hisham Roshdy
- Department of Cardiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Elshaimaa Seaoud
- Department of Cardiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Radwa Elbelbesy
- Department of Cardiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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22
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Bankoti K, Rameshbabu AP, Datta S, Goswami P, Roy M, Das D, Ghosh SK, Das AK, Mitra A, Pal S, Maulik D, Su B, Ghosh P, Basu B, Dhara S. Dual Functionalized Injectable Hybrid Extracellular Matrix Hydrogel for Burn Wounds. Biomacromolecules 2020; 22:514-533. [PMID: 33289564 DOI: 10.1021/acs.biomac.0c01400] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Low strength and rapid biodegradability of acellular dermal matrix (ADM) restrict its wider clinical application as a rapid cell delivery platform in situ for management of burn wounds. Herein, the extracted ADM was modified by a dual cross-linking approach with ionic crosslinking using chitosan and covalent cross-linking using an iodine-modified 2,5-dihydro-2,5-dimethoxy-furan cross-linker, termed as CsADM-Cl. In addition, inherent growth factors and cytokines were found to be preserved in CsADM-Cl, irrespective of ionic/covalent crosslinking. CsADM-Cl demonstrated improvement in post crosslinking stiffness with a decreased biodegradation rate. This hybrid crosslinked hydrogel supported adhesion, proliferation, and migration of human foreskin-derived fibroblasts and keratinocytes. Also, the angiogenic potential of CsADM-Cl was manifested by chick chorioallantoic membrane assay. CsADM-Cl showed excellent antibacterial activity against Escherichia coli and Staphylococcus aureus. Moreover, CsADM-Cl treated full thickness burn wounds and demonstrated rapid healing marked with superior angiogenesis, well-defined dermal-epidermal junctions, mature basket weave collagen deposition, and development of more pronounced secondary appendages. Altogether, the bioactive CsADM-Cl hydrogel established significant clinical potential to support wound healing as an apt injectable antibacterial matrix to encounter unmet challenges concerning critical burn wounds.
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Affiliation(s)
- Kamakshi Bankoti
- Biomaterials and Tissue Engineering Laboratory, School of Medical Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India
| | - Arun Prabhu Rameshbabu
- Biomaterials and Tissue Engineering Laboratory, School of Medical Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India
| | - Sayanti Datta
- Biomaterials and Tissue Engineering Laboratory, School of Medical Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India
| | - Piyali Goswami
- Department of Biotechnology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India
| | - Madhurima Roy
- Department of Biotechnology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India
| | - Dipankar Das
- Polymer Chemistry Laboratory, Department of Applied Chemistry, Indian Institute of Technology (Indian School of Mines), Dhanbad 826004, India
| | - Sudip Kumar Ghosh
- Department of Biotechnology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India
| | - Amit Kumar Das
- Department of Biotechnology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India
| | - Analava Mitra
- Natural Products Research Laboratory, School of Medical Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India
| | - Sagar Pal
- Polymer Chemistry Laboratory, Department of Applied Chemistry, Indian Institute of Technology (Indian School of Mines), Dhanbad 826004, India
| | - Dhrubajyoti Maulik
- Department of Surgery, Bankura Sammilani Medical College, Bankura 722102, India
| | - Bo Su
- Bristol Dental School, University of Bristol, Bristol BS1 2LY, U.K
| | - Paulomi Ghosh
- Structural Biology and Bioinformatics, CSIR-Indian Institute of Chemical Biology (CSIR-IICB), 4, Raja S C Mullick Road, Kolkata 700032, India
| | - Bikramajit Basu
- Materials Research Center, Indian Institute of Science, Bangalore 560012, India
| | - Santanu Dhara
- Biomaterials and Tissue Engineering Laboratory, School of Medical Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India
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Synergistic effect of fennel essential oil and hydrogen peroxide on bacterial biofilm. Postepy Dermatol Alergol 2020; 37:690-694. [PMID: 33240007 PMCID: PMC7675088 DOI: 10.5114/ada.2019.83621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 02/08/2019] [Indexed: 11/26/2022] Open
Abstract
Introduction Staphylococcal biofilm formation significantly challenges wound management. The causes of difficult-to-treat wounds are not only methicillin-resistant staphylococci, but also methicillin-sensitive strains with different patterns of resistance. Bacterial biofilm significantly limits the access and activity of antimicrobials used in dermatological infections. Aim To evaluate the synergistic effect of fennel essential oil (FEO) and H2O2 on biofilm formation by Staphylococcus aureus (MSSA and MRSA) reference strains. Material and methods Minimum inhibitory concentration (MIC) values were determined for FEO and H2O2 against S. aureus reference strains by the broth microdilution method. The combined effects of the FEO and H2O2 were calculated and expressed in terms of a fractional inhibitory concentration index (FICI) using the checkerboard method. The FEO composition was analyzed by the GC-MS method. The data were analysed by one-way ANOVA. Results Decreased MIC values for FEO combined with H2O2 were observed in comparison to FEO itself. The combinations of FEO and H2O2 determined synergistic effects on all S. aureus reference strains. Subinhibitory concentration of FEO alone and in combination with 0.5 MIC of H2O2 significantly decreased the production of biofilm biomass in S. aureus strains and reduced the metabolic activity of attached cells. Conclusions Combination of fennel essential oil containing nearly 80% trans-anethole and H2O2 represents a potential for further basic and applied research on wound management.
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Zhao SL, Zhang XY, Xiao Y, Mo XY, Chen ZP, Lin W, Huang ZF, Chen BL. Gas Embolism After Hydrogen Peroxide Use During Spine Surgery: Case Report and Literature Review. World Neurosurg 2020; 143:228-231. [PMID: 32758653 DOI: 10.1016/j.wneu.2020.07.210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 07/25/2020] [Accepted: 07/28/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND As an irrigant, an antiseptic, and a hemostatic agent, hydrogen peroxide (H2O2) is widely used in surgical treatment, but it has been surrounded by persistent controversy. Fatal or near-fatal embolic events caused by H2O2 have been reported sporadically in spine surgery. CASE DESCRIPTION In this report, we present an 87-year-old man who underwent lumbar instrumentation removal and debridement consequent to surgical site infection in a prone position. H2O2 was used to irrigate the infected screw tracks and surrounding tissues during the procedures. Soon after irrigation, the patient suddenly developed tachycardia, hypotension, and rapid oxygen desaturation, followed by bradycardia. Transesophageal echocardiography indicated gas embolism. After prompt first aid treatment, the patient's condition improved and the gas embolus disappeared within a few minutes without any evidence of organ embolism. CONCLUSIONS Spine surgeons should reconsider the pending results of using H2O2 during surgery. Prolonged prone positioning and semiclosed cavities may increase the risk of gas embolism. An early diagnosis and timely intervention may be the key measures to prevent the occurrence of fatal consequences caused by gas embolism.
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Affiliation(s)
- Sheng-Li Zhao
- Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiao-Yan Zhang
- Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ying Xiao
- Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiao-Yi Mo
- Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhi-Peng Chen
- Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wei Lin
- Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zi-Fang Huang
- Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Bai-Ling Chen
- Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
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25
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Aspirin enhances regulatory functional activities of monocytes and downregulates CD16 and CD40 expression in myocardial infarction autoinflammatory disease. Int Immunopharmacol 2020; 83:106349. [DOI: 10.1016/j.intimp.2020.106349] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 02/20/2020] [Accepted: 02/24/2020] [Indexed: 12/14/2022]
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26
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Hamblin MR, Abrahamse H. Oxygen-Independent Antimicrobial Photoinactivation: Type III Photochemical Mechanism? Antibiotics (Basel) 2020; 9:antibiotics9020053. [PMID: 32023978 PMCID: PMC7168166 DOI: 10.3390/antibiotics9020053] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 01/28/2020] [Accepted: 01/29/2020] [Indexed: 01/04/2023] Open
Abstract
Since the early work of the 1900s it has been axiomatic that photodynamic action requires the presence of sufficient ambient oxygen. The Type I photochemical pathway involves electron transfer reactions leading to the production of reactive oxygen species (superoxide, hydrogen peroxide, and hydroxyl radicals), while the Type II pathway involves energy transfer from the PS (photosensitizer) triplet state, leading to production of reactive singlet oxygen. The purpose of the present review is to highlight the possibility of oxygen-independent photoinactivation leading to the killing of pathogenic bacteria, which may be termed the "Type III photochemical pathway". Psoralens can be photoactivated by ultraviolet A (UVA) light to produce DNA monoadducts and inter-strand cross-links that kill bacteria and may actually be more effective in the absence of oxygen. Tetracyclines can function as light-activated antibiotics, working by a mixture of oxygen-dependent and oxygen independent pathways. Again, covalent adducts may be formed in bacterial ribosomes. Antimicrobial photodynamic inactivation can be potentiated by addition of several different inorganic salts, and in the case of potassium iodide and sodium azide, bacterial killing can be achieved in the absence of oxygen. The proposed mechanism involves photoinduced electron transfer that produces reactive inorganic radicals. These new approaches might be useful to treat anaerobic infections or infections in hypoxic tissue.
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Affiliation(s)
- Michael R Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Dermatology, Harvard Medical School, Boston, MA 02115, USA
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein 2028, South Africa;
- Correspondence:
| | - Heidi Abrahamse
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein 2028, South Africa;
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Ke Z, Zhang Q, Huang Q. Potassium Iodide Potentiates Bacterial Killing by Helium Atmospheric Pressure Plasma Jet. ACS OMEGA 2019; 4:8365-8372. [PMID: 31459925 PMCID: PMC6648913 DOI: 10.1021/acsomega.9b00160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 04/12/2019] [Indexed: 05/27/2023]
Abstract
Cold atmospheric plasma (CAP) is an effective new antimicrobial approach that is gaining increasing attention and has a wide range of potential applications in biomedical fields. Among all of the bactericidal factors generated by CAP, the synergy of reactive nitrogen species (RNS) and reactive oxygen species is generally considered as the main reason for its high bactericidal efficiency. However, the produced RNS (such as nitrite) may also pose potential risks to human health. Therefore, it is of significance to keep the high disinfection efficiency of CAP but with producing no or little harmful RNS. In this study, we investigated whether it is possible to improve the disinfection efficiency of CAP without producing the harmful RNS by adding a certain amount of inert halogen salt such as potassium iodide (KI). We found that the inactivation of both Gram-negative and Gram-positive bacteria by helium atmospheric pressure plasma jet (He-APPJ), one form of CAP, is enhanced consistently in the presence of a certain amount of KI. The mechanism of action is due to the fact that the He-APPJ-generated hydrogen peroxide (H2O2) oxidizes the iodide anion to triiodide (I3 -), which contributes to the major bactericidal activity. We believe that the results in this work can be highly relevant to the practical application of plasma for disinfection in the biomedical field.
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Affiliation(s)
- Zhigang Ke
- Key
Laboratory of High Magnetic Field and Ion Beam Physical Biology, Institute
of Technical Biology and Agriculture Engineering, Hefei Institutes
of Physical Science, Chinese Academy of
Sciences, Hefei 230031, China
- University
of Science & Technology of China, Hefei 230026, China
| | - Qifu Zhang
- Key
Laboratory of High Magnetic Field and Ion Beam Physical Biology, Institute
of Technical Biology and Agriculture Engineering, Hefei Institutes
of Physical Science, Chinese Academy of
Sciences, Hefei 230031, China
- University
of Science & Technology of China, Hefei 230026, China
| | - Qing Huang
- Key
Laboratory of High Magnetic Field and Ion Beam Physical Biology, Institute
of Technical Biology and Agriculture Engineering, Hefei Institutes
of Physical Science, Chinese Academy of
Sciences, Hefei 230031, China
- University
of Science & Technology of China, Hefei 230026, China
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Murphy EC, Friedman AJ. Hydrogen peroxide and cutaneous biology: Translational applications, benefits, and risks. J Am Acad Dermatol 2019; 81:1379-1386. [PMID: 31103570 DOI: 10.1016/j.jaad.2019.05.030] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 05/02/2019] [Accepted: 05/12/2019] [Indexed: 12/23/2022]
Abstract
Hydrogen peroxide (H2O2) is an endogenous reactive oxygen species that contributes to oxidative stress directly as a molecular oxidant and indirectly through free radical generation. Topically applied 1% to 45% H2O2 can be used for a range of clinical purposes, which will be reviewed here in addition to its safety. In concentrations from 1% to 6%, H2O2 has antimicrobial properties and can act as a debriding agent through its effervescence, making low-concentration H2O2 useful for wound care. H2O2 has also been shown to promote venous insufficiency ulcer healing, but studies in other wound types are needed. In 1% formulations, H2O2 is used outside the United States to treat acne and has shown efficacy similar to or greater than benzoyl peroxide, with reduced side effects. In a concentration of 40%, H2O2 is US Food and Drug Administration-approved to treat seborrheic keratoses and may cause fewer pigmentary changes than cryotherapy, although elimination often requires 2 to 4 treatments. However, H2O2 should be used with caution, as exposure can cause adverse effects through its oxidant capabilities. Low H2O2 concentrations cause only transient symptoms (blanching and blistering), but exposure to 9% to 45% H2O2 can cause more severe skin damage, including epidermal necrosis leading to erythema and bullae. Overall, H2O2 has numerous therapeutic uses, and novel indications, such as treating actinic keratoses and skin cancers, continue to be explored.
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Affiliation(s)
- Emily C Murphy
- George Washington University School of Medicine and Health Sciences, Washington, DC; Georgetown University, School of Medicine, Washington, DC
| | - Adam J Friedman
- George Washington University School of Medicine and Health Sciences, Washington, DC.
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Božik M, Cejnar P, Maršík P, Klouček P. Data on low-molecular weight proteins of Escherichia coli treated by essential oils components, tetracycline, chlorine and peroxide by MALDI-TOF MS. Data Brief 2018; 21:962-965. [PMID: 30426052 PMCID: PMC6222066 DOI: 10.1016/j.dib.2018.10.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/08/2018] [Accepted: 10/17/2018] [Indexed: 11/26/2022] Open
Abstract
In this dataset we provide MALDI-TOF MS spectra of Escherichia coli. The data presented in this article are related to the article entitled “Stress response of Escherichia coli to essential oil components – insights on low-molecular-weight proteins from MALDI-TOF” (Božik et al., 2018) [1]. Essential oils and their components are known for their antibacterial effect. Many studies evaluated the effect of essential oil components (EOCs) on the cell wall, bacterial membranes, and energetic metabolism. But data about low molecular weight proteins (<20 kDa) are limited. Provided data are focused on bacterial response to EOCs; tetracycline, peroxide and chlorine was used as control as common antibiotic and disinfectant agents used against bacteria. These data describe the effect of tested substances to bacterial protein synthesis.
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Affiliation(s)
- Matěj Božik
- Czech University of Life Sciences, Faculty of Agrobiology, Food and Natural Resources, Department of Food Science, Kamycká 129, 16500 Prague, Czech Republic
| | - Pavel Cejnar
- University of Chemistry and Technology, Department of Computing and Control Engineering, Technická 5, 166 28 Prague 6, Czech Republic
| | - Petr Maršík
- Czech University of Life Sciences, Faculty of Agrobiology, Food and Natural Resources, Department of Food Science, Kamycká 129, 16500 Prague, Czech Republic
| | - Pavel Klouček
- Czech University of Life Sciences, Faculty of Agrobiology, Food and Natural Resources, Department of Food Science, Kamycká 129, 16500 Prague, Czech Republic
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30
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Ombiro GS, Sawai T, Noutoshi Y, Nishina Y, Matsui H, Yamamoto M, Toyoda K, Ichinose Y. Specific growth inhibitors of Ralstonia solanacearum, Xanthomonas oryzae pv. oryzae, X. campestris pv. campestris, and Clavibacter michiganensis subsp. michiganensis. Microbiol Res 2018; 215:29-35. [DOI: 10.1016/j.micres.2018.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/28/2018] [Accepted: 06/09/2018] [Indexed: 11/26/2022]
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Božik M, Cejnar P, Šašková M, Nový P, Maršík P, Klouček P. Stress response of Escherichia coli to essential oil components - insights on low-molecular-weight proteins from MALDI-TOF. Sci Rep 2018; 8:13042. [PMID: 30158663 PMCID: PMC6115441 DOI: 10.1038/s41598-018-31255-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 08/15/2018] [Indexed: 01/21/2023] Open
Abstract
The antibacterial effects of essential oils and their components (EOCs) are usually attributed to effects on membranes and metabolism. Studies of the effects of EOCs on protein expression have primarily analysed proteins larger than 10 kDa using gel electrophoresis. In the present study, we used MALDI-TOF-MS to investigate the effects of EOCs on low-molecular-weight proteins. From 297 m/z features, we identified 94 proteins with important differences in expression among untreated samples, samples treated with EOCs, and samples treated with antibiotics, peroxide, or chlorine. The targets of these treatments obviously differ, even among EOCs. In addition to ribosomal proteins, stress-, membrane- and biofilm-related proteins were affected. These findings may provide a basis for identifying new targets of essential oils and synergies with other antibiotics.
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Affiliation(s)
- Matěj Božik
- Czech University of Life Sciences, Faculty of Agrobiology, Food and Natural Resources, Department of Quality of Agricultural Products, Prague, Czech Republic
| | - Pavel Cejnar
- University of Chemistry and Technology, Department of Computing and Control Engineering, Prague, Czech Republic.,Czech University of Life Sciences, Faculty of Agrobiology, Food and Natural Resources, Department of Plant Protection, Prague, Czech Republic
| | - Martina Šašková
- Czech University of Life Sciences, Faculty of Agrobiology, Food and Natural Resources, Department of Quality of Agricultural Products, Prague, Czech Republic
| | - Pavel Nový
- Czech University of Life Sciences, Faculty of Agrobiology, Food and Natural Resources, Department of Quality of Agricultural Products, Prague, Czech Republic
| | - Petr Maršík
- Czech University of Life Sciences, Faculty of Agrobiology, Food and Natural Resources, Department of Quality of Agricultural Products, Prague, Czech Republic
| | - Pavel Klouček
- Czech University of Life Sciences, Faculty of Agrobiology, Food and Natural Resources, Department of Quality of Agricultural Products, Prague, Czech Republic.
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32
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Hamblin MR, Abrahamse H. Can light-based approaches overcome antimicrobial resistance? Drug Dev Res 2018; 80:48-67. [PMID: 30070718 DOI: 10.1002/ddr.21453] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 07/06/2018] [Accepted: 07/07/2018] [Indexed: 01/10/2023]
Abstract
The relentless rise of antibiotic resistance is considered one of the most serious problems facing mankind. This mini-review will cover three cutting-edge approaches that use light-based techniques to kill antibiotic-resistant microbial species, and treat localized infections. First, we will discuss antimicrobial photodynamic inactivation using rationally designed photosensitizes combined with visible light, with the added possibility of strong potentiation by inorganic salts such as potassium iodide. Second, the use of blue and violet light alone that activates endogenous photoactive porphyrins within the microbial cells. Third, it is used for "safe UVC" at wavelengths between 200 nm and 230 nm that can kill microbial cells without damaging host mammalian cells. We have gained evidence that all these approaches can kill multidrug resistant bacteria in vitro, and they do not induce themselves any resistance, and moreover can treat animal models of localized infections caused by resistant species that can be monitored by noninvasive bioluminescence imaging. Light-based antimicrobial approaches are becoming a growing translational part of anti-infective treatments in the current age of resistance.
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Affiliation(s)
- Michael R Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts.,Department of Dermatology, Harvard Medical School, Boston, Massachusetts.,Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts
| | - Heidi Abrahamse
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, South Africa
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Pourhajibagher M, Ghorbanzadeh R, Bahador A. Expression patterns of oxyR induced by oxidative stress from Porphyromonas gingivalis in response to photo-activated disinfection. Infect Drug Resist 2018; 11:717-725. [PMID: 29805265 PMCID: PMC5960254 DOI: 10.2147/idr.s152834] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Porphyromonas gingivalis, an important endodontic pathogen, may be exposed to sublethal doses of photo-activated disinfection (sPAD) during root canal therapy. Such an exposure can affect bacterial survival and virulence features. In this study, we evaluated the effect of sPAD-related oxidative stresses on the expression of oxidative stress response gene (oxyR) in P. gingivalis clinical isolates surviving in vitro photodynamic treatment. Materials and methods To determine the sPAD, 16 clinical P. gingivalis isolates photosensitized with toluidine blue O (TBO), methylene blue (MB), and indocyanine green (ICG) were irradiated with specific wavelength and energy density of diode laser corresponding to the photosensitizers following bacterial viability measurements. The effects of sPAD on the expression ratio of oxyR of 16 clinical P. gingivalis isolates were then assessed using quantitative real-time PCR (qRT-PCR) assay. Results Maximum values of sPAD against P. gingivalis were 6.25, 15.6, and 25 μg/mL at fluencies of 171.87, 15.6, and 93.75 J/cm2, respectively, for TBO-, ICG-, and MB-sPAD (P>0.05). ICG-, MB-, and TBO-sPAD could increase the oxyR gene expression of the clinical P. gingivalis isolates 12.3-, 5.6-, and 8.5-fold, respectively. ICG-sPAD increased the expression of oxyR gene in clinical isolates of P. gingivalis ~1.5- and 2-fold higher than TBO- and MB-sPAD, respectively. Conclusion Our results showed that upregulation of oxyR during sPAD may lead to better survival and increased pathogenicity of P. gingivalis isolates. Therefore, selection of appropriate photo-activated disinfection dosage should be considered for the successful treatment of endodontic infection.
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Affiliation(s)
- Maryam Pourhajibagher
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Abbas Bahador
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Laser Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Boyle KK, Duquin TR. Antibiotic Prophylaxis and Prevention of Surgical Site Infection in Shoulder and Elbow Surgery. Orthop Clin North Am 2018; 49:241-256. [PMID: 29499825 DOI: 10.1016/j.ocl.2017.11.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Infection after orthopedic procedures is a devastating and serious complication associated with significant clinical and financial challenges to the health care system and unfortunate patient. The time and resource-intensive nature of treating infection after orthopedic procedures has turned attention toward enhancing prevention and establishing quality improvement measures. Prevention strategies throughout the perioperative period include host optimization, risk mitigation, reducing bacterial burden and proper wound management. Understanding the most common offending organisms of the shoulder, Propionibacterium acnes and coagulase negative Staphylococcus species, and their hypothesized mechanism of infection is crucial to selecting appropriate preventative measures.
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Affiliation(s)
- K Keely Boyle
- Department of Orthopaedics, State University of New York at Buffalo, Erie County Medical Center, 462 Grider Street, Buffalo, NY 14215, USA.
| | - Thomas R Duquin
- Department of Orthopaedics, State University of New York at Buffalo, Erie County Medical Center, 462 Grider Street, Buffalo, NY 14215, USA
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35
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Nagao T, Nakayama‑Imaohji H, Elahi M, Tada A, Toyonaga E, Yamasaki H, Okazaki K, Miyoshi H, Tsuchiya K, Kuwahara T. L‑histidine augments the oxidative damage against Gram‑negative bacteria by hydrogen peroxide. Int J Mol Med 2018; 41:2847-2854. [DOI: 10.3892/ijmm.2018.3473] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 02/05/2018] [Indexed: 11/05/2022] Open
Affiliation(s)
- Tamiko Nagao
- Department of Microbiology, Faculty of Medicine, Kagawa University, Miki, Kagawa 761‑0793, Japan
| | | | - Miad Elahi
- Department of Microbiology, Faculty of Medicine, Kagawa University, Miki, Kagawa 761‑0793, Japan
| | - Ayano Tada
- Department of Microbiology, Faculty of Medicine, Kagawa University, Miki, Kagawa 761‑0793, Japan
| | - Emika Toyonaga
- Department of Microbiology, Faculty of Medicine, Kagawa University, Miki, Kagawa 761‑0793, Japan
| | - Hisashi Yamasaki
- Division of Biology, Hyogo College of Medicine, Mukogawa, Nishinomiya 663‑8501, Japan
| | - Katsuichiro Okazaki
- Department of Applied Bioscience, Faculty of Agriculture, Kagawa University, Miki, Kagawa 761‑0795, Japan
| | - Hirokazu Miyoshi
- Advance Radiation Research, Education and Management Center, Tokushima University, Tokushima 770‑8503, Japan
| | - Koichiro Tsuchiya
- Department of Medical Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770‑8505, Japan
| | - Tomomi Kuwahara
- Department of Microbiology, Faculty of Medicine, Kagawa University, Miki, Kagawa 761‑0793, Japan
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Yamasaki K, Saito F, Ota R, Kilvington S. Antimicrobial efficacy of a novel povidone iodine contact lens disinfection system. Cont Lens Anterior Eye 2017; 41:277-281. [PMID: 29233457 DOI: 10.1016/j.clae.2017.12.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 11/04/2017] [Accepted: 12/01/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE Contact lens (CL) wear is a risk factor for the acquisition of microbial keratitis. Accordingly, compliance to manufacturers' recommended hygiene and disinfection procedures are vital to safe (CL) use. In this study we evaluated a novel povidone-iodine (PI) (CL) disinfection system (cleadew, Ophtecs Corporation, Japan) against a range of bacterial, fungal and Acanthamoeba. METHODS Antimicrobial assays were conducted according to ISO 14729 using the recommended strains of bacteria and fungi, with and without the presence of organic soil. Regrowth of bacteria and fungi in the disinfection system was also examined. The activity on biofilms formed from Stenotrophomonas maltophilia and Achromobacter sp. was evaluated. Efficacy against A. castellanii trophozoites and cysts was also investigated. RESULTS The PI system gave >4 log10 kill of all bacteria and fungi following the manufacturer's recommended disinfection and cleaning time of 4h, with or without the presence of organic soil. No regrowth of organisms was found after 14days in the neutralized solution. In the biofilm studies the system resulted in at least a 7 log10 reduction in viability of bacteria. For Acanthamoeba, >3 log10 kill of trophozoites and 1.1-2.8 log10 kill for the cyst stage was obtained. CONCLUSIONS The PI system effective against a variety of pathogenic microorganisms under a range of test conditions. Strict compliance to recommended CL hygiene procedures is essential for safe CL wear. The use of care systems such as PI, with broad spectrum antimicrobial activity, may aid in the prevention of potentially sight threatening microbial keratitis.
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Affiliation(s)
- Katsuhide Yamasaki
- Ophtecs Corporation. 5-2-4 Minatojima-Minami-Machi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan
| | - Fumio Saito
- Ophtecs Corporation. 5-2-4 Minatojima-Minami-Machi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan
| | - Ritsue Ota
- Ophtecs Corporation. 5-2-4 Minatojima-Minami-Machi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan
| | - Simon Kilvington
- Ophtecs Corporation. 5-2-4 Minatojima-Minami-Machi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.
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Current and Emerging Topical Antibacterials and Antiseptics: Agents, Action, and Resistance Patterns. Clin Microbiol Rev 2017; 30:827-860. [PMID: 28592405 DOI: 10.1128/cmr.00112-16] [Citation(s) in RCA: 186] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Bacterial skin infections represent some of the most common infectious diseases globally. Prevention and treatment of skin infections can involve application of a topical antimicrobial, which may be an antibiotic (such as mupirocin or fusidic acid) or an antiseptic (such as chlorhexidine or alcohol). However, there is limited evidence to support the widespread prophylactic or therapeutic use of topical agents. Challenges involved in the use of topical antimicrobials include increasing rates of bacterial resistance, local hypersensitivity reactions (particularly to older agents, such as bacitracin), and concerns about the indiscriminate use of antiseptics potentially coselecting for antibiotic resistance. We review the evidence for the major clinical uses of topical antibiotics and antiseptics. In addition, we review the mechanisms of action of common topical agents and define the clinical and molecular epidemiology of antimicrobial resistance in these agents. Moreover, we review the potential use of newer and emerging agents, such as retapamulin and ebselen, and discuss the role of antiseptic agents in preventing bacterial skin infections. A comprehensive understanding of the clinical efficacy and drivers of resistance to topical agents will inform the optimal use of these agents to preserve their activity in the future.
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Hamblin MR. Potentiation of antimicrobial photodynamic inactivation by inorganic salts. Expert Rev Anti Infect Ther 2017; 15:1059-1069. [PMID: 29084463 DOI: 10.1080/14787210.2017.1397512] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Antimicrobial photodynamic inactivation (aPDI) involves the use of non-toxic dyes excited with visible light to produce reactive oxygen species (ROS) that can destroy all classes of microorganisms including bacteria, fungi, parasites, and viruses. Selectivity of killing microbes over host mammalian cells allows this approach (antimicrobial photodynamic therapy, aPDT) to be used in vivo as an alternative therapeutic approach for localized infections especially those that are drug-resistant. Areas covered: We have discovered that aPDI can be potentiated (up to 6 logs of extra killing) by the addition of simple inorganic salts. The most powerful and versatile salt is potassium iodide, but potassium bromide, sodium thiocyanate, sodium azide and sodium nitrite also show potentiation. The mechanism of potentiation with iodide is likely to be singlet oxygen addition to iodide to form iodine radicals, hydrogen peroxide and molecular iodine. Another mechanism involves two-electron oxidation of iodide/bromide to form hypohalites. A third mechanism involves a one-electron oxidation of azide anion to form azide radical. Expert commentary: The addition of iodide has been shown to improve the performance of aPDT in several animal models of localized infection. KI is non-toxic and is an approved drug for antifungal therapy, so its transition to clinical use in aPDT should be straightforward.
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Affiliation(s)
- Michael R Hamblin
- a Massachusetts General Hospital , Wellman Center for Photomedicine , Boston , MA , USA
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Huang L, El-Hussein A, Xuan W, Hamblin MR. Potentiation by potassium iodide reveals that the anionic porphyrin TPPS4 is a surprisingly effective photosensitizer for antimicrobial photodynamic inactivation. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2017; 178:277-286. [PMID: 29172135 DOI: 10.1016/j.jphotobiol.2017.10.036] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/17/2017] [Accepted: 10/29/2017] [Indexed: 01/30/2023]
Abstract
We recently reported that addition of the non-toxic salt, potassium iodide can potentiate antimicrobial photodynamic inactivation of a broad-spectrum of microorganisms, producing many extra logs of killing. If the photosensitizer (PS) can bind to the microbial cells, then delivering light in the presence of KI produces short-lived reactive iodine species, while if the cells are added after light the killing is caused by molecular iodine produced as a result of singlet oxygen-mediated oxidation of iodide. In an attempt to show the importance of PS-bacterial binding, we compared two charged porphyrins, TPPS4 (thought to be anionic and not able to bind to Gram-negative bacteria) and TMPyP4 (considered cationic and well able to bind to bacteria). As expected TPPS4+light did not kill Gram-negative Escherichia coli, but surprisingly when 100mM KI was added, it was highly effective (eradication at 200nM+10J/cm2 of 415nm light). TPPS4 was more effective than TMPyP4 in eradicating the Gram-positive bacteria, methicillin-resistant Staphylococcus aureus and the fungal yeast Candida albicans (regardless of KI). TPPS4 was also highly active against E. coli after a centrifugation step when KI was added, suggesting that the supposedly anionic porphyrin bound to bacteria and Candida. This was confirmed by uptake experiments. We compared the phthalocyanine tetrasulfonate derivative (ClAlPCS4), which did not bind to bacteria or allow KI-mediated killing of E. coli after a spin, suggesting it was truly anionic. We conclude that TPPS4 behaves as if it has some cationic character in the presence of bacteria, which may be related to its delivery from suppliers in the form of a dihydrochloride salt.
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Affiliation(s)
- Liyi Huang
- Department of Infectious Diseases, First Affiliated Hospital, Guangxi Medical University, Nanning, China; Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA; Department of Dermatology, Harvard Medical School, Boston, MA, USA
| | - Ahmed El-Hussein
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA; The National Institute of Laser Enhanced Science, Cairo University, Egypt
| | - Weijun Xuan
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA; Department of Otorhinolaryngology, Head and Neck Surgery, First Clinical Medical College and Hospital, Guangxi University of Chinese Medicine, Nanning, China
| | - Michael R Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA; Department of Dermatology, Harvard Medical School, Boston, MA, USA; Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, USA.
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40
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Rezapoor M, Nicholson T, Tabatabaee RM, Chen AF, Maltenfort MG, Parvizi J. Povidone-Iodine-Based Solutions for Decolonization of Nasal Staphylococcus aureus: A Randomized, Prospective, Placebo-Controlled Study. J Arthroplasty 2017; 32:2815-2819. [PMID: 28578841 DOI: 10.1016/j.arth.2017.04.039] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 04/06/2017] [Accepted: 04/18/2017] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Nasal Staphylococcus aureus decolonization reduces the risk of surgical site infections after orthopedic procedures. Povidone-iodine (PI)-based solutions have shown promising results in bacteria decolonization. The unique physiology of the nose may pose challenges for the bioactivity profiles of PI solutions. This study compared the antibacterial efficacy of an off-the-shelf PI product with a specifically manufactured PI-based skin and nasal antiseptic (SNA). METHODS This randomized, placebo-controlled study was conducted at a single institution between April 2014 and July 2015. Four hundred and twenty-nine patients undergoing primary or revision total joint arthroplasty, femoroacetabular osteoplasty, pelvic osteotomy, or total shoulder arthroplasty were included. 10% off-the-shelf PI, 5% PI-based SNA, or saline (placebo) were used for nasal decolonization. Baseline cultures were taken immediately preoperatively, followed by treatment of both nares twice for 2 minutes with 4 applicators. Reculturing of the right nostril occurred at 4 hours and the left at 24 hours. RESULTS Ninety-five of the 429 patients (22.1%) had a positive culture result for S. aureus; 13 (3.03%) were methicillin-resistant S. aureus. Of these 95, 29 were treated with off-the-shelf PI, 34 with SNA, and 32 with saline swabs. At 4 hours post-treatment, S. aureus culture was positive in 52% off-the-shelf PI patients, 21% SNA patients, and 59% saline patients. After 24 hours posttreatment, S. aureus culture was positive in 72% off-the-shelf PI patients, 59% SNA patients, and 69% saline group. SNA was significantly more effective at decolonizing S. aureus over the 4-hour time interval (P = .003); no significant difference was observed over the 24-hour time interval between the 3 groups. CONCLUSION A single application of PI-based SNA before surgery may be effective in eliminating nasal S. aureus in over two-thirds of patients. Off-the-shelf PI swabs were not as effective at 4 hours as the specifically manufactured product for S. aureus decolonization.
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Affiliation(s)
- Maryam Rezapoor
- Rothman Institute of Orthopaedics, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Thema Nicholson
- Rothman Institute of Orthopaedics, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | | | - Antonia F Chen
- Rothman Institute of Orthopaedics, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Mitchell G Maltenfort
- Rothman Institute of Orthopaedics, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Javad Parvizi
- Rothman Institute of Orthopaedics, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
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Wu X, Kwon SJ, Kim J, Kane RS, Dordick JS. Biocatalytic Nanocomposites for Combating Bacterial Pathogens. Annu Rev Chem Biomol Eng 2017; 8:87-113. [DOI: 10.1146/annurev-chembioeng-060816-101612] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Xia Wu
- Department of Chemical and Biological Engineering, Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, New York 12180
| | - Seok-Joon Kwon
- Department of Chemical and Biological Engineering, Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, New York 12180
| | - Jungbae Kim
- Department of Chemical and Biological Engineering, Korea University, Seoul 02841, Republic of Korea
| | - Ravi S. Kane
- School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332
| | - Jonathan S. Dordick
- Department of Chemical and Biological Engineering, Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, New York 12180
- Department of Biological Sciences, Rensselaer Polytechnic Institute, Troy, New York 12180
- Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, New York 12180
- Department of Materials Science and Engineering, Rensselaer Polytechnic Institute, Troy, New York 12180
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Abstract
As the burden of deep hardware infections continues to rise in orthopaedics, there is increasing interest in strategies for more effective debridement of colonized tissues and biofilm. Hydrogen peroxide has been used medically for almost a century, but its applications in orthopaedic surgery have yet to be fully determined. The basic science and clinical research on the antiseptic efficacy of hydrogen peroxide have demonstrated its efficacy against bacteria, and it has demonstrated potential synergy with other irrigation solutions such as chlorhexidine and povidone-iodine. While hydrogen peroxide is effective in infection reduction, there are concerns with wound healing, cytotoxicity, and embolic phenomena, and we recommend against hydrogen peroxide usage in the treatment of partial knee replacements, hemiarthroplasties, or native joints. Additionally, due to the potential for oxygen gas formation, hydrogen peroxide should not be used in cases of dural compromise, when pressurizing medullary canals, or when irrigating smaller closed spaces to avoid the possibility of air embolism. Finally, we present our protocol for irrigation and debridement and exchange of modular components in total joint arthroplasty, incorporating hydrogen peroxide in combination with povidone-iodine and chlorhexidine.
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Affiliation(s)
- Min Lu
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California, USA
| | - Erik Nathan Hansen
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California, USA
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Sultana ST, Call DR, Beyenal H. Maltodextrin enhances biofilm elimination by electrochemical scaffold. Sci Rep 2016; 6:36003. [PMID: 27782161 PMCID: PMC5080540 DOI: 10.1038/srep36003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 09/22/2016] [Indexed: 01/08/2023] Open
Abstract
Electrochemical scaffolds (e-scaffolds) continuously generate low concentrations of H2O2 suitable for damaging wound biofilms without damaging host tissue. Nevertheless, retarded diffusion combined with H2O2 degradation can limit the efficacy of this potentially important clinical tool. H2O2 diffusion into biofilms and bacterial cells can be increased by damaging the biofilm structure or by activating membrane transportation channels by exposure to hyperosmotic agents. We hypothesized that e-scaffolds would be more effective against Acinetobacter baumannii and Staphylococcus aureus biofilms in the presence of a hyperosmotic agent. E-scaffolds polarized at -600 mVAg/AgCl were overlaid onto preformed biofilms in media containing various maltodextrin concentrations. E-scaffold alone decreased A. baumannii and S. aureus biofilm cell densities by (3.92 ± 0.15) log and (2.31 ± 0.12) log, respectively. Compared to untreated biofilms, the efficacy of the e-scaffold increased to a maximum (8.27 ± 0.05) log reduction in A. baumannii and (4.71 ± 0.12) log reduction in S. aureus biofilm cell densities upon 10 mM and 30 mM maltodextrin addition, respectively. Overall ~55% decrease in relative biofilm surface coverage was achieved for both species. We conclude that combined treatment with electrochemically generated H2O2 from an e-scaffold and maltodextrin is more effective in decreasing viable biofilm cell density.
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Affiliation(s)
- Sujala T. Sultana
- School of Chemical Engineering & Bioengineering, Washington State University, Pullman, 99164, WA, USA
| | - Douglas R. Call
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, 99164, WA, USA
| | - Haluk Beyenal
- School of Chemical Engineering & Bioengineering, Washington State University, Pullman, 99164, WA, USA
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44
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Byon CH, Heath JM, Chen Y. Redox signaling in cardiovascular pathophysiology: A focus on hydrogen peroxide and vascular smooth muscle cells. Redox Biol 2016; 9:244-253. [PMID: 27591403 PMCID: PMC5011184 DOI: 10.1016/j.redox.2016.08.015] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 08/23/2016] [Indexed: 02/07/2023] Open
Abstract
Oxidative stress represents excessive intracellular levels of reactive oxygen species (ROS), which plays a major role in the pathogenesis of cardiovascular disease. Besides having a critical impact on the development and progression of vascular pathologies including atherosclerosis and diabetic vasculopathy, oxidative stress also regulates physiological signaling processes. As a cell permeable ROS generated by cellular metabolism involved in intracellular signaling, hydrogen peroxide (H2O2) exerts tremendous impact on cardiovascular pathophysiology. Under pathological conditions, increased oxidase activities and/or impaired antioxidant systems results in uncontrolled production of ROS. In a pro-oxidant environment, vascular smooth muscle cells (VSMC) undergo phenotypic changes which can lead to the development of vascular dysfunction such as vascular inflammation and calcification. Investigations are ongoing to elucidate the mechanisms for cardiovascular disorders induced by oxidative stress. This review mainly focuses on the role of H2O2 in regulating physiological and pathological signals in VSMC.
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Affiliation(s)
| | - Jack M Heath
- Department of Pathology, Birmingham, AL 35294, USA
| | - Yabing Chen
- Department of Pathology, Birmingham, AL 35294, USA; University of Alabama at Birmingham, and the Birmingham Veterans Affairs Medical Center, Birmingham, AL 35294, USA.
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Gurram RN, Al-Shannag M, Lecher NJ, Duncan SM, Singsaas EL, Alkasrawi M. Bioconversion of paper mill sludge to bioethanol in the presence of accelerants or hydrogen peroxide pretreatment. BIORESOURCE TECHNOLOGY 2015; 192:529-39. [PMID: 26086086 DOI: 10.1016/j.biortech.2015.06.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 06/02/2015] [Accepted: 06/03/2015] [Indexed: 05/12/2023]
Abstract
In this study we investigated the technical feasibility of convert paper mill sludge into fuel ethanol. This involved the removal of mineral fillers by using either chemical pretreatment or mechanical fractionation to determine their effects on cellulose hydrolysis and fermentation to ethanol. In addition, we studied the effect of cationic polyelectrolyte (as accelerant) addition and hydrogen peroxide pretreatment on enzymatic hydrolysis and fermentation. We present results showing that removing the fillers content (ash and calcium carbonate) from the paper mill sludge increases the enzymatic hydrolysis performance dramatically with higher cellulose conversion at faster rates. The addition of accelerant and hydrogen peroxide pretreatment further improved the hydrolysis yields by 16% and 25% (g glucose / g cellulose), respectively with the de-ashed sludge. The fermentation process of produced sugars achieved up to 95% of the maximum theoretical ethanol yield and higher ethanol productivities within 9h of fermentation.
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Affiliation(s)
- Raghu Nandan Gurram
- Wisconsin Institute for Sustainable Technology, University of Wisconsin - Stevens Point, 2001 Fourth Avenue, Stevens Point, WI 54481, USA
| | - Mohammad Al-Shannag
- Department of Chemical Engineering, The University of Jordan, 11942 Amman, Jordan
| | - Nicholas Joshua Lecher
- Wisconsin Institute for Sustainable Technology, University of Wisconsin - Stevens Point, 2001 Fourth Avenue, Stevens Point, WI 54481, USA
| | - Shona M Duncan
- Wisconsin Institute for Sustainable Technology, University of Wisconsin - Stevens Point, 2001 Fourth Avenue, Stevens Point, WI 54481, USA
| | - Eric Lawrence Singsaas
- Department of Paper Science and Engineering, University of Wisconsin, Stevens Point, USA
| | - Malek Alkasrawi
- Wisconsin Institute for Sustainable Technology, University of Wisconsin - Stevens Point, 2001 Fourth Avenue, Stevens Point, WI 54481, USA; Department of Paper Science and Engineering, University of Wisconsin, Stevens Point, USA.
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When antibiotics can be avoided in skin inflammation and bacterial colonization: a review of topical treatments. Curr Opin Infect Dis 2014; 27:125-9. [PMID: 24514163 DOI: 10.1097/qco.0000000000000044] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW This review looks at the recent evidence on the safety, toxicity, microbiology and the prevention and management of acute and chronic wound infections with regard to antiseptics and antiseptic wound dressings. It is timely and relevant because of the global concerns of antimicrobial resistance and the need to address the inappropriate use of antimicrobials in the healthcare setting. RECENT FINDINGS There have been a number of recent Cochrane reviews that have concluded that there is little evidence to delineate clinical outcomes between antiseptics and antiseptic dressings. Published in-vitro evidence offers some new techniques and evaluates some new dressings and antiseptics. There are no economic evaluations of antiseptics and antiseptic dressings. SUMMARY Better clinical trials on the effectiveness and cost-effectiveness of wound dressings are needed to ensure evidence-based guidance is developed for optimizing the treatment of patients. It is surprising that with the paucity of evidence of clinical effectiveness, healthcare organizations continue to spend considerable resources on poorly evaluated topical wound products.
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