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Zhang D, Zhu M, Xu P, Wen X, Liang G, Zheng W, Zeng Y, Sun T, Fan R, Lu Y, Tan X, Gong M, Wang T, Chen J, Guan J. Mechanistic Interrogation on Wound Healing and Scar Removing by the Mo 4/3B 2-x Nanoscaffold Revealed Regulated Amino Acid and Purine Metabolism. ACS NANO 2024. [PMID: 39150010 DOI: 10.1021/acsnano.4c06796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
Wound rehabilitation is invariably time-consuming, scar formation further weakens therapeutic efficacy, and detailed mechanisms at the molecular level remain unclear. In this work, a Mo4/3B2-x nanoscaffold was fabricated and utilized for wound healing and scar removing in a mice model, while metabolomics was used to study the metabolic reprogramming of metabolome during therapy at the molecular level. The results showed that transition metal borides, called Mo4/3B2-x nanoscaffolds, could mimic superoxide dismutase and glutathione peroxidase to eliminate excess reactive oxygen species (ROS) in the wound microenvironment. During the therapeutic process, the Mo4/3B2-x nanoscaffold could facilitate the regeneration of wounds and removal of scars by regulating the biosynthesis of collagen, fibers, and blood vessels at the pathological, imaging, and molecular levels. Subsequent metabolomics study revealed that the Mo4/3B2-x nanoscaffold effectively ameliorated metabolic disorders in both wound and scar microenvironments through regulating ROS-related pathways including the amino acid metabolic process (including glycine and serine metabolism and glutamate metabolism) and the purine metabolic process. This study is anticipated to illuminate the potential clinical application of the Mo4/3B2-x nanoscaffold as an effective therapeutic agent in traumatic diseases and provide insights into the development of analytical methodology for interrogating wound healing and scar removal-related metabolic mechanisms.
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Affiliation(s)
- Dingkun Zhang
- Department of Neurosurgery, Laboratory of Clinical Proteomics and Metabolomics, Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, P. R. China
| | - Man Zhu
- Laboratory of Aging Research, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610050, P. R. China
| | - Pei Xu
- Department of Pathology, Deyang People's Hospital, Deyang 618000, P. R. China
| | - Xue Wen
- Department of Plastic and Burn Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China
| | - Ge Liang
- Metabolomics and Proteomics Technology Platform, West China Hospital, Sichuan University, Chengdu 610041, P. R. China
| | - Wen Zheng
- Metabolomics and Proteomics Technology Platform, West China Hospital, Sichuan University, Chengdu 610041, P. R. China
| | - Yu Zeng
- Department of Neurosurgery, Laboratory of Clinical Proteomics and Metabolomics, Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, P. R. China
| | - Tong Sun
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China
| | - Rong Fan
- Department of Mechanical Engineering, City University of Hong Kong, Kowloon 999077, Hong Kong SAR, P. R. China
- Chengdu Research Institute, City University of Hong Kong, Chengdu 610200, P. R. China
| | - Yang Lu
- Department of Mechanical Engineering, City University of Hong Kong, Kowloon 999077, Hong Kong SAR, P. R. China
- Chengdu Research Institute, City University of Hong Kong, Chengdu 610200, P. R. China
| | - Xueqin Tan
- Department of Plastic and Burn Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China
| | - Meng Gong
- Department of Neurosurgery, Laboratory of Clinical Proteomics and Metabolomics, Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, P. R. China
| | - Tingting Wang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu 610041, P. R. China
| | - Junjie Chen
- Department of Plastic and Burn Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China
| | - Junwen Guan
- Department of Neurosurgery, Laboratory of Clinical Proteomics and Metabolomics, Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, P. R. China
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China
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Libson K, Barba J, Henning A, Fisher K, Kirven RM, Korman AM, Plaza JA, Kaffenberger BH, Chung C. Acute Interstitial Inflammation on Skin Biopsies and Positive Tissue Cultures in Cellulitis Patients Are Associated a Worse Prognosis. Am J Dermatopathol 2024:00000372-990000000-00348. [PMID: 38842316 DOI: 10.1097/dad.0000000000002753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
BACKGROUND Cellulitis is a significant public health burden and lacks a gold standard for diagnosis. Up to 1/3 of patients are incorrectly diagnosed. The skin biopsy has been proposed as the gold standard. OBJECTIVE In this study, we evaluate the histopathologic characteristics and tissue culture positivity of biopsies in patients diagnosed with cellulitis seen by our inpatient dermatology consultation service. METHODS This retrospective cohort study examined patients who were hospitalized with a skin and soft tissue infection at our institution between 2011 and 2020 and underwent a skin biopsy. RESULTS Those with a positive tissue culture were more likely to die within 30 days compared with those with negative tissue cultures (26% vs. 6%, P = 0.048). Patients who died within 30 days were more likely to have acute interstitial inflammation as a feature on histopathology (38%, P = 0.03). LIMITATIONS Single institutional design, unintentional exclusion of patients with organism-specific diagnosis, and selection for a medically complex patient population because of the nonroutine collection of biopsies. CONCLUSION Positive tissue cultures and histopathology showing acute interstitial space inflammation on skin and soft tissue infection (SSTI) biopsies are associated with increased mortality and thus may serve as indicators of poor prognosis.
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Affiliation(s)
- Karissa Libson
- The Ohio State University College of Medicine, Columbus, OH
| | - Johnny Barba
- The Ohio State University College of Medicine, Columbus, OH
| | - Ania Henning
- Department of Pathology, Summa Health, Akron, OH
| | - Kristopher Fisher
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH; and
| | - Rachel M Kirven
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH; and
| | - Abraham M Korman
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH; and
| | - Jose A Plaza
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Benjamin H Kaffenberger
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH; and
| | - Catherine Chung
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH; and
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Hua R, Zhong J, Xian J, Liang Y, Gan Z, Deng S. Perforation of descending colonic cancer as a rare cause of gas gangrene of the lower limb in an 80-year-old female: a case report. J Surg Case Rep 2024; 2024:rjae033. [PMID: 38605695 PMCID: PMC11007638 DOI: 10.1093/jscr/rjae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 01/14/2024] [Indexed: 04/13/2024] Open
Abstract
Gas gangrene is a rare, severe gas-producing infection that can be related to colorectal cancer. Gas gangrene can be confirmed by radiologic findings and crepitation on touch. Spontaneous gas gangrene can be associated with colorectal cancer. An 80-year-old female complaint about a sudden abdominal pain, accompanied with progressive swelling pain in thigh and fever. Diagnosis based on assessment findings were gas gangrene and descending colonic cancer perforation. Emergency surgery was performed for debridement and drainage, followed by vacuum sealing drainage (VSD) with polyurethane (PU). Two more surgical interventions were given before the colonic tumor surgery. The patient recovered well in the long-term follow-up. This report demonstrates the diagnosis, treatment, and management of a successful case of gas gangrene caused by perforation of descending colonic cancer. Accurate preoperative diagnosis and reasonable use of VSD (PU) material played an important role in the treatment of this case.
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Affiliation(s)
- Ruoyue Hua
- Burn and Plastic Surgery Department, Wuzhou Gongren Hospital, Wuzhou, Guangxi Zhuang Autonomous Region, China
| | - Jun Zhong
- Burn and Plastic Surgery Department, Wuzhou Gongren Hospital, Wuzhou, Guangxi Zhuang Autonomous Region, China
| | - Jianlin Xian
- Burn and Plastic Surgery Department, Wuzhou Gongren Hospital, Wuzhou, Guangxi Zhuang Autonomous Region, China
| | - Yaoqi Liang
- Burn and Plastic Surgery Department, Wuzhou Gongren Hospital, Wuzhou, Guangxi Zhuang Autonomous Region, China
| | - Zilin Gan
- Burn and Plastic Surgery Department, Wuzhou Gongren Hospital, Wuzhou, Guangxi Zhuang Autonomous Region, China
| | - Shoupeng Deng
- Burn and Plastic Surgery Department, Wuzhou Gongren Hospital, Wuzhou, Guangxi Zhuang Autonomous Region, China
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Li Y, Li H, Yu Z, Liu J, Lin Y, Xu J, Zhang C, Chen Q, Han X, Peng Q. Drug-free and multifunctional sodium bicarbonate/hyaluronic acid hybrid dressing for synergistic healing of infected wounds. Int J Biol Macromol 2024; 259:129254. [PMID: 38191113 DOI: 10.1016/j.ijbiomac.2024.129254] [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] [Received: 09/25/2023] [Revised: 12/30/2023] [Accepted: 01/03/2024] [Indexed: 01/10/2024]
Abstract
Skin wounds are susceptible to microbial infections which commonly lead to the delayed wound healing. Rapid clearance of pathogens from the wound is of great significance and importance for efficient healing of the infected wounds. Herein, we report a multifunctional hybrid dressing, which simply combines sodium bicarbonate (NaHCO3) and hyaluronic acid (HA) for the synergistic wound healing. Addition of NaHCO3 allows the hybrid dressing to have the great antibacterial and antioxidant activity, while maintaining the intrinsic skin repair function of HA. As a result, NaHCO3/HA hybrid dressing showed the great antibacterial activity against both Gram-positive (S. aureus) and Gram-negative (E. coli) pathogens, the ability to improve the fibroblasts proliferation and migration, the cell-protection capacity under H2O2-induced oxidative stress, and most importantly, the great healing efficacy for the mice wound infected by S. aureus. We further found that the epidermal regeneration, the collagen deposition and the angiogenesis were enhanced by NaHCO3/HA hybrid dressing. All these effects were NaHCO3 concentration-dependent. Since the NaHCO3/HA hybrid dressing is drug-free, easily fabricated, biocompatible, and efficient for wound healing, it may have great potentials for clinical management of infected wounds.
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Affiliation(s)
- Yuanhong Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Houze Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Zhuohang Yu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Jianhong Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yao Lin
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Jingchen Xu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Chaoliang Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Qianming Chen
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Xianglong Han
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Qiang Peng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
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Hailu Wondafrash A, Laifa Lima U, Abebe D, Negash KS. Incidence and Causes of Cellulitis Among Patients at Tupua Tamasese Meaole Hospital in Upolu, Samoa in 2019. Cureus 2023; 15:e48318. [PMID: 38058333 PMCID: PMC10697806 DOI: 10.7759/cureus.48318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE To study the incidence and causes of cellulitis in patients who visited the only tertiary hospital in Samoa, i.e., Tupua Tamasese Meaole (TTM) Hospital, in 2019. METHOD Of the total of 14,198 patients who presented to TTM Hospital in 2019, a chart review of all 258 patients who presented with cellulitis was conducted. All charts with the final primary admitting diagnosis of cellulitis were extracted. No exclusion criteria were employed, and raw data were analyzed manually. RESULTS Of the 14,198 patients who sought care at TTM Hospital in 2019, 258 patients received care for cellulitis. This represents an incidence rate of 1.8%. Most patients were male (62.4%). Those in the age group of 41 to 80 years old accounted for 79.5% of the total. The leg (94.6%) was the major site of infection. Of those who had blood cultures drawn, 76.4% had negative results. Of the 56 patients with positive microbial growth, Staphylococcus and Streptococcus species accounted for a combined total of 71.4% of the cases. The mainstay of antibiotic treatment was flucloxacillin alone or in conjunction with other antibiotics (92.2%). Of the many comorbidities affecting patients, diabetes (44.2%) was the most prevalent. Hospital admission, ranging from three to 10 days was needed in 63.5% of patients. CONCLUSION The incidence rate of cellulitis at TTM in 2019 was 1.8%, which was marginally higher than noted in other parts of the world. Male patients and people over the age of 40 years are affected the most. The leg is affected the most mainly by Staphylococcus and Streptococcus species. Flucloxacillin is the main antibiotic used to treat cellulitis at the TTM Hospital. From the data analyses, it is inferred that a large proportion of patients who presented had moderate to severe cellulitis.
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Affiliation(s)
| | - Uila Laifa Lima
- Department of Medicine, Oceania University of Medicine, Apia, WSM
| | - Degu Abebe
- Department of Medicine, Oceania University of Medicine, Apia, WSM
| | - Kidus S Negash
- Department of Medicine, Hayat Medical College, Addis Ababa, ETH
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Mudjahid M, Meidianto Asri R, Nainu F, Dian Permana A. Validation of spectrophotometric method to quantify chloramphenicol in fluid and rat skin tissue mimicking infection environment: Application to in vitro release and ex vivo dermatokinetic studies from dissolving microneedle loaded microparticle sensitive bacteria. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2023; 291:122374. [PMID: 36682254 DOI: 10.1016/j.saa.2023.122374] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 12/15/2022] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Cellulitis is a common dermis/subcutaneous tissue skin infection and shared global disease burden, with a higher incidence for males and people aged 45-64 years. Application therapy of chloramphenicol (CHL) has been hindered because of its toxicity and limited penetration into the skin. In this research, CHL was developed into a bacterially sensitive microparticles which were further incorporated into a microneedle system to increase penetration. To support this formulation, in this study, UV-vis spectrophotometry method was validated in methanol, polyvinyl alcohol (PVA) 1%, phosphate buffered saline (PBS), tryptic soy broth (TSB) (fluid-mimicking infection), and skin tissue to quantify amount of CHL. The developed analytical method was subsequently validated according to ICH guidelines. The results obtained showed that the correlation coefficients were linear ≥0.9934. The values of LLOQ inside the methanol, PVA 1%, PBS, TSB, and skin tissue were 7.20 µg/mL, 4.40 µg/mL, 8.18 µg/mL, 387.48 µg/mL, and 7.27 µg/mL, respectively. The accuracy and precision of the developed method were prominent. These methods were successfully applied to quantify the amount of CHL in microparticle and microneedle system in fluid and tissue skin infection. The result showed the high drug release microparticle sensitive bacteria, and high drug retention in ex vivo dermatokinetic evaluation in rat skin tissue containing bacterial infection. This was due to the presence of Staphylococcus aureus bacteria culture that produced lipase enzymes, playing a role in lysing microparticle matrix to develop selectively delivery antimicrobials. A further analytical method needs to be matured to quantify CHL inside the in vivo studies.
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Affiliation(s)
- Mukarram Mudjahid
- Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia
| | | | - Firzan Nainu
- Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia
| | - Andi Dian Permana
- Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia.
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Bouza E, Burillo A, Muñoz P. How to manage skin and soft-tissue infections in the emergency department. Curr Opin Infect Dis 2023; 36:81-88. [PMID: 36853739 DOI: 10.1097/qco.0000000000000906] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
PURPOSE OF REVIEW Our purpose is to review the state-of-the-art on the management of skin and soft tissue infections (SSTI) in emergency departments (ED).Although the information is scarce, SSTI may account for 3-30% of all cases presenting to an ED, of which 25-40% require hospital admission.SSTI include very different entities in aetiology, location, pathogenesis, extension, and severity. Therefore, no single management can be applied to them all. A simple approach is to classify them as non-purulent, purulent, and necrotising, to which a severity scale based on their systemic repercussions (mild, moderate, and severe) must be added.The initial approach to many SSTIs often requires no other means than anamnesis and physical examination, but imaging tests are an indispensable complement in many other circumstances (ultrasound, computerized tomography, magnetic resonance imaging…). In our opinion, an attempt at etiological filiation should be made in severe cases or where there is suspicion of a causality other than the usual one, with tests based not only on cultures of the local lesion but also molecular tests and blood cultures. RECENT FINDINGS Recent contributions of interest include the value of bedside ultrasound and the potential usefulness of biomarkers such as thrombomodulin to differentiate in early stages the presence of necrotising lesions not yet explicit.New antimicrobials will allow the treatment of many of these infections, including severe ones, with oral drugs with good bioavailability and for shorter periods. SUMMARY The ED has an essential role in managing SSTIs, in their classification, in decisions on when and where to administer antimicrobial treatment, and in the rapid convening of multidisciplinary teams that can deal with the most complex situations.
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Affiliation(s)
- Emilio Bouza
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón
- Medicine Department, School of Medicine, Universidad Complutense de Madrid
- Gregorio Marañón Health Research Institute (IiSGM)
- CIBER of Respiratory Diseases (CIBERES CB06/06/0058), Madrid, Spain
| | - Almudena Burillo
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón
- Medicine Department, School of Medicine, Universidad Complutense de Madrid
- Gregorio Marañón Health Research Institute (IiSGM)
| | - Patricia Muñoz
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón
- Medicine Department, School of Medicine, Universidad Complutense de Madrid
- Gregorio Marañón Health Research Institute (IiSGM)
- CIBER of Respiratory Diseases (CIBERES CB06/06/0058), Madrid, Spain
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Lim S, Yoo YM, Kim KH. No more tears from surgical site infections in interventional pain management. Korean J Pain 2023; 36:11-50. [PMID: 36581597 PMCID: PMC9812697 DOI: 10.3344/kjp.22397] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 12/31/2022] Open
Abstract
As the field of interventional pain management (IPM) grows, the risk of surgical site infections (SSIs) is increasing. SSI is defined as an infection of the incision or organ/space that occurs within one month after operation or three months after implantation. It is also common to find patients with suspected infection in an outpatient clinic. The most frequent IPM procedures are performed in the spine. Even though primary pyogenic spondylodiscitis via hematogenous spread is the most common type among spinal infections, secondary spinal infections from direct inoculation should be monitored after IPM procedures. Various preventive guidelines for SSI have been published. Cefazolin, followed by vancomycin, is the most commonly used surgical antibiotic prophylaxis in IPM. Diagnosis of SSI is confirmed by purulent discharge, isolation of causative organisms, pain/tenderness, swelling, redness, or heat, or diagnosis by a surgeon or attending physician. Inflammatory markers include traditional (C-reactive protein, erythrocyte sedimentation rate, and white blood cell count) and novel (procalcitonin, serum amyloid A, and presepsin) markers. Empirical antibiotic therapy is defined as the initial administration of antibiotics within at least 24 hours prior to the results of blood culture and antibiotic susceptibility testing. Definitive antibiotic therapy is initiated based on the above culture and testing. Combination antibiotic therapy for multidrug-resistant Gram-negative bacteria infections appears to be superior to monotherapy in mortality with the risk of increasing antibiotic resistance rates. The never-ending war between bacterial resistance and new antibiotics is continuing. This article reviews prevention, diagnosis, and treatment of infection in pain medicine.
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Affiliation(s)
- Seungjin Lim
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Yeong-Min Yoo
- Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Korea
| | - Kyung-Hoon Kim
- Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Korea,Correspondence: Kyung-Hoon Kim Pain Clinic, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea, Tel: +82-55-360-1422, Fax: +82-55-360-2149, E-mail:
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Mudjahid M, Nainu F, Utami RN, Sam A, Marzaman ANF, Roska TP, Asri RM, Himawan A, Donnelly RF, Permana AD. Enhancement in Site-Specific Delivery of Chloramphenicol Using Bacterially Sensitive Microparticle Loaded Into Dissolving Microneedle: Potential For Enhanced Effectiveness Treatment of Cellulitis. ACS APPLIED MATERIALS & INTERFACES 2022; 14:56560-56577. [PMID: 36516276 DOI: 10.1021/acsami.2c16857] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
One of the biggest challenges in infectious disease treatment is the existence of bacterial infections in underskin wound tissue, such as cellulitis. Compared to other treatments, it is harder for antibacterial drugs to penetrate the physical barrier on the affected skin with a nonspecific target, making conventional therapy for cellulitis infection more difficult and considered. In this novel research, we pioneer a combined strategy of dissolving microneedles (MNs) and bacteria-sensitive microparticles (MPs) for enhanced penetration and targeted delivery of chloramphenicol (CHL) to the infection site specifically. The polycaprolactone polymer was used to make MPs because of its sensitivity to bacterial enzyme stimuli. The best microparticle formulation was discovered and optimized using the Design-Expert application. Furthermore, this study evaluated the antibacterial activity of MPs in vitro and in vivo on the mutant Drosophila larval infection model. This strategy shows improvement in the antibacterial activity of MPs and higher retention duration compared to conventional cream formulation, and the inclusion of these MPs into dissolving MNs was able to greatly improve the dermatokinetic characteristics of CHL in ex vivo evaluation. Importantly, the antimicrobial efficacy in an ex vivo infection model demonstrated that, following the use of this strategy, bacterial bioburdens decreased by up to 99.99% after 24 h. The findings offered a proof of concept for the enhancement of CHL dermatokinetic profiles and antimicrobial activities after its preparation into bacteria-sensitive MPs and distribution by MNs. Future research should investigate in vivo effectiveness in an appropriate animal model.
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Affiliation(s)
- Mukarram Mudjahid
- Department of Pharmaceutics, Faculty of Pharmacy, Hasanuddin University, Makassar90245, Indonesia
| | - Firzan Nainu
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Universitas Hasanuddin, Makassar90245, Indonesia
| | - Rifka Nurul Utami
- Department of Pharmaceutics, Faculty of Pharmacy, Hasanuddin University, Makassar90245, Indonesia
| | - Anwar Sam
- Department of Pharmaceutics, Faculty of Pharmacy, Hasanuddin University, Makassar90245, Indonesia
| | | | - Tri Puspita Roska
- Department of Pharmaceutics, Faculty of Pharmacy, Hasanuddin University, Makassar90245, Indonesia
| | - Rangga Meidianto Asri
- Department of Pharmaceutics, Faculty of Pharmacy, Hasanuddin University, Makassar90245, Indonesia
| | - Achmad Himawan
- Department of Pharmaceutics, Faculty of Pharmacy, Hasanuddin University, Makassar90245, Indonesia
| | - Ryan F Donnelly
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, BelfastBT9 7BL, United Kingdom
| | - Andi Dian Permana
- Department of Pharmaceutics, Faculty of Pharmacy, Hasanuddin University, Makassar90245, Indonesia
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10
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Zhao DW, Ni J, Sun XL. Histiocytoid giant cellulitis-like Sweet syndrome at the site of sternal aspiration: A case report and review of literature. World J Clin Cases 2022; 10:9768-9775. [PMID: 36186189 PMCID: PMC9516896 DOI: 10.12998/wjcc.v10.i27.9768] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/26/2022] [Accepted: 08/17/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Giant cellulitis-like Sweet syndrome (SS) is a rare subtype of SS, and reports of the combined histiocytoid type of pathology are scarce. Here, we report a case of SS with distinctive clinical presentations and which was difficult to distinguish from cellulitis. By sharing this case and a discussion of the related literature in detail, we aim to provide clinicians with new insights into the characteristics of histiocytoid giant cellulitis-like (HGC)-SS and the pathogenesis of SS.
CASE SUMMARY A 52-year-old male was admitted after experiencing progressive fatigue for 1 mo and tongue swelling with pain for 1 d. He was diagnosed with myelodysplastic syndrome (MDS) and angioneurotic edema of the tongue and floor of the mouth. However, 7 d after examination by sternal aspiration, a violaceous, tender, and swollen nodule developed at the site, with poorly demarcated erythema of the surrounding skin. Considering his profile of risk factors, the diagnosis of cellulitis was made and he was administered broad-spectrum antibiotics. When the lesion continued to worsen and he developed chills and fever, pathogenic and dermatopathological examination led to the diagnosis of HGC-SS. Treatment with prednisone led to the fever being relieved within 24 h and the skin lesion being resolved within 1 wk. The patient refused intensive treatment and was instead given thalidomide, erythropoietin, stanozolol, and supportive care. The prednisone was gradually tapered, with no signs of recurrence, but he died 2 mo later of severe pneumonia.
CONCLUSION HGC-SS demonstrates unique manifestation. SS and leukemia cutis share cytological origin. Myelofibrosis and SS are adverse prognostic factors for MDS.
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Affiliation(s)
- De-Wan Zhao
- Department of Hematology, The First Affiliated Hospital of Dalian Medical University, Dalian 116014, Liaoning Province, China
| | - Jing Ni
- Department of Dermatology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
| | - Xiu-Li Sun
- Department of Hematology, The First Affiliated Hospital of Dalian Medical University, Dalian 116014, Liaoning Province, China
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Biglione B, Cucka B, Kroshinsky D. Cellulitis and Its Mimickers: an Approach to Diagnosis and Management. CURRENT DERMATOLOGY REPORTS 2022. [DOI: 10.1007/s13671-022-00363-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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