Interventions for wound healing among diabetic patients infected with Staphylococcus aureus: a systematic review

Lima, Anacássia Fonseca de; Costa, Lívia; Silva, Joás Lucas da; Maia, Maria Bernadete de Sousa; Ximenes, Eulália Camelo Pessoa Azevedo

doi:10.1590/s1516-31802011000300007

Cited by 23 publications

(13 citation statements)

References 25 publications

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“…We found a high rate (44.2%) of methicillin resistance in our series. Nevertheless, in a recent review, Lima et al [21] reported an increase in antibiotic resistance among diabetic patients with foot infections and recommended the avoidance of wide empirical antibiotic coverage unnecessarily. Another important finding of this study was the fact that fusidic acid was efficient against all S. aureus species, including MRSA.…”

Section: Discussionmentioning

confidence: 99%

Increasing incidence of Gram-negative organisms in bacterial agents isolated from diabetic foot ulcers

Turhan

Mutluoğlu

Acar

et al. 2013

J Infect Dev Ctries

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Section: Discussionmentioning

confidence: 99%

Increasing incidence of Gram-negative organisms in bacterial agents isolated from diabetic foot ulcers

Turhan

Mutluoğlu

Acar

et al. 2013

J Infect Dev Ctries

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“…Wounds are a risk factor for colonization with methicillin-resistant S. aureus (MRSA) and other multidrug-resistant organisms, especially in hospital environments [14-18]. Bacterial colonization of wounds can increase wound severity and interfere with healing [6,11]. …”

Section: Introductionmentioning

confidence: 99%

“…in a hospital environment is therefore warranted, especially in wounds, which may be a source of cross-contamination by MRSA and coagulase-negative Staphylococcus spp. [11,15,18]. …”

Section: Introductionmentioning

confidence: 99%

Prevalence and factors associated with wound colonization by Staphylococcus spp. and Staphylococcus aureusin hospitalized patients in inland northeastern Brazil: a cross-sectional study

et al. 2014

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BackgroundInfections by Staphylococcus spp. are often associated with wounds, especially in hospitalized patients. Wounds may be the source of bacteria causing cross-contamination, and are a risk factor for methicillin-resistant Staphylococcus aureus (MRSA) infection. The aim of this study was to investigate the prevalence of wound colonization by Staphylococcus spp., especially S. aureus and MRSA, in hospitalized patients, and to identify the factors associated with such colonization.MethodsThis cross-sectional study enrolled patients with wounds who were hospitalized in a remote and underdeveloped inland region of northeastern Brazil with extreme poverty. Samples were collected using sterile swabs with 0.85% saline solution, and coagulase-negative Staphylococcus spp., S. aureus, and MRSA were identified using standard laboratory procedures. Data regarding the sociodemographic characteristics, antibiotic use, and comorbidities of the patients were collected using the medical records and a questionnaire.ResultsA total of 125 wounds were analyzed. The patients had a mean age of 63.88 years and a mean 3.84 years of school education. Eighty-one wounds (64.80%) were colonized by Staphylococcus spp. Twenty-five wounds (20%) were colonized by S. aureus, 32% of which were colonized by MRSA. Wound colonization by Staphylococcus spp. was associated with pneumonia or other respiratory disease (p = 0.03). Wound colonization by S. aureus was associated with nasal colonization by S. aureus (p < 0.001), fewer days of prior antibiotic use (p = 0.04), admission to a medical ward (p = 0.02), and age >65 years (p = 0.05). Among patients with wound colonization by MRSA, 37.50% had a history of prior antibiotic use, 75% had two or more comorbidities, 25% had cancer or diabetes, 50% had cardiovascular disease, and 50% died.ConclusionsWounds can be the source of Staphylococcus spp. infection, and high proportions of wounds are colonized by S. aureus and MRSA. Nasal colonization by S. aureus may be a source for wound colonization by S. aureus, illustrating the importance of preventing cross-contamination in hospital environments, especially among elderly patients. Wounds should be carefully managed to prevent microbial spread, thereby assisting patient recovery and reducing healthcare costs.

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“…Three systematic reviews including four meta-analyses [24,35,57] and 10 systematic reviews without a meta-analysis [69,70,74,79,81,86,88,93,98,112] (Table 4 ; Additional files 4 and 6) examined healing improvements of diabetic foot/leg ulcers. Three had an AMSTAR score ≥8 [24,74,98].…”

Section: Resultsmentioning

confidence: 99%

Seeking effective interventions to treat complex wounds: an overview of systematic reviews

Tricco

Antony

Vafaei

et al. 2015

BMC Med

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BackgroundNumerous, often multi-faceted regimens are available for treating complex wounds, yet the evidence of these interventions is recondite across the literature. We aimed to identify effective interventions to treat complex wounds through an overview of systematic reviews.MethodsMEDLINE (OVID interface, 1946 until October 26, 2012), EMBASE (OVID interface, 1947 until October 26, 2012), and the Cochrane Database of Systematic Reviews (Issue 10 of 12, 2012) were searched on October 26, 2012. Systematic reviews that examined adults receiving care for their complex wounds were included. Two reviewers independently screened the literature, abstracted data, and assessed study quality using the Assessment of Multiple Systematic Reviews (AMSTAR) tool.ResultsOverall, 99 systematic reviews were included after screening 6,200 titles and abstracts and 422 full-texts; 54 were systematic reviews with a meta-analysis (including data on over 54,000 patients) and 45 were systematic reviews without a meta-analysis. Overall, 44% of included reviews were rated as being of high quality (AMSTAR score ≥8). Based on data from systematic reviews including a meta-analysis with an AMSTAR score ≥8, promising interventions for complex wounds were identified. These included bandages or stockings (multi-layer, high compression) and wound cleansing for venous leg ulcers; four-layer bandages for mixed arterial/venous leg ulcers; biologics, ultrasound, and hydrogel dressings for diabetic leg/foot ulcers; hydrocolloid dressings, electrotherapy, air-fluidized beds, and alternate foam mattresses for pressure ulcers; and silver dressings and ultrasound for unspecified mixed complex wounds. For surgical wound infections, topical negative pressure and vacuum-assisted closure were promising interventions, but this was based on evidence from moderate to low quality systematic reviews.ConclusionsNumerous interventions can be utilized for patients with varying types of complex wounds, yet few treatments were consistently effective across all outcomes throughout the literature. Clinicians and patients can use our results to tailor effective treatment according to type of complex wound. Network meta-analysis will be of benefit to decision-makers, as it will permit multiple treatment comparisons and ranking of the effectiveness of all interventions.Please see related article: http://dx.doi.org/10.1186/s12916-015-0326-3Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-015-0288-5) contains supplementary material, which is available to authorized users.

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Interventions for wound healing among diabetic patients infected with Staphylococcus aureus: a systematic review

Cited by 23 publications

References 25 publications

Increasing incidence of Gram-negative organisms in bacterial agents isolated from diabetic foot ulcers

Increasing incidence of Gram-negative organisms in bacterial agents isolated from diabetic foot ulcers

Prevalence and factors associated with wound colonization by Staphylococcus spp. and Staphylococcus aureusin hospitalized patients in inland northeastern Brazil: a cross-sectional study

Seeking effective interventions to treat complex wounds: an overview of systematic reviews

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