Acetic acid treatment for toe web infection caused by Pseudomonas Aeruginosa combined with fungal infection: A case series of ten patients

Rozenblat, Mati; Last, Omer; Fisher, Sharon; Ziv, Michael

doi:10.1111/dth.12883

Cited by 5 publications

(7 citation statements)

References 19 publications

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“…With the widespread use of colistin, the emergence of COL-R P. aeruginosa is increasing, posing significant clinical antiinfection prevention and treatment issues. AA, the active component of vinegar, has been reported to cure P. aeruginosa wound infections [42] and be an effective tuberculocidal disinfectant [41]. Although the disinfectant properties of organic acids, AA, are widely recognized, they have rarely been mentioned in bactericides evaluations [41].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the antibacterial, antibiofilm, and anti-virulence effects of acetic acid and the related mechanisms on colistin-resistant Pseudomonas aeruginosa

Feng

Zeng

et al. 2022

BMC Microbiol

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Background Pseudomonas aeruginosa (P. aeruginosa) has been majorly implicated in the infection of burns, wounds, skin, and respiratory tract. Colistin is considered the last line of defense against P. aeruginosa infections. However, colistin is becoming increasingly invalid in treating patients infected with colistin-resistant (COL-R) P. aeruginosa. As one of the disinfectants used for wound infections, acetic acid (AA) offers good antibacterial and antibiofilm activities against P. aeruginosa. This study investigated the effects of AA on COL-R P. aeruginosa in terms of its antibacterial, antibiofilm, and anti-virulence properties and the corresponding underlying mechanisms. Results The antimicrobial susceptibility and growth curve data revealed that 0.078% (v/v) AA exhibited good antibacterial activity against COL-R P. aeruginosa. Subinhibitory concentrations of AA were ineffective in inhibiting biofilm formation, but 4 × and 8 × of the minimum inhibitory concentration (MIC) was effective in removing the preformed biofilms in biofilm-eradication assays. The virulence results illustrated that AA inhibited COL-R P. aeruginosa swimming, swarming, twitching, and pyocyanin and elastase production. The analysis of the potential antibacterial mechanisms of AA on COL-R P. aeruginosa revealed that AA acted by increasing the outer and inner membrane permeability, polarizing the membrane potential, and decreasing the reduction potential in a concentration-dependent manner. The qRT-PCR results revealed that AA may inhibit the virulence of COL-R P. aeruginosa by inhibiting the expression of T3SS-related and QS-related genes. Conclusions AA possesses antibacterial, antibiofilm, and anti-virulence properties that ultimately lead to the alteration of the bacterial membrane permeability, membrane potential, and reduction potential. Our findings indicated that AA is presently one of the effective treatment options for infections. A high concentration of AA (> 0.156% v/v) can be used to sterilize biofilm-prone surgical instruments, for hospital disinfection, and for treating the external wound, whereas a low concentration of AA (0.00975–0.039% v/v) may be used as an anti-virulence agent for adjuvant treatment of COL-R P. aeruginosa, thereby further improving the application value of AA in the treatment of infections.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the antibacterial, antibiofilm, and anti-virulence effects of acetic acid and the related mechanisms on colistin-resistant Pseudomonas aeruginosa

Feng

Zeng

et al. 2022

BMC Microbiol

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“…Third, health education for patients, such as lifestyle changes, has generally been ignored and may prove to be a simple method for prevention. Finally, recent literature has con rmed that immersing feet in 1% acetic acid is a relatively effective adjuvant treatment to signi cantly reduce relapse of interdigital infections caused by P. aeruginosa [20][21][22].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of interdigital infections of toe web spaces in Shanghai, China: Etiology, risk factors, and therapeutic approaches

Yu¹,

Li²,

Kan³

et al. 2020

Preprint

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Background Interdigital infections are frequently misdiagnosed as tinea pedis and remain intractable to treatments because of high recurrence rates and potential complications. We aimed to understand the epidemiology of interdigital infections in Shanghai, China. Methods We conducted a cross-sectional study at Shanghai Dermatology Hospital from January 2019 to December 2019, enrolling 57 patients with acute interdigital inflammation. Patients received antibiotic therapy and underwent long-term follow-up. Clinical features and medical histories, including blood, bacterial, and mycologic examination results, cultures and drug susceptibility test results, and follow-up data were analyzed for pathogenic agents. Results We found Pseudomonas aeruginosa (40.35%), Staphylococcus aureus (36.84%), and other bacteria (22.8%). Compared to other bacteria, P. aeruginosa interdigital infection were more inclined to co-infect with fungal agents. Further, P. aeruginosa interdigital infections were frequently seen in the spring and autumn and in patients aged 60–69 years. However, interdigital infections caused by S. aureus occurred more frequently in the summer and in patients aged 31–40 years. We found that levofloxacin had excellent therapeutic effects. Conclusion Our findings may inform treatment and diagnostic guidelines and, subsequently, help reduce the rate of recurrence and improve patient outcomes following interdigital infections.

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“…There are multiple dermatologic conditions with sufficient evidence to support the use of vinegar, which are outlined in detail in Table 1. While acetic acid has been utilized as a component of compounded therapies, [14][15][16][17][18][19]21 we will highlight here the evidence for commercially available vinegar (5% acetic acid), as this is available to all patients. It has proven antimicrobial and antifungal effects, antioxidant properties, 63 and is useful in the treatment of several skin conditions, including EB, 22 uremic pruritis, 50 and striae gravidarum.…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…17 AA is a relatively inexpensive ingredient for the treatment of gram-negative bacterial toe web infection caused by P. aeruginosa. 18 In 10 patients, the combination of 20minute 1% AA soaks with either topical (bifonazole, clotrimazole) or systemic (terbinafine, itraconazole) antifungals was effective when used between 10 and 21 days. Furthermore, vinegar holds potential as a solubilizer for the poorly water-soluble antibiotic ciprofloxacin, improving drug delivery and thus preventing P. aeruginosa biofilm formation on wounds.…”

Section: Antimicrobial Effectsmentioning

confidence: 98%

“…AA is a relatively inexpensive ingredient for the treatment of gram‐negative bacterial toe web infection caused by P . aeruginosa 18 . In 10 patients, the combination of 20‐minute 1% AA soaks with either topical (bifonazole, clotrimazole) or systemic (terbinafine, itraconazole) antifungals was effective when used between 10 and 21 days.…”

Section: Antimicrobial Effectsmentioning

confidence: 99%

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Acetic acid and the skin: a review of vinegar in dermatology

2021

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Vinegar is commonly used as a home remedy for many skin problems. It is important for dermatologists to understand the evidence supporting its use in skin disease, as well as potential adverse effects, so they can properly counsel patients on the safe use of this widely available treatment. Vinegar possesses antimicrobial and antioxidant properties that provide utility in wound care as well as bacterial and fungal infections. There is also evidence to support its use in pruritus, head lice removal, and treatment of striae gravidarum. While generally safe, inappropriate use can result in damage to the skin. In this review, we discuss the evidence supporting vinegar as a treatment for skin disease, as well as adverse events reported from misuse, to provide dermatologists the knowledge to counsel patients on the safe and appropriate use of vinegar.

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Acetic acid treatment for toe web infection caused by Pseudomonas Aeruginosa combined with fungal infection: A case series of ten patients

Cited by 5 publications

References 19 publications

Evaluation of the antibacterial, antibiofilm, and anti-virulence effects of acetic acid and the related mechanisms on colistin-resistant Pseudomonas aeruginosa

Evaluation of the antibacterial, antibiofilm, and anti-virulence effects of acetic acid and the related mechanisms on colistin-resistant Pseudomonas aeruginosa

Epidemiology of interdigital infections of toe web spaces in Shanghai, China: Etiology, risk factors, and therapeutic approaches

Acetic acid and the skin: a review of vinegar in dermatology

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