Citric acid treatment of severe electric burns complicated by multiple antibiotic resistant Pseudomonas aeruginosa

Nagoba, Basavraj; Gandhi, Rajan C; Wadher, B.J.; Deshmukh, Sandeep R.; Gandhi, Sanjay P

doi:10.1016/s0305-4179(98)00052-7

Cited by 25 publications

(23 citation statements)

References 3 publications

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“…Our finding that citric acid plus acetic acid were collectively effective in mediating the bactericidal effect of RescuDerm TM is in agreement with studies showing that topical application of such organic acids can successfully eradicate P. aeruginosa from burns and promote formation of granulation tissue (Sloss et al. 1993; Nagoba et al. 1998b).…”

Section: Discussionsupporting

confidence: 90%

Biofilm reduction by a new burn gel that targets nociception

Martineau

Dosch

2007

J Appl Microbiol

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Aims: To compare the ability of an amorphous first aid topical gel containing vinegar, citric acid and EDTA (RescuDermTM; RESC) and various derivative formulations to eradicate Pseudomonas aeruginosa (PSEUD) and Staphylococcus epidermidis (STAPH) biofilms. Methods and Results: 24‐h biofilms prepared using the Minimum Biofilm Elimination Concentration (MBECTM) Assay System were exposed for 4 or 24 h to the different gel formulations. Citric acid‐free, acetic acid‐free or acetic acid‐free/sodium acetate‐supplemented RESC gels reduced PSEUD and STAPH biofilm formation as effectively as RESC. Substituting the weak organic acids with equivalent concentrations of glacial acetic acid reduced the effectiveness of gel against PSEUD and STAPH biofilms by half, but viable bacterial counts still remained below 4 log10 CFU/peg. Removal of gelling agent and/or EDTA enhanced efficacy against PSEUD but not STAPH biofilms. An acidified placebo gel formulation generated an only marginal bactericidal effect compared to that of RESC. Conclusions: RESC is a promising new antimicrobial agent. Its weak organic acid content, rather than merely acidic pH, mediates its considerable in vitro bactericidal efficacy against bacterial biofilms. Significance and Impact of the Study: These data, taken together with the observation that RescuDermTM possesses broad in vitro bactericidal activity against other pathogen species, suggest the potential usefulness of this product for controlling biofilm formation on a variety of cutaneous traumatic and surgical wounds.

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Section: Discussionsupporting

confidence: 90%

Biofilm reduction by a new burn gel that targets nociception

Martineau

Dosch

2007

J Appl Microbiol

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“…This findings is similar to our earlier reports in which 2% citric acid has been reported to be effective in in vitro studies. [9][10] In the present study, oxalic acid, lactic acid and trichloroacetic acid were also found highly effective in in vitro study. To the best of our knowledge, the activity of these acids against P. aeruginosa has not been reported so far.…”

Section: Discussionsupporting

confidence: 64%

In-vitro susceptibility of multiple drug resistant Pseudomonas aeruginosa to organic acids

Nagoba¹,

Wadher²,

Selkar³

2013

Jmid

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Objectives: Pseudomonas aeruginosa is a classic opportunistic pathogen with innate resistance to many antibiotics and disinfectants. Resistance to antimicrobial agents makes it the most noxious organism to eliminate from infection site. In view of its antimicrobial resistance, an attempt was made to study its susceptibility to various organic acids. Methods:Seven clinical isolates of P. aeruginosa resistant to multiple antibiotics were subjected to in vitro susceptibility to various organic acids by broth dilution method to find out susceptibility to various organic acids. Results:The isolates of P. aeruginosa resistant to 14 antimicrobials were found susceptible to one percent oxalic acid and trichloroacetic acid, two percent lactic acid and citric acid, and three percent acetic acid. It is interesting to note that strains resistant to multiple antibiotics were also found susceptible to organic acids. Oxalic acid and trichloroacetic acid were found highly effective. Conclusions:Clinical use of oxalic acid, trichloroacetic acid and lactic acid as topical agents to treat superficial pseudomonal infections caused by difficult strains of P. aeruginosa may be recommended after confirmation of their toxicity and in vivo efficacy in animal models. J Microbiol Infect Dis 2013; 3(2): 67-70

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“…Topical medications such as boric acid, acetic acid, 3% citric acid, 0.5% chlorhexidine acetate (Bactigrass), silver-coated dressing (Acticoat), and 1% silver sulfadiazine (Silverdin) have been used to treat burn wounds infected with Pseudomonas aeruginosa. [12][13][14][15][16]18,19,25,27 However, no study has compared the effectiveness of topical antimicrobial agents against multidrug-resistant Pseudomonas aeruginosa infections. Similarly, no experimental study has investigated the effectiveness of citric acid against Pseudomonas aeruginosa infections in burn patients.…”

Section: Discussionmentioning

confidence: 99%

“…Topical medications such as sulfamylon (mafenide acetate), silver nitrate, aquacel silver, Contreet antimicrobial foam, PolyMem Silver dressings, boric acid, acetic acid, 3% citric acid, 0.5% chlorhexidine acetate (Bactigrass), silver sulfadiazine 1% (Silverdin), and silver-coated dressing (Acticoat) are used clinically to treat Pseudomonas aeruginosa infections, which are frequently encountered in burn intensive care units and often lead to mortality. [12][13][14][15][16][17] Several topical and systemic antibacterial agents are used to treat infections in burn patients, and different drug groups produce distinct clinical responses. Most studies investigating such responses have examined topical agents individually.…”

mentioning

confidence: 99%

“…Here, we evaluated the efficacy of citric acid for treating severe burn wounds. 15,[18][19] No experimental studies have evaluated the effects of antibiotics used to treat infections caused by the multi-drug resistant Pseudomonas aeruginosa. Therefore, we evaluated the effectiveness of topical antimicrobial agents [3% citric acid, 0.5% chlorhexidine acetate (Bactigrass), 1% silver sulfadiazine (Silverdin) and silver-coated dressing (Acticoat)] on multidrug-resistant Pseudomonas aeruginosa infections established in experimental rats.…”

mentioning

confidence: 99%

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Assessment of the Effectiveness of Silver-Coated Dressing, Chlorhexidine Acetate (0.5%), Citric Acid (3%), and Silver Sulfadiazine (1%) for Topical Antibacterial Effects Against the Multi-Drug Resistant Pseudomonas Aeruginosa Infecting Full-Skin Thickness Burn Wounds on Rats

Yabanoğlu

Başaran

Aydoğan

et al. 2013

International Surgery

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The aim of this study was to compare the effects of four different topical antimicrobial dressings on a multi-drug resistant Pseudomonas aeruginosa contaminated full-thickness burn wound rat model. A total of 40 adult male Wistar albino rats were used. The control group (group 1), silver sulfadiazine (1%) group 2, chlorhexidine acetate (0.5%) group 3, citric acid (3%) group 4, and silver-coated dressing group 5 were compared to assess the antibacterial effects of a daily application to a 30% full-skin thickness burn wound seeded 10 minutes earlier with 108 CFU (colony forming unit)/0.5 mL of a multi-drug resistant Pseudomonas aeruginosa strain. Five groups (1 control group and 4 treatment groups) were compared. The administration of third-degree burns to all rats was confirmed based on histopathologic data. The tissue cultures from groups 2 and 5 exhibited significant differences compared to those of the other 3 groups, whereas no significant differences were observed between groups 1, 3, and 4. The effectiveness of the treatments was as follows: 1% silver sulfadiazine > silver-coated dressing > 3% citric acid > 0.5% chlorhexidine acetate > control group. Our results supported the efficacy of topical therapy by silver sulfadiazine and silver-coated dressing on infections caused by multi-drug resistant Pseudomonas spp.

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Citric acid treatment of severe electric burns complicated by multiple antibiotic resistant Pseudomonas aeruginosa

Cited by 25 publications

References 3 publications

Biofilm reduction by a new burn gel that targets nociception

Biofilm reduction by a new burn gel that targets nociception

In-vitro susceptibility of multiple drug resistant Pseudomonas aeruginosa to organic acids

Assessment of the Effectiveness of Silver-Coated Dressing, Chlorhexidine Acetate (0.5%), Citric Acid (3%), and Silver Sulfadiazine (1%) for Topical Antibacterial Effects Against the Multi-Drug Resistant Pseudomonas Aeruginosa Infecting Full-Skin Thickness Burn Wounds on Rats

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