Swift Cure of a Chronic Wound Infected With Multiresistant Staphylococcus aureus in an Elderly Patient With Stage 5 Renal Disease

We present a case of a 91-year-old female with stage 5 renal disease, diabetes type 2, and considerable weakness, suffering from a 2-month-old wound infected by a multiresistant Staphylococcus aureus. The wound measured 7 cm in length, 5 cm in width, and 1.5 cm in depth, having purulent white edges...

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Veröffentlicht in:International journal of lower extremity wounds 2019-06, Vol.18 (2), p.192-196
Hauptverfasser: Kyriakopoulos, Anthony M., Grapsa, Eirini, Marcinkiewicz, Janusz, Nagl, Markus
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container_end_page 196
container_issue 2
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container_title International journal of lower extremity wounds
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creator Kyriakopoulos, Anthony M.
Grapsa, Eirini
Marcinkiewicz, Janusz
Nagl, Markus
description We present a case of a 91-year-old female with stage 5 renal disease, diabetes type 2, and considerable weakness, suffering from a 2-month-old wound infected by a multiresistant Staphylococcus aureus. The wound measured 7 cm in length, 5 cm in width, and 1.5 cm in depth, having purulent white edges and exudates exceeding the size of the wound. The systemic antibiotic use was opposing to improve the patient’s clinical condition due to underlying nephrotoxicity that may have deteriorated renal failure and resistance of the infecting pathogen. The halogenated taurine (Tau) derivatives N-chlorotaurine (NCT) and N-bromotaurine (NBrT) with potent anti-inflammatory and antimicrobial efficacy were alternatively employed as combination topical treatment to provide a therapeutic solution. Each agent was applied separately with an interval of 5 minutes as a 1% spray in aqueous solution every 30 minutes during the day for 3 days. This treatment was very well tolerated and led to rapid disappearance of the purulent exudate, rapid epithelialization, and complete healing. To avoid relapse, the application was continued 4 times daily for a further 4 days. No complications occurred in the course of treatment. This case report confirms the therapeutic efficacy of NCT in chronic purulent wounds. NBrT is well tolerated, too, and can be used in combination with NCT in emergency clinical settings. Its potential as a single agent should be investigated in further studies. Advancement of wound closure by these agents proved to be life-saving for this patient. Further molecular research is needed to identify mechanisms that promote wound healing.
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The wound measured 7 cm in length, 5 cm in width, and 1.5 cm in depth, having purulent white edges and exudates exceeding the size of the wound. The systemic antibiotic use was opposing to improve the patient’s clinical condition due to underlying nephrotoxicity that may have deteriorated renal failure and resistance of the infecting pathogen. The halogenated taurine (Tau) derivatives N-chlorotaurine (NCT) and N-bromotaurine (NBrT) with potent anti-inflammatory and antimicrobial efficacy were alternatively employed as combination topical treatment to provide a therapeutic solution. Each agent was applied separately with an interval of 5 minutes as a 1% spray in aqueous solution every 30 minutes during the day for 3 days. This treatment was very well tolerated and led to rapid disappearance of the purulent exudate, rapid epithelialization, and complete healing. To avoid relapse, the application was continued 4 times daily for a further 4 days. No complications occurred in the course of treatment. This case report confirms the therapeutic efficacy of NCT in chronic purulent wounds. NBrT is well tolerated, too, and can be used in combination with NCT in emergency clinical settings. Its potential as a single agent should be investigated in further studies. Advancement of wound closure by these agents proved to be life-saving for this patient. 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dosage</topic><topic>Taurine - analogs &amp; derivatives</topic><topic>Wound Healing - drug effects</topic><topic>Wound Healing - physiology</topic><topic>Wound Infection - complications</topic><topic>Wound Infection - drug therapy</topic><topic>Wound Infection - microbiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kyriakopoulos, Anthony M.</creatorcontrib><creatorcontrib>Grapsa, Eirini</creatorcontrib><creatorcontrib>Marcinkiewicz, Janusz</creatorcontrib><creatorcontrib>Nagl, Markus</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>International journal of lower extremity wounds</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kyriakopoulos, Anthony M.</au><au>Grapsa, Eirini</au><au>Marcinkiewicz, Janusz</au><au>Nagl, Markus</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Swift Cure of a Chronic Wound Infected With Multiresistant Staphylococcus aureus in an Elderly Patient With Stage 5 Renal Disease</atitle><jtitle>International journal of lower extremity wounds</jtitle><addtitle>Int J Low Extrem Wounds</addtitle><date>2019-06</date><risdate>2019</risdate><volume>18</volume><issue>2</issue><spage>192</spage><epage>196</epage><pages>192-196</pages><issn>1534-7346</issn><eissn>1552-6941</eissn><abstract>We present a case of a 91-year-old female with stage 5 renal disease, diabetes type 2, and considerable weakness, suffering from a 2-month-old wound infected by a multiresistant Staphylococcus aureus. 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subjects Administration, Topical
Aged, 80 and over
Anti-Infective Agents - therapeutic use
Anti-Inflammatory Agents - administration & dosage
Chronic Disease
Drug Resistance, Microbial
Drug Resistance, Multiple
Drug Therapy, Combination
Female
Humans
Kidney Failure, Chronic - complications
Kidney Failure, Chronic - diagnosis
Lower Extremity
Prognosis
Risk Assessment
Staphylococcal Infections - complications
Staphylococcal Infections - diagnosis
Staphylococcal Infections - drug therapy
Taurine - administration & dosage
Taurine - analogs & derivatives
Wound Healing - drug effects
Wound Healing - physiology
Wound Infection - complications
Wound Infection - drug therapy
Wound Infection - microbiology
title Swift Cure of a Chronic Wound Infected With Multiresistant Staphylococcus aureus in an Elderly Patient With Stage 5 Renal Disease
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