The effect of ascorbic acid irrigation during debridementon the colony count of staphylococcus aureus and interleukin-6 blood count in grade ii open fracture of long bone

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Trimanto Wibowo ◽  
IGK Mulyadi Ridia ◽  
Putu Astawa
Keyword(s):  
Staphylococcus Aureus ◽  
Ascorbic Acid ◽  
Interleukin 6 ◽  
Blood Count ◽  
Open Fracture ◽  
Colony Count ◽  
Long Bone ◽  
Acid Irrigation ◽  
Grade Ii

scholarly journals Ascorbic acid irrigation during debridement decreased the colony count of Staphylococcus aureus and interleukin-6 blood count in grade ii open fracture of long bones

2020 ◽  
Vol 8 (9) ◽  
pp. 3194
Author(s):  
I. Ketut Suyasa ◽  
Putu Astawa ◽  
Mulyadi Ridia ◽  
Trimanto Wibowo
Keyword(s):  
Staphylococcus Aureus ◽  
Ascorbic Acid ◽  
Serum Level ◽  
Open Fracture ◽  
Colony Count ◽  
Control Group ◽  
Long Bones ◽  
Acid Irrigation ◽  
Before And After ◽  
Grade Ii

Background: Infection in open fractures is still a problem that cannot be fully managed. Various types of studies have been conducted to find an effective and efficient solution to wash open fracture wounds. This study compared the effectiveness of ascorbic acid irrigation in reduction of Staphylococcus aureus colony and interleukin-6 (IL-6) serum level as systemic inflammation marker in debridement procedure of grade II Gustilo-Anderson open fracture of long bones.Methods: This study was an experimental study with pre-post-test control group design. This study included 24 subjects aged 15-75 years old with Gustillo-Anderson type II open fractures which were divided into two groups. The treatment group had additional irrigation by using 10 mg/ml ascorbic acid solution during debridement, whereas the control group had debridement only without irrigation with ascorbic acid. The culture and colony count of Staphylococcus aureus and IL-6 serum level was obtained and measured before and after the treatment in both groups. Statistical analysis (Wilcoxon test) was performed to compare the difference of the two parameters (Δ colony count and Δ IL-6) before and after the treatment.Results: There were no significant difference in Δ colony count of Staphylococcus aureus (p=0.308) and ΔIL-6 serum level (p=0.239) between the control group and treatment group.Conclusions: Ascorbic acid irrigation was not proved to decrease the colony count of Staphylococcus aureus and IL-6 serum level in grade II open fracture of long bones.

scholarly journals The Effect of Irrigation to the Amount of Bacterial Colony Formation in Open Fracture

2021 ◽  
pp. 214-220
Author(s):  
Udi Heru Nefihancoro ◽  
Muhammad Fariza Audi Putra
Keyword(s):  
Lower Extremity ◽  
Normal Saline ◽  
Open Fracture ◽  
Physiological Saline ◽  
Fracture Site ◽  
Long Bone ◽  
Wound Irrigation ◽  
Bacterial Colony ◽  
Hospital Emergency Room ◽  
Grade Ii

Aims: To determine the effectiveness of 3, 6, and 9 liters of physiological saline for                   wound irrigation in grade II open fracture at lower extremity in reducing the number of bacterial colonies Study Design:  This observational study determined the quantity of physiological saline for wound irrigation in grade II open fracture at lower extremity which is effective in reducing the number of bacterial colonies. Place of Study: Moewardi Hospital Emergency Room and the Microbiology Laboratory of the Faculty of Medicine, Universitas Sebelas Maret. Methodology: 16 patients with grade II open fracture at lower extremity who came and received treatment was included. Patients with grade II long bone open fracture less than six hours, patients with multiple open fractures of the long bones taken only in one place, patients who had not received medical treatment since the incident were included. Patients suffering from previous bone and/or soft tissue infections at the fracture site and suffering from multiple trauma who should receive immediate life-saving measures were included. Results: There were 12 patients who met criteria inclusion. After 3 L irrigation, there was a decrease in the amount of bacterial colony, same as 6 L irrigation, while there was no increase in the number of bacterial colonies in 9 L irrigation. There were significant differences in 3L, 6L, 9L irrigations (p = 0.001), but the most effective irrigation fluid was in 9 liters compared with 6 liters (p <0.05). Conclusion: Wound irrigation with 3, 6, and 9 liters of normal saline will significantly reduce the number of bacteria. However, irrigation with 9 liters of normal saline dilution in grade II open fracture at the lower extremity is the most effective.

scholarly journals A prospective study on results of bacterial culture from wound in type III compound fractures

2018 ◽  
Vol 4 (6) ◽  
pp. 935
Author(s):  
Ashwin H. ◽  
George Thomas
Keyword(s):  
Staphylococcus Aureus ◽  
Prospective Study ◽  
Antimicrobial Susceptibility ◽  
Open Fracture ◽  
Bone Fractures ◽  
Open Fractures ◽  
Long Bone ◽  
Type Iii ◽  
Long Bone Fractures ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> Open fractures still represent a major challenge for the treating surgeon. Sound knowledge of the bacteriological epidemiology and antimicrobial susceptibility helps to prevent complications. Our aim is to study about the common bacteria causing open fracture infection and their antibiotic sensitivity in patients who are admitted in the department of Orthopedics, Government medical college, Kottayam.</p><p class="abstract"><strong>Methods:</strong> A prospective study on 130 patients with type III open long bone fractures were studied for infection during study period of June 2016 to July 2017. After initial debridement and at third day during follow up wound inspection, swabs were taken from wound site. Swabs were send for microscopic examination, culture and antimicrobial susceptibility testing.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 130 type III open long bone fractures, 7.7% were having day 0 infection and 25.4% were having day 3 infection. 19.2% of patients developed infection from day 3 onwards. <em>Staphylococcus aureus</em> (37.1%) was the most commonly isolated bacteria from wound. Other organisms isolated were <em>Acinetobacter, Pseudomonas, Klebsiella</em>, <em>E coli</em>, <em>Enterococcus</em>, <em>Streptococcus</em> and <em>Enterobacter</em>. 100% of diabetic patients developed infection on day 3. Gentamicin, amikacin doxycycline, ciprofloxacin, vancomycin, piperacillin + tazobactum and cefoperazone + sulbactum were found to be effective against isolated organisms.</p><p class="abstract"><strong>Conclusions:</strong> Gram positive <em>Staphylococcus aureus</em> was found to be the most common cause of wound infection in type III open fractures. An early adequate wound debridement, proper antibiotic therapy and aseptic post-operative wound care are essential for wound healing and fracture union in an open fracture.</p>

scholarly journals Effectiveness of Surface Cleaning and Disinfection in a Brazilian Healthcare Facility

2018 ◽  
Vol 12 (1) ◽  
pp. 36-44 ◽  
Author(s):  
Aires G. Santos-Junior ◽  
Adriano M. Ferreira ◽  
Oleci P. Frota ◽  
Marcelo A. Rigotti ◽  
Larissa da S. Barcelos ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Adenosine Triphosphate ◽  
Healthcare Facility ◽  
Surface Cleaning ◽  
Point Of View ◽  
Colony Count ◽  
Before And After ◽  
Bioluminescence Assay ◽  
Cleaning And Disinfection ◽  
Hospital Cleaning

Background: Failures in the processes of cleaning and disinfecting health service surfaces may result in the spread and transfer of pathogens that are often associated with healthcare-related infections and outbreaks. Aims: To assess the effectiveness of environmental surface cleaning and disinfection in a hospital clinic. Method: The study was conducted in a nursing ward with 45 beds. A total of 80 samples from five high-touch surfaces were evaluated before and after cleaning and disinfection, using the following methods: visual inspection, adenosine triphosphate bioluminescence assay, aerobic colony count, Staphylococcus aureus colony count, and evaluation of resistance to methicillin. The data analysis used nonparametric comparative and correlative tests to observe any differences in the pre- and post- cleaning and disinfection results for the surfaces assessed. Results: Effective cleaning and disinfection had a significant effect on only two surfaces when measured for the presence of adenosine triphosphate, the inner bathroom door handle (p=0.007) and the toilet bowl (p=0.01). When evaluated for Staphylococcus aureus colony count, the toilet flush handle also demonstrated a significant effect (p=0.04). Conclusion: The effectiveness of cleaning and disinfection of the surfaces tested was not satisfactory. An educational intervention is recommended for the cleaning and disinfection staff and the nursing team at the healthcare facility. Relevance to Clinical Practice: The data in the study revealed that daily hospital cleaning and disinfection in the sampled sites are not sufficient in medical and surgical wards. Hospital cleanliness must be reevaluated from the point of view of materials, such as an adequate supply of clean cloths, in addition to establishing more precise cleanliness protocols and accurate monitoring systems.

scholarly journals Is intracellular Staphylococcus aureus associated with recurrent infection in a rat model of open fracture?

2020 ◽  
Vol 9 (2) ◽  
pp. 71-76
Author(s):  
Tao Gao ◽  
Junqing Lin ◽  
Changqing Zhang ◽  
Hongyi Zhu ◽  
Xianyou Zheng
Keyword(s):  
Staphylococcus Aureus ◽  
Bone Marrow ◽  
Green Fluorescent Protein ◽  
Rat Model ◽  
Open Fracture ◽  
Fluorescent Protein ◽  
Kirschner Wire ◽  
Recurrent Infection ◽  
Host Immune System ◽  
Green Fluorescent

Aims The purpose of this study was to determine whether intracellular Staphylococcus aureus is associated with recurrent infection in a rat model of open fracture. Methods After stabilizing with Kirschner wire, we created a midshaft femur fracture in Sprague-Dawley rats and infected the wound with green fluorescent protein (GFP)-tagged S. aureus. After repeated debridement and negative swab culture was achieved, the isolation of GFP-containing cells from skin, bone marrow, and muscle was then performed. The composition and viability of intracellular S. aureus in isolated GFP-positive cells was assessed. We suppressed the host immune system and observed whether recurrent infection would occur. Finally, rats were assigned to one of six treatment groups (a combination of antibiotic treatment and implant removal/retention). The proportion of successful eradication was determined. Results Green fluorescent protein-containing cells were successfully isolated after the swab culture was negative from skin (n = 0, 0%), muscle (n = 10, 100%), and bone marrow (n = 10, 100%) of a total of ten rats. The phagocytes were predominant in GFP-positive cells from muscle (73%) and bone marrow (81%) with a significantly higher viability of intracellular S. aureus (all p-values < 0.001). The recurrent infection occurred in up to 75% of rats after the immunosuppression. The proportion of successful eradication was not associated with implant retention or removal, and the efficacy of linezolid in eradicating intracellular S. aureus is significantly higher than that of vancomycin. Conclusion Intracellular S. aureus is associated with recurrent infection in the rat model of open fracture. Usage of linezolid, a membrane-permeable antibiotic, is an effective strategy against intracellular S. aureus. Cite this article: Bone Joint Res. 2020;9(2):71–76.

Microbiological Quality of Non-Dairy Creamers, Fillings and Toppings

1986 ◽  
Vol 49 (8) ◽  
pp. 621-622 ◽  
Author(s):  
DONALD W. WARBURTON ◽  
KARL F. WEISS
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Microbiological Quality ◽  
Colony Count ◽  
Bacteriological Quality

A study conducted in 1984–1985, in the province of Ontario, Canada, assessed the bacteriological quality of three types of non-dairy substitutes including creamers, fillings and toppings. All sample units tested contained acceptable levels of aerobic colony count (ACC), yeast/mold and aerobic sporeformers. Escherichia coli, Staphylococcus aureus and Salmonella were not detected in any of the 79 lots tested, indicating that good hygienic practices were used during the manufacture of these products.

Identification of ica-dependent biofilm production by Staphylococcus aureus clinical isolates and antibiofilm effects of ascorbic acid against biofilm production

2020 ◽  
Vol 73 (5) ◽  
pp. 261-266
Author(s):  
Sahra Kırmusaoğlu ◽  
Havva Kaşıkçı
Keyword(s):  
Staphylococcus Aureus ◽  
Ascorbic Acid ◽  
Biofilm Formation ◽  
Surface Proteins ◽  
Clinical Isolates ◽  
High Morbidity ◽  
Dependent Manner ◽  
Independent Manner ◽  
Biofilm Production ◽  
Life Threatening

AimsStaphylococcus aureus (S. aureus) is a life-threatening pathogen with high morbidity and mortality rates which causes nosocomial and community-acquired infections. Biofilm, considered to be a common virulence factor for pathogens, plays a significant role in recurrent and untreatable infections. Biofilm formation of S. aureus is mediated by synthesis of either poly-N-acetylglucosamine in an ica-dependent manner or surface proteins in an ica-independent manner. In some cases treatment is impossible and recurrent. In this study, ica-dependent biofilm-producing S. aureus isolates were detected and the anti-biofilm effect of ascorbic acid against biofilm formation of isolates was investigated.MethodsA total of 21 methicillin-sensitive S. aureus (MSSA) clinical isolates stored in our bacterial stock were used to detect ica-dependent biofilm-producing MSSA isolates. The anti-biofilm study was undertaken with three ica-dependent biofilm-producing isolates (MSSA2–4) and ATCC 29213 (MSSA1). Biofilms and the anti-biofilm effect of ascorbic acid were detected using the microtitre plate (MtP) method. 16S-rRNA, nuc, icaA and icaD genes and expression levels of icaA and icaD of isolates were detected by RT-PCR.ResultsThe minimum inhibitory concentrations (MICs) of ascorbic acid prevented biofilm formation of MSSA1 and MSSA3. Also, 1/2 MIC of ascorbic acid prevented biofilm formation of MSSA3. It was observed that biofilm formation decreased with increased concentration. There was no significant increase in ica gene expression of MSSA1 and MSSA2. Expression of icaA and icaD of MSSA3 decreased 13% and 38%, respectively. Expression of icaA in MSSA4 decreased 12%.ConclusionThe results of our study show that ascorbic acid can be used as an anti-biofilm agent to prevent biofilm formation of S. aureus and thus biofilm-related infections.

The Addition Of Interleukin-6 Inhibition To Standard Gvhd Prophylaxis Prevents Acute Gvhd: Interim Results Of a Phase I/II Clinical Study

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 908-908 ◽  
Author(s):  
Glen A Kennedy ◽  
Antiopi Varelias ◽  
Slavica Vuckovic ◽  
Ping Zhang ◽  
Kelli PA MacDonald ◽  
...  
Keyword(s):  
Phase I ◽  
Interleukin 6 ◽  
Immune Reconstitution ◽  
Acute Gvhd ◽  
Off Label Use ◽  
Control Cohort ◽  
Off Label ◽  
Gvhd Prophylaxis ◽  
Matched Sibling ◽  
Grade Ii

Abstract We and others have demonstrated the dysregulation of interleukin-6 (IL-6) early after experimental bone marrow transplantation (BMT) and protection from acute GVHD following the administration of an anti-IL-6 receptor (IL-6R) antibody. In these models, where GVHD prophylaxis is not administered, systemic IL-6, IFNγ and TNF levels peak 7 days after BMT before returning to baseline by the third week. We have determined cytokine dysregulation in a large clinical cohort of allogeneic stem cell transplant (SCT) recipients conditioned with myeloablative Cy/TBI (12 Gy, n = 25) or reduced intensity Flu/Mel (120mg/m2, n = 25) receiving standard GVHD prophylaxis with cyclosporine and MTX (d 1 at 15mg/m2, d 3, 6, 11 at 10mg/m2). IL-6 levels rose from pre-transplant levels of 6.4 ± 0.7 pg/ml to a peak of 58.8 ± 8.8 pg/ml at day 7 (P < 0.0001) with a fall at day 14 to 39.0 ± 12.5 pg/ml (P < 0.0001) and return to baseline by day 30 (6.2 ± 0.9 pg/ml), consistent with the preclinical data. IL-6 dysregulation was not different in recipients of matched sibling or unrelated donor grafts but was proportional to the intensity of conditioning (day 7 levels after Cy/TBI vs. Flu/Mel: 83.3 ± 12.2 pg/ml vs. 31.0 ± 10.1 pg/ml, P< 0.0001). In contrast to preclinical mouse data, no systemic increases were seen in any other cytokine including IFNγ, TNF, IL-17, IL-4, IL-13 and IL-10. We thus initiated a phase I/II study whereby a human neutralizing monoclonal antibody (mAb) against the IL-6R was administered on day -1 to patients receiving Cy/TBI or Flu/Mel conditioned allogeneic SCT from HLA (10/10)–matched sibling or unrelated donors with standard cyclosporine/MTX GVHD prophylaxis. There was no T cell depletion. The primary endpoint was the incidence of grade II-IV acute GVHD and the study has achieved its planned enrollment (n = 48). There was no toxicity attributable to IL-6R antibody administration. Pharmacokinetic analysis confirmed high levels of IL-6R Ab at day 3 (mean 64.7 ug/ml) which persisted in all patients 3 weeks after BMT (mean = 9.8 ug/ml) and remained above the level of detection (0.1ug/ml) in 75% of patients at day 30 (mean = 1.9 ug/ml). IL-6 levels were dramatically increased (relative to baseline) in patients receiving antibody due to the inability to excrete the inactive IL-6 – soluble IL-6R antibody complex (peak IL-6 levels at day 7 = 773.6 ± 207.9 pg/ml; P < 0.0001) and remained increased at day 30 (60.9 ± 24.4 pg/ml; P < 0.0001), returning to baseline by day 60 (9.5 ± 1.7 pg/ml), consistent with antibody clearance. Soluble IL-6R levels also rose over the first month of SCT and levels at day 30 correlated with residual antibody levels (r2 = 0.72, P = 0.02). Neutrophil (> 0.5x109/L) and platelet (> 20x109/L) recovery was normal relative to a matched untreated control cohort at a median of 16 and 18 days respectively. Donor chimerism and immune reconstitution (conventional T, regulatory T and B cells) was equivalent at day 30 in recipients of IL-6R inhibition versus the control cohort. In contrast, changes in innate immunity were seen in patients receiving IL-6R inhibition with increases in plasmacytoid DC (P = 0.002), CD1c+ conventional DC (P = 0.04) NKT cells (P =0.03) and marked reductions in inflammatory (CD14+CD16+) monocytes (P < 0.0001). Transcriptional profiling of T cell subsets is underway. With 36 patients evaluable (beyond day 100, median follow up of 297 days), the incidence of grade II-IV GVHD is 11.1% in recipients of IL-6R inhibition versus 39.6% in the matched (n = 53) control cohort (P = 0.004). The incidence of grade III/IV acute GVHD is 5.6% in recipients of IL-6R inhibition versus 20.8% in the control cohort (P = 0.045). Protection from grade II-IV acute GVHD was noted in patients receiving both Cy/TBI (7.7% vs. 40.7%, P=0.045) and Flu/Mel conditioning (13.0% vs. 38.5%, P = 0.044). Rates of CMV reactivation were very low in the IL-6R neutralized patients (16.7% vs. 35.8% in controls, P = 0.04), likely due to the prevention of acute GVHD and its’ consequent therapy. At one year, the relapse incidence and disease free survival in patients receiving IL-6R inhibition versus the control cohort is 21.2% vs. 30.0% (P = 0.28) and 73.1% vs. 62.4% (P = 0.14) respectively. IL-6 is thus the principal inflammatory cytokine dysregulated after clinical allogeneic SCT and its inhibition appears to offer profound protection from acute GVHD despite robust immune reconstitution, without compromise of the GVL effect. Disclosures: Off Label Use: The use of Tocilizumab to prevent GVHD is experimental and an off label use.

Interleukin-1, interleukin-6, and interleukin-10 responses after antibiotic treatment in experimental chronic Staphylococcus aureus osteomyelitis

2006 ◽  
Vol 11 (4) ◽  
pp. 370-374 ◽  
Author(s):  
Felícito García-Alvarez ◽  
Marta Monzón ◽  
José María Grasa ◽  
Antonio Laclériga ◽  
Beatriz Amorena ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Treatment ◽  
Interleukin 6 ◽  
Interleukin 1 ◽  
Interleukin 10
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