Bacterial antimicrobial resistance and dermatological ramifications*

Muhaj, Fiorinda; George, Saira; Tyring, Stephen K.

doi:10.1111/bjd.21033

Cited by 7 publications

(7 citation statements)

References 91 publications

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“…Another important aspect is that antibiotics in dermatology are often used for prolonged courses, with significant potential microbiome alteration and antibiotic-related adverse effects. 1,9,10 Biocidal substances frequently used for the decolonization of human skin increasingly encounter the development of resistant bacteria, sometimes accompanied by cross-resistance to antibiotics. 6,59 Clones of Escherichia coli were recently detected, which were even less sensitive to povidone-iodine.…”

Section: F I G U R Ementioning

confidence: 99%

“…9 Thus, there is an urgent need for further research on antimicrobial alternatives in order to prevent the appearance of even more drug-resistant bacteria. 10 Such novel processes could be the use of bacteriophages 11 or antimicrobial peptides. 12 Another innovative approach is the photodynamic inactivation of bacteria (PDI), whose strength is to kill Gram-positive and Gram-negative bacteria regardless of their resistance profiles.…”

Section: Introductionmentioning

confidence: 99%

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Photodynamic inactivation of different pathogenic bacteria on human skin using a novel photosensitizer hydrogel

Eckl

Hoffmann

Landgraf

et al. 2023

Acad Dermatol Venereol

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Background The colonization of skin with pathogenic, partially antibiotic‐resistant bacteria is frequently a severe problem in dermatological therapies. For instance, skin colonization with Staphylococcus aureus is even a disease‐promoting factor in atopic dermatitis. The photodynamic inactivation (PDI) of bacteria could be a new antibacterial procedure. Upon irradiation with visible light, a special photosensitizer exclusively generates singlet oxygen. This reactive oxygen species kills bacteria via oxidation independent of species or strain and their antibiotic resistance profile causing no bacterial resistance on its part. Objective To investigate the antibacterial potential of a photosensitizer, formulated in a new hydrogel, on human skin ex vivo. Methods The photochemical stability of the photosensitizer and its ability to generate singlet oxygen in the hydrogel was studied. Antimicrobial efficacy of this hydrogel was tested step by step, firstly on inanimate surfaces and then on human skin ex vivo against S. aureus and Pseudomonas aeruginosa using standard colony counting. NBTC staining and TUNEL assays were performed on skin biopsies to investigate potential necrosis and apoptosis effects in skin cells possibly caused by PDI. Results None of the hydrogel components affected the photochemical stability and the life time of singlet oxygen. On inanimate surfaces as well as on the human skin, the number of viable bacteria was reduced by up to 4.8 log10 being more effective than most other antibacterial topical agents. Histology and assays showed that PDI against bacteria on the skin surface caused no harmful effects on the underlying skin cells. Conclusion Photodynamic inactivation hydrogel proved to be effective for decolonization of human skin including the potential to act against superficial skin infections. Being a water‐based formulation, the hydrogel should be also suitable for the mucosa. The results of the present ex vivo study form a good basis for conducting clinical studies in vivo.

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Section: F I G U R Ementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Photodynamic inactivation of different pathogenic bacteria on human skin using a novel photosensitizer hydrogel

Eckl

Hoffmann

Landgraf

et al. 2023

Acad Dermatol Venereol

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“…In streptococcal infections, penicillin remains the antibiotic of choice. Importantly, clindamycin-resistant isolates have also been reported in Europe, including France and Finland, and Asian countries, with alarming rates of 94% in China [ 7 ]. Other species, such as Pseudomonas aeruginosa , are less common but they are a major problem leading to high mortality rates due to the appearance of drug-resistant strains, especially in critically ill and immunocompromised patients [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…The spectrum of P. aeruginosa cutaneous diseases includes localized and often self-limited infections, such as hot-tub folliculitis, chloronychia, hot-foot syndrome and interdigital intertrigo. Ecthyma gangrenosum and sometimes subcutaneous nodules are manifestations in immunocompromised hosts and as such present a medical emergency [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Repurposing Disulfiram as an Antimicrobial Agent in Topical Infections

et al. 2022

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Antimicrobial drugs applied topically offer several advantages. However, the widespread use of antibiotics has led to increasing antimicrobial resistance. One interesting approach in the drug discovery process is drug repurposing. Disulfiram, which was originally approved as an anti-alcoholism drug, offers an attractive alternative to treat topical multidrug resistance bacteria in skin human infections. This study aimed to evaluate the biopharmaceutical characteristics of the drug and the effects arising from its topical application in detail. Microdilution susceptibility testing showed antibacterial activity against Gram-positive bacteria Staphylococcus aureus and Streptococcus pyogenes. Dermal absorption revealed no permeation in pig skin. The quantification of the drug retained in pig skin demonstrated concentrations in the stratum corneum and epidermis, enough to treat skin infections. Moreover, in vitro cytotoxicity and micro-array analyses were performed to better understand the mechanism of action and revealed the importance of the drug as a metal ion chelator. Together, our findings suggest that disulfiram has the potential to be repurposed as an effective antibiotic to treat superficial human skin infections.

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“…This new‐class topical agent for acne is a welcome addition to our therapeutic choices. In light of the increasing risk of antimicrobial resistance, raising concerns over the use of antibiotics for acne, the selection of nonantibiotic therapies may offer significant advantages 1,5 . Last but not least, the advent of this novel topical treatment opens exciting new pathways to explore in future research and phase III clinical trials, namely the usefulness of this topical treatment for resistant acne, its possible combination with other treatments, and further applicability as a maintenance treatment.…”

mentioning

confidence: 99%

Advances in acne clinical research: a new class of topical treatment for moderate-to-severe facial acne

Dessinioti

2022

British Journal of Dermatology

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Bacterial antimicrobial resistance and dermatological ramifications*

Abstract: Data availability statementData sharing not applicable to this article as no datasets were generated or analysed during the current study.

Cited by 7 publications

References 91 publications

Photodynamic inactivation of different pathogenic bacteria on human skin using a novel photosensitizer hydrogel

Photodynamic inactivation of different pathogenic bacteria on human skin using a novel photosensitizer hydrogel

Repurposing Disulfiram as an Antimicrobial Agent in Topical Infections

Advances in acne clinical research: a new class of topical treatment for moderate-to-severe facial acne

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