The results of monitoring the dynamics and antibiotic resistance of microflora when performing split-skin grafting in a general surgical hospital

Relevance. One of the effective ways to close chronic wounds according to many authors is split-skin grafting. To obtain good results of plastic operations, a constant monitoring of the structure of microbiological associations of chronic wounds and their sensitivity to antimicrobial agents is necessary. Aim. Analysis of the structure and properties of pathogens of wound infections when performing split-skin grafting and optimizing the choice of drugs for starting empirical antibacterial therapy. Materials and methods. A retrospective analysis of the results of microbiological studies was conducted in 86 patients who underwent split-skin grafting. For statistical processing of the data obtained, the computer program Statistica 6.0 was used. Results. Microbial contamination in patients on admission to hospital was (Me [Q1; Q3]) 106 [102; 108] CFU/ml. Unsatisfactory results of split-skin grafting were noted in 15 patients (17%). In this group of patients, strains of non-fermenting gram-negative bacteria - Pseudomonas aeruginosa (in 6 cases) and Acinetobacter baumannii (in 4 cases), which retained sensitivity to carbapenems in 65% of cases, were most often detected. Conclusions. Non-fermenting gram-negative microorganisms sharply reduce the likelihood of good results of plastic operations. If found in the recipient wound after split-skin grafting signs of an infectious process, it is advisable to use carbapenems.

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COLLAGEN DRESSING VERSUS CONVENTIONAL DRESSINGS IN BURN AND CHRONIC WOUNDS: A COMPARATIVE STUDY

10.36106/gjra/6201571 ◽

2021 ◽

pp. 43-45

Author(s):

Sujeet Kumar Bharti ◽

Kirti Priya

Keyword(s):

Granulation Tissue ◽

Chronic Wounds ◽

Skin Grafting ◽

Conventional Group ◽

Wound Surface ◽

Early Conclusion ◽

Patients Satisfaction ◽

Collagen Group ◽

Split Skin Grafting ◽

Split Skin

Objective: Biological dressings are water-resistant to bacteria, and generate the most physiological interfacebetween the wound surface and the environment. Collagen dressings have other superiority over conventional dressings in terms of ease of application and being natural, non-immunogenic, non-pyrogenic, hypoallergenic, and pain-free. Materials And Methods: The data of 120 patients with chronic wounds of diverse aetiologies and with signify age 43.7 years were accumulated and analyzed. The patients had been treated with collagen or other conventional dressing substance. The patients were split into two groups; 'Collagen group' and 'Conventional group', For the cause of comparison. 60 patients wereincluded in both groups. For assessment the wound characteristics in size, edge, oor, granulation tissue, and wound swab were recorded. With starting treatment, appearance of granulation tissue, completeness of healing, require for skin grafting, and patients' satisfaction was noted in both groups. Results: Sixty percentage of the 'collagen group' wounds and only forty-two percentage of the 'conventionalgroup' wounds were sterile (P=0.04) within two weeks of treatment. Healthy granulation tissue seemed earlier over collagen-dressed woundsthan over conventionally treated wounds (P=0.04). After eight weeks, (87%) of 'collagen group' wounds and (80%) of 'conventional group' wounds were >75% healed (P=0.21). In the 'collagen group' eight patients and twelvein the 'conventional group' required partial split-skin grafting (P=0.05). Collagen-treated patients enjoyed early. Conclusion: No remarkable better results were found in terms of complete of healing of burn andchronic wounds between collagen dressing and conventional dressing. Collagen dressing, however, mayavoid the require of skin grafting, and provides additional benet of patients' comfort.

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Faculty Opinions recommendation of Randomized clinical trial of donor-site wound dressings after split-skin grafting.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717995277.793475234 ◽

2013 ◽

Author(s):

Marian Northington

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Donor Site ◽

Skin Grafting ◽

Wound Dressings ◽

Split Skin Grafting ◽

Split Skin

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Synthesis, In Vitro and In Silico Studies of Indolequinone Derivatives against Clinically Relevant Bacterial Pathogens

Current Topics in Medicinal Chemistry ◽

10.2174/1568026620666191223110518 ◽

2020 ◽

Vol 20 (3) ◽

pp. 192-208 ◽

Cited By ~ 1

Author(s):

Talita Odriane Custodio Leite ◽

Juliana Silva Novais ◽

Beatriz Lima Cosenza de Carvalho ◽

Vitor Francisco Ferreira ◽

Leonardo Alves Miceli ◽

...

Keyword(s):

In Silico ◽

Bacterial Infections ◽

Antimicrobial Agents ◽

Mass Spectrometry Analysis ◽

World Health ◽

Gram Negative Bacteria ◽

Gram Negative ◽

Dione Derivative ◽

In Silico Studies

Background: According to the World Health Organization, antimicrobial resistance is one of the most important public health threats of the 21st century. Therefore, there is an urgent need for the development of antimicrobial agents with new mechanism of action, especially those capable of evading known resistance mechanisms. Objective: We described the synthesis, in vitro antimicrobial evaluation, and in silico analysis of a series of 1H-indole-4,7-dione derivatives. Methods: The new series of 1H-indole-4,7-diones was prepared with good yield by using a copper(II)- mediated reaction between bromoquinone and β-enamino ketones bearing alkyl or phenyl groups attached to the nitrogen atom. The antimicrobial potential of indole derivatives was assessed. Molecular docking studies were also performed using AutoDock 4.2 for Windows. Characterization of all compounds was confirmed by one- and two-dimensional NMR techniques 1H and 13C NMR spectra [1H, 13C – APT, 1H x 1H – COSY, HSQC and HMBC], IR and mass spectrometry analysis. Results: Several indolequinone compounds showed effective antimicrobial profile against Grampositive (MIC = 16 µg.mL-1) and Gram-negative bacteria (MIC = 8 µg.mL-1) similar to antimicrobials current on the market. The 3-acetyl-1-(2,5-dimethylphenyl)-1H-indole-4,7-dione derivative exhibited an important effect against different biofilm stages formed by a serious hospital life-threatening resistant strain of Methicillin-Resistant Staphylococcus aureus (MRSA). A hemocompatibility profile analysis based on in vitro hemolysis assays revealed the low toxicity effects of this new series. Indeed, in silico studies showed a good pharmacokinetics and toxicological profiles for all indolequinone derivatives, reinforcing their feasibility to display a promising oral bioavailability. An elucidation of the promising indolequinone derivatives binding mode was achieved, showing interactions with important sites to biological activity of S. aureus DNA gyrase. These results highlighted 3-acetyl-1-(2-hydroxyethyl)-1Hindole- 4,7-dione derivative as broad-spectrum antimicrobial prototype to be further explored for treating bacterial infections. Conclusion: The highly substituted indolequinones were obtained in moderate to good yields. The pharmacological study indicated that these compounds should be exploited in the search for a leading substance in a project aimed at obtaining new antimicrobials effective against Gram-negative bacteria.

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Clonal Clusters, Molecular Resistance Mechanisms and Virulence Factors of Gram-Negative Bacteria Isolated from Chronic Wounds in Ghana

Antibiotics ◽

10.3390/antibiotics10030339 ◽

2021 ◽

Vol 10 (3) ◽

pp. 339

Author(s):

Denise Dekker ◽

Frederik Pankok ◽

Thorsten Thye ◽

Stefan Taudien ◽

Kwabena Oppong ◽

...

Keyword(s):

Molecular Epidemiology ◽

Virulence Factors ◽

Iron Uptake ◽

Chronic Wounds ◽

Sub Saharan Africa ◽

Gram Negative Bacteria ◽

Beta Lactamase ◽

Secretion Systems ◽

Gram Negative ◽

E Coli

Wound infections are common medical problems in sub-Saharan Africa but data on the molecular epidemiology are rare. Within this study we assessed the clonal lineages, resistance genes and virulence factors of Gram-negative bacteria isolated from Ghanaian patients with chronic wounds. From a previous study, 49 Pseudomonas aeruginosa, 21 Klebsiellapneumoniae complex members and 12 Escherichia coli were subjected to whole genome sequencing. Sequence analysis indicated high clonal diversity with only nine P. aeruginosa clusters comprising two strains each and one E. coli cluster comprising three strains with high phylogenetic relationship suggesting nosocomial transmission. Acquired beta-lactamase genes were observed in some isolates next to a broad spectrum of additional genetic resistance determinants. Phenotypical expression of extended-spectrum beta-lactamase activity in the Enterobacterales was associated with blaCTX-M-15 genes, which are frequent in Ghana. Frequently recorded virulence genes comprised genes related to invasion and iron-uptake in E. coli, genes related to adherence, iron-uptake, secretion systems and antiphagocytosis in P. aeruginosa and genes related to adherence, biofilm formation, immune evasion, iron-uptake and secretion systems in K. pneumonia complex. In summary, the study provides a piece in the puzzle of the molecular epidemiology of Gram-negative bacteria in chronic wounds in rural Ghana.

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Super-Cationic Peptide Dendrimers—Synthesis and Evaluation as Antimicrobial Agents

Antibiotics ◽

10.3390/antibiotics10060695 ◽

2021 ◽

Vol 10 (6) ◽

pp. 695

Author(s):

Estelle J. Ramchuran ◽

Isabel Pérez-Guillén ◽

Linda A. Bester ◽

René Khan ◽

Fernando Albericio ◽

...

Keyword(s):

Antibacterial Agent ◽

Antimicrobial Agents ◽

Health Concern ◽

Gram Negative Bacteria ◽

Cationic Peptide ◽

Public Health Concern ◽

Gram Negative ◽

Peptide Dendrimers ◽

Microbial Infections ◽

Lead Candidate

Microbial infections are a major public health concern. Antimicrobial peptides (AMPs) have been demonstrated to be a plausible alternative to the current arsenal of drugs that has become inefficient due to multidrug resistance. Herein we describe a new AMP family, namely the super-cationic peptide dendrimers (SCPDs). Although all members of the series exert some antibacterial activity, we propose that special attention should be given to (KLK)2KLLKLL-NH2 (G1KLK-L2KL2), which shows selectivity for Gram-negative bacteria and virtually no cytotoxicity in HepG2 and HEK293. These results reinforce the validity of the SCPD family as a valuable class of AMP and support G1KLK-L2KL2 as a strong lead candidate for the future development of an antibacterial agent against Gram-negative bacteria.

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Newer Quinolones in the Treatment of Continuous Ambulatory Peritoneal Dialysis (CAPD) Related Infections

Peritoneal Dialysis International ◽

10.1177/089686089001000202 ◽

1990 ◽

Vol 10 (2) ◽

pp. 127-133 ◽

Cited By ~ 10

Author(s):

Paul Nikolaidis

Keyword(s):

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Adverse Reactions ◽

Antimicrobial Agents ◽

Hospital Staff ◽

Gram Negative Bacteria ◽

Promising Alternative ◽

Gram Negative ◽

Dosing Intervals ◽

Good Oral Bioavailability

Newer fluoroquinolones such as ciprofloxacin, pefloxacin, ofloxacin, enoxacin, and fleroxacin are potent antimicrobial agents against many gram-negative bacteria, including Pseudomonas aeruginosa species and staphylococci-sensitive or resistant to methicillin. They are almost completely absorbed when given orally, reaching therapeutic plasma and dialysate concentrations, and their long half lives permit infrequent dosing intervals. Clinical studies on fluoroquinolones efficacy in continuous ambulatory peritoneal dialysis (CAPD) infections, although not extensive, demonstrate good results. They are well tolerated and the adverse reactions, consisting mainly of gastrointestinal disturbance, were uncommon, mild, and reversible. The fluoroquinolones offer a promising alternative to standard parenteral treatments in CAPD patients, while their good oral bioavailability makes them attractive and convenient for both patients and hospital staff. However, they must be used with caution until we have more information and gain further experience.

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OMN6 a novel bioengineered peptide for the treatment of multidrug resistant Gram negative bacteria

Scientific Reports ◽

10.1038/s41598-021-86155-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Shira Mandel ◽

Janna Michaeli ◽

Noa Nur ◽

Isabelle Erbetti ◽

Jonathan Zazoun ◽

...

Keyword(s):

Mechanism Of Action ◽

Antimicrobial Agents ◽

Cyclic Peptide ◽

Safety Margin ◽

Multidrug Resistant ◽

Gram Negative Bacteria ◽

Antibiotic Resistant ◽

Gram Negative ◽

Development Of Resistance ◽

Cecropin A

AbstractNew antimicrobial agents are urgently needed, especially to eliminate multidrug resistant Gram-negative bacteria that stand for most antibiotic-resistant threats. In the following study, we present superior properties of an engineered antimicrobial peptide, OMN6, a 40-amino acid cyclic peptide based on Cecropin A, that presents high efficacy against Gram-negative bacteria with a bactericidal mechanism of action. The target of OMN6 is assumed to be the bacterial membrane in contrast to small molecule-based agents which bind to a specific enzyme or bacterial site. Moreover, OMN6 mechanism of action is effective on Acinetobacter baumannii laboratory strains and clinical isolates, regardless of the bacteria genotype or resistance-phenotype, thus, is by orders-of-magnitude, less likely for mutation-driven development of resistance, recrudescence, or tolerance. OMN6 displays an increase in stability and a significant decrease in proteolytic degradation with full safety margin on erythrocytes and HEK293T cells. Taken together, these results strongly suggest that OMN6 is an efficient, stable, and non-toxic novel antimicrobial agent with the potential to become a therapy for humans.

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MANAGEMENT OF POST BURN CONTRACTURE OF NECK IN A TERTIARY BURN CARE CENTRE

10.36106/ijsr/2601210 ◽

2021 ◽

pp. 33-35

Author(s):

Nangineedi Nagaprasad ◽

Karthik G B

Keyword(s):

Surgical Planning ◽

Skin Grafting ◽

Burn Care ◽

Split Skin Grafting ◽

Contracture Release ◽

Common Problems ◽

A Prospective Study ◽

Split Skin ◽

Burn Contractures

Background: Post burn contracture is one of the most common problems in our country and usually seen in lower socio-economic people. Burn contractures of the neck can produce a signicant impact on quality of life by reducing a patient's ability to perform activities of daily living Methods: A prospective study was conducted with a sample size of 30 patients with post burn neck contracture conducted for a duration of 24 months. After meticulous surgical planning, patients underwent contracture release and split skin grafting/z-plasty followed by rigorous splintage and physiotherapy. Majority of the patients were in the age group of 11-30 years (63%).70% of the Results: patients sustained burns in the range of 21-40% and 80% were due to ame burns.46.66% (14) of patients had severe contracture while 13.33% (4) had extensive mento-sternal adhesions. 90% of the patients underwent release + SSG while 10% underwent z-plasty. Postoperatively cervico-mental angle of 100-120 degrees was achieved Skin grafting is a simple, reliable and safe operation however postoperative splinting is n Conclusion: ecessary. The use of skin grafts continues to deliver excellent results with adequate restoration of cervico-mental angle.

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