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Musuroi C, Musuroi SI, Baditoiu L, Crainiceanu Z, Muntean D, Voinescu A, Izmendi O, Sirmon A, Licker M. The Profile of Bacterial Infections in a Burn Unit during and after the COVID-19 Pandemic Period. Antibiotics (Basel) 2024; 13:823. [PMID: 39334997 PMCID: PMC11428671 DOI: 10.3390/antibiotics13090823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 08/24/2024] [Accepted: 08/26/2024] [Indexed: 09/30/2024] Open
Abstract
Infections represent a major complication for burn-injured patients. The aim of this study was to highlight the changes in the incidence and antimicrobial resistance of bacterial strains isolated from burn patients, at the end of the COVID-19 pandemic, in relation to the antibiotics used during the pandemic. A comparative analysis of the demographic data and the microorganisms identified in the clinical samples of two groups of burn patients admitted to a university hospital in Romania was carried out. The first group consisted of 48 patients and the second of 69 patients, hospitalized in January-August 2020 and 2023, respectively. The bacterial species with the highest incidence were S. aureus, A. baumannii, Pseudomonas spp. The significant changes between 2023 and 2020 are reflected in the increase in the frequency of non-fermentative Gram-negative bacteria, especially S. maltophilia, and the increase in antimicrobial resistance of Pseudomonas and Klebsiella spp. Klebsiella spp. did not change in frequency (7%), but there was a significant increase in the incidence of K. pneumoniae strains with pan-drug resistant behaviour to antibiotics (40%), including colistin. The phenomenon can be explained by the selection of specimens carrying multiple resistance genes, as a result of antibiotic treatment during the COVID-19 period. The post-pandemic antimicrobial resistance detected in burn patients indicates the need for permanent surveillance of the resistance trends, primarily due to the limited therapeutic options available for these patients.
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Affiliation(s)
- Corina Musuroi
- Multidisciplinary Research Center of Antimicrobial Resistance, Microbiology Department, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Microbiology Laboratory, "Pius Brinzeu" County Clinical Emergency Hospital, 300723 Timisoara, Romania
| | - Silvia-Ioana Musuroi
- Doctoral School, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Luminita Baditoiu
- Epidemiology Department, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Zorin Crainiceanu
- Department of Plastic Surgery, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Delia Muntean
- Multidisciplinary Research Center of Antimicrobial Resistance, Microbiology Department, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Microbiology Laboratory, "Pius Brinzeu" County Clinical Emergency Hospital, 300723 Timisoara, Romania
| | - Adela Voinescu
- Multidisciplinary Research Center of Antimicrobial Resistance, Microbiology Department, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Microbiology Laboratory, "Pius Brinzeu" County Clinical Emergency Hospital, 300723 Timisoara, Romania
- Doctoral School, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Oana Izmendi
- Multidisciplinary Research Center of Antimicrobial Resistance, Microbiology Department, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Doctoral School, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Alexandra Sirmon
- Epidemiology Department, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Epidemiology Department, "Pius Brinzeu" County Clinical Emergency Hospital, 300723 Timisoara, Romania
| | - Monica Licker
- Multidisciplinary Research Center of Antimicrobial Resistance, Microbiology Department, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Microbiology Laboratory, "Pius Brinzeu" County Clinical Emergency Hospital, 300723 Timisoara, Romania
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Tao S, Zhang S, Wei K, Maniura-Weber K, Li Z, Ren Q. An Injectable Living Hydrogel with Embedded Probiotics as a Novel Strategy for Combating Multifaceted Pathogen Wound Infections. Adv Healthc Mater 2024:e2400921. [PMID: 38923269 DOI: 10.1002/adhm.202400921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 06/25/2024] [Indexed: 06/28/2024]
Abstract
Wound infections pose a significant challenge in healthcare, and traditional antibiotic treatments often result in the development of resistant pathogens. Addressing this gap, ProGel is introduced, a living hydrogel created by entrapping probiotic Lactobacillus plantarum as a therapeutic component within a gelatin matrix. With a double-syringe system, ProGel can be easily mixed and applied, conforming swiftly to any wound shape and forming hydrogel in situ. It also demonstrates robust mechanical and self-healing properties owing to the Schiff-base bonds. ProGel sustains more than 80% viability of the entrapped L. plantarum while restricting their escape from the hydrogel. After a week of storage, more than 70% viability of the entrapped L. plantarum is preserved. Importantly, ProGel exhibits broad-spectrum antimicrobial efficacy against pathogens commonly associated with wound infections, i.e., Pseudomonas aeruginosa (7Log reduction), Staphylococcus aureus (3-7Log reduction), and Candida albicans (40-70% reduction). Moreover, its cytocompatibility is affirmed through coculture with human dermal fibroblasts. The effectiveness of ProGel is further highlighted in more clinically relevant tests on human skin wound models infected with P. aeruginosa and S. aureus, where it successfully prevents the biofilm formation of these pathogens. This study showcases an injectable living hydrogel system for the management of complex wound infections.
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Affiliation(s)
- Siyuan Tao
- Laboratory for Biointerfaces, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, 9014, Switzerland
| | - Sixuan Zhang
- Laboratory for Biointerfaces, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, 9014, Switzerland
| | - Kongchang Wei
- Laboratory for Biointerfaces, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, 9014, Switzerland
- Laboratory for Biomimetic Membranes and Textiles, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, CH 9014, Switzerland
| | - Katharina Maniura-Weber
- Laboratory for Biointerfaces, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, 9014, Switzerland
| | - Zhihao Li
- Laboratory for Biointerfaces, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, 9014, Switzerland
| | - Qun Ren
- Laboratory for Biointerfaces, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, 9014, Switzerland
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Kahl LJ, Stremmel N, Esparza-Mora MA, Wheatley RM, MacLean RC, Ralser M. Interkingdom interactions between Pseudomonas aeruginosa and Candida albicans affect clinical outcomes and antimicrobial responses. Curr Opin Microbiol 2023; 75:102368. [PMID: 37677865 DOI: 10.1016/j.mib.2023.102368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 09/09/2023]
Abstract
Infections that involve interkingdom microbial communities, such as those between bacteria and yeast pathogens, are difficult to treat, associated with worse patient outcomes, and may be a source of antimicrobial resistance. In this review, we address co-occurrence and co-infections of Candida albicans and Pseudomonas aeruginosa, two pathogens that occupy multiple infection niches in the human body, especially in immunocompromised patients. The interaction between the pathogen species influences microbe-host interactions, the effectiveness of antimicrobials and even infection outcomes, and may thus require adapted treatment strategies. However, the molecular details of bacteria-fungal interactions both inside and outside the infection sites, are insufficiently characterised. We argue that comprehensively understanding the P. aeruginosa-C. albicans interaction network through integrated systems biology approaches will capture the highly dynamic and complex nature of these polymicrobial infections and lead to a more comprehensive understanding of clinical observations such as reshaped immune defences and low antimicrobial treatment efficacy.
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Affiliation(s)
- Lisa J Kahl
- Charité Universitätsmedizin Berlin, Department of Biochemistry, 10117 Berlin, Germany
| | - Nina Stremmel
- Charité Universitätsmedizin Berlin, Department of Biochemistry, 10117 Berlin, Germany
| | | | - Rachel M Wheatley
- University of Oxford, Department of Biology, Oxford OX1 3SZ, United Kingdom
| | - R Craig MacLean
- University of Oxford, Department of Biology, Oxford OX1 3SZ, United Kingdom
| | - Markus Ralser
- Charité Universitätsmedizin Berlin, Department of Biochemistry, 10117 Berlin, Germany; University of Oxford, The Wellcome Centre for Human Genetics, Nuffield Department of Medicine, Oxford OX3 7BN, United Kingdom; Max Planck Institute for Molecular Genetics, 14195 Berlin, Germany.
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Wang C, Li C, Li X, Cai L, Han Z, Du R. RETRACTED ARTICLE: Burn Wounds: Proliferating Site for Biofilm Infection. Appl Biochem Biotechnol 2023; 195:5478. [PMID: 35604533 DOI: 10.1007/s12010-022-03964-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Chao Wang
- Second Department of Burn and Plastic Surgery, Tangshan Worker's Hospital, 063000, Tangshan, Hebei, China
| | - Chungeng Li
- Department of proctology, Tangshan Hospital of Traditional Chinese Medicine, 063000, Tangshan, Hebei, China
| | - Xiaoying Li
- Department of Internal Emergency, Tangshan Worker's Hospital, 063000, Tangshan, Hebei, China
| | - Lanfang Cai
- Second Department of Burn and Plastic Surgery, Tangshan Worker's Hospital, 063000, Tangshan, Hebei, China
| | - Zhenning Han
- Second Department of Burn and Plastic Surgery, Tangshan Worker's Hospital, 063000, Tangshan, Hebei, China
| | - Rui Du
- Department one of Cardiology, Tangshan Worker's Hospital, 063000, Tangshan, Hebei, China.
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Wellkamp L, Obed D, Enechukwu AOM, Bingoel AS, Dastagir K, Vogt PM. Correlation between Bacterial Wound Colonization and Skin-Graft Loss in Burn Patients. J Burn Care Res 2022; 44:649-654. [PMID: 36044197 DOI: 10.1093/jbcr/irac129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Indexed: 11/13/2022]
Abstract
Loss of skin grafts can be a dangerous complication during the early postoperative course of patients with extensive burns. A major risk factor for impaired healing of grafts is local wound infection due to bacterial colonization. Burn wounds are particularly prone to bacterial colonization. In this retrospective cohort study, we analyzed correlations between bacteria isolates from burn wounds and loss of skin grafts after surgical treatment. A cohort of patients with burn wounds who received split-skin grafts for wound coverage was divided into groups with and without loss of skin grafts. Demographics, comorbidities, trauma characteristics and bacterial isolates from wound cultures were reviewed and compared. Bacterial colonization isolated from burn wounds upon hospital admission was found to be a significant predictor of skin-graft loss. Additionally, an Abbreviated Burn Severity Index greater 6 predicted graft loss. When comparing bacterial swab results from admission with isolates from revision surgery after graft loss, causative pathogens were found to have changed.
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Affiliation(s)
- Lukas Wellkamp
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Germany
| | - Doha Obed
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Germany
| | | | - Alperen Sabri Bingoel
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Germany
| | - Khaled Dastagir
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Germany
| | - Peter Maria Vogt
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Germany
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Bagameri L, Baci GM, Dezmirean DS. Royal Jelly as a Nutraceutical Natural Product with a Focus on Its Antibacterial Activity. Pharmaceutics 2022; 14:1142. [PMID: 35745715 PMCID: PMC9227439 DOI: 10.3390/pharmaceutics14061142] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/20/2022] [Accepted: 05/25/2022] [Indexed: 02/06/2023] Open
Abstract
Royal jelly (RJ) is one of the most valued natural products and is known for its health-promoting properties. Due to its therapeutic effects, it has been used in medicine since antiquity. Nowadays, several studies indicate that RJ acts as a powerful antimicrobial agent. Indeed, researchers shed light on its antioxidant and anticancer activity. RJ's biological properties are related to its bioactive compounds, such as proteins, peptides, phenolic, and fatty acids. The aim of this review is to highlight recent findings on RJ's main bioactive compounds correlated with its health-promoting properties. The available literature suggests that these bioactive compounds can be used as an alternative approach in order to enhance human health. Moreover, throughout this paper, we underline the prominent antibacterial effect of RJ against several target bacterial strains. In addition, we briefly discuss other therapeutic activities, such as antioxidative and anticancer effects, of this outstanding natural product.
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Affiliation(s)
- Lilla Bagameri
- Faculty of Animal Science and Biotechnology, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400372 Cluj-Napoca, Romania;
| | - Gabriela-Maria Baci
- Faculty of Animal Science and Biotechnology, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400372 Cluj-Napoca, Romania;
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Burns and biofilms: priority pathogens and in vivo models. NPJ Biofilms Microbiomes 2021; 7:73. [PMID: 34504100 PMCID: PMC8429633 DOI: 10.1038/s41522-021-00243-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 08/02/2021] [Indexed: 02/08/2023] Open
Abstract
Burn wounds can create significant damage to human skin, compromising one of the key barriers to infection. The leading cause of death among burn wound patients is infection. Even in the patients that survive, infections can be notoriously difficult to treat and can cause lasting damage, with delayed healing and prolonged hospital stays. Biofilm formation in the burn wound site is a major contributing factor to the failure of burn treatment regimens and mortality as a result of burn wound infection. Bacteria forming a biofilm or a bacterial community encased in a polysaccharide matrix are more resistant to disinfection, the rigors of the host immune system, and critically, more tolerant to antibiotics. Burn wound-associated biofilms are also thought to act as a launchpad for bacteria to establish deeper, systemic infection and ultimately bacteremia and sepsis. In this review, we discuss some of the leading burn wound pathogens and outline how they regulate biofilm formation in the burn wound microenvironment. We also discuss the new and emerging models that are available to study burn wound biofilm formation in vivo.
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