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.

65891 Comments

Reply cheap jordans
10:09 AM on May 18, 2022 
My wife and i ended up being so joyous Michael managed to do his inquiry from the ideas he made out of the web page. It's not at all simplistic to simply be giving for free ideas which men and women might have been trying to sell. And we grasp we need you to be grateful to for that. Most of the explanations you have made, the simple site menu, the relationships you will give support to promote - it's all superb, and it's really letting our son in addition to us do think that situation is amusing, which is tremendously vital. Many thanks for the whole thing!
url=http://www.cheapjordan.us says...
cheap jordans
Reply golden goose sneakers
9:51 AM on May 18, 2022 
I wanted to create you one bit of word so as to thank you so much as before over the nice guidelines you've shared in this article. This has been generous of people like you to provide unhampered all a number of us might have offered for sale for an e-book in making some bucks for themselves, principally now that you might well have done it if you ever desired. These strategies additionally acted to provide a good way to be certain that many people have the identical keenness like mine to understand much more with regards to this issue. I'm certain there are a lot more fun times ahead for those who look into your site.
golden goose sneakers http://www.goldengoosesonline.com
Reply JaneLob
9:23 AM on May 18, 2022 
effexor 150 mg price
Reply retro jordans
9:20 AM on May 18, 2022 
I am also writing to make you understand of the beneficial encounter our daughter found browsing your blog. She picked up too many issues, including what it's like to have a marvelous coaching character to let others completely know chosen problematic subject areas. You actually did more than readers' expectations. Many thanks for supplying those practical, safe, informative and as well as easy guidance on your topic to Gloria.
retro jordans http://www.jordan-retro.us.com
Reply hermes online
9:17 AM on May 18, 2022 
I not to mention my friends have already been reviewing the good items on your web blog and so then I got an awful feeling I never expressed respect to the website owner for those secrets. My women were certainly glad to read them and have in effect sincerely been making the most of them. Thanks for truly being well thoughtful and then for making a choice on this form of remarkable topics most people are really needing to discover. My honest regret for not saying thanks to sooner.
hermes online http://www.hermesonlineshop.com
Reply hermes
8:43 AM on May 18, 2022 
I am glad for commenting to make you understand what a fantastic experience my friend's girl found checking the blog. She discovered plenty of pieces, including what it is like to have a marvelous giving mood to get the rest without problems know precisely certain impossible subject matter. You actually exceeded readers' desires. I appreciate you for displaying those great, trustworthy, edifying and in addition unique guidance on this topic to Emily.
hermes http://www.hermes-handbags.us.com
Reply jordan shoes
8:42 AM on May 18, 2022 
I intended to compose you this very little note in order to thank you so much once again for the fantastic tricks you have shared here. It has been really unbelievably open-handed with you to supply unhampered what a number of people might have sold as an ebook to make some money for themselves, certainly seeing that you might well have done it in case you considered necessary. The tips as well served as the fantastic way to realize that other individuals have the same desire similar to my very own to know the truth a good deal more in terms of this issue. Certainly there are a lot more pleasurable occasions ahead for many who look over your website.
jordan shoes http://www.jordan13.us.com
Reply supreme clothing
8:12 AM on May 18, 2022 
I intended to compose you a tiny remark to be able to say thanks a lot over again for the splendid guidelines you have shared above. It has been simply seriously generous with you to grant easily what exactly some people could have advertised for an ebook to generate some profit for themselves, even more so since you could have tried it if you ever wanted. The tips in addition worked to become a easy way to be aware that some people have the same desire the same as my personal own to find out a lot more with regard to this matter. Certainly there are a lot more fun times up front for folks who look over your blog post.
supreme clothing http://www.supremesoutlet.us.com
Reply nike kyrie 7
8:01 AM on May 18, 2022 
I simply wanted to appreciate you again. I'm not certain the things I might have implemented in the absence of the entire hints discussed by you regarding that subject matter. It had become a very daunting dilemma in my circumstances, however , looking at a professional tactic you dealt with it forced me to weep for happiness. I'm just happier for this assistance and in addition expect you recognize what a powerful job you are always doing instructing men and women by way of your web blog. Probably you haven't encountered all of us.
nike kyrie 7 http://www.kyrie-7.com
Reply supreme new york
8:01 AM on May 18, 2022 
I simply wished to thank you so much once again. I'm not certain the things I would've taken care of without the type of information shared by you over such a situation. Entirely was an absolute scary dilemma in my opinion, but viewing the very specialized style you processed it forced me to cry for joy. I am grateful for this service as well as expect you know what a great job you are always accomplishing educating the others all through your web page. Probably you haven't got to know all of us.
supreme new york http://www.supremenewyork.us.com
Reply off-white
7:56 AM on May 18, 2022 
I intended to send you a very little note just to say thanks again about the wonderful basics you've shown on this website. It's certainly incredibly open-handed of people like you to convey unhampered exactly what a number of us would've advertised as an electronic book to get some dough on their own, mostly considering that you could have tried it if you ever wanted. These things also served like the great way to realize that most people have similar zeal really like my personal own to know a great deal more with reference to this problem. I believe there are many more pleasurable opportunities in the future for folks who examine your blog.
off-white http://www.off--white.us.com
Reply viormouri
7:22 AM on May 18, 2022 
roses greatness
http://buyonepage.com/community/profile/fvslula67839582/ gleevec dosage
http://keralaregistrationguru.com/ML/community/profile/brandenbri
fman/ how to order neorecormon visa europe
http://www.tvpm.nammudetheeram.com/community/profile/kristy581877
294/ can i buy flexeril over the counter uk
http://health.gd/community/profile/kalawoolnough76/ low price desvenlafaxine
http://www.livecleo.xxx/community/profile/mitchelmcaulay2/ buy copegus over the counter
http://itmaa.org/community/profile/clintonn0695723/ buy generic dicloberl
http://www.theartmovement.co.uk/community/profile/tammiephillip97
/ buy mentax uk amex
http://www.tovoy.net/community/profile/lauriedominquez/ transamin online store
http://myremission.ru/community/profile/rickie849381795/ can i buy theophylline online
http://www23.ownskin.com/wap_theme_download.oss?c=11&h=monequateu
r.com
https://www.stelrad.ie/redirect/?url=https://tlumiki.org/
https://xc-elitesports.ru:443/bitrix/redirect.php?goto=https://tl
umiki.org/
https://prodvigaem.top/bitrix/redirect.php?goto=https://thecgc.ne
t/
https://suveniri-sochi.ru:443/bitrix/rk.php?goto=https://monequat
eur.com/
https://virtualtrials.org/outsidelink.cfm?u=http://monequateur.co
m
https://xn-----6kccac2aaabiqp1bvfe3bh7av4hh9fg.xn--p1ai/bitrix/re
direct.php?goto=https://monequateur.com/
http://www.direktiva.eu/url?q=http://web-pods.com
https://www.v-motion.ru/bitrix/redirect.php?goto=https://tlumiki.
org/
http://www.baraga.de/url?q=http://antidarvin.ru
http://saro-decor.ru/bitrix/redirect.php?event1=&event2=&event3=&
goto=http://vietvoters.org
https://xn--80ahxims.xn--p1ai/bitrix/redirect.php?goto=https://ma
ldimix.com/
http://www.gp777.net/cm.asp?href=https://antidarvin.ru/
http://qd315.net/study_linkkiller-link.html?url=http://tlumiki.or
g
https://www.stolze-edv.de/kontakt.php?message=Captcha&vorName=Lep
eboopy&nachName=Lepeboopy&firma=&senderPhone=88934354253&nachrich
t=do+need+prescription+order+viagra+%3Ca+href=%22+https://monequa
teur.com/
https://admin.understand.com/Legacy/ImageBanner.aspx?id=ecd6f65a-
9154-497f-b880-5911cab7518f&clickTag=http%3A%2F%2Fweb-pods.com&cu
stomerID=d8e9801b-2c07-4cc1-b2dc-7a5805dca1db&target=_parent
scrap traveler
Reply 100% real jordans for cheap
7:18 AM on May 18, 2022 
I intended to put you that very little note to be able to give thanks the moment again for your personal stunning tactics you've contributed in this article. This is certainly unbelievably generous with you giving extensively all a lot of folks would've offered for an electronic book to help with making some dough for themselves, and in particular considering the fact that you might well have done it if you considered necessary. These suggestions in addition acted as the easy way to realize that many people have the same desire just like my very own to learn a good deal more when considering this issue. I think there are a lot more pleasant periods in the future for individuals who see your website.
100% real jordans for cheap http://www.jordansforcheap.us.com
Reply off white hoodie
7:17 AM on May 18, 2022 
I'm writing to make you understand what a outstanding encounter my cousin's child encountered studying your site. She learned numerous issues, not to mention how it is like to have a wonderful helping nature to let many people clearly fully understand various extremely tough subject matter. You undoubtedly surpassed visitors' expected results. Thanks for supplying these interesting, trustworthy, edifying as well as easy tips about the topic to Emily.
off white hoodie http://www.offwhitehoodies.us
Reply yeezy
7:13 AM on May 18, 2022 
I as well as my guys were actually studying the great items found on your site then unexpectedly I had a terrible suspicion I had not thanked the blog owner for those techniques. My ladies became as a consequence thrilled to study all of them and have pretty much been enjoying these things. Thank you for turning out to be well kind and then for obtaining this sort of essential guides millions of individuals are really desperate to discover. My personal sincere regret for not expressing gratitude to you sooner.
yeezy http://www.yeezy-supply.us.org
Reply supreme clothing
7:12 AM on May 18, 2022 
Thanks for all of your efforts on this web page. My mum enjoys going through research and it's easy to understand why. We all know all regarding the lively form you give functional thoughts through the web blog and boost participation from some other people on this article then my simple princess has been becoming educated so much. Enjoy the rest of the new year. You are carrying out a brilliant job.
supreme clothing http://www.supremeclothingsstore.com
Reply yeezy boost 350
7:11 AM on May 18, 2022 
I intended to post you one very small note to give thanks yet again just for the amazing strategies you've featured in this case. It is certainly remarkably generous of people like you to make unhampered what exactly a number of us might have offered for sale for an e-book in order to make some bucks on their own, particularly considering the fact that you could have tried it if you wanted. The tips as well served to become a good way to realize that most people have the same dreams just like my own to know a whole lot more when considering this issue. I am sure there are some more pleasant situations in the future for people who look into your blog.
yeezy boost 350 http://www.yeezy350boost.us.com
Reply BooLob
7:02 AM on May 18, 2022 
anafranil coupon