A&M AssortedTherapy.LLC

For acute or chronic pain management,chronic inflammation in the body

Blog

Blog

METHICILLIN-RESISTANT S. AUREUS (MRSA) SKIN ABSCESS AND VARIOUS OTHER SKIN CONDITIONS TREATED WITH NON-INVASIVE COLD LASER THERAPY.

Posted on September 1, 2014 at 5:05 PM

INTRODUCTION:

The extensive and inappropriate use of antibiotics in the early 1980s gradually led to the buildup of universal antimicrobial resistance. Penicillin was first widely used in the early 1940s and by 1944 half of all clinical Staphylococci spp isolates were resistant to this proclaimed “miracle drug [1]. In recent times infectious disease has become the second most important killer in the world, number three in developed nations and fourth in the USA [2]. Additionally it is one of the leading cause of death in Europe, mostly in elderly and debilitated populations, and despite existing antibiotic therapies and vaccines, infectious diseases remain the leading cause of mortality and morbidity [3]. Worldwide, 17 million people die each year from bacterial infections [4].In addition to that, five classes of antibiotic-resistant pathogens are emerging as major threats to public health: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus faecalis (VRE), multidrug-resistant mycobacteria, Gram-negative pathogens and fungi [5].

As the efficacy of antibiotics reduces and the end of the “antibiotic era” gets closer, major international research efforts to discover new ways to eradicate bacteria are evolving. Antibiotic therapy failure can result in variants of Staphylococcus aureus that are more resistant to antibiotics and can lead to persistent infections, necessitating the development of more effective antimicrobial strategies to combat small colony variant infections.

CAUSES AND RISK FACTORS FOR MRSA:

S. aureus small colony variants (SCVs) are clinically important owing to their reduced susceptibility to antibiotics. SCVs are commonly auxotroph’s for hemin, menadione or thymidine, resulting in electron transport chain defects and consequently reduced membrane potential and reduced uptake of cationic antibiotics [6]. Resistance to cell wall–active antibiotics such as β-lactams occurs due to the slow growth rate and reduced cell wall metabolism of SCVs [7]. Given their persistent nature and their selection by and resistance to conventional antibiotics, there is a need to identify effective therapies for SCV infections. One relatively new potential novel strategy is high powered non-invasive laser therapy.

STANDARD TREATMENT METHODS FOR MRSA RELATED SKIN CONDITIONS:

Primary topical anti-microbial and antiseptic agents are indicated in both prophylaxis and treatment of superficial skin infections. One advantage of topical application of anti-microbial agents is their low systemic absorption, consequently the reduced exposure of the commensal gastrointestinal flora to these antibiotics and low systemic toxicity [8]. The principles of anti-microbial treatment of infected skin wounds are discussed extensively by Filius et al. [9]. Today topical therapy with antibiotics has become unpopular because of the development of resistance [10].

Colsky and colleagues made a comparison of antibiotic resistance profiles using data collected from 1992 to 1996 from patients with skin wounds and revealed a marked increase in oxacillin and ciprofloxacin resistance in S. aureus and P. aeruginosa. In leg ulcers, an increase from 24% to 50% oxacillin resistance in S. aureus and from 9% to 24% ciprofloxacin resistance in P. aeruginosa. In superficial wounds, an increase from 24% to 36% ciprofloxacin resistance in P. aeruginosa [11, 12]. This study demonstrated the rapid increase of antibiotic resistant bacterial pathogens due to the systemic use of antibiotics in dermatology and highlights the importance of searching for alternatives.

USE OF NON-INVASIVE COLD LASER THERAPY:

In a first report, Hamblin et al. showed the use of a photochemical approach to destroy bacteria infecting a wound in an animal model without damaging the surrounding host tissue [13]. After topical application of achlorin (e6) photosensitizer conjugated with poly-Lysine, E. coli was rapidly killed upon exposure to selected visible light wavelengths.

MECHANISM OF ACTION OF LASER INACTIVATION OF MICROORGANISMS:

Upon irradiation with light from a high powered non-invasive laser using parameters of 1275 nm or 1064 nm wavelength and within the 750 mW to 2.8 watts per cm2range , the photosensitizer (PS) or chromosphere undergoes a transition from a low energy ground state to a higher energy triplet state. This triplet state photosensitizer can react directly with biomolecules to produce free radicals and/or radical ions (type I reaction), or with molecular oxygen to produce highly reactive singlet oxygen (type II reaction) as shown is figure. Various studies showed that there is a difference in susceptibility to anti-bacterial PDT between gram-positive and gram-negative bacteria [14, 15, 16]. Anionic and neutral photosensitizers were found to bind efficiently to gram-positive bacteria to induce growth inhibition or killing by visible light, whereas gram-negative bacteria were not killed. Growth inhibition of E. coli by porphyrin photosensitization was possible only in the presence of membrane disorganizing substances, e.g. the nona-peptide polymyxin or Tris–EDTA [16]. However, direct photo killing of gram-negative bacteria is also possible. In recent years, different chemical classes of positively charged PS, including phthalocyanines and porphyrins, were successfully tested as photo inactivating agents against gram-positive and gram-negative bacteria so far [17, 18, 19, 15, 20]. In general, photosensitizers with an overall cationic charge and meso-substituted cationic porphyrins and water-soluble cationic zinc phthalocyanines can efficiently kill gram negative bacteria by photosensitization even in the absence of additives. This resistance of gram-negative bacteria against efficient killing by anti-bacterial photodynamic therapy is due to the different outer membrane structures of gram-positive and gram-negative bacteria, which is discussed in detail elsewhere [21]. Inactivation of S. aureus, E. coli and P. aeruginosa is accompanied by alterations of the ultra-structure of the cells, e.g. disordered cell wall structure; elongated cells connected together without separation of the daughter cells and different low density areas in the cytoplasm [16, 22].

CONCLUSION:

The current research work provides sufficient evidence that cold laser therapy can be an effective tool in the management of non-healing MRSA abscess or related skin conditions. Such results prove that there is still hope for the cure and even prevention of MRSA infection complications. The research to develop a standard guideline for the use of such laser therapy should be continued and promoted so that a larger number of patients can benefit from laser therapy.

REFERENCES:

1. Livermore DM. Antibiotic resistance in staphylococci. Int J Antimicrob Agents 2000; 16:3-10; PMID:11137402; http://dx.doi.org/10.1016/S0924- 8579(00)00299-5.

2. Kraus CN. Low hanging fruit in infectious disease drug development. Curr Opin Microbiol 2008; 11:434-8; PMID:18822387;http://dx.doi.org/10.1016/j.mib.2008.09.009.

3. Vicente M, Hodgson J, Massidda O, Tonjum T,Henriques-Normark B, Ron EZ. The fallacies of hope: will we discover new antibiotics to combat pathogenic bacteria in time? FEMS Microbiol Rev 2006; 30:841-52; PMID:17064283; http://dx.doi. org/10.1111/j.1574-6976.2006.00038.x.

4. Butler MS, Buss AD. Natural products—the future scaffolds for novel antibiotics? Biochem Pharmacol 2006; 71:919-29; PMID:16289393; http://dx.doi. org/10.1016/j.bcp.2005.10.012.

5. Nicolau DP. Current challenges in the management of the infected patient. Curr Opin Infect Dis 2011; 24:1-10; PMID:21200179; http://dx.doi.org/10.1097/01. qco.0000393483.10270.ff.

6. Proctor RA, von Eiff C, Kahl BC, Becker K, McNamara P, Herrmann M, et al:Small colony variants: a pathogenic form of bacteria that facilitates persistent and recurrent infections. Nat Rev Microbiol 2006, 4:295–305.

7. Proctor RA, Kahl B, von Eiff C, Vaudaux PE, Lew DP, Peters G:Staphylococcal small colony variants have novel mechanisms for antibiotic resistance. Clin Infect Dis 1998, 27(suppl 1):S68–S74.

8. Kaye ET (2000) Topical antibacterial agents: role in prophylaxis and treatment of bacterial infections. Curr Clin Top Infect Dis 20:43–62.

9. Filius PM, Gyssens IC (2002) Impact of increasing antimicrobial resistance on wound management. Am J Clin Dermatol 3:1–7.

10. Wyatt TD, Ferguson WP, Wilson TS, McCormick E (1977) Gentamicin resistant Staphylococcus aureus associated with the use of topical gentamicin. J Antimicrob Chemother 3:213–217.

11. Colsky AS, Kirsner RS, Kerdel FA (1998) Analysis of antibiotic susceptibilities of skin wound flora in hospitalized dermatology patients. The crisis of antibiotic resistance has come to the surface. Arch Dermatol 134:1006–1009.

12. Colsky AS, Kirsner RS, Kerdel FA (1998) Microbiologic evaluation of cutaneous wounds in hospitalized dermatology patients. Ostomy Wound Manage 44:40–42, 44, 46.

13. Hamblin MR, O’Donnell DA, Murthy N, Contag CH, Hasan T(2002) Rapid control of wound infections by targeted photodynamic therapy monitored by in vivo bioluminescence imaging. Photochem Photobiol 75:51–57.

14. Merchat M, Bertolini G, Giacomini P, Villanueva A, Jori G(1996) Meso-substituted cationic porphyrins as efficient photosensitizers of gram-positive and gram-negative bacteria.J Photochem Photobiol B 32:153–157.

15. Minnock A, Vernon DI, Schofield J, Griffiths J, Parish JH,Brown ST (1996) Photoinactivation of bacteria. Use of a cationic water-soluble zinc phthalocyanine to photoinactivate both gram-negative and gram-positive bacteria. J PhotochemPhotobiol B 32:159–164.

16. Nitzan Y, Gutterman M, Malik Z, Ehrenberg B (1992) Inactivation of gram-negative bacteria by photosensitized porphyrins. Photochem Photobiol 55:89–96.

17. Maisch T, Bosl C, Szeimies RM, Lehn N, Abels C (2005).Photodynamic effects of novel XF porphyrin derivatives on prokaryotic and eukaryotic cells. Antimicrob Agents Chemother 49:1542–1552.

18. Merchat M, Spikes JD, Bertoloni G, Jori G (1996) Studies on the mechanism of bacteria photosensitization by meso-substitutedcationic porphyrins. J Photochem Photobiol B 35:149–157.

19. Minnock A, Vernon DI, Schofield J, Griffiths J, Parish JH,Brown SB (2000) Mechanism of uptake of a cationic watersoluble pyridinium zinc phthalocyanine across the outer membrane of Escherichia coli. Antimicrob Agents Chemother44:522–527.

20. Segalla A, Borsarelli CD, Braslavsky SE, Spikes JD, Roncucci G, Dei D, Chiti G, Jori G, Reddi E (2002) Photophysical,photochemical and antibacterial photosensitizing properties of a novel octacationic Zn(II)-phthalocyanine. Photochem Photobiol Sci 1:641–648.

21. Maisch T, Szeimies RM, Jori G, Abels C (2004) Antibacterial photodynamic therapy in dermatology. Photochem PhotobiolSci 3:907–917.

22. Malik Z, Faraggi A, Savion N (1992).Ultrastructural damage in photosensitized endothelial cells: dependence on hematoporphyrin delivery pathways. J Photochem Photobiol B 14:359–368.

 

Categories: None

Post a Comment

Oops!

Oops, you forgot something.

Oops!

The words you entered did not match the given text. Please try again.

49069 Comments

Reply jordan 12
12:55 AM on December 4, 2021 
My husband and i were absolutely thrilled that Ervin managed to deal with his studies via the precious recommendations he acquired through your web pages. It is now and again perplexing to simply be giving freely secrets which other people have been trying to sell. We really acknowledge we have got the writer to appreciate for this. The type of explanations you made, the easy web site navigation, the relationships your site give support to foster - it's everything incredible, and it is aiding our son and the family feel that that article is amusing, and that is pretty mandatory. Many thanks for the whole lot!
jordan 12 http://www.jordan12.us.com
Reply golden goose
12:53 AM on December 4, 2021 
I simply wished to thank you very much once again. I do not know what I might have achieved without the recommendations contributed by you on that situation. It absolutely was a real terrifying matter for me, but finding out the very expert technique you handled that made me to leap over joy. Now i'm happy for your guidance and even expect you really know what a great job you are always doing educating other individuals through a web site. Most likely you've never encountered all of us.
golden goose http://www.goldengoosesneakers.us.org
Reply supreme clothing
12:51 AM on December 4, 2021 
I am only commenting to make you understand what a awesome encounter my cousin's princess went through viewing your web site. She mastered such a lot of details, not to mention what it's like to have an excellent teaching spirit to get certain people easily master several specialized subject matter. You undoubtedly did more than readers' expectations. Thanks for supplying the insightful, trustworthy, edifying and also fun thoughts on the topic to Tanya.
supreme clothing http://www.supremes-clothing.com
Reply AshLob
11:50 PM on December 3, 2021 
trimox cheap
Reply golden goose outlet
10:29 PM on December 3, 2021 
I wish to point out my admiration for your generosity giving support to people that require help with your subject matter. Your personal commitment to passing the solution all through has been certainly useful and has specifically empowered many people just like me to attain their ambitions. The interesting help means a lot a person like me and especially to my colleagues. Thank you; from everyone of us.
golden goose outlet http://www.goldengoosesneakers.us.com
Reply cheap jordans
10:25 PM on December 3, 2021 
I precisely needed to thank you very much once more. I'm not certain the things that I might have handled without the tricks discussed by you over that question. Certainly was a real challenging scenario for me, nevertheless encountering a professional avenue you handled the issue forced me to jump over contentment. I am just happy for the assistance as well as believe you are aware of a powerful job you are always putting in teaching most people all through your webblog. Most likely you've never got to know any of us.
cheap jordans http://www.jordansforcheap.us.com
Reply golden goose shoes
10:24 PM on December 3, 2021 
I want to convey my gratitude for your kindness supporting people that have the need for guidance on your content. Your real commitment to passing the solution along became exceptionally useful and have continuously allowed regular people much like me to arrive at their endeavors. Your informative key points entails this much a person like me and especially to my colleagues. With thanks; from each one of us.
golden goose shoes http://www.goldengoosesneakers.us.org
Reply JudyLob
9:17 PM on December 3, 2021 
tadalafil 2
Reply yeezy 350
6:25 PM on December 3, 2021 
Thanks so much for giving everyone a very remarkable chance to read in detail from this site. It is always very pleasurable and also jam-packed with a great time for me personally and my office mates to search your site not less than 3 times in one week to learn the latest issues you have. And of course, I am just usually astounded considering the mind-boggling inspiring ideas you give. Selected 1 points in this article are undoubtedly the most efficient we have had.
yeezy 350 http://www.yeezy350s.com
Reply supreme clothing
6:21 PM on December 3, 2021 
I am only commenting to let you understand what a really good discovery our child gained studying yuor web blog. She even learned so many pieces, which included what it's like to have a great giving character to let many people without difficulty fully grasp several hard to do matters. You undoubtedly did more than people's expected results. Thanks for producing the good, dependable, edifying not to mention cool thoughts on your topic to Emily.
supreme clothing http://www.supremesonline.com
Reply pg 1
6:20 PM on December 3, 2021 
I precisely had to thank you so much once again. I am not sure the things I might have accomplished in the absence of the actual points contributed by you concerning such area of interest. It actually was a real frightful problem for me personally, nevertheless encountering a new skilled form you resolved the issue made me to weep for joy. I'm happier for this guidance and thus wish you realize what an amazing job your are putting in training others with the aid of your blog post. I am sure you have never come across any of us.
pg 1 http://www.paulgeorgeshoes.us.com
Reply golden goose outlet
5:27 PM on December 3, 2021 
I intended to draft you a very small remark to thank you so much yet again on your unique basics you've provided on this website. It has been certainly strangely open-handed with you to offer extensively all that most of us could possibly have sold as an e-book to generate some bucks on their own, primarily considering that you might have tried it in the event you decided. These secrets likewise worked like a fantastic way to comprehend someone else have a similar desire much like my own to realize lots more on the subject of this matter. I am sure there are several more pleasant sessions ahead for those who look over your blog post.
golden goose outlet http://www.goldengoose-outlet.us.com
Reply golden goose
5:23 PM on December 3, 2021 
I simply wished to appreciate you yet again. I am not sure the things that I would have gone through without the type of ways contributed by you regarding my subject. This was the scary condition for me personally, nevertheless taking a look at a professional mode you resolved the issue made me to leap for gladness. Now i am grateful for the work and even trust you comprehend what a powerful job that you are doing instructing people via your web site. I know that you've never met any of us.
golden goose http://www.goldengooseofficial.com
Reply hermes handbags
5:22 PM on December 3, 2021 
I am just writing to make you be aware of of the notable experience our princess undergone using your webblog. She picked up a lot of pieces, with the inclusion of what it's like to have a great teaching heart to let many others without difficulty understand specific tortuous subject matter. You truly surpassed readers' expected results. I appreciate you for presenting the helpful, trustworthy, edifying and also fun tips on the topic to Sandra.
hermes handbags http://www.hermes-handbags.us.com
Reply JasonLob
4:44 PM on December 3, 2021 
price of viagra 100mg acyclovir gel med price levitra cialis 20mg price australia how to get sildenafil prescription furosemide 4 mg viagra us bupropion 300 mg best cheap cialis finpecia 1 mg
Reply kobe shoes
3:20 PM on December 3, 2021 
My husband and i ended up being really satisfied when Albert could finish up his studies through the ideas he gained in your web page. It is now and again perplexing just to continually be offering tips and hints that some others might have been selling. And we already know we need the blog owner to give thanks to for this. All the explanations you have made, the straightforward blog menu, the friendships you can assist to create - it is most wonderful, and it's leading our son in addition to our family recognize that that issue is fun, which is rather important. Thank you for the whole thing!
kobe shoes http://www.kobe-shoes.us.com
Reply bape
3:16 PM on December 3, 2021 
My husband and i have been very comfortable when John managed to round up his basic research because of the ideas he acquired from your very own weblog. It's not at all simplistic just to always be giving freely guides which other people have been making money from. Therefore we know we have the website owner to thank for this. The type of explanations you have made, the straightforward web site menu, the friendships your site give support to create - it is mostly amazing, and it's really facilitating our son and us consider that this content is enjoyable, which is certainly exceedingly fundamental. Thank you for everything!
bape http://www.bapesonline.com
Reply supreme outlet
3:15 PM on December 3, 2021 
I would like to voice my affection for your generosity supporting those individuals that absolutely need help with this one topic. Your special commitment to passing the message throughout had become amazingly invaluable and has regularly empowered individuals just like me to realize their desired goals. Your own valuable key points denotes much a person like me and far more to my colleagues. Many thanks; from everyone of us.
supreme outlet http://www.supreme.us.org
Reply AshLob
1:42 PM on December 3, 2021 
modafinil 20mg
Reply TedLob
1:35 PM on December 3, 2021 
strattera 10 mg prices