Antimicrobial photodynamic therapy for the decolonization of methicillin-resistant Staphylococcus aureus from the anterior nares

Street, Cale N.; Pedigo, Lisa; Gibbs, Aaron; Loebel, Nicolas G.

doi:10.1117/12.828279

Cited by 14 publications

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“…In contrast, PDT treatment using a combination of methylene blue and CHG produced a statistically significant 5.1-log 10 reduction compared with the nontreated control and a rapid antibacterial effect. In addition, the combination produced sustained decolonization that persisted for up to 5 days (93).…”

Section: Photodynamic Therapymentioning

confidence: 97%

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Decolonization in Prevention of Health Care-Associated Infections

2016

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SUMMARYColonization with health care-associated pathogens such asStaphylococcus aureus, enterococci, Gram-negative organisms, andClostridium difficileis associated with increased risk of infection. Decolonization is an evidence-based intervention that can be used to prevent health care-associated infections (HAIs). This review evaluates agents used for nasal topical decolonization, topical (e.g., skin) decolonization, oral decolonization, and selective digestive or oropharyngeal decontamination. Although the majority of studies performed to date have focused onS. aureusdecolonization, there is increasing interest in how to apply decolonization strategies to reduce infections due to Gram-negative organisms, especially those that are multidrug resistant. Nasal topical decolonization agents reviewed include mupirocin, bacitracin, retapamulin, povidone-iodine, alcohol-based nasal antiseptic, tea tree oil, photodynamic therapy, omiganan pentahydrochloride, and lysostaphin. Mupirocin is still the gold standard agent forS. aureusnasal decolonization, but there is concern about mupirocin resistance, and alternative agents are needed. Of the other nasal decolonization agents, large clinical trials are still needed to evaluate the effectiveness of retapamulin, povidone-iodine, alcohol-based nasal antiseptic, tea tree oil, omiganan pentahydrochloride, and lysostaphin. Given inferior outcomes and increased risk of allergic dermatitis, the use of bacitracin-containing compounds cannot be recommended as a decolonization strategy. Topical decolonization agents reviewed included chlorhexidine gluconate (CHG), hexachlorophane, povidone-iodine, triclosan, and sodium hypochlorite. Of these, CHG is the skin decolonization agent that has the strongest evidence base, and sodium hypochlorite can also be recommended. CHG is associated with prevention of infections due to Gram-positive and Gram-negative organisms as well asCandida. Conversely, triclosan use is discouraged, and topical decolonization with hexachlorophane and povidone-iodine cannot be recommended at this time. There is also evidence to support use of selective digestive decontamination and selective oropharyngeal decontamination, but additional studies are needed to assess resistance to these agents, especially selection for resistance among Gram-negative organisms. The strongest evidence for decolonization is for use among surgical patients as a strategy to prevent surgical site infections.

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Section: Photodynamic Therapymentioning

confidence: 97%

“…In preliminary human testing, PDT eradicated nasal MRSA, with total treatment times of less than 10 min (93). In a small cohort study, Bryce et al found that the colonization rates for MSSA and MRSA were 24.4% and 0.9%, respectively, before PDT therapy (94).…”

Section: Photodynamic Therapymentioning

confidence: 99%

Decolonization in Prevention of Health Care-Associated Infections

2016

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“…Lambrechts et al (33) reported similar results, in which human plasma and serum both reduced the killing of S. aureus , P. aeruginosa and C. albicans using the cationic 5-phenyl-10,15,20-tris(N-methyl-4-pyridyl)porphyrin chloride and white light (30 mW cm- 2 ). Street et al (34) asked whether PDI mediated by methylene blue (MB) could kill MRSA growing on an artificial skin construct composed of human-derived epidermal keratinocytes and dermal fibroblasts cultured at an air/media interface to form a stratified (epidermis and dermis), intact model of full thickness epithelialized human skin. Application of MB alone resulted in small reductions in MRSA viability from non-treated control while PDT treatment produced a significant (5.1 log10 reduction from control) immediately post-treatment and at 24 hours after treatment were almost sterile.…”

Section: Antimicrobial Pdt Ex Vivo or In Biological Materialsmentioning

confidence: 99%

Photodynamic therapy for localized infections—State of the art

Dai

Huang

Hamblin

2009

Photodiagnosis and Photodynamic Therapy

655

494

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Photodynamic therapy (PDT) was discovered over one hundred years ago by observing the killing of microorganisms when harmless dyes and visible light were combined in vitro. Since then it has primarily been developed as a treatment for cancer, ophthalmologic disorders and in dermatology. However in recent years interest in the antimicrobial effects of PDT has revived and it has been proposed as a therapy for a large variety of localized infections. This revival of interest has largely been driven by the inexorable increase in drug resistance amongst many classes of pathogen. Advantages of PDT include equal killing effectiveness regardless of antibiotic resistance, and a lack of induction of PDT resistance. Disadvantages include the cessation of the antimicrobial effect when the light is turned off, and less than perfect selectivity for microbial cells over host tissue. This review will cover the use of PDT to kill or inactivate pathogens in ex vivo tissues and in biological materials such as blood. PDT has been successfully used to kill pathogens and even to save life in several animal models of localized infections such as surface wounds, burns, oral sites, abscesses and the middle ear. A large number of clinical studies of PDT for viral papillomatosis lesions and for acne refer to its anti-microbial effect, but it is unclear how important this microbial killing is to the overall therapeutic outcome. PDT for periodontitis is a rapidly growing clinical application and other dental applications are under investigation. PDT is being clinically studied for other dermatological infections such as leishmaniasis and mycobacteria. Antimicrobial PDT will become more important in the future as antibiotic resistance is only expected to continue to increase.

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“…For better simulating in vivo condition, an artificial skin construct was applied to test whether methylene blue (MB) mediating PDT could inactivate MRSA growing on it [32]. The artificial skin was composed of human-derived epidermal keratinocytes and dermal fibroblasts cultured at an air/media interface to form a stratified model of full thickness epithelialized human skin.…”

Section: Inactivating Mrsa By Pdtmentioning

confidence: 99%

“…The artificial skin was composed of human-derived epidermal keratinocytes and dermal fibroblasts cultured at an air/media interface to form a stratified model of full thickness epithelialized human skin. PDT combined with MB treatment produced a significant reduction (5.1 logs) from control immediately after treatment and the effect was sustained over multiple days, while application of MB alone resulted in small reduction in MRSA viability from nontreated control [32]. …”

Section: Inactivating Mrsa By Pdtmentioning

confidence: 99%

Antimicrobial Photodynamic Therapy for Methicillin-ResistantStaphylococcus aureusInfection

Fang

Yao

2013

BioMed Research International

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Nowadays methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common multidrug resistant bacteria both in hospitals and in the community. In the last two decades, there has been growing concern about the increasing resistance to MRSA of the most potent antibiotic glycopeptides. MRSA infection poses a serious problem for physicians and their patients. Photosensitizer-mediated antimicrobial photodynamic therapy (PDT) appears to be a promising and innovative approach for treating multidrug resistant infection. In spite of encouraging reports of the use of antimicrobial PDT to inactivate MRSA in large in vitro studies, there are only few in vivo studies. Therefore, applying PDT in the clinic for MRSA infection is still a long way off.

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Antimicrobial photodynamic therapy for the decolonization of methicillin-resistant Staphylococcus aureus from the anterior nares

Cited by 14 publications

References 0 publications

Decolonization in Prevention of Health Care-Associated Infections

Decolonization in Prevention of Health Care-Associated Infections

Photodynamic therapy for localized infections—State of the art

Antimicrobial Photodynamic Therapy for Methicillin-ResistantStaphylococcus aureusInfection

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