Abstract

Simple SummaryMethicillin-resistant Staphylococcus aureus is often found in skin lesions infected in particular in diabetic foot ulcers, in which the prevalence can reach 40%. Clinical methicillin-resistant Staphylococcus aureus is generally resistant to most classes of antibiotics and therefore it is necessary to develop new antimicrobial agents. Ozone has a recognized bactericidal activity and has been widely used as a clinical therapeutic agent for chronic wounds, such as ulcers and other injuries, due to its ability to heal wounds. This is a preliminary study that reports the effectiveness of ozonated oils on the eradication of skin infection in vivo. The study provides further insights into the antibacterial effect of ozone in infected skin ulcers in diabetic rats and also, the potential wound healing effect of ozonated oils. Furthermore, this is the first study investigating the efficacy of ozone in the eradication of diabetic foot ulcers infected by methicillin-resistant Staphylococcus aureus. Our results indicate that topical application of ozonated oils infected skin in rats have significant antimicrobial activity as well as wound healing capacity. Achieving the healing of infected diabetic foot wounds has become a challenge and ozonated oils may be used to treat these infections.Diabetic foot ulcers are a common cause of morbidity in diabetic patients. One of the main pathogens found in these ulcers is methicillin-resistant Staphylococcus aureus (MRSA). MRSA often carries resistance to several classes of antibiotics and their infections are becoming harder to treat. Therefore, new alternatives are urgently needed. Thus, this study aimed to investigate the capacity of topical ozonated oil application on the treatment of early-stage skin infected with MRSA in an animal model. Ozonated oil was prepared from a mixture of oils subjected to a gas stream of O2/O3 mixture. Sixteen Wistar rats were inoculated by an intradermic injection of MRSA suspension, producing an abscess lesion. After 3 days, the skin epidermis was removed to open the wound. Group 1 received an application of oil mixture without ozone treatment and Group 2 received an application of ozonated oil. After the treatment period, skin was collected, colony-forming units (CFU) of bacteria were quantified and the histological analysis of the skin was carried out. Skin samples from the control 1 and 2 had a bacterial load was of 1.1 × 105 and 5.7 × 103 CFU/mL, respectively. Group 2 showed better wound healing from mild to moderate epidermal regeneration. Topical application of ozonated vegetable oil in MRSA-infected skin in rats showed a small reduction of the bacterial load and better wound healing.

Highlights

  • Diabetes belongs to the group of metabolic diseases, characterized by high blood glucose levels, and is one of four priority non-communicable diseases [1]

  • Group 1 received an application of oil mixture without ozone treatment and Group 2 received an application of ozonated oil

  • Studies have shown that oxygen tension in wounds and their treatment with ozone may increase the formation of granulation tissue; the accelerated trend of wound closure shown in group 2 may be due to the exposure to ozonated oil together with decreased bacterial load found in this group [41,42]

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Summary

Introduction

Diabetes belongs to the group of metabolic diseases, characterized by high blood glucose levels, and is one of four priority non-communicable diseases [1]. Diabetes can trigger the development of several long-term associated conditions that contribute to a higher risk of morbidity and mortality. Such conditions can lead to a reduction of blood flow which, in combination with nerve damage, increases the chances of developing diabetic foot ulcers (DFU) [3]. DFU often heal very slowly and these open wounds provide a niche for colonization and infection [4]. MRSA has a high capacity to form biofilms in DFU, shielding bacteria from the action of neutrophils, delaying wound healing and increasing their resistance to antimicrobial agents [12].

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