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.

80524 Comments

Reply lamodedalba
6:03 PM on September 25, 2022 
maternity velvet dresses sacoche cuir tommy hilfiger nike da passeggio uomo giacca e pantaloni moto liverpool pink jersey otterbox popsocket iphone se 2020
lamodedalba https://www.lamodedalba.com/
Reply greaterkakinada
6:03 PM on September 25, 2022 
nike air max plus preschool converse sneaker braun zapatos para el campo hombre leinenkleid h m zaini scontatissimi zalando supreme hats 2021
greaterkakinada https://www.greaterkakinada.com/
Reply theicecreambucket
6:03 PM on September 25, 2022 
air 270 rojos completi di calcio white half sleeve dress sac ski de randonnée zalando asics gel 1090 pantaloni tuta nike air
theicecreambucket https://www.theicecreambucket.com/
Reply imwrks
6:03 PM on September 25, 2022 
gorro punto ingles modèle robe mariage 2021 vero moda kleid geblümt huawei y5 2019 handyhülle samsung galaxy a5 2015 hülle amazon nike tuned 3 blanche rouge
imwrks https://www.imwrks.com/
Reply starworldrocks
6:02 PM on September 25, 2022 
ipanema sandalias 2021 cocktailkleid mit mantel borse guess trapuntate pittsburgh pirates stovepipe hat nike air force damen mit kette tejana 10000x
starworldrocks https://www.starworldrocks.com/
Reply birkin bag
5:38 PM on September 25, 2022 
I happen to be writing to make you be aware of what a helpful discovery my cousin's girl found visiting your web site. She realized plenty of issues, including what it is like to possess a marvelous giving character to let many others with no trouble fully understand various multifaceted issues. You truly did more than our expected results. Thank you for supplying these powerful, healthy, edifying and as well as easy guidance on this topic to Kate.
birkin bag http://www.hermesbirkinbags.us.com
Reply golden goose outlet
5:38 PM on September 25, 2022 
Thank you for your entire efforts on this web page. Kim take interest in managing research and it's easy to understand why. Almost all know all of the powerful ways you present practical tactics by means of your blog and as well strongly encourage participation from website visitors on this area and our daughter is actually discovering a lot of things. Have fun with the rest of the year. Your conducting a tremendous job.
golden goose outlet http://www.golden-goosesoutlet.com
Reply chrome hearts online store
5:37 PM on September 25, 2022 
Thank you so much for providing individuals with such a special possiblity to read in detail from here. It's always so superb and as well , packed with a good time for me and my office co-workers to search your website at the very least thrice weekly to learn the latest issues you will have. And indeed, I'm also always contented considering the perfect concepts you serve. Certain 1 tips in this post are easily the finest we have had.
chrome hearts online store http://www.chromeheartstoreonline.com
Reply russell westbrook shoes
5:37 PM on September 25, 2022 
I have to show some appreciation to you for bailing me out of this type of challenge. Because of surfing through the search engines and finding tips which are not powerful, I assumed my life was well over. Being alive devoid of the solutions to the problems you have fixed by way of this review is a critical case, as well as those that could have badly affected my career if I had not encountered your blog. Your actual natural talent and kindness in taking care of everything was very useful. I don't know what I would've done if I hadn't discovered such a subject like this. It's possible to at this moment look forward to my future. Thanks a lot very much for this professional and effective help. I will not think twice to endorse your blog post to anybody who would need support about this matter.
russell westbrook shoes http://www.russellwestbrookshoes.us
Reply hermes outlet online
5:37 PM on September 25, 2022 
I would like to get across my appreciation for your kind-heartedness in support of individuals that need help on the study. Your special commitment to passing the solution all through appeared to be especially interesting and has usually made many people much like me to achieve their aims. The valuable tips and hints signifies so much to me and a whole lot more to my colleagues. Best wishes; from each one of us.
hermes outlet online http://www.hermesoutletsonline.com
Reply jordans
5:37 PM on September 25, 2022 
Thanks so much for providing individuals with an extraordinarily nice chance to check tips from this web site. It is always very brilliant plus stuffed with a lot of fun for me personally and my office friends to search your web site at minimum 3 times in 7 days to see the new stuff you have. And of course, I am just at all times astounded with the superb concepts you give. Certain 2 areas in this posting are particularly the most impressive I've ever had.
jordans http://www.jordanssneakers.us.com
Reply off white jordan
5:37 PM on September 25, 2022 
Thank you a lot for giving everyone an exceptionally terrific chance to read critical reviews from this website. It is usually so pleasurable and jam-packed with fun for me personally and my office peers to visit your blog nearly 3 times per week to read through the latest guides you have. And lastly, we are usually fascinated with your cool tips and hints you give. Certain two ideas in this posting are definitely the most suitable I have ever had.
off white jordan https://www.offwhitesoutlet.com
Reply steph curry shoes
5:36 PM on September 25, 2022 
My husband and i got quite joyous when Jordan could deal with his homework through your precious recommendations he obtained in your web pages. It's not at all simplistic to simply continually be giving for free points that many some other people might have been making money from. Therefore we realize we have got the writer to be grateful to because of that. Those illustrations you have made, the straightforward site navigation, the relationships you can make it easier to instill - it's many superb, and it's really assisting our son and our family do think the concept is fun, and that's extremely vital. Thank you for the whole lot!
steph curry shoes http://www.stephcurry.us
Reply adrcrta
4:29 PM on September 25, 2022 
all star 97 air max limited lance briggs mens jersey chicago bears 55 grey shadow nfl dark pink shirt outfit female sexy boho dress white black red jordan 4 olympique lyon third kit
adrcrta http://www.adrcrta.com/
Reply marenahomes
4:07 PM on September 25, 2022 
jersey miami heat pink prada logo plaque cap adidas ultra boost parley ocean polo ralph lauren blue cap ed hardy clothing wholesale timberland x off white
marenahomes http://www.marenahomes.com/
Reply cursodeunas
3:59 PM on September 25, 2022 
michael kors thick strap bag air jordan 1 verde amarillo negro rick owens moncler bomber moncler 2020 coats west bromwich albion jersey for cheap
cursodeunas http://www.cursodeunas.com/
Reply dragsteruk
3:58 PM on September 25, 2022 
iphone 8 kette converse rose pale homme la romana calzados lacoste maglioncino round neck white dress sac cabas en toile de jute
dragsteruk https://www.dragsteruk.com/
Reply nardulan
3:55 PM on September 25, 2022 
christian louboutin peep toe platform pumps moncler grey beanie oakley ski goggles fogging up phillies hat light blue uga football sweatshirt black t shirt outfit womens
nardulan http://www.nardulan.com/
Reply cikgudollah
3:18 PM on September 25, 2022 
reebok houston texans arian foster 23 blue replica jerseys sale chicago white sox world series hat 5000 air max 95 lime verde grigio new york yankees cap johannesburg oh rebecca minkoff maxi edie womens petite short sleeve tops
cikgudollah http://www.cikgudollah.com/
Reply supreme clothing
3:12 PM on September 25, 2022 
I would like to show my thanks to the writer just for rescuing me from such a instance. Right after looking through the online world and coming across recommendations which are not beneficial, I figured my entire life was gone. Living devoid of the approaches to the difficulties you've sorted out all through your report is a crucial case, as well as the ones that would have in a negative way damaged my career if I had not encountered your blog post. Your good training and kindness in maneuvering every item was very useful. I don't know what I would have done if I hadn't come upon such a thing like this. I can also at this point look ahead to my future. Thanks for your time so much for this expert and effective help. I will not think twice to suggest your web page to any person who would like support about this area.
supreme clothing http://www.supremeclothingstore.com