scholarly journals Efficacy of an acid-oxidising solution (AOS) against Mycobacterium ulcerans

2021 ◽  
Author(s):  
Louisa Warryn ◽  
Gerd Pluschke
Keyword(s):  
Chronic Wounds ◽  
Buruli Ulcer ◽  
Mycobacterium Ulcerans ◽  
Wound Management ◽  
Management Problem ◽  
Tissue Formation ◽  
Granulation Tissue Formation ◽  
Secondary Infections ◽  
Resource Poor ◽  
And Control

For the treatment of chronic wounds, acid-oxidising solutions (AOSs) with broad-spectrum microbicidal activity without disturbing granulation tissue formation, have been developed. We found AOSs to efficiently kill Mycobacterium ulcerans , the causative agent of Buruli ulcer, which is able to survive harsh decontamination treatments. Topical AOS treatment of Buruli ulcer lesions may support the recommended antibiotic therapy (oral rifampicin and clarithromycin), prevent contamination of the environment by the mycobacteria, and control secondary infections, which are a prevalent wound management problem in resource-poor Buruli ulcer endemic settings.

scholarly journals Povidone Iodine Ointment vs Cadexomer Iodine Ointment in Management of the Chronic Wound: A Study Protocol

2021 ◽  
pp. 33-37
Author(s):  
Shubham Gupta ◽  
Raju Kamalrao Shinde ◽  
Sangita Shinde
Keyword(s):  
Health Care ◽  
Wound Healing ◽  
Granulation Tissue ◽  
Health Care Professionals ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Povidone Iodine ◽  
Wound Management ◽  
Tissue Formation ◽  
Granulation Tissue Formation

Introduction: Chronic wound and its care has always been a health burden for patient, health care professionals and the entire health care system. There have been certain topical preparations available in market today for application in chronic wound management. In our study, we are comparing effects of cadexomer and povidone iodine ointment in context of reduction in bacterial overload, slough reduction, facilitations of granulation tissue formation, reduction in size of the wound and ultimately in percentage of wound healing and its cost of management. Aim: Comparison of outcome of Povidone Iodine Ointment and Cadexomer iodine Ointment in management of the wound. Methodology: This cross section observational study has been conducted among 40 patients diagnosed as chronic wound with 20 patients in each group. Student’s paired t-test and Pearson’s Correlation Coefficient is being used as statistical analysis. Results: The percentage of patient treated with cadexomer iodine ointment shows significantly (p<0.05) higher rate of wound healing along with significant reduction in bacterial overload and promotion of granulation tissue formation. Conclusion: Cadexomer as a vector with iodine ointment shows higher rate of reduction of biofilm, slough and debris with better rate of promotion of granulation tissue formation, thus leading to increased and effective rate of healing of wound as well as cost effective management of chronic wounds.

scholarly journals A comparative study of the efficacy of topical negative pressure moist dressings and conventional moist dressings in chronic wounds

2007 ◽  
Vol 40 (02) ◽  
pp. 133-140
Author(s):  
Surajit Bhattacharya ◽  
J Ravikrishnan ◽  
B S Satish Rao ◽  
H. Divakar Shenoy ◽  
S R Shetty ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Surface Area ◽  
Negative Pressure ◽  
Chronic Wounds ◽  
Tissue Formation ◽  
Granulation Tissue Formation ◽  
Topical Negative Pressure ◽  
Graft Take ◽  
The Mean ◽  
Negative Pressure Dressings

ABSTRACT Aim: To assess the efficacy of topical negative pressure moist wound dressing as compared to conventional moist wound dressings in improving the healing process in chronic wounds and to prove that negative pressure dressings can be used as a much better treatment option in the management of chronic wounds. Materials and Methods: This is a prospective comparative study of data from 112 patients with chronic wounds, of which 56 patients underwent topical negative pressure dressings (17 diabetic, 10 pressure sores, nine ischemic, two varicose, 10 post-infective raw areas and eight traumatic - six had bone exposed, two orthopaedic prosthesis exposed). The remaining 56 patients underwent conventional moist dressings (20 diabetic, two ischemic, 15 pressure sores, three varicose, eight post-infective raw areas and eight traumatic - five had bone exposed, three orthopaedic prosthesis exposed). The results were compared after 10 days. The variables compared were, rate of granulation tissue formation as a percentage of ulcer area covered, skin graft take up as the percentage of ulcer surface area and duration of hospital stay. The variables were compared using Unpaired Student′s t test. A " P" value < 0.05 was considered significant. Results: Out of 56 patients who underwent topical negative pressure dressings, six (10.71%) were failures, due to failure in maintaining topical negative pressure due to defective sealing technique; these were included into the study group. After 10 days, the mean rate of granulation tissue formation was 71.43% of ulcer surface area. All these 56 cases underwent split-thickness skin grafting. The mean graft take-up was 79.29%. The mean hospital stay was 32.64 days. In the remaining 56 patients, the mean rate of granulation tissue formation was 52.85% of ulcer surface area. The mean graft take-up was only 60.45% of the total ulcer surface area. The mean hospital stay was 60.45 days. Conclusion: To conclude, topical negative pressure dressings help in faster healing of chronic wounds and better graft take-up and reduce hospital stay of these patients.

scholarly journals Delays in Patient Presentation and Diagnosis for Buruli Ulcer (Mycobacterium ulcerans Infection) in Victoria, Australia, 2011–2017

2019 ◽  
Vol 4 (3) ◽  
pp. 100
Author(s):  
Shaun P. Coutts ◽  
Colleen L. Lau ◽  
Emma J. Field ◽  
Michael J. Loftus ◽  
Ee Laine Tay
Keyword(s):  
Multivariable Analysis ◽  
Buruli Ulcer ◽  
Mycobacterium Ulcerans ◽  
Control Measures ◽  
Diagnosis Delay ◽  
The Public ◽  
Endemic Areas ◽  
Significant Change ◽  
Transmission Pathways ◽  
And Control

Uncertainty regarding transmission pathways and control measures makes prompt presentation and diagnosis for Buruli ulcer critical. To examine presentation and diagnosis delays in Victoria, Australia, we conducted a retrospective study of 703 cases notified between 2011 and 2017, classified as residing in an endemic (Mornington Peninsula; Bellarine Peninsula; South-east Bayside and Frankston) or non-endemic area. Overall median presentation delay was 30 days (IQR 14–60 days), with no significant change over the study period (p = 0.11). There were significant differences in median presentation delay between areas of residence (p = 0.02), but no significant change over the study period within any area. Overall median diagnosis delay was 10 days (IQR 0–40 days), with no significant change over the study period (p = 0.13). There were significant differences in median diagnosis delay between areas (p < 0.001), but a significant decrease over time only on the Mornington Peninsula (p < 0.001). On multivariable analysis, being aged <15 or >65 years; having non-ulcerative disease; and residing in the Bellarine Peninsula or South-East Bayside (compared to non-endemic areas) were significantly associated with shorter presentation delay. Residing in the Bellarine or Mornington Peninsula and being notified later in the study period were significantly associated with shorter diagnosis delay. To reduce presentation and diagnosis delays, awareness of Buruli ulcer must be raised with the public and medical professionals, particularly those based outside established endemic areas.

scholarly journals Microbiology of secondary infections in Buruli ulcer lesions; implications for therapeutic interventions

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elizabeth Gyamfi ◽  
Charles A Narh ◽  
Charles Quaye ◽  
Adiza Abbass ◽  
Bartholomew Dzudzor ◽  
...  
Keyword(s):  
Secondary Infection ◽  
Buruli Ulcer ◽  
Fungal Species ◽  
Mycobacterium Ulcerans ◽  
Therapeutic Interventions ◽  
Antimicrobial Drugs ◽  
Delayed Wound Healing ◽  
Secondary Infections ◽  
Microbial Infections ◽  
Bacteria And Fungi

Abstract Background Buruli ulcer (BU) is a skin disease caused by Mycobacterium ulcerans and is the second most common mycobacterial disease after tuberculosis in Ghana and Côte d’Ivoire. M. ulcerans produces mycolactone, an immunosuppressant macrolide toxin, responsible for the characteristic painless nature of the infection. Secondary infection of ulcers before, during and after treatment has been associated with delayed wound healing and resistance to streptomycin and rifampicin. However, not much is known of the bacteria causing these infections as well as antimicrobial drugs for treating the secondary microorganism. This study sought to identify secondary microbial infections in BU lesions and to determine their levels of antibiotic resistance due to the prolonged antibiotic therapy required for Buruli ulcer. Results Swabs from fifty-one suspected BU cases were sampled in the Amansie Central District from St. Peters Hospital (Jacobu) and through an active case surveillance. Forty of the samples were M. ulcerans (BU) positive. Secondary bacteria were identified in all sampled lesions (N = 51). The predominant bacteria identified in both BU and Non-BU groups were Staphylococci spp and Bacilli spp. The most diverse secondary bacteria were detected among BU patients who were not yet on antibiotic treatment. Fungal species identified were Candida spp, Penicillium spp and Trichodema spp. Selected secondary bacteria isolates were all susceptible to clarithromycin and amikacin among both BU and Non-BU patients. Majority, however, had high resistance to streptomycin. Conclusions Microorganisms other than M. ulcerans colonize and proliferate on BU lesions. Secondary microorganisms of BU wounds were mainly Staphylococcus spp, Bacillus spp and Pseudomonas spp. These secondary microorganisms were less predominant in BU patients under treatment compared to those without treatment. The delay in healing that are experienced by some BU patients could be as a result of these bacteria and fungi colonizing and proliferating in BU lesions. Clarithromycin and amikacin are likely suitable drugs for clearance of secondary infection of Buruli ulcer.

Effect of Mechanical Debridement and Irrigation With Hypochlorous Acid Wound Management Solution on Methicillin-resistant Staphylococcus aureus Contamination and Healing Deep Dermal Wounds in a Porcine Model

2021 ◽  
Vol 67 (8) ◽  
pp. 24-31
Author(s):  
Stephen Davis ◽  
Joel Gil ◽  
Jie Li ◽  
Colin Simms ◽  
Jose Valdes ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Granulation Tissue ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Hypochlorous Acid ◽  
Wound Management ◽  
Tissue Formation ◽  
Saline Irrigation ◽  
Granulation Tissue Formation ◽  
Methicillin Resistant ◽  
Epithelial Thickness

BACKGROUND: Wound cleansing is an important component of wound management. PURPOSE: This study was conducted to examine the effect of a wound management solution (WMS) containing hypochlorous acid (HOCl) on methicillin-resistant Staphylococcus aureus (MRSA) and healing when used in conjunction with debridement. METHODS: Nineteen (19) deep reticular dermal wounds (22 mm × 22 mm × 3 mm deep) were created on the paravertebral and thoracic areas of 3 female pigs using a specialized electrokeratome. Wounds were separated by at least 5 cm to 7 cm of unwounded skin and inoculated with MRSA. After 72 hours, all wounds were debrided with a curette and irrigated with either the WMS or sterile saline solution twice per day from day 0 to day 4. Wounds then were irrigated once a day until the completion of the study (day 11). Wound tissue specimens were taken using punch biopsy for microbiological and histological analysis on days 4, 8, and 11 post treatment. Percent of wound epithelialized, epithelial thickness (cell layers µm), white cell infiltrate (1 = absent, 2 = mild, 3 = moderate, 4 = marked, 5 = exuberant), and percent of granulation tissue formation were calculated and assessed. Microbiology and histology results were analyzed for significant differences between treatments and among assessment days using one-way analysis of variance and student t-tests. A P value ≤ .05 was considered significant. RESULTS: The WMS effected a bacterial reduction (P ≤ .05) of more than 2.74 ± 0.43 and 1.03 ± 0.22 Log CFU/g in all assessment days compared with baseline before and after debridement, respectively. Percent epithelialization was significantly different between treatments on day 8, only 78.3% and 67.8% for HOCl and saline, respectively (P ≤ .05). No significant differences between treatments were observed for epithelial thickness or granulation tissue formation. CONCLUSION: The combination of debridement and HOCl wound irrigation can significantly reduce MRSA contamination and facilitate the healing process compared to saline irrigation. Clinical studies are needed to confirm these results.

A comparative study of phenytoin dressing versus honey dressing in the treatment of cronic ulcers in tertiary care hospital

2021 ◽  
Vol 19 (1) ◽  
pp. 05-09
Author(s):  
Sandesh M ◽  
Keyword(s):  
Wound Healing ◽  
Granulation Tissue ◽  
Chronic Wounds ◽  
Tertiary Care ◽  
Skin Grafting ◽  
Care Hospital ◽  
Tissue Formation ◽  
Granulation Tissue Formation ◽  
Diabetic Ulcers

Background: Diabetic foot infections are the leading cause of hospitalization morbidity and mortality in diabetics worldwide In India it accounts for 20% of hospitalizations. honey has been investigated to treat ulcers like pressure ulcers, venous ulcers, diabetic ulcers, traumatic wounds and burns. Phenytoin is also now known to promote wound healing and can be an alternative to normal saline specifically in chronic wounds related to diabetes. The present study compares these two modalities in management of diabetic ulcers. Objective: To compare the efficacy of topical phenytoin vs topical honey in chronic diabetic ulcers in terms of rate of wound healing, granulation tissue formation and quality of graft bed for skin grafting. Methods: A comparative prospective study of 50 patients with chronic diabetic ulcers selected based on a predefined criteria divided into two groups: Group A (Phenytoin group) (n=25) and Group B (honey group) (n=25). Final wound area was measured on 30th day. Comparison between the wound size reduction among two groups done at end of 30th day. Outcome was measured in terms of wound reduction, granulation tissue formation and quality of bed for skin grafting between the two groups. Results: This study has shown faster rate of wound healing, better granulation tissue formation and quality graft bed for skin grafting in patients who received topical phenytoin dressing as compared to topical honey dressing.

scholarly journals Susceptibility Profiles ofMycobacterium ulceransIsolates to Streptomycin and Rifampicin in Two Districts of the Eastern Region of Ghana

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Enid Owusu ◽  
Mercy Jemima Newman ◽  
Nana Konama Kotey ◽  
Amos Akumwena ◽  
Elizabeth Bannerman
Keyword(s):  
Drug Resistance ◽  
Antibiotic Susceptibility ◽  
Disease Surveillance ◽  
Buruli Ulcer ◽  
Mycobacterium Ulcerans ◽  
Eastern Region ◽  
Proportion Method ◽  
Susceptibility Profiles ◽  
And Control ◽  
Definitive Management

Background. Drug resistance is a major challenge in antibiotic chemotherapy. Assessing resistance profiles of pathogens constitutes an essential surveillance tool in the epidemiology and control of infectious diseases, including Buruli ulcer (BU) disease. With the successful definitive management of BU using rifampicin and streptomycin, little attention had been paid to monitoring emergence of resistantMycobacterium ulcerans (M. ulcerans)isolates in endemic communities. This study investigated the susceptibility profiles ofM. ulceransisolates from two BU endemic areas in Ghana to streptomycin and rifampicin.Methods. The antibiotic susceptibility of seventy (70)M. ulceransisolates to rifampicin and streptomycin was determined simultaneously at critical concentrations of 40 µg/mL and 4 µg/mL, respectively, by the Canetti proportion method.Results. Resistance to rifampicin was observed for 12 (17.1%)M. ulceransisolates tested, whilst 2 (2.9%) showed resistance to streptomycin. None of the isolates tested showed dual resistance to both rifampicin and streptomycin.Conclusion. Outcomes from this study may not be reflective of all BU endemic communities; it, however, provides information on the resistance status of the isolates, which is useful for monitoring ofM. ulcerans, as well as BU disease surveillance and control.

Consensus recommendations for the diagnosis, treatment and control of Mycobacterium ulcerans infection (Bairnsdale or Buruli ulcer) in Victoria, Australia

2007 ◽  
Vol 186 (2) ◽  
pp. 64-68 ◽  
Author(s):  
Paul D R Johnson ◽  
John A Hayman ◽  
Tricia Y Quek ◽  
Janet A M Fyfe ◽  
Grant A Jenkin ◽  
...  
Keyword(s):  
Buruli Ulcer ◽  
Mycobacterium Ulcerans ◽  
Consensus Recommendations ◽  
And Control

scholarly journals Chronic wounds in Sierra Leone: Searching for Buruli ulcer, a NTD caused by Mycobacterium ulcerans, at Masanga Hospital

2021 ◽  
Vol 15 (10) ◽  
pp. e0009862
Author(s):  
Helen R. Please ◽  
Jonathan H. Vas Nunes ◽  
Rashida Patel ◽  
Gerd Pluschke ◽  
Mohamed Tholley ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Chronic Wounds ◽  
Financial Burden ◽  
Bacterial Load ◽  
Buruli Ulcer ◽  
Mycobacterium Ulcerans ◽  
Lower Limbs ◽  
World Health ◽  
High Morbidity ◽  
Surgical Interventions

Background Chronic wounds pose a significant healthcare burden in low- and middle-income countries. Buruli ulcer (BU), caused by Mycobacterium ulcerans infection, causes wounds with high morbidity and financial burden. Although highly endemic in West and Central Africa, the presence of BU in Sierra Leone is not well described. This study aimed to confirm or exclude BU in suspected cases of chronic wounds presenting to Masanga Hospital, Sierra Leone. Methodology Demographics, baseline clinical data, and quality of life scores were collected from patients with wounds suspected to be BU. Wound tissue samples were acquired and transported to the Swiss Tropical and Public Health Institute, Switzerland, for analysis to detect Mycobacterium ulcerans using qPCR, microscopic smear examination, and histopathology, as per World Health Organization (WHO) recommendations. Findings Twenty-one participants with wounds suspected to be BU were enrolled over 4-weeks (Feb-March 2019). Participants were predominantly young working males (62% male, 38% female, mean 35yrs, 90% employed in an occupation or as a student) with large, single, ulcerating wounds (mean diameter 9.4cm, 86% single wound) exclusively of the lower limbs (60% foot, 40% lower leg) present for a mean 15 months. The majority reported frequent exposure to water outdoors (76%). Self-reports of over-the-counter antibiotic use prior to presentation was high (81%), as was history of trauma (38%) and surgical interventions prior to enrolment (48%). Regarding laboratory investigation, all samples were negative for BU by microscopy, histopathology, and qPCR. Histopathology analysis revealed heavy bacterial load in many of the samples. The study had excellent participant recruitment, however follow-up proved difficult. Conclusions BU was not confirmed as a cause of chronic ulceration in our cohort of suspected cases, as judged by laboratory analysis according to WHO standards. This does not exclude the presence of BU in the region, and the definitive cause of these treatment-resistance chronic wounds is uncertain.

Interactions between ecological and socio-economic drivers of Buruli ulcer burden in Sub-Saharan Africa: opportunities for an improved control

2018 ◽  
Author(s):  
Andes Garchitorena ◽  
Matthew H. Bonds ◽  
Jean-Francois Guégan ◽  
Benjamin Roche
Keyword(s):  
Socioeconomic Factors ◽  
Disease Transmission ◽  
Access To Health Care ◽  
Buruli Ulcer ◽  
Mycobacterium Ulcerans ◽  
Sub Saharan Africa ◽  
Aquatic Environments ◽  
Human Populations ◽  
Complex Interactions ◽  
Sub Saharan

This chapter provides an overview of the complex interactions between ecological and socioeconomic factors for the development and control of Buruli ulcer in Sub-Saharan Africa. We review key ecological and evolutionary processes driving the environmental persistence and proliferation of Mycobacterium ulcerans, the causative agent, within aquatic environments, as well as transmission processes from these aquatic environments to human populations. We also outline key socioeconomic factors driving the economic and health burden of Buruli ulcer in endemic regions, revealed by reciprocal feedbacks between poverty, disease transmission from exposure aquatic environments and disease progression to severe stages owing to low access to health care. The implications of such insights for disease control, both in terms of limitations of current strategies and directions for the future, are discussed.

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