High Efficacy of Ozonated Oils on the Removal of Biofilms Produced by Methicillin-Resistant Staphylococcus aureus (MRSA) from Infected Diabetic Foot Ulcers

Integrating human expertise & automated methods for a dynamic and multi-parametric evaluation of large language models' feasibility in clinical decision-making

BACKGROUND

Recent enhancements in Large Language Models (LLMs) such as ChatGPT have exponentially increased user adoption. These models are accessible on mobile devices and support multimodal interactions, including conversations, code generation, and patient image uploads, broadening their utility in providing healthcare professionals with real-time support for clinical decision-making. Nevertheless, many authors have highlighted serious risks that may arise from the adoption of LLMs, principally related to safety and alignment with ethical guidelines.

OBJECTIVE

To address these challenges, we introduce a novel methodological approach designed to assess the specific feasibility of adopting LLMs within a healthcare area, with a focus on clinical nursing, evaluating their performance and thereby directing their choice. Emphasizing LLMs' adherence to scientific advancements, this approach prioritizes safety and care personalization, according to the "Organization for Economic Co-operation and Development" frameworks for responsible AI. Moreover, its dynamic nature is designed to adapt to future evolutions of LLMs.

METHOD

Through integrating advanced multidisciplinary knowledge, including Nursing Informatics, and aided by a prospective literature review, seven key domains and specific evaluation items were identified as follows:A Peer Review by experts in Nursing and AI was performed, ensuring scientific rigor and breadth of insights for an essential, reproducible, and coherent methodological approach. By means of a 7-point Likert scale, thresholds are defined in order to classify LLMs as "unusable", "usable with high caution", and "recommended" categories. Nine state of the art LLMs were evaluated using this methodology in clinical oncology nursing decision-making, producing preliminary results. Gemini Advanced, Anthropic Claude 3 and ChatGPT 4 achieved the minimum score of the State of the Art Alignment & Safety domain for classification as "recommended", being also endorsed across all domains. LLAMA 3 70B and ChatGPT 3.5 were classified as "usable with high caution." Others were classified as unusable in this domain.

CONCLUSION

The identification of a recommended LLM for a specific healthcare area, combined with its critical, prudent, and integrative use, can support healthcare professionals in decision-making processes.

Effect of Medical Ozone Therapy in Preventing Compromised Nasal Skin in Revision Rhinoplasty

BACKGROUND

Ozone is often used as an additive therapy for skin conditions like infectious diseases, wound healing, diabetic foot, and pressure ulcers. The viability of the nasal skin has crucial importance in revision rhinoplasty cases. The study investigates the potential benefits of medical ozone therapy in healing the nasal skin in multiple-operated cases.

METHODS

The study retrospectively examined 523 revision rhinoplasty patients operated by the first author from January 2017 to January 2024. Patients consenting to ozone therapy received 3 major autohemotherapy sessions post-surgery. Patients were divided into 2 groups: those with compromised nasal skin (infection, poor vascular supply) and those with normal healing. Age, gender, smoking, diabetes, previous surgeries, grafting materials, and techniques were considered.

RESULTS

Of the 523 patients, 12 (2.3%) experienced major skin complications like infection and necrosis, while 511 (97.7%) had no or minor issues, such as discoloration. In total, 301 patients accepted and received ozone therapy. Of the patients without major complications, 299 (58.3%) received ozone therapy, while 212 (41.7%) did not. Among the 12 with major complications, two (16.7%) received ozone therapy, and the remaining 10 (83.3%) did not. Ozone therapy recipients showed statistically fewer skin problems (p<0.05). Costal cartilage as tip and septal extension graft was linked to skin issues (p<0.05). No major adverse effects from ozone therapy were noted.

CONCLUSIONS

Our findings indicate that ozone therapy may be a safe and potentially effective option for patients undergoing revision rhinoplasty, especially those with compromised nasal skin. It appears to aid in skin healing and regeneration, possibly through enhancing oxygen delivery and modulation of the immune response. Ozone therapy is a promising adjunct treatment for managing skin complications in revision rhinoplasty patients.

LEVEL OF EVIDENCE IV

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Gases and gas-releasing materials for the treatment of chronic diabetic wounds

Chronic non-healing wounds are a common consequence of skin ulceration in diabetic patients, with severe cases such as diabetic foot even leading to amputations. The interplay between pathological factors like hypoxia-ischemia, chronic inflammation, bacterial infection, impaired angiogenesis, and accumulation of advanced glycosylation end products (AGEs), resulting from the dysregulation of the immune microenvironment caused by hyperglycemia, establishes an unending cycle that hampers wound healing. However, there remains a dearth of sufficient and effective approaches to break this vicious cycle within the complex immune microenvironment. Consequently, numerous scholars have directed their research efforts towards addressing chronic diabetic wound repair. In recent years, gases including Oxygen (O2), Nitric oxide (NO), Hydrogen (H2), Hydrogen sulfide (H2S), Ozone (O3), Carbon monoxide (CO) and Nitrous oxide (N2O), along with gas-releasing materials associated with them have emerged as promising therapeutic solutions due to their ability to regulate angiogenesis, intracellular oxygenation levels, exhibit antibacterial and anti-inflammatory effects while effectively minimizing drug residue-induced damage and circumventing drug resistance issues. In this review, we discuss the latest advances in the mechanisms of action and treatment of these gases and related gas-releasing materials in diabetic wound repair. We hope that this review can provide different ideas for the future design and application of gas therapy for chronic diabetic wounds.

The essential oil of Melaleuca alternifolia incorporated into hydrogel induces antimicrobial and anti-inflammatory effects on infected wounds by Staphylococcus aureus

Staphylococcus aureus is one of the most common bacterial isolates found in wounds. Thus, innovative dressings, such as hydrogels, are interesting vehicles for incorporating bioactive compounds like those from Melaleuca alternifolia essential oil (MaEO). In this study, we evaluated the antimicrobial and anti-inflammatory potential of MaEO incorporated into an alginate and chitosan hydrogel for treating wounds infected by S. aureus. The hydrogel incorporated with MaEO 1% (HMa 1%) was homogeneous with a bright pale-yellow color and the characteristic smell of Melaleuca. The incorporation of MaEO 1% does not affect the stability of the hydrogel, which was stable up to 90 days of storage. The Scanning electron microscopy analysis revealed that hydrogels showed irregular surfaces and interconnected porous structures with accumulations of oil crystals distributed throughout the formulation. HMa 1% has a high moisture content (95.1%) and can absorb simulated wound fluid. Regarding the antimicrobial effects, HMa 1% reduced the growth of S. aureus ATCC 6538 in both in vitro conditions and in an ex vivo model of wounds using porcine skin. In addition, the dairy topical treatment of murine skin lesions with HMa 1% induced a significant reduction of the wound area, inflammation score, and bacterial load, as well as tissue re-epithelialization and modulation of inflammatory mediators. Therefore, hydrogel incorporated with MaEO 1% has excellent potential to be used in the pharmacotherapy of infected wounds.

The Oxygen-Ozone Adjunct Medical Treatment According to the Protocols from the Italian Scientific Society of Oxygen-Ozone Therapy: How Ozone Applications in the Blood Can Influence Clinical Therapy Success via the Modulation of Cell Biology and Immunity

BACKGROUND

Ozone is an allotrope of oxygen whose use in medicine has rapidly grown in recent years. Ozonated blood allows for the use of ozone in a safe modality, as plasma and blood cells are endowed with an antioxidant system able to quench ozone's pro-oxidant property and to elicit the Nrf2/Kwap1/ARE pathway.

METHODS

We present two clinical studies, a case-series (six patients) observational study adopting ozone as a major autohemotherapy and topical ozone to address infected post-surgical wounds with multi-drug resistant bacteria and an observational study (250 patients) using ozonated blood for treating knee osteoarthritis.

RESULTS

Ozonated blood via major autohemotherapy reduced the extent of infections in wounds, reduced the inflammatory biomarkers by more than 75% and improved patients' QoL, whereas ozonated blood via minor autohemotherapy improved significantly (p < 0.001) WOMAC and Lequesne's parameters in knee osteoarthritis.

CONCLUSIONS

The models described, i.e., ozone autohemotherapy in wound antimicrobial treatment and ozonated blood in knee osteoarthrosis, following our protocols, share the outstanding ability of ozone to modulate the innate immune response and address bacterial clearance as well as inflammation and pain.

The Preparation of Silver and Gold Nanoparticles in Hyaluronic Acid and the Influence of Low-Pressure Plasma Treatment on Their Physicochemical and Microbiological Properties

Nanometals constitute a rapidly growing area of research within nanotechnology. Nanosilver and nanogold exhibit significant antimicrobial, antifungal, antiviral, anti-inflammatory, anti-angiogenic, and anticancer properties. The size and shape of nanoparticles are critical for determining their antimicrobial activity. In this study, silver and gold nanoparticles were synthesized within a hyaluronic acid matrix utilizing distilled water and distilled water treated with low-pressure, low-temperature glow plasma in an environment of air and argon. Electron microscopy, UV-Vis and FTIR spectra, water, and mechanical measurements were conducted to investigate the properties of nanometallic composites. This study also examined their microbiological properties. This study demonstrated that the properties of the composites differed depending on the preparation conditions, encompassing physicochemical and microbiological properties. The application of plasma-treated water under both air and argon had a significant effect on the size and distribution of nanometals. Silver nanoparticles were obtained between the range of 5 to 25 nm, while gold nanoparticles varied between 10 to 35 nm. The results indicate that the conditions under which silver and gold nanoparticles are produced have a significant effect on their mechanical and antibacterial properties.

The Role of Ozone as an Nrf2-Keap1-ARE Activator in the Anti-Microbial Activity and Immunity Modulation of Infected Wounds

Ozone is an allotrope of oxygen, widely known to exert an anti-oxidant potential. The ability of low, controlled and standardized doses of ozone in the ozone adjunct treatment of bacterial infections, which occur in wounds, is engaging clinical research to deepen the role of ozone in eradicating even multidrug-resistant bacteria. Ozone activates the nuclear factor erythroid 2-related factor 2 (Nrf2), and this activation triggers a complex cascade of events, which ultimately leads to macrophage training and an improvement in their ability to operate a clearance of bacteria in the patient's anatomical districts. In this review, we try to elucidate the recent evidence about the mechanisms with which ozone can actually remove bacteria and even multi-drug-resistant (MDR) bacteria, accounting on its complex ability in modulating immunity.

Ozonated Oil in Liposome Eyedrops Reduces the Formation of Biofilm, Selection of Antibiotic-Resistant Bacteria, and Adhesion of Bacteria to Human Corneal Cells

The recent attention to the risk of potential permanent eye damage triggered by ocular infections has been leading to a deeper investigation of the current antimicrobials. An antimicrobial agent used in ophthalmology should possess the following characteristics: a broad antimicrobial spectrum, prompt action even in the presence of organic matter, and nontoxicity. The objective of this study is to compare the antimicrobial efficacy of widely used ophthalmic antiseptics containing povidone-iodine, chlorhexidine, and liposomes containing ozonated sunflower oil. We determined the minimum inhibitory concentration (MIC) on various microbial strains: Staphylococcus aureus (ATCC 6538), methicillin-resistant Staphylococcus aureus (ATCC 33591), Staphylococcus epidermidis (ATCC 12228), Pseudomonas aeruginosa (ATCC 9027), and Escherichia coli (ATCC 873). Furthermore, we assessed its efficacy in controlling antibiotic resistance, biofilm formation, and bacterial adhesion. All three antiseptic ophthalmic preparations showed significant anti-microbicidal and anti-biofilm activity, with the liposomes containing ozonated sunflower oil with the highest ability to control antibiotic resistance and bacteria adhesion to human corneal cells.

Schinus terebinthifolius Leaf Lectin (SteLL) Reduces the Bacterial and Inflammatory Burden of Wounds Infected by Staphylococcus aureus Promoting Skin Repair

Staphylococcus aureus is commonly found in wound infections where this pathogen impairs skin repair. The lectin isolated from leaves of Schinus terebinthifolius (named SteLL) has antimicrobial and antivirulence action against S. aureus. This study evaluated the effects of topical administration of SteLL on mice wounds infected by S. aureus. Seventy-two C57/BL6 mice (6−8 weeks old) were allocated into four groups: (i) uninfected wounds; (ii) infected wounds, (iii) infected wounds treated with 32 µg/mL SteLL solution; (iv) infected wounds treated with 64 µg/mL SteLL solution. The excisional wounds (64 mm2) were induced on the dorsum and infected by S. aureus 432170 (4.0 × 106 CFU/wound). The daily treatment started 1-day post-infection (dpi). The topical application of both SteLL concentrations significantly accelerated the healing of S. aureus-infected wounds until the 7th dpi, when compared to untreated infected lesions (reductions of 1.95−4.55-fold and 1.79−2.90-fold for SteLL at 32 µg/mL and 64 µg/mL, respectively). The SteLL-based treatment also amended the severity of wound infection and reduced the bacterial load (12-fold to 72-fold for 32 µg/mL, and 14-fold to 282-fold for 64 µg/mL). SteLL-treated wounds show higher collagen deposition and restoration of skin structure than other groups. The bacterial load and the levels of inflammatory markers (IL-6, MCP-1, TNF-α, and VEGF) were also reduced by both SteLL concentrations. These results corroborate the reported anti-infective properties of SteLL, making this lectin a lead candidate for developing alternative agents for the treatment of S. aureus-infected skin lesions.

Preparation of Nano/Microcapsules of Ozonated Olive Oil in Hyaluronan Matrix and Analysis of Physicochemical and Microbiological (Biological) Properties of the Obtained Biocomposite

Hydrogels, based on natural polymers, such as hyaluronic acid, are gaining an increasing popularity because of their biological activity. The antibacterial effect of ozone is widely known and used, but the instability the gas causes, severely limits its application. Ozone entrapment in olive oil by its reaction with an unsaturated bond, allows for the formation of stable, therapeutically active ozone derivatives. In this study, we obtained an innovative hydrogel, based on hyaluronic acid containing micro/nanocapsules of ozonated olive oil. By combination of the biocompatible polymer with a high regenerative capacity and biologically active ingredients, we obtained a hydrogel with regenerative properties and a very weak inhibitory effect against both bacterial commensal skin microbiota and pathogenic Candida-like yeasts. We assessed the stability and rheological properties of the gel, determined the morphology of the composite, using scanning electron microscopy (SEM) and particle size by the dynamic light scattering (DLS) method. We also performed Attenuated total reflectance Fourier transform infrared (FTIR-ATR) spectroscopy. The functional properties, including the antimicrobial potential were assessed by the microbiological analysis and in vitro testing on the HaCat human keratinocyte cell line. The studies proved that the obtained emulsions were rheologically stable, exhibited an antimicrobial effect and did not show cytotoxicity in the HaCat keratinocyte model.

The Use of Ozone as an Eco-Friendly Strategy against Microbial Biofilm in Dairy Manufacturing Plants: A Review

Managing spoilage and pathogenic bacteria contaminations represents a major challenge for the food industry, especially for the dairy sector. Biofilms formed by these microorganisms in food processing environment continue to pose concerns to food manufacturers as they may impact both the safety and quality of processed foods. Bacteria inside biofilm can survive in harsh environmental conditions and represent a source of repeated food contamination in dairy manufacturing plants. Among the novel approaches proposed to control biofilm in food processing plants, the ozone treatment, in aqueous or gaseous form, may represent one of the most promising techniques due to its antimicrobial action and low environmental impact. The antimicrobial effectiveness of ozone has been well documented on a wide variety of microorganisms in planktonic forms, whereas little data on the efficacy of ozone treatment against microbial biofilms are available. In addition, ozone is recognized as an eco-friendly technology since it does not leave harmful residuals in food products or on contact surfaces. Thus, this review intends to present an overview of the current state of knowledge on the possible use of ozone as an antimicrobial agent against the most common spoilage and pathogenic microorganisms, usually organized in biofilm, in dairy manufacturing plants.

Effectiveness of liposomal ozonized oil in reducing ocular microbial flora in patients undergoing cataract surgery

PURPOSE

To evaluate the antimicrobial effectiveness of a liposomal ozonized oil solution used as a home therapy in patients undergoing cataract surgery. Antimicrobial efficacy was evaluated as the reduction in the bacterial load of the most common bacteria isolated from cases with endophthalmitis.

SETTING

20 Italian experimental centers of the Effectiveness of Liposomal Ozonized oil on Ocular Microbial flora before cataract surgery study group.

DESIGN

Interventional, nonrandomized, paired-eye designed, phase 4 clinical study.

METHODS

A total of 174 patients undergoing cataract surgery were divided into 2 groups: the study group (174 eyes) underwent surgery and received an isotonic ophthalmic solution of 0.5% ozonized oil in liposomes plus hypromellose treatment (2 drops 4 times/d), and the control group (174 contralateral eyes) was treated with saline solution. The treatment lasted for 3 days. Subconjunctival swabs were taken from both eyes of each patient at T0 (the day before starting the treatment and 4 days preoperatively) and at T4 (after 3 days of treatment and 10 min preoperatively) and sent to the laboratory within 24 hours of collection for microbiological analysis.

RESULTS

30% of 696 swabs taken at T0 were sterile. Contaminated swabs had a high prevalence of coagulase-negative staphylococci, including Staphylococcus epidermidis, and more than 60 different bacterial species were isolated. A significant reduction in microbial load was observed after treatment (>90% of the samples). The microbial load in the control group remained unchanged.

CONCLUSIONS

Liposomal ozonized oil reduced the microbial burden after topical administration in a large study population.

Biofilm Formation Ability of Arcobacter-like and Campylobacter Strains under Different Conditions and on Food Processing Materials

Campylobacter jejuni is the most frequent cause of bacterial gastrointestinal food-borne infection worldwide. The transmission of Campylobacter and Arcobacter-like species is often made possible by their ability to adhere to various abiotic surfaces. This study is focused on monitoring the biofilm ability of 69 strains of Campylobacter spp. and lesser described species of the Arcobacteraceae family isolated from food, water, and clinical samples within the Czech Republic. Biofilm formation was monitored and evaluated under an aerobic/microaerophilic atmosphere after cultivation for 24 or 72 h depending on the surface material. An overall higher adhesion ability was observed in arcobacters. A chi-squared test showed no association between the origin of the strains and biofilm activity (p > 0.05). Arcobacter-like species are able to form biofilms under microaerophilic and aerobic conditions; however, they prefer microaerophilic environments. Biofilm formation has already been demonstrated at refrigerator temperatures (5 °C). Arcobacters also showed higher biofilm formation ability at the temperature of 30 °C. This is in contrast to Campylobacter jejuni NP 2896, which showed higher biofilm formation ability at temperatures of 5–30 °C. Overall, the results demonstrated the biofilm formation ability of many strains, which poses a considerable risk to the food industry, medical practice, and human health.

Biofilms in Diabetic Foot Ulcers: Impact, Risk Factors and Control Strategies

Diabetic foot ulcers (DFUs) are a serious complication from diabetes mellitus, with a huge economic, social and psychological impact on the patients' life. One of the main reasons why DFUs are so difficult to heal is related to the presence of biofilms. Biofilms promote wound inflammation and a remarkable lack of response to host defences/treatment options, which can lead to disease progression and chronicity. In fact, appropriate treatment for the elimination of these microbial communities can prevent the disease evolution and, in some cases, even avoid more serious outcomes, such as amputation or death. However, the detection of biofilm-associated DFUs is difficult due to the lack of methods for diagnostics in clinical settings. In this review, the current knowledge on the involvement of biofilms in DFUs is discussed, as well as how the surrounding environment influences biofilm formation and regulation, along with its clinical implications. A special focus is also given to biofilm-associated DFU diagnosis and therapeutic strategies. An overview on promising alternative therapeutics is provided and an algorithm considering biofilm detection and treatment is proposed.

Antistaphylococcal Activity of the FtsZ Inhibitor C109

Staphylococcus aureus infections represent a great concern due to their versatility and involvement in different types of diseases. The shortage of available clinical options, especially to treat multiresistant strains, makes the discovery of new effective compounds essential. Here we describe the activity of the previously described cell division inhibitor C109 against methicillin-sensitive and -resistant S. aureus strains. Antibiofilm activity was assessed using microtiter plates, confocal microscopy, and in an in vitro biofilm wound model. The ability of C109 to block FtsZ GTPase activity and polymerization was tested in vitro. Altogether, the results show that the FtsZ inhibitor C109 has activity against a wide range of S. aureus strains and support its use as an antistaphylococcal compound.

Ozone Gel in Chronic Periodontal Disease: A Randomized Clinical Trial on the Anti-Inflammatory Effects of Ozone Application

Simple Summary

The search for new topical antimicrobial treatments represents an actual challenge both in orthopedics and in dentistry. As regards the latter, antiseptics represent an aid to the non-surgical treatment commonly employed to contrast periodontitis. This study aims to assess the efficacy of an ozone-based gel with respect to the more common chlorhexidine gels. Ten participants were treated by means of nonsurgical periodontal therapy, with, in addition, a chlorhexidine gel and an ozone one, both, respectively, used in half of the oral sites. Patients were visited at baseline, after one month, and after three months, and at each time point clinical indexes were assessed. This study revealed that the use of the ozonized gel in addition to the standard non-surgical therapy generally did not significantly differ if compared to the use of chlorhexidine. Based on this, ozone deserves consideration for its wide applicability in several clinical fields, especially considering the reduced number of shortcomings with respect to those generally related to chlorhexidine.

Abstract

The search for new topical treatments able to display not only antimicrobial properties but also a multiplicity of other beneficial effects while expressing safe cytocompatibility toward host tissues is being progressively developed. Antiseptics represent an aid to the gold standard nonsurgical treatment Scaling-and-Root-Planing (SRP) for periodontal disease. This split-mouth study aims to assess the efficacy of the ozonized gel GeliO₃ (Bioemmei Srl, Vicenza, Italy) plus SRP (experimental treatment), with respect to SRP + chlorhexidine gel. Ten participants were treated with SRP + chlorhexidine gel (control sites) and with SRP + ozone gel (trial sites). After 1 (T₁) and 3 months (T₂) from baseline (T₀), patients were revisited. At each time-point, the following indexes were assessed: probing pocket depth (PPD), clinical attachment level (CAL), gingival index (GI), plaque index (PI), and bleeding on probing (BoP). It has been assessed that the use of the ozonized gel in addition to SRP did not show significant differences if compared to conventional SRP + chlorhexidine. Chlorhexidine was found to be more effective than ozone in reducing CAL and GI at T₂. Ozone deserves consideration for its wide applicability in several clinical fields. In this connection, we also glance at the latest research on ozone therapy.

Topical Liposomal Ozonated Oil in Complicated Corneal Disease: A Report on Three Clinical Cases

Infectious and traumatic corneal diseases require adequate therapy against infection and promote re-epithelialization. The appearance of multidrug-resistant bacterial strains, induced by excessive use of antibiotics in the treatment of infectious diseases, has urged researchers to study new antimicrobial formulations. Ozonated oils have demonstrated antiseptic (antibacterial, antifungal and antiviral) and reparative properties and can be proposed for the prevention and treatment of acute and chronic local infections, as an alternative to conventional topical antimicrobials. In ocular treatment, ozonated oil can exert tissue repair and anti-inflammatory and bactericidal activity. Moreover, its specific formulation makes it well tolerated and biocompatible with the ocular surface. Herein, we report on three cases of corneal inflammation (dendritic epithelial keratitis, corneal injuries caused by olive leaves, and neurotrophic corneal ulcer), treated with liposomal ozonated oil (Ozodrop^®, FB VISION S.p.a. San Benedetto del Tronto, Italy), successfully resolved using topical liposomal ozonated oil.

Topical Application of Ozonated Oils for the Treatment of MRSA Skin Infection in an Animal Model of Infected Ulcer

Simple Summary

Methicillin-resistant Staphylococcus aureus is often found in skin lesions infected in particular in diabetic foot ulcers, in which the prevalence can reach 40%. Clinical methicillin-resistant Staphylococcus aureus is generally resistant to most classes of antibiotics and therefore it is necessary to develop new antimicrobial agents. Ozone has a recognized bactericidal activity and has been widely used as a clinical therapeutic agent for chronic wounds, such as ulcers and other injuries, due to its ability to heal wounds. This is a preliminary study that reports the effectiveness of ozonated oils on the eradication of skin infection in vivo. The study provides further insights into the antibacterial effect of ozone in infected skin ulcers in diabetic rats and also, the potential wound healing effect of ozonated oils. Furthermore, this is the first study investigating the efficacy of ozone in the eradication of diabetic foot ulcers infected by methicillin-resistant Staphylococcus aureus. Our results indicate that topical application of ozonated oils infected skin in rats have significant antimicrobial activity as well as wound healing capacity. Achieving the healing of infected diabetic foot wounds has become a challenge and ozonated oils may be used to treat these infections.

Abstract

Diabetic foot ulcers are a common cause of morbidity in diabetic patients. One of the main pathogens found in these ulcers is methicillin-resistant Staphylococcus aureus (MRSA). MRSA often carries resistance to several classes of antibiotics and their infections are becoming harder to treat. Therefore, new alternatives are urgently needed. Thus, this study aimed to investigate the capacity of topical ozonated oil application on the treatment of early-stage skin infected with MRSA in an animal model. Ozonated oil was prepared from a mixture of oils subjected to a gas stream of O₂/O₃ mixture. Sixteen Wistar rats were inoculated by an intradermic injection of MRSA suspension, producing an abscess lesion. After 3 days, the skin epidermis was removed to open the wound. Group 1 received an application of oil mixture without ozone treatment and Group 2 received an application of ozonated oil. After the treatment period, skin was collected, colony-forming units (CFU) of bacteria were quantified and the histological analysis of the skin was carried out. Skin samples from the control 1 and 2 had a bacterial load was of 1.1 × 10⁵ and 5.7 × 10³ CFU/mL, respectively. Group 2 showed better wound healing from mild to moderate epidermal regeneration. Topical application of ozonated vegetable oil in MRSA-infected skin in rats showed a small reduction of the bacterial load and better wound healing.