IMMERSION OF DEBRIDED DIABETIC FOOT ULCER (DFU) TISSUE IN ELECTROCHEMICALLY GENERATED PH NEUTRAL HYPOCHLOROUS ACID SIGNIFICANTLY REDUCES THE MICROBIAL BIOBURDEN: WHOLE-GENOME SEQUENCING OF Staphylococcus aureus, THE MOST PREVALENT SPECIES RECOVERED
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2023Access:
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GREALY L, WILSON P, GILLEN C, DUFFY E, HEALY M-L, DALY B, POLYZOIS I, VAN HARTEN M, DIUGALL A, BRENNAN GI, COLEMAN DC, McMANUS BA, IMMERSION OF DEBRIDED DIABETIC FOOT ULCER (DFU) TISSUE IN ELECTROCHEMICALLY GENERATED PH NEUTRAL HYPOCHLOROUS ACID SIGNIFICANTLY REDUCES THE MICROBIAL BIOBURDEN: WHOLE-GENOME SEQUENCING OF Staphylococcus aureus, THE MOST PREVALENT SPECIES RECOVERED, JOURNAL OF HOSPITAL INFECTION, 138, August, 2023, 42 - 51Abstract:
Background: Diabetic foot ulcer infections (DFUIs) are the leading cause of lower limb amputations, mediated predominantly by Staphylococcus aureus. pH neutral electrochemically-generated hypochlorous acid (anolyte) is a non-toxic, microbiocidal agent with significant potential for wound disinfection.
Aims: To investigate both the effectiveness of anolyte for microbial bioburden reduction in debrided ulcer tissues and the population of resident S. aureus.
Methods: Fifty-one debrided tissues from 30 people with type II diabetes were aliquoted by wet weight and immersed in 1 or 10 ml volumes of anolyte (200 parts per million) or saline for three min. Microbial loads recovered were determined in colony forming units/g (CFU/g) of tissue following aerobic, anaerobic and staphylococcal-selective culture. Bacterial species were identified and 50 S. aureus isolates from 30 tissues underwent whole-genome sequencing (WGS).
Findings: The ulcers were predominantly superficial, lacking signs of infection (39/51, 76.5%). Of the 42/51 saline-treated tissues yielding ≥105 CFU/g, a microbial threshold reported to impede wound-healing, only 4/42 (9.5%) were clinically-diagnosed DFUIs. Microbial loads from anolyte-treated tissues were significantly lower than saline-treated tissues using 1 ml (1065-fold, 2.0 log) and 10 ml (8216-fold, 2.1 log) immersion volumes (p<0.0005). Staphylococcus aureus was the predominant species recovered (44/51, 86.3%) and 50 isolates underwent WGS. All were meticillin-susceptible and comprised 12 sequence types (STs), predominantly ST1, ST5 and ST15. Whole-genome multilocus sequence typing identified three clusters of closely related isolates from 10 patients indicating inter-patient transmission.
Conclusions: Short immersions of debrided ulcer tissue in anolyte significantly reduced microbial bioburden: a potential novel DFUI treatment.
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Health Research Board (HRB)
EIA-2019-002
Author's Homepage:
http://people.tcd.ie/dcolemanhttp://people.tcd.ie/dougala
http://people.tcd.ie/bmcmanu
http://people.tcd.ie/dalybl
http://people.tcd.ie/polyzoi
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PUBLISHED10th June 2023; Pub ahead of print
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JOURNAL OF HOSPITAL INFECTION138
August
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Full text availableKeywords:
Whole-genome sequencing., Electrolyzed water, Disinfection, Debrided foot ulcer tissue, Electrochemically-generated hypochlorous acid, Staphylococcus aureusSubject (TCD):
Immunology, Inflammation & Infection , Genomes, Genomics , Oral microbiology , STAPHYLOCOCCUS AUREUS INFECTION , Whole Genome SequencingDOI:
https://doi.org/10.1016/j.jhin.2023.06.006Metadata
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