Burn Infection Research Articles

Burn wound bacterial profile and antibiotic sensitivity results in Turkey’s southeast region of Anatolia

Introduction: The conducted study was done to reveal the profile of bacteria isolated from wound sites of patients hospitalized in our burn center. We also aimed to find the appropriate sensitive antibiotics for use in the treatment.
 Methods: In the study, we examined 394 patients with (+) wound cultures reports from the 1,415 patients hospitalized at the Gazi Yaşargil Training and Research Hospital Burn Center between January 2010 and January 2020.
 Results: From 394 patients, 217 (55%) were male and 177 (45%) were female. The average age of patients was 12.86 ± 17.34 (min 1 - max: 94 years). In the wound culture results, bacteria were 70.55% gram-pozitive and 28.68% gram-negative Candida albicans was found in wound culture growth at a rate of 0.07%. The most common gram (+) pathogen was Staphylococcus aureus at 23.09% (n = 91). The most common gram (-) pathogens were Escherichia coli at 9.13% (n = 36) and Pseudomonas aeruginosa at 9.13% (n = 36).
 Conclusion: As a result of our study, we found that the most common causes of burn infections in our region were due to S. aureus, E. coli, and P. aeruginosa, We hope that the use of broad spectrum antibiotics can be effective against these bacteria and will contribute to clinical treatments until culture reports are available.

New findings about comparing the effects of antibiotic therapy and phage therapy on memory and hippocampal pyramidal cells in rats.

Pseudomonas aeruginosa is a significant cause of infection in burn wounds. Antibiotics are widely used to treat infectious diseases, and alongside their therapeutic benefits, they can damage host cells. Significant side effects, such as nephrotoxicity and neurotoxicity, are observed in 60% of patients treated with colistin. Therefore, using a suitable alternative instead of antibiotics is paramount. This study aimed to investigate the effects of phage therapy and antibiotic therapy on memory function in rats with P. aeruginosa infected burn wounds. Adult male rats were divided into three groups: (1) infected without treatment (control), (2) infected and treated with colistin antibiotic (3,000,000 international units/kg/day), and (3) infected and treated with 100 μL of phage suspension (approximately 109 PFU/mL). In all animals, after anesthesia, a third-degree burn was created in the back area. One hour later, treatment was performed for seven consecutive days. Passive avoidance test, novel object recognition test, locomotion activity, hippocampal neuron count, and oxidative stress measurement in blood serum were performed. In antibiotic-treated group memory recall, recognition index, number of healthy neurons in CA1, CA2, and CA3 hippocampus areas and the amounts of MDA, and FRAP significantly decreased compared with the control group. The phage-treated group was not shown any harmful effect on the memory process, number of healthy hippocampal neurons, and showed more positive effects in blood serum examinations compared with the antibiotic group. Phage therapy could be a safe and effective alternative to antibiotics in the treatment of burn-related infections.

A Photo‐Therapeutic Nanocomposite with Bio‐Responsive Oxygen Self‐Supplying Combats Biofilm Infections and Inflammation from Drug‐Resistant Bacteria

AbstractThe use of non‐antibiotic strategies to combat refractory drug‐resistant bacterial infections, especially biofilms and accompanying inflammation, has recently aroused widespread interest. Herein, a photo‐therapeutic nanocomposite with bio‐responsive oxygen (O2) self‐supplying is introduced by integrating manganese dioxide (MnO2) nanozymes onto photosensitizer (indocyanine green, ICG)‐loaded mesoporous polydopamine nanoparticles (MPDA), namely MI‐MPDA NPs. MI‐MPDA can activate O2 generation in the infection microenvironment, thereby effectively alleviating biofilm hypoxia. Under near‐infrared light (NIR) irradiation, continuous O2 supplying further boosts the level of singlet oxygen (1O2), enabling robust biofilm elimination through O2‐potentiated photodynamic/photothermal therapy. Interestingly, MI‐MPDA down‐regulates the factor expression of inflammatory signaling pathways through MnO2‐mediated reactive oxygen species scavenging, which ameliorates the inflammatory condition. Meanwhile, O2 supplying prevents the M1‐phenotype switch of macrophages from the overexpression of hypoxia‐inducible factor‐1α (HIF‐1α), thereby prompting macrophage reprogramming toward pro‐regenerative M2‐phenotype. In the mouse models of subcutaneous implant‐associated infection caused by methicillin‐resistant Staphylococcus aureus (MRSA) biofilms and burn infection caused by Pseudomonas aeruginosa biofilms, NIR‐irradiated MI‐MPDA not only effectively eliminates the formed biofilms, but also alleviates the oxidative stress and accompanying inflammation, and drives the cascade reaction of immunomodulation‐wound healing. Overall, this O2‐potentiated photo‐therapeutic strategy provides a reliable tool for combating biofilm infections and inflammation from drug‐resistant bacteria.

Strong immune responses and protection of PcrV and OprF-I mRNA vaccine candidates against Pseudomonas aeruginosa

Pseudomonas aeruginosa (PA) is a leading cause of hospital-acquired and ventilator-associated pneumonia. The multidrug-resistance (MDR) rate of PA is increasing making the management of PA a global challenge. Messenger RNA (mRNA) vaccines represent the most promising alternative to conventional vaccines and are widely studied for viral infection and cancer immunotherapy while rarely studied for bacterial infections. In this study, two mRNA vaccines encoding PcrV– the key component of the type III secretion system in Pseudomonas and the fusion protein OprF-I comprising outer membrane proteins OprF and OprI were constructed. The mice were immunized with either one of these mRNA vaccines or with the combination of both. Additionally, mice were vaccinated with PcrV, OprF, or the combination of these two proteins. Immunization with either mRNA-PcrV or mRNA-OprF-I elicited a Th1/Th2 mixed or slighted Th1-biased immune response, conferred broad protection, and reduced bacterial burden and inflammation in burn and systemic infection models. mRNA-PcrV induced significantly stronger antigen-specific humoral and cellular immune responses and higher survival rate compared with the OprF-I after challenging with all the PA strains tested. The combined mRNA vaccine demonstrated the best survival rate. Moreover, the mRNA vaccines showed the superiority over protein vaccines. These results suggest that mRNA-PcrV as well as the mixture of mRNA-PcrV and mRNA-OprF-I are promising vaccine candidates for the prevention of PA infection.

Preparation and Characterization of Silver Nanoparticles and its Medical Application against Pathogenic Bacteria

The fabrication of Solid and Hollow silver nanoparticles (Ag NPs) has been achieved and their characterization was performed using transmission electron microscopy (TEM), zeta potential, UV–VIS spectroscopy, and X-ray diffraction (XRD). A TEM image revealed a quasispherical form for both Solid and Hollow Ag NPs. The measurement of surface charge revealed that although Hollow Ag NPs have a zeta potential of -43 mV, Solid Ag NPs have a zeta potential of -33 mV. According to UV-VIS spectroscopy measurement Solid and Hollow Ag NPs both showed absorption peaks at wavelengths of 436 nm and 412 nm, respectively. XRD pattern demonstrates that the samples' crystal structure is cubic, similar to that of the bulk materials, with average particle sizes of 28 nm and 27 nm for Solid and Hollow Ag NPs, respectively. The antimicrobial activity of synthesized Ag NPs was tested on some pathogenic bacterial strains which were isolated from urinary tract infection (UTI) and burn infection. The experiment results showed positive bactericidal activity against isolated bacteria with Solid Ag NPs which were most effective against both G-ve and G+ve bacteria. In addition, solid nanoparticles showed time and concentration dependent antibacterial activity.

Silver resistance in Pseudomonas aeruginosa and Acinetobacter baumannii isolated from burn patients

Introduction: Burn infections are a serious obstacle to the patient’s recovery. Infection is estimated to account for 75% of burn patient mortality. Widespread and often indiscriminate administration of antibiotics and lack of basic infection control methods are major factors in the emergence of drug-resistant bacteria. Due to the growing and serious threat of antibiotic resistance, interest in silver compounds has grown in modern medicine. Objectives: The aim of this descriptive study was to evaluate the frequency of sil genes and its phenotypic expression in Pseudomonas aeruginosa and Acinetobacter baumannii isolates isolated from the burn ward of Imam Khomeini hospital in Urmia. Patients and Methods: P. aeruginosa (n=16) and A. baumannii (n=32) isolates were collected from burn wound samples in an 8-month period from August to March 2017 from the burn ward of the hospital. The minimum inhibitory concentration of silver nitrate on the clinical isolates was determined using microdilution method. The presence of silP, silE and silS silver resistance genes was investigated by polymerase chain reaction (PCR). Results: The results of minimum inhibitory concentration (MIC) test showed that 62.5% (n = 10) of P. aeruginosa isolates and 56.25% (n = 18) of A. baumannii isolates showed MIC above 512 mg/ml. Polymerase chain reaction results revealed that only one P. aeruginosa isolate had silE gene and among A. baumannii isolates, 20 isolates had silE gene and six isolates had silS gene. None of the isolates showed positive results for the silP gene. Conclusion: Based on the results, A. baumannii was the most common microorganism of burn wounds in the burn ward of our hospital in Urmia. This study showed a high degree of phenotypic resistance to silver in A. baumannii and P. aeruginosa isolates which silE and silS genes were also observed in some isolates.

Antibacterial and Wound Healing Activity of 2% Formulation of 2-Medpy-3-CN on Infected Burn Wounded Animal Model

Introduction: Humans have learned to recognize and process plants into medicinal forms through centuries. Burns can spread to other tissues, especially when infected with bacteria such as Methicillin-Resistant Staphylococcus aureus (MRSA). The study aimed to assess the in vivo antibacterial and wound healing activity of 2% formulation of 2-Medpy-3-CN on infected burn wounded animal model. Methods: In vitro antibacterial activity of the Alsti was done by broth dilution and disc diffusion methods. Alsti 2% ointment was prepared for the infected burn wound treatment. A total of 18 rats are grouped into A, B, C, and D, the first three groups (A-C) were injured thermally, and Group D was used as healthy controls. The three test Groups were exposed to MRSA ATCC 43300 at 105 CFU/mL. Group A was treated with 2% Alsti, Group B with Silver sulfadiazine 1% (SSD), and Group C was untreated. Wounds healing was assessed by the healed area and microscopic identification of hematoxylin and eosin (H&E)-stained skin tissue. Results: Wound healing progresses with application of Alsti 2% ointment as observed through wound diameter and histopathological changes of the skin. Wound diameter decreases with treatments, while the contrary was observed in the non-treated group. Microscopic observation of the stained skin showed that epidermal development, and collagen formation progress with treatment days. Untreated wounds showed marked inflammation, progressive ulceration, and necrosis. Conclusion: Alsti 2% formulation showed antibacterial and wound healing activities, hence, can be used as alternative in burn wound infections.

Effects of Plantago major leaf aqueous extracts against Pseudomonas aeruginosa isolated from wound infections

Background: The use of herbal extracts is becoming more popular as a result of the rise in bacterial resistanceto conventional antibiotics. Plantago major is a commonherbal plant used in conventional medicine. It was well known to have a number of medicinal benefits. Aim: The currentstudy aimed to evaluate the antibacterial activityof aqueous extractof P. major leaves against Pseudomonas aeruginosa isolated from burn infections. Materials and Methods: One hundred and thirty five of P. aeruginosa were collected from hospitalized patients in Emergency hospital in Duhok city. The isolates were identified by routine methods. P. major leaves antibacterial activity were performed by using aqueous extract in serial dilutions with the concentrations of (100, 75, 50, 25, and 10 %) by agar well diffusion assay, also antibiotics susceptibility test were done by the disc diffusion method using Muller-Hinton agar medium. Results: Varied aqueous extractof P. major leaves concentrations showed differentinhibitory zones of P. aeruginosa. The inhibitory zone measured by the efficacy of the aqueous extract of P. major leaves on P. aeruginosa ranges fro m [6.8-16.4] mm in diameter.The zone of inhibition grew as extract concentration increased; P. aeruginosa was most inhibited by an extract conc entration of [100%] ethanolic extract, which exhibited a [16.4 mm] inhibition zone. Additionaly, the bacteria display ed a high level of resistance to the utilized antibiotics. Conclusion: The results of this study show that the replacement of chemical drugs with herbal extract could be effective in the elimination of bacterial growth.

Effects of Plantago major leaf aqueous extracts against Pseudomonas aeruginosa isolated from wound infections

Background: The use of herbal extracts is becoming more popular as a result of the rise in bacterial resistanceto conventional antibiotics. Plantago major is a commonherbal plant used in conventional medicine. It was well known to have a number of medicinal benefits. Aim: The currentstudy aimed to evaluate the antibacterial activityof aqueous extractof P. major leaves against Pseudomonas aeruginosa isolated from burn infections. Materials and Methods: One hundred and thirty five of P. aeruginosa were collected from hospitalized patients in Emergency hospital in Duhok city. The isolates were identified by routine methods. P. major leaves antibacterial activity were performed by using aqueous extract in serial dilutions with the concentrations of (100, 75, 50, 25, and 10 %) by agar well diffusion assay, also antibiotics susceptibility test were done by the disc diffusion method using Muller-Hinton agar medium. Results: Varied aqueous extractof P. major leaves concentrations showed differentinhibitory zones of P. aeruginosa. The inhibitory zone measured by the efficacy of the aqueous extract of P. major leaves on P. aeruginosa ranges fro m [6.8-16.4] mm in diameter.The zone of inhibition grew as extract concentration increased; P. aeruginosa was most inhibited by an extract conc entration of [100%] ethanolic extract, which exhibited a [16.4 mm] inhibition zone. Additionaly, the bacteria display ed a high level of resistance to the utilized antibiotics. Conclusion: The results of this study show that the replacement of chemical drugs with herbal extract could be effective in the elimination of bacterial growth.

PlyKp104, a Novel Phage Lysin for the Treatment of Klebsiella pneumoniae, Pseudomonas aeruginosa, and Other Gram-Negative ESKAPE Pathogens.

Klebsiella pneumoniae and Pseudomonas aeruginosa are two leading causes of burn and wound infections, pneumonia, urinary tract infections, and more severe invasive diseases, which are often multidrug resistant (MDR) or extensively drug resistant. Due to this, it is critical to discover alternative antimicrobials, such as bacteriophage lysins, against these pathogens. Unfortunately, most lysins that target Gram-negative bacteria require additional modifications or outer membrane permeabilizing agents to be bactericidal. We identified four putative lysins through bioinformatic analysis of Pseudomonas and Klebsiella phage genomes in the NCBI database and then expressed and tested their intrinsic lytic activity in vitro. The most active lysin, PlyKp104, exhibited >5-log killing against K. pneumoniae, P. aeruginosa, and other Gram-negative representatives of the multidrug-resistant ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, K. pneumonia, Acinetobacter baumannii, P. aeruginosa, and Enterobacter species) without further modification. PlyKp104 displayed rapid killing and high activity over a wide pH range and in high concentrations of salt and urea. Additionally, pulmonary surfactants and low concentrations of human serum did not inhibit PlyKp104 activity in vitro. PlyKp104 also significantly reduced drug-resistant K. pneumoniae >2 logs in a murine skin infection model after one treatment of the wound, suggesting that this lysin could be used as a topical antimicrobial against K. pneumoniae and other MDR Gram-negative infections.

Comparative Study of the Antibacterial Activity of Algerian Honeys and Manuka Honey Toward Pathogenic Bacteria from Burn Wound Infections

Objective. Honey is an extremely promising agent in the treatment of infected wounds of burned patients. This study aims to evaluate the antibacterial activity of 14 Algerian honey samples in comparison to Manuka honey towards pathogenic bacteria isolated from burn wound infections. Methods. The antibacterial effect of 14 Algerian honey samples and the Manuka honey was assessed against six multidrug-resistant bacteria: Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus, Staphylococcus saprophyticus, and Enterococcus faecalis. Well agar diffusion, microdilution broth assay, and time-kill assay were used to evaluate the effects of honey samples on the growth of pathogenic bacteria. Results. The results obtained show that all tested honey samples have good antibacterial effects and there is no significant difference between Algerian honey samples and Manuka honey, except honey samples H12 and H13. The Gram-positive bacteria were more susceptible to honey samples than Gram-negative bacteria. The inhibitory diameters were between 14 to 38 mm for Gram-positive bacteria and from 8 to 28 mm for Gram-negative bacteria. The minimal inhibitory concentration of Algerian honey was between 5 and 80% (v/v) and minimal bactericidal concentration was between 10 and 80 % (v/v). However, the minimal inhibitory concentration of Manuka honey was between 5 and 40% (v/v) and minimal bactericidal concentration was between 10 and 80% (v/v). The MBC/MIC ratio was from 1 to 2, which proves that both Algeria honeys and Manuka honey have a bactericidal effect rather than a bacteriostatic effect. A time-kill assay showed that the inhibition effect of honey samples started after the first 3 hours of incubation. Honey samples 3 and 7 inhibited the growth of S. aureus and S. saprophyticus in 15 hours; however, they inhibited the growth of the other pathogenic bacteria in 18 hours. Conclusions. This study proposes honey as an extremely promising treatment against multidrug-resistant bacteria from burn infections.

Discussion on classification and diagnostic nomenclature of burn infection

Infection is the most common complication after burn injury and one of the leading causes of death in burn patients. Thus, how to effectively prevent the occurrence and development of infection is an important task in treating burns. Till now, there are still many controversies in the clinical definition, diagnosis, and treatment of infection, especially burn infection. The authors of this article put forward their opinions and views on this subject, hoping to deepen the readers' understanding of burn infection.

Türkiye’nin Güneydoğu Anadolu Bölgesinde Yanık Yarası Enfeksiyonundan Bakteri İzolasyonu ve Antibiyotik Duyarlılık Testi Sonuçları

This study was conducted to find the bacterial profile isolated from the wound areas of the patients hospitalized in our burn center, which is the only one in our region and to find the sensitive antibiotics to be used in the treatment. In this study, the culture reports of 395 patients, whose wound culture results were (+), obtained from 1415 patients hospitalized in Gazi Yaşargil Training and Research Hospital burn center between January 2010 and January 2020, were included. Of the 394 patients, 217 (55%) were male and 117 (45%) were female. The average age of the patients is 12,86±17,34 years. The average burn degree is 2,67. In the wound culture results, 70,55% of gram (+) and 28,68% of gram (-) bacteria were found. Candida albicans were found in wound culture growth results with a rate of 0,07%. The most common gram (+) pathogen is Staphylococcus aureus with 23,09% (n: 91). In our study, the resistance rate of Staphylococcus aureus to methicillin was 20,31%. The most common gram (-) pathogen was E. coli with 9,13% (n: 36) and Pseudomonas aeruginosa with 9,13% (n: 36). Gram (+) organisms were mostly isolated with a rate of 78,95% in the culture results of patients who needed intensive care clinically due to infection. Staphylococcus aureus is the most common bacteria with 21,05%. As a result of our study, it was found that the most common cause of burn infection in our region was S. aureus, P. aeruginosa, and E. coli. We hope that the use of broad-spectrum antibiotics that can be effective against these bacteria will contribute to clinical treatment until culture results are available.

Engineered Superinfective Pf Phage Prevents Dissemination of Pseudomonas aeruginosa in a Mouse Burn Model.

Pf is a filamentous bacteriophage integrated in the chromosome of most clinical isolates of Pseudomonas aeruginosa. Under stress conditions, mutations occurring in the Pf genome result in the emergence of superinfective variants of Pf (SI-Pf) that are capable of circumventing phage immunity; therefore, SI-Pf can even infect Pf-lysogenized P. aeruginosa. Here, we identified specific mutations located between the repressor and the excisionase genes of Pf4 phage in the P. aeruginosa PAO1 strain that resulted in the emergence of SI-Pf. Based on these findings, we genetically engineered an SI-Pf (eSI-Pf) and tested it as a phage therapy tool for the treatment of life-threatening burn wound infections caused by PAO1. In validation experiments, eSI-Pf was able to infect PAO1 grown in a lawn as well as biofilms formed in vitro on polystyrene. eSI-Pf also infected PAO1 present in burned skin wounds on mice but was not capable of maintaining a sustained reduction in bacterial burden beyond 24 h. Despite not lowering bacterial burden in burned skin tissue, eSI-Pf treatment completely abolished the capability of P. aeruginosa to disseminate from the burn site to internal organs. Over the course of 10 days, this resulted in bacterial clearance and survival of all treated mice. We subsequently determined that eSI-Pf induced a small-colony variant of P. aeruginosa that was unable to disseminate systemically. This attenuated phenotype was due to profound changes in virulence determinant production and altered physiology. Our results suggest that eSI-Pf has potential as a phage therapy against highly recalcitrant antimicrobial-resistant P. aeruginosa infections of burn wounds. IMPORTANCE Pseudomonas aeruginosa is a major cause of burn-related infections. It is also the most likely bacterial infection to advance to sepsis and result in burn-linked death. Frequently, P. aeruginosa strains isolated from burn patients display a multidrug-resistant phenotype necessitating the development of new therapeutic strategies and prophylactic treatments. In this context, phage therapy using lytic phages has demonstrated exciting potential in the control P. aeruginosa infection. However, lytic phages can present a set of drawbacks during phage therapy, including the induction of bacterial resistance and limited bacteria-phage interactions in vivo. Here, we propose an alternative approach to interfere with P. aeruginosa pathogenesis in a burn infection model, i.e., by using an engineered superinfective filamentous phage. Our study demonstrates that treatment with the engineered Pf phage can prevent sepsis and death in a burn mouse model.

The Use of Negative Pressure Wound Therapy in Infected Burn Wounds: Bridging the Gap

The Use of Negative Pressure Wound Therapy in Infected Burn Wounds: Bridging the Gap

Патогенез инфицированной ожоговой раны у крыс

Burns are a severe and widespread type of injury and are accompanied by local and systemic complications, leading to disability and death. Infection is a major complication of burn injury because thermal burns can cause disturbances of humoral and cellular immunity, and necrotized tissue ceases to perform its normal barrier function, which leads to the development of infection caused by environmental opportunistic microorganisms and commensals, which limits the ability of the skin to heal. In addition, the scab of a burn wound is a nutrient-rich environment that is easily colonized by microorganisms. Gram-positive bacteria are the first colonizers of the wound bed because they make up the microflora of the skin microbiome. Burn wounds are most commonly associated with Staphylococcus aureus, which is capable of producing virulence factors that slow wound healing. The frequency of thermal injuries and their subsequent infection necessitates the creation of new therapeutic agents as well as the development and adaptation of relevant model systems for preclinical studies. A sufficient number of in vivo models have been developed to study the pathogenesis of burn injuries, as well as to conduct specific studies as part of preclinical studies of potential therapeutic agents. Rats are an adaptable model for reproducing infected burn wounds and evaluating their course. The aim of the study was to evaluate the pathogenesis of infected burns, allowing further use of this model pathology in the study of a wide range of potential antiseptic and anti-burn agents. The study successfully generated a model of infected skin burn in Wistar rats. Creation of burn wounds was carried out by contact method, the inducing damage temperature was 100 °C, Staphylococcus aureus ATCC 25923 was used as an infectious agent. Evaluation of the dynamics of the course of an infected burn wound was carried out according to the results of planimetric, microbiological, cytological and histological studies. The developed model of an infected skin burn in rats is relevant to study the pharmacological activity of antiseptic agents and local anti-burn agents with an antimicrobial component of the mechanism of action.

Anti-Pseudomonas aeruginosa Vaccines and Therapies: An Assessment of Clinical Trials.

Pseudomonas aeruginosa is a Gram-negative opportunistic pathogen that causes high morbidity and mortality in cystic fibrosis (CF) and immunocompromised patients, including patients with ventilator-associated pneumonia (VAP), severely burned patients, and patients with surgical wounds. Due to the intrinsic and extrinsic antibiotic resistance mechanisms, the ability to produce several cell-associated and extracellular virulence factors, and the capacity to adapt to several environmental conditions, eradicating P. aeruginosa within infected patients is difficult. Pseudomonas aeruginosa is one of the six multi-drug-resistant pathogens (ESKAPE) considered by the World Health Organization (WHO) as an entire group for which the development of novel antibiotics is urgently needed. In the United States (US) and within the last several years, P. aeruginosa caused 27% of deaths and approximately USD 767 million annually in health-care costs. Several P. aeruginosa therapies, including new antimicrobial agents, derivatives of existing antibiotics, novel antimicrobial agents such as bacteriophages and their chelators, potential vaccines targeting specific virulence factors, and immunotherapies have been developed. Within the last 2-3 decades, the efficacy of these different treatments was tested in clinical and preclinical trials. Despite these trials, no P. aeruginosa treatment is currently approved or available. In this review, we examined several of these clinicals, specifically those designed to combat P. aeruginosa infections in CF patients, patients with P. aeruginosa VAP, and P. aeruginosa-infected burn patients.

Emergency in Group A Streptococcal Infections: Single center data from Turkey.

Emergency in Group A Streptococcal Infections: Single center data from Turkey.

Research advances on the prevention and treatment of burn infection in the elderly

Infection is a common complication after burns and the major cause of death in patients suffering severe burn injury. The infection of the elderly after burns is more serious due to their decreased immune function that is complicated with factors such as multiple chronic diseases and dysfunction of various organs. In addition, the burn infection in the elderly lacks the specific symptoms and signs, which brings great challenges to its diagnosis and treatment. To effectively prevent and control infection is very important for the treatment of elderly burn patients. Combined the clinical characteristics of burn infection in the elderly, this paper summarized the research advances of prevention and treatment for burn infection in the elderly from fluid resuscitation, wound treatment, antibiotic using, organ protection, nutritional support, and infection prevention, aiming to provide reference for clinical practice.

The antibacterial activity of LL-37 peptide against multidrug-resistant Pseudomonas aeruginosa isolated from burn infections

Multidrug-resistant Pseudomonas aeruginosa has emerged as a significant problem worldwide, posing a severe hazard to burn-infected patients. Antimicrobial peptides produced from humans or animals and synthetic peptides have received interest as antibiotic options for treating resistant bacteria, particularly those obtained from burn patients. The current work evaluated the role of antimicrobial peptide LL-37 as an antibacterial agent against multidrug P. aeruginosa isolates from burn infections. The study samples were collected between November 2021 and the end of February 2022 and included 157 clinical specimens as burn swabs from patients with burn infections admitted to four Baghdad hospitals in Baghdad, Iraq. The results of selective media, biochemical tests, and the ITEK2 system identified 39 isolates (24.8%) as p. aeruginosa from all collected bacterial cultures. The findings of the antimicrobial susceptibility test by disc diffusion method for the isolates under investigation revealed that P. aeruginosa clinical isolates were moderately resistant to antibiotics tested. Most P. aeruginosa isolates were highly resistant to Tetracycline (89.7%), Azithromycin (71.7%), and Amikacin, Cefepime, and Gentamycin. Also, the highest sensitivity was recorded for Ciprofloxacin, Piperacillin/tazobactam, C ceftazidime and Levofloxacin. The results of minimum inhibitory concentrations (MICs) of LL-37 against (8) multidrug-resistant P. aeruginosa isolates revealed that the concentration range of LL-37 was (15.6-1000 µg/ml), indicating that LL-37 has a significant effect on P. aeruginosa growth at low concentrations. In conclusion, t using the antimicrobial peptides LL-37 in treating life-threaded infections could lead to developing a new generation of antimicrobials that can overcome bacterial resistance mechanisms. Keywords: Antibacterial, Burns, LL-37, Pseudomonas aeruginosa