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 |
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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. Further molecular research is needed to identify mechanisms that promote wound healing.</description><identifier>ISSN: 1534-7346</identifier><identifier>EISSN: 1552-6941</identifier><identifier>DOI: 10.1177/1534734619834746</identifier><identifier>PMID: 30929522</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>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</subject><ispartof>International journal of lower extremity wounds, 2019-06, Vol.18 (2), p.192-196</ispartof><rights>The Author(s) 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c337t-e3871167086ce4e1d7e5f08c694478ca7392186d89cdb1d93709ce80ba8ec8d13</citedby><cites>FETCH-LOGICAL-c337t-e3871167086ce4e1d7e5f08c694478ca7392186d89cdb1d93709ce80ba8ec8d13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1534734619834746$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1534734619834746$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30929522$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kyriakopoulos, Anthony M.</creatorcontrib><creatorcontrib>Grapsa, Eirini</creatorcontrib><creatorcontrib>Marcinkiewicz, Janusz</creatorcontrib><creatorcontrib>Nagl, Markus</creatorcontrib><title>Swift Cure of a Chronic Wound Infected With Multiresistant Staphylococcus aureus in an Elderly Patient With Stage 5 Renal Disease</title><title>International journal of lower extremity wounds</title><addtitle>Int J Low Extrem Wounds</addtitle><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.</description><subject>Administration, Topical</subject><subject>Aged, 80 and over</subject><subject>Anti-Infective Agents - therapeutic use</subject><subject>Anti-Inflammatory Agents - administration & dosage</subject><subject>Chronic Disease</subject><subject>Drug Resistance, Microbial</subject><subject>Drug Resistance, Multiple</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Humans</subject><subject>Kidney Failure, Chronic - complications</subject><subject>Kidney Failure, Chronic - diagnosis</subject><subject>Lower Extremity</subject><subject>Prognosis</subject><subject>Risk Assessment</subject><subject>Staphylococcal Infections - complications</subject><subject>Staphylococcal Infections - diagnosis</subject><subject>Staphylococcal Infections - drug therapy</subject><subject>Taurine - administration & dosage</subject><subject>Taurine - analogs & derivatives</subject><subject>Wound Healing - drug effects</subject><subject>Wound Healing - physiology</subject><subject>Wound Infection - complications</subject><subject>Wound Infection - drug therapy</subject><subject>Wound Infection - microbiology</subject><issn>1534-7346</issn><issn>1552-6941</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMFLwzAYxYMobk7vniT_QDVp2iY5Sp06mChO2bFkyVeX0bUjSZEd_c_NnHoQPH0Pvvd78B5C55RcUsr5Fc1ZxllWUCmiyIoDNKR5niaFzOjhTrMs2f0H6MT7FSEpJZIfowEjMpV5mg7Rx-zd1gGXvQPc1Vjhcum61mo87_rW4Elbgw5g8NyGJX7om2AdeOuDagOeBbVZbptOd1r3HquYEY9tsWrxuDHgmi1-UsFC9H7xEXgDnONnaFWDb6wH5eEUHdWq8XD2fUfo9Xb8Ut4n08e7SXk9TTRjPCTABKe04EQUGjKghkNeE6Fj1YwLrTiTKRWFEVKbBTWScSI1CLJQArQwlI0Q2edq13nvoK42zq6V21aUVLs1q79rRuRij2z6xRrML_AzXzQke4OPxapV17tYzP8f-AkxsH0w</recordid><startdate>201906</startdate><enddate>201906</enddate><creator>Kyriakopoulos, Anthony M.</creator><creator>Grapsa, Eirini</creator><creator>Marcinkiewicz, Janusz</creator><creator>Nagl, Markus</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>201906</creationdate><title>Swift Cure of a Chronic Wound Infected With Multiresistant Staphylococcus aureus in an Elderly Patient With Stage 5 Renal Disease</title><author>Kyriakopoulos, Anthony M. ; Grapsa, Eirini ; Marcinkiewicz, Janusz ; Nagl, Markus</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c337t-e3871167086ce4e1d7e5f08c694478ca7392186d89cdb1d93709ce80ba8ec8d13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Administration, Topical</topic><topic>Aged, 80 and over</topic><topic>Anti-Infective Agents - therapeutic use</topic><topic>Anti-Inflammatory Agents - administration & dosage</topic><topic>Chronic Disease</topic><topic>Drug Resistance, Microbial</topic><topic>Drug Resistance, Multiple</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Humans</topic><topic>Kidney Failure, Chronic - complications</topic><topic>Kidney Failure, Chronic - diagnosis</topic><topic>Lower Extremity</topic><topic>Prognosis</topic><topic>Risk Assessment</topic><topic>Staphylococcal Infections - complications</topic><topic>Staphylococcal Infections - diagnosis</topic><topic>Staphylococcal Infections - drug therapy</topic><topic>Taurine - administration & dosage</topic><topic>Taurine - analogs & 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. 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.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>30929522</pmid><doi>10.1177/1534734619834746</doi><tpages>5</tpages></addata></record> |
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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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