Abstract
Among the most common complications of both chronic wound and surgical sites are staphylococcal skin infections, which slow down the wound healing process due to various virulence factors, including the ability to produce biofilms. Furthermore, staphylococcal skin infections are often caused by methicillin-resistant Staphylococcus aureus (MRSA) and become a therapeutic challenge. The aim of this narrative review is to collect the latest evidence on old and new anti-staphylococcal therapies, assessing their anti-biofilm properties and their effect on skin wound healing. We considered antibiotics, quorum sensing inhibitors, antimicrobial peptides, topical dressings, and antimicrobial photo-dynamic therapy. According to our review of the literature, targeting of biofilm is an important therapeutic choice in acute and chronic infected skin wounds both to overcome antibiotic resistance and to achieve better wound healing.
Highlights
Staphylococcal skin infections are one of the most common complications of both surgical sites [1] and chronic wounds, such as arterial, venous, and diabetic ulcers [2].Staphylococcus aureus is one of the top four bacteria in terms of prevalence among chronic wounds [3,4,5], and its ability to produce biofilm is a major virulence factor contributing to wound chronicity and delayed healing [6]
All staphylococcal species are responsible for 65% of persistent infections in chronic wounds [2] and can adhere to wound surface proteins to form colonies embedded in the biofilm that are resistant to antibiotic therapy [12]
Infections sustained by methicillin-resistant Staphylococcus aureus (MRSA), or methicillin-resistant coagulase-negative staphylococci (CNS), require an antibiogram to select the appropriate antibiotic [61]
Summary
Staphylococcus aureus is one of the top four bacteria in terms of prevalence among chronic wounds [3,4,5], and its ability to produce biofilm is a major virulence factor contributing to wound chronicity and delayed healing [6]. Of chronic wounds and contributes to persistent infection. All staphylococcal species are responsible for 65% of persistent infections in chronic wounds [2] and can adhere to wound surface proteins to form colonies embedded in the biofilm that are resistant to antibiotic therapy [12]. Biofilm confers antiphagocytic capabilities, prevents the action of leukocytes [15], and can capture and make both complement and antibiotics ineffective, triggering persistent tissue damage and chronic inflammation [16].
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