Efficacy of Using Probiotics with Antagonistic Activity against Pathogens of Wound Infections: An Integrative Review of Literature

Abstract

e skin and its microbiota serve as physical barriers to prevent invasion of pathogens. Skin damage can be a consequence of illness, surgery, and burns. e most effective wound management strategy is to prevent infections, promote healing, and prevent excess scarring. It is well established that probiotics can aid in skin healing by stimulating the production of immune cells, and they also exhibit antagonistic effects against pathogens via competitive exclusion of pathogens. Our aim was to conduct a review of recent literature on the efficacy of using probiotics against pathogens that cause wound infections. In this integrative review, we searched through the literature published in the international following databases: PubMed, ScienceDirect, Web of Science, and Scopus using the search terms "probiotic" AND "wound infection." During a comprehensive review and critique of the selected research, fourteen in vitro studies, 8 animal studies, and 19 clinical studies were found. Two of these in vitro studies also included animal studies, yielding a total of 39 articles for inclusion in the review. e most commonly used probiotics for all studies were well-known strains of the species Lactobacillus plantarum, Lactobacillus casei, Lactobacillus acidophilus, and Lactobacillus rhamnosus. All in vitro studies showed successful inhibition of chosen skin or wound pathogens by the selected probiotics. Within the animal studies on mice, rats, and rabbits, probiotics showed strong opportunities for counteracting wound infections. Most clinical studies showed slight or statistically significant lower incidence of surgical site infections, foot ulcer infection, or burn infections for patients using probiotics. Several of these studies also indicated a statistically significant wound healing effect for the probiotic groups. is review indicates that exogenous and oral application of probiotics has shown reduction in wound infections, especially when used as an adjuvant to antibiotic therapy, and therefore the potential use of probiotics in this field remains worthy of further studies, perhaps focused more on typical skin inhabitants as next-generation probiotics with high potential.

Bacterial Biofilm and its Role in the Pathogenesis of Disease

“…Most wounds that contain microorganisms heal successfully. However, sometimes microorganisms, and particularly bacteria, multiply, healing is disrupted and wound tissues are damaged resulting in an infection [106,107]. Both chronic and acute wounds are susceptible to infection as a result of the loss of the innate barrier function of the skin and dermal appendages [108].…”

Synergistic Activation of Toll-Like and NOD Receptors by Complementary Antigens as Facilitators of Autoimmune Disease: Review, Model and Novel Predictions

“…Microbiome constituents have apparently been selected for their antigenic similarity to “self” antigens, including T cell receptors, so that microbiome constituents are treated as “self” by the immune system [ 69 , 70 ]. Because of this immune system mimicry, a healthy microbiome appears to act like a secondary immune system, controlling potential pathogens [ 91 , 92 , 93 , 94 , 95 ]. Thus, the microbiome does not qualify as something that can activate a CAT mechanism although elements of it may be targeted by AD if they mimic the host antigens attacked by the AD [ 69 ].…”

<p>Bacteriophages, a New Therapeutic Solution for Inhibiting Multidrug-Resistant Bacteria Causing Wound Infection: Lesson from Animal Models and Clinical Trials</p>

“…2 Wounds and skin damage can be induced by heat, colds, rays and chemical burns, cuts, various surgeries, or an underlying disease such as diabetes. 3 In general, wounds are divided into acute and chronic categories. Types of acute ulcers include surgical wounds, insect bites, burns, cuts, and abrasions that expected to heal within a predictable time frame; however, given the severity of the injury, treatment options can speed up the healing process.…”

“…1,6,7 Wound infection, frequent types of nosocomial infections, affects many people around the world each year and has a high mortality rate. 3,8 In healthy and immunocompetent individuals, the immune system naturally plays a protective role against infectious agents, but in the event of an immunodeficiency, various microbial pathogens will damage the underlying tissues, spread throughout the body, resulting in disruption of different organs and even death. 9 Wound infection is often caused by the entry of bacterial pathogens through the other parts of the body or the environment into the skin gaps, and depending on the type of pathogen, adjacent tissues may also be involved.…”

“…Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae and Acinetobacter baumannii are common bacteria that cause wound infection. 2,3,10 These pathogens can cause damage and infections by utilizing various virulence factors. [11][12][13] Wounds, especially burn wounds, in the first week are colonized by grampositive pathogens such as S. aureus, and from the beginning of the second week, the gram-negative pathogens enter the wound.…”