Skin Infections Research Articles

An ethnobotanical survey investigating medicinal plants used by Cape bush doctors to treat dermatophyte infections.

Introduction: Over the past few years, the incidence of dermatophyte infections has increased at an alarming rate. The treatment for these infections is becoming more difficult especially because fungal pathogens have developed resistance to conventional treatments. The Cape Metropole region in South Africa has an abundance of plant species and is the residence of herbalists, called Cape bush doctors who use some of these diverse plants to treat various skin-related conditions. There are limited ethnobotanical studies that have been conducted on the medicinal plants they use to treat dermatophyte infections. Therefore, this study aimed to report on the knowledge and practices of Cape bush doctors concerning their use of medicinal plants for treating dermatophyte infections. MethodologyA cross-sectional study was performed using an interview-based questionnaire to investigate 1) the knowledge of bush doctors regarding skin infections, 2) the practices of bush doctors along with the medicinal plants used when treating fungal skin infections, and 3) selected plants identified with potential anti-fungal activity in vitro, were further explored to assess their application in the treatment of fungal infections by bush doctors. Results: Participants confirmed the use of the fifteen selected medicinal plants identified in the literature. Additionally, twenty other plant species were mentioned as having antifungal properties. Most plants reported belonged to the Xanthorrhoeaceae, Amaryllidaceae, Asteraceae, Lamiaceae, and Rutaceae families. Conclusion: This study shows that bush doctors use a vast array of plant species to treat dermatophyte conditions. This indicates the diversity of medicinal plant species used and that these doctors associated indigenous knowledge is of great value. Therapeutic uses of the documented plants provide data for further pharmacological studies.

Universal antibacterial and anti-inflammatory treatment using chitosan-prussian blue nanozyme

Bacterial infections are a growing global public health problem, exacerbated by the widespread and often inappropriate use of antibiotics, leading to the emergence of non-antibiotic pathogens. Herein, we synthesized a chitosan-Prussian blue nanozyme (CS@PB), a non-antibiotic agent, for universal antibacterial and anti-inflammatory treatment of bacterial infections. Confocal microscopy images showed that CS@PB significantly enhanced the physical interaction between chitosan and bacteria, thereby increasing the antibacterial ability. Moreover, these nanozymes exhibited potent antioxidant and anti-inflammatory properties, promoting macrophage polarization toward the M2-like phenotype, reducing oxidative stress, and alleviating inflammation. This dual-action approach effectively accelerates the healing of bacteria-infected inflammatory wounds. The synergistic bactericidal and anti-inflammatory properties of CS@PBs inhibited wound infection and promoted the healing of skin infections in a mouse model. In addition, CS@PB displayed remarkable lung retention and potent bactericidal effects, resulting in significantly improved survival rates in mouse models of acute pulmonary bacterial infections. In conclusion, CS@PBs exhibited exceptional bactericidal capabilities, anti-inflammatory properties, and minimal toxicity, suggesting that they are promising candidates for a new generation of non-antibiotic antimicrobial agents for the treatment of bacterial infections.

Research on: Formulation and evaluation of polyherbal soap

People have been using medicinal plants for centuries to treat various ailments. The extract from the leaves, stems, and roots of these plants has been a natural remedy for many health issues. Commercial soaps often contain harmful ingredients, making natural herbal soaps a good alternative. Bacterial skin infections are common and require proper treatment and skincare. Some herbal plant extracts and oils have been found to have antibacterial properties. To address this, an antibacterial Polyherbal soap was formulated using ingredients like curcumin, neem, lemon juice, aloe vera, and almond oil. Neem leaves have traditionally been used to treat skin disorders due to their antioxidant properties. Lemon water has antibacterial and antioxidant capabilities that keep the skin healthy and rejuvenated. Aloe vera is known for preventing aging, reducing acne, and moisturizing the skin. Turmeric is beneficial for treating skin injuries and conditions like psoriasis. The Polyherbal soap was tested for its antibacterial activity and showed positive results. So, the use of medicinal plants in soap production offers cost-effective benefits with minimal side effects.

Caesalpinia sappan Reduce Fever with An Anti-inflammatory and Antioxidant Mechanism: A Review

<p><em><span lang="EN-US">Caesalpinia sappan L</span></em><span lang="EN-US"> (Sappan wood) is an herbal plant that has long been trusted by the public as an herbal medicine for tuberculosis, diarrhea, dysentery, skin infections, anemia, and other diseases by utilizing the decoction of <em>C.sappan</em>. Sappan wood is an herbal plant widely used as a raw material for traditional medicinal products. Sappan wood has been reported to have substantial pharmacological effects in analgesic, antioxidant, antibacterial, anti-inflammatory, and anti-viral. Fever is a clinical manifestation of certain conditions or diseases characterized by increased body temperature above the normal range (36.5–37.5 °C). Many studies declare that antioxidant and anti-inflammatory activity in <em>C.sappan</em> reduces oxidative stress and pro-inflammatory cytokines. This literature review shows that the antioxidant and anti-inflammatory properties of <em>C.sappan</em> are linked to fever as a sign of illness. Literature review using the last ten years' Scopus, ScienceDirect, and Pubmed databases. There are as many as 20 journals regarding sappan wood's antioxidant and anti-inflammatory effects. Sappan wood has been shown to have an antioxidant effect by lowering reactive oxygen species levels via SOD, GPx, or CAT markers. It inhibits inflammation cytokines such as IL-1, IL-6, TNF-</span><span lang="EN-US">𝝰</span><span lang="EN-US">, and INF produced during fever. Sappan wood also has an anti-inflammatory effect by inhibiting PGE2 production when someone has a fever. The findings of our review state that <em>C.sappan</em> can be used to treat fever for both of these reasons. The use of <em>C.sappan</em> as a component in producing traditional health beverages has potential.</span></p>

Auditory brainstem implants: an analysis of adverse events in the MAUDE database

ObjectiveAuditory Brainstem Implants (ABI) are used to restore hearing in patients lacking appropriate cochlear anatomy and/or cochlear nerve. The objective of this study was to examine the Manufacture and User Facility Device Experience (MAUDE) database to analyze adverse events. Study designThis is a study of a multi-institutional database maintained by the US FDA. SettingA database analysis was performed via collaboration of multiple clinicians at tertiary referral centers. MethodsThe MAUDE database was queried for Medical Device Reports (MDRs) relating to ABIs. MDRs were identified using the advanced search term “Implant, Auditory Brainstem” and reviewing all reports with the basic search term “Brainstem Implant”. All collected reports were individually reviewed. ResultsA total of 265 individual patient reports were reviewed, of which 55 reports met inclusion criteria. Reports regarding audiologic outcome included failure to provide hearing benefit (n = 27), implant failure/device malfunction (n = 10), and device non-use (n = 6). Postoperative complications included local skin infection (n = 3), CSF leak (n = 3), elevated ICP (n = 1), surgical site dehiscence (n = 1), swelling (n = 1), seroma formation requiring drainage (n = 1), and meningitis (n = 2). Two patients had dislodged magnets during 1.5 Tesla MRI acquisition. There were 35 instances of full explantation of the device and 1 partial removal; 13 patients had a new device implanted following explantation. ConclusionsPoor hearing results, device failure, and non-use were commonly reported causes for explanation in this analysis. This information can aid physicians in counseling patients and family members and managing device expectations.

Hypogammaglobulinemia-induced skin infections as a factor of post rituximab paradoxical flare in pemphigus

Hypogammaglobulinemia-induced skin infections as a factor of post rituximab paradoxical flare in pemphigus

Skin manifestations and human immunodeficiency virus infection in the Tigray region, Ethiopia: Implications for clinical management and epidemiologic surveillance

AbstractBackgroundPatients with human immunodeficiency virus (HIV) infection may present a large variety of skin manifestations, often associated with significant morbidity. In turn, dermatological diseases may represent an early sign of HIV infection, particularly in resource‐limited settings.ObjectivesThis study aimed to assess the spectrum of dermatological diseases and their potential value as clinical proxies for the early detection and management of HIV in a rural region of Ethiopia.MethodsThe study was performed on a population of 67,161 patients with skin diseases attending the Italian Dermatological Center in Mekele, Tigray region, Ethiopia. HIV infection was diagnosed in 1892 individuals (1065 female), all naïve to antiretroviral therapy.ResultsInfectious skin diseases were present in 57.2% of the total HIV population. Among the infectious skin manifestations, dermatophytosis (20.5%), impetigo (5.9%), candidiasis (4.7%) and molluscum contagiosum (4.7%) were significantly more represented in patients with HIV infection (p < 0.001). Regarding the noninfectious manifestations, pruritus and atrophy of the papillae on the tongue were significantly associated with HIV (p < 0.001). Notably, females had a significantly higher incidence of dermatophytosis and seborrheic dermatitis as compared to their male counterparts (p < 0.001), whereas scabies, psoriasis and leishmaniasis were significantly more frequent in males (p < 0.001).ConclusionsSkin manifestations are common in HIV patients, often reflecting compromised immune status. In addition, Dermatophytosis and pruritus were the most frequently reported manifestations of HIV, thus representing useful clinical proxies to raise the suspicion of an underlying HIV infection. Besides, gender differences in skin manifestations should also be considered in the clinical evaluation.

Protium spruceanum Extract Enhances Mupirocin Activity When Combined with Nanoemulsion-Based Hydrogel: A Multi-Target Strategy for Treating Skin and Soft Tissue Infections

The treatment of skin and soft tissue infections (SSTIs) can be challenging due to bacterial resistance, particularly from strains like MRSA and biofilm formation. However, combining conventional antibiotics with natural products shows promise in treating SSTIs. The objective of this study is to develop a nanoemulsion-based hydrogel containing Protium spruceanum extract and mupirocin and evaluate its potential for the treatment of SSTIs. The nanoemulsion was obtained by phase inversion and subsequently characterized. The antibacterial activity was evaluated in vitro against S. aureus MRSA, including the synergism of the combination, changes in membrane permeability using flow cytometry, and the anti-biofilm effect. In addition, the irritative potential was evaluated by the HET-CAM assay. The combination exhibited synergistic antibacterial activity against S. aureus and MRSA due to the extract enhancing membrane permeability. The hydrogel demonstrated suitable physicochemical properties, inhibited biofilm formation, and exhibited low irritation. The formulation was nanometric (176.0 ± 1.656 nm) and monodisperse (polydispersity index 0.286 ± 0.011). It exhibited a controlled release profile at 48 h and high encapsulation efficacy (94.29 ± 4.54% for quercitrin and 94.20 ± 5.44% for mupirocin). Therefore, these findings suggest that the hydrogel developed could be a safe and effective option for treating SSTIs.

#332 Dermatological manifestations in pediatric CKD patients

Abstract Background and Aims Chronic kidney disease (CKD), regardless of its cause, may be accompanied by various skin lesions. The most common symptom in children suffering from CKD is pruritus however other signs that may be seen are xerosis, skin hyperpigmentation, ecchymoses, acquired perforating dermatoses, nail lesions, calcinosis cutis, as well as eczematous lesions at the site of an arteriovenous fistula and skin infections. Data on different skin lesions in children with CKD is very limited; only few reports have been published discussing xerosis in pediatric patients and most studies were conducted on a small number of patients who needed renal replacement therapy . This study aimed primarily to screen the different dermatological manifestations in pediatric patients with CKD, in addition to studying the relationship of dermatological manifestations with the CKD stage, types of dialysis, various clinical and metabolic parameters. Method This was a cross sectional study, that was conducted at Pediatric Dialysis and Nephrology unit, Children's Hospital, Faculty of Medicine, Ain Shams University Hospital, Cairo, Egypt, during the period from February 2023 to August 2023, where 70 patients were enrolled in our study being divided into two groups: group 1 including CKD patients stages (2-4) and group 2 including CKD patients with stage 5 on regular hemodialysis. Detailed dermatological & nail examination were conducted. Xerosis severity was assessed using a four-point xerosis assessment scale (0, normal skin, without any xerosis; 1, mild xerosis; 2, moderately dry skin with minimal flaking; 3, severe xerosis, heavy scaling visible), whereas pruritus was assessed using a visual analogue scale (VAS) on a scale of 1 (no itch) to 10 (worst possible itch). Laboratory data were withdrawn at the time of examination to correlate with different dermatological manifestation. Results In our study, xerosis was the most frequent dermatological manifestation (78.6%) following it pruritus (62.9%) then pallor (35.7%), hyperpigmentation (20%), hypertrichosis (10 %), nail and hair abnormalities (8.5%) & post inflammatory hyperpigmentation (4.3%). The prevalence of xerosis was not affected by clinico-demographic data, CKD duration & stage, type and duration of dialysis, the only significant relation was between efficacy of dialysis (Kt/V) and incidence of xerosis, where the higher dialysis efficacy rates were associated with low incidence rates of xerosis, in which effective hemodialysis contributes to better removal of uremic toxins, & hence decrease the xerosis. Leukocytosis was noticed in xerotic & pruritic patients, where xerosis & impaired skin barrier in children with CKD pose a risk for different cutaneous infections & inflammation, and hence pruritis. Conclusion Xerosis and pruritis are not uncommon dermatological manifestations among pediatric patients with chronic kidney disease, meanwhile the age of the patients and the underlying CKD etiology had no direct effect on skin changes. The most determinant factory affecting the xerosis was the hemodialysis efficacy, where higher efficacy was associated with less xerosis, meanwhile leukocytosis was associated with higher xerosis and pruritis. Further studies are needed to detect various skin manifestations in CKD patients with different CKD stages and correlate it with the used dialysis modalities.

Cross-sectional study on exercise-related skin complaints among sports students at two German universities

Sports activities can lead to exercise-related skin complaints. These include different symptoms (e.g. infections, mechanical injuries, contact dermatitis). Previous studies mostly focused only on skin infections and injuries in competitive athletes. The purpose of this study was to determine the frequency and characteristics of exercise-related skin complaints among sports students and to what extent these complaints influence physical fitness. We performed a self-administered online survey among 259 actively exercising sports students from two German universities. Descriptive analyses were conducted. The most common complaints were blistering (57.3%), dryness (56.7%), redness (44.7%), and chafing (34.0%). Hands and feet (78.0% each) were most frequently affected. Participants whose skin was particularly stressed (47.5%) had higher training duration (7.6 h/week, 95%-CI 6.8–8.3 h) than those without complaints (5.1 h/week, 95%-CI 5.5–6.7 h, p = 0.003). The students reported reduced intensity (34.7%) and frequency (22.7%) of training due to their skin complaints. A reduction in performance was reported by 32.0% of the students. Actively exercising sports students considered an intact skin as essential for their physical fitness. Reported impairments of the skin led to a reduced intensity and frequency of training. To enhance the awareness of exercise-related skin complaints, further research is necessary.

Cutaneous Lagenidium deciduum infection in a patient with relapsed acute myeloid leukemia

BackgroundLagenidium deciduum is an oomycete that can cause infections in mammals that present similarly to pythiosis and mucormycosis. Most of the existing case reports have occurred in canines and have been fatal. In animals, medical therapy has not been successful, so surgical excision is the mainstay of treatment. Lagenidium sp. infections in humans are rare. There is only one case of a human Lagenidium sp. infection in the literature, and it presented as an ocular infection. The human ocular infection was resistant to medical therapy and required a penetrating keratoplasty for cure. Additional reports of effective therapy are needed to guide management of this emerging pathogen. We present the first case of a cutaneous Lagenidium deciduum infection in a human patient, which is also the first documented case of a Lagenidium deciduum infection in an immunocompromised host of any species.Case presentationAn 18-year-old female with relapsed acute myeloid leukemia, awaiting a haploidentical stem cell transplant, presented with erythematous cutaneous lesions on her left hip and bilateral buttocks that enlarged and blackened over several days. About 1 week later, boil-like lesions appeared on her bilateral buttocks. The skin lesions were initially presumed to be bacterial in origin, so the patient was treated with clindamycin and cefepime with little improvement. Upon further investigation, fungal cultures and skin biopsies revealed aseptate hyphae, so the patient was switched to isavuconazole and amphotericin B due to concern for mucormycosis. Phenotypic characterization and DNA sequencing were performed by the Fungus Testing Laboratory, University of Texas Health Science Center at San Antonio, which identified the causal fungal organism as Lagenidium deciduum. All of her cutaneous lesions were surgically excised, and the patient was treated with micafungin, terbinafine, doxycycline, and azithromycin. Micafungin and terbinafine were continued until she achieved engraftment post-transplant.ConclusionsWe report the first successful treatment of a human Lagenidium infection in an immunocompromised host through a combination of aggressive surgical excision and prolonged antifungal therapy during the prolonged neutropenia associated with allogeneic stem cell transplant. Prompt diagnosis and management may prevent disseminated oomycosis.

Formulation and Characterization of Nanoemulsion Incorporating Chamomilla recutita L. Extract Stabilized with Hyaluronic Acid

Skin lesions are an important health concern, exposing the body to infection risks. Utilizing natural products containing chamomile (Chamomilla recutita L.) holds promise for curative purposes. Additionally, hyaluronic acid (HA), an active ingredient known for its tissue regeneration capacity, can expedite healing. In this study, we prepared and characterized an extract of C. recutita and integrated it into a nanoemulsion system stabilized with HA, aiming at harnessing its healing potential. We assessed the impact of alcoholic strength on flavonoid extraction and chemically characterized the extract using UHPLC/MS while quantifying its antioxidant and antimicrobial capacity. We developed a nanoemulsion loaded with C. recutita extract and evaluated the effect of HA stabilization on pH, droplet size, polydispersity index (PDI), zeta potential, and viscosity. Results indicated that 70% hydroalcoholic extraction yielded a higher flavonoid content. The extract exhibited antioxidant capacity in vitro, a desirable trait for skin regeneration, and demonstrated efficacy against key microbial strains (Staphylococcus aureus, Streptococcus pyogenes, Escherichia coli, and Pseudomonas aeruginosa) associated with skin colonization and infections. Flavonoids spireoside and apiin emerged as the most abundant bioactives. The addition of HA led to increased viscosity while maintaining a suitable pH for topical application. Zeta potential, droplet size, and PDI met acceptable criteria. Moreover, incorporating C. recutita extract into the nanoemulsion enhanced its antimicrobial effect. Hence, the nanoemulsion system loaded with C. recutita and HA stabilization exhibits favorable characteristics for topical application, showing promise in aiding the healing processes.

Antimicrobial Peptide Reduces Cytotoxicity and Inflammation in Canine Epidermal Keratinocyte Progenitor Cells Induced by Pseudomonas aeruginosa Infection

The direct effects and antimicrobial activity of synthetic antimicrobial peptides (AMPs) obtained from dogs, including cBD, cBD103, and cCath, against P. aeruginosa wild-type strain PAO1 and canine keratinocytes were analyzed. Antibacterial effects on planktonic bacteria were assessed by determining the minimum bactericidal concentrations (MBCs) of AMPs and by a time-kill assay. Antibiofilm effects were assessed using the microtiter plate assay. We also evaluated the effects of AMPs on cell cytotoxicity and host immune response induced by stimulating canine epidermal keratinocyte progenitor (CPEK) cells with PAO1 and its LPS. cBD, cBD103, and cCath all exhibited dose-dependent antimicrobial and antibiofilm effects. In particular, 25 μg/mL cBD103 showed rapid bactericidal activity within 60 min and inhibited biofilm formation. In addition, pretreatment with cBD103 (25 µg/mL) and cCath (50 µg/mL) 1 h before stimulation significantly reduced the cytotoxicity of the CPEK cells by PAO1 and LPS-induced IL-6 and TNF-a expressions. cBD had little effect on the response to PAO1 and LPS in the cells. These results indicate the therapeutic potential of AMPs in P. aeruginosa skin infections. However, further studies on the mechanism of action of AMPs in keratinocytes and clinical trials are needed.

Antimicrobial and anti-inflammatory efficiency of green synthesized zinc oxide nanoparticles using Polianthes tuberosa flower concentrate

Aim: In the present study, zinc oxide nanoparticles (ZnO NPs) were synthesized using Polianthes tuberosa flower concentrate. Antimicrobial and anti-inflammatory efficiency of the green synthesized ZnO NPs were analysed under in vitro conditions. Methodology: Nanoparticles formation was confirmed by UV-visible spectroscopy. Size, shape and morphology of the green synthesized ZnO NPs was determined by SEM coupled with EDAX and AFM. Molecular and elemental compositions of the nanoparticle were determined by XRD and FT-IR analyses. Results: X-ray diffraction analysis depicted the hexagonal wurtzite structure of ZnO NPs with a particle size of 80 nm. The FT-IR analysis illustrated the functional groups responsible for the encapsulation and stabilization of ZnO NPs. At micromolar concentration, ZnO NPs was found to inhibit the growth of selected skin pathogens and suppress biofilm formation in Pseudomonas aeruginosa. Interpretation: P. tuberosa flower concentrate and green synthesized ZnO Nps inhibited the growth of bacterial and fungal pathogen in a dose-dependent manner. Biofilm inhibitory efficiency and anti-inflammatory activity of the zinc oxide nanoparticle illustrated that it can be used for treating skin infections. Key words: Anti-biofilm, Anti-inflammatory, Polianthes tuberosa, Zinc oxide nanoparticles

Phytochemical inhibitors from Leucas aspera against the target proteins induced by Trichophyton mentagrophytes using computational techniques.

Dermatophytosis is a cutaneous infection that is able to degrade the keratinized tissues of the animal/human body, like skin, nails, and hair, causing chronic or subacute infection with the contact of some specific fungal strains. Trichophyton mentagrophytes are the most potential fungal pathogen causing dermatophytoses. The present study focuses on computationally based in silico antifungal activity of selected phytocompounds of Leucas aspera (Willd.) Link. against dermatophytic fungus, T. mentagrophytes. Validation and screening of derived phytocompounds is performed using Lipinski rule of five and toxicity test through Protox-II. Five target genes involved in dermatophytosis, induced by T. mentagrophytes are retrieved from the UniProt Database, and the corresponding proteins such as glucan 1,3-beta-glucosidase ARB_02797, Probable class II chitinase ARB_00204, squalene monooxygenase, actin, and ubiquitin are selected for in silico study. Three-dimensional structures of the target protein were computationally determined and validated through modeling tools and techniques due to the lack of validated protein structures in the database. Then, these proteins are used for in silico molecular docking through the AutoDock Vina tool to find out the promising phytocompounds. This study could be utilized in designing more effective drugs against T. mentagrophytes. Based on this work, a plant-based natural alternative can be added to the treatment of dermatophytosis rather than synthetic supplements.

Tedizolid phosphate alleviates DSS-induced ulcerative colitis by inhibiting senescence of cell and colon tissue through activating AMPK signaling pathway

Ulcerative colitis (UC) is a subtype of inflammatory bowel disease. Previous studies have suggested a link between senescence process and the body’s inflammatory reaction, indicating that senescence may exacerbate UC, yet the relation between UC and senescence remains unclear. Tedizolid Phosphate (TED), a novel oxazolidinone antimicrobial, is indicated in acute bacterial skin infections, its impact on senescence is not known. Our research revealed that the UC inducer dextran sulfate sodium (DSS) triggers senescence in both colon epithelial NCM460 cells and colon tissues, and TED that screened from a compound library demonstrated a strong anti-senescence effect on DSS treated NCM460 cells. As an anti-senescence medication identified in this research, TED efficiently alleviated UC and colonic senescence in mice caused by DSS. By proteomic analysis and experimental validation, we found that DSS significantly inhibits the AMPK signaling pathway, while TED counteracts senescence by restoring AMPK activity. This research verified that the development of UC is accompanied with colon tissue senescence, and TED, an anti-senescence medication, can effectively treat UC caused by DSS and alleviate colon senescence. Our work suggests anti-senescence strategy is an effective approach for UC treatment.

Self-Healing Guar Gum-Based Nanocomposite Hydrogel Promotes Infected Wound Healing through Photothermal Antibacterial Therapy.

Preventing bacterial infections is a crucial aspect of wound healing. There is an urgent need for multifunctional biomaterials without antibiotics to promote wound healing. In this study, we fabricated a guar gum (GG)-based nanocomposite hydrogel, termed GBTF, which exhibited photothermal antibacterial therapy for infected wound healing. The GBTF hydrogel formed a cross-linked network through dynamic borate/diol interactions between GG and borax, thereby exhibiting simultaneously self-healing, adaptable, and injectable properties. Additionally, tannic acid (TA)/Fe3+ nanocomplexes (NCs) were incorporated into the hydrogel to confer photothermal antibacterial properties. Under the irradiation of an 808 nm near-infrared laser, the TA/Fe3+ NCs in the hydrogel could rapidly generate heat, leading to the disruption of bacterial cell membranes and subsequent bacterial eradication. Furthermore, the hydrogels exhibited good cytocompatibility and hemocompatibility, making them a precandidate for preclinical and clinical applications. Finally, they could significantly promote bacteria-infected wound healing by reducing bacterial viability, accelerating collagen deposition, and promoting epithelial remodeling. Therefore, the multifunctional GBTF hydrogel, which was composed entirely of natural substances including guar gum, borax, and polyphenol/ferric ion NCs, showed great potential for regenerating infected skin wounds in clinical applications.

Clinical characteristics and treatment outcomes of skin and soft tissue infections in children: a prospective study

ABSTRACT Backgroundː This study addresses the elevated prevalence of skin and soft tissue infections (SSTIs) within the pediatric demographic, necessitating a comprehensive inquiry into their varied clinical manifestations. The primary objectives involve the assessment of clinical and laboratory characteristics of SSTIs in children and an exploration of their correlation with treatment efficacy. Methodsː From April 2022 to June 2023, a prospective observational study was conducted on 87 pediatric bacterial SSTI cases at a Tertiary Paediatric Centre in Central Vietnam. Resultsː SSTIs were most common in children ages 1-4, 48.3%. Seasonal trends showed a peak incidence in summer (43.7%). In 93.1% of patients, febrile presentation and edema predominated. About 40.2% of people had lower extremity involvement. Analysis showed significant rates of severe (73.6%) and purulent (67.8%) SSTIs. Leukocytosis was found in 39.1% of patients, mostly due to 72.4% increased CRP. Even though only 2.4% of blood cultures were positive, Staphylococcus aureus caused 76.9% of infections. About 42.5% of patients had shorter treatments. Significantly, purulent SSTIs required longer antibiotic therapy than nonpurulent infections (p < 0.05). 27.6% of children needed surgery, and most received intravenous antibiotics. Most importantly, all patients recovered. Conclusionsː Predominantly observed among pediatric cases were purulent SSTIs, exhibiting a proclivity for the lower limbs, with Staphylococcus aureus as the predominant etiological agent. Treatment duration for purulent SSTIs exceeded that for nonpurulent infections. Intravenous antibiotic administration emerged as the predominant therapeutic modality, yielding favorable outcomes.

Identifying excessive length of antibiotic treatment duration for hospital-acquired infections: a semi-automated approach to support antimicrobial stewardship

BackgroundAvoiding excessive antibiotic treatment duration is a fundamental goal in antimicrobial stewardship. Manual collection of data is a time-consuming process, but a semi-automated approach for data extraction has been shown feasible for community-acquired infections (CAI). Extraction of data however may be more challenging in hospital-acquired infections (HAI). The aim of this study is to explore whether semi-automated data extraction of treatment duration is also feasible and accurate for HAI.MethodsData from a university-affiliated hospital over the period 1-6-2020 until 1-6-2022 was used for this study. From the Electronic Health Record, raw data on prescriptions, registered indications and admissions was extracted and processed to define treatment courses. In addition, clinical notes including prescription instructions were obtained for the purpose of validation. The derived treatment course was compared to the registered indication and the actual length of treatment (LOT) in the clinical notes in a random sample of 5.7% of treatment courses, to assess the accuracy of the data for both CAI and HAI.ResultsIncluded were 10.564 treatment courses of which 73.1% were CAI and 26.8% HAI. The registered indication matched the diagnosis as recorded in the clinical notes in 79% of treatment courses (79.2% CAI, 78.5% HAI). Higher error rates were seen in urinary tract infections (UTIs) (29.0%) and respiratory tract infections (RTIs) (20.5%) compared to intra-abdominal infections (7.4%), or skin or soft tissue infections (11.1%), mainly due to incorrect specification of the type of UTI or RTI. The LOT was accurately extracted in 98.5% of courses (CAI 98.2%, HAI 99.3%) when compared to prescriptions in the EHR. In 21% of cases however the LOT did not match with the clinical notes, mainly if patients received treatment from other health care providers preceding or following the present course.ConclusionSemi-automatic data extraction can yield reliable information about the indication and LOT in treatment courses of hospitalized patients, for both HAI and CAI. This can provide stewardship programs with a surveillance tool for all in-hospital treated infections, which can be used to achieve stewardship goals.

Exploring new avenues of health protection: plant-derived nanovesicles reshape microbial communities.

Symbiotic microbial communities are crucial for human health, and dysbiosis is associated with various diseases. Plant-derived nanovesicles (PDNVs) have a lipid bilayer structure and contain lipids, metabolites, proteins, and RNA. They offer unique advantages in regulating microbial community homeostasis and treating diseases related to dysbiosis compared to traditional drugs. On the one hand, lipids on PDNVs serve as the primary substances that mediate specific recognition and uptake by bacteria. On the other hand, due to the multifactorial nature of PDNVs, they have the potential to enhance growth and survival of beneficial bacterial while simultaneously reducing the pathogenicity of harmful bacteria. In addition, PDNVs have the capacity to modulate bacterial metabolism, thus facilitating the establishment of a harmonious microbial equilibrium and promoting stability within the microbiota. These remarkable attributes make PDNVs a promising therapeutic approach for various conditions, including periodontitis, inflammatory bowel disease, and skin infection diseases. However, challenges such as consistency, isolation methods, and storage need to be addressed before clinical application. This review aims to explore the value of PDNVs in regulating microbial community homeostasis and provide recommendations for their use as novel therapeutic agents for health protection.