mupirocin and Diabetes-Mellitus

Diabetic wounds (DW) are constantly challenged by excessive reactive oxygen species (ROS) accumulation and susceptibility to bacterial contamination. Therefore, the elimination of ROS in the immediate vicinity and the eradication of local bacteria are critical to stimulating the efficient healing of diabetic wounds. In the current study, we encapsulated mupirocin (MP) and cerium oxide nanoparticles (CeNPs) into a polyvinyl alcohol/chitosan (PVA/CS) polymer, and then a PVA/chitosan nanofiber membrane wound dressing was fabricated using electrostatic spinning, which is a simple and efficient method for fabricating membrane materials. The PVA/chitosan nanofiber dressing provided a controlled release of MP, which produced rapid and long-lasting bactericidal activity against both methicillin-sensitive S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) strains. Simultaneously, the CeNPs embedded in the membrane exhibited the desired ROS scavenging capacity to maintain the local ROS at a normal physiological level. Moreover, the biocompatibility of the multifunctional dressing was evaluated both in vitro and in vivo. Taken together, PVA-CS-CeNPs-MP integrated the desirable features of a wound dressing, including rapid and broad-spectrum antimicrobial and ROS scavenging activities, easy application, and good biocompatibility. The results validated the effectiveness of our PVA/chitosan nanofiber dressing, highlighting its promising translational potential in the treatment of diabetic wounds.

Topics: Anti-Bacterial Agents; Bandages; Chitosan; Diabetes Mellitus; Humans; Methicillin-Resistant Staphylococcus aureus; Mupirocin; Nanofibers; Polyvinyl Alcohol; Reactive Oxygen Species; Staphylococcus aureus; Wound Healing

Preoperative colonization with Staphylococcus aureus (SA) increases risk of surgical site infection. Screening for SA followed by skin and nasal decolonization can help to reduce the risk of postoperative infections. Risk factors for colonization are, however, not completely understood.. A case-control study using questionnaires and patient demographics specifically designed to observe SA colonization risk factors in a presurgical orthopedic population. A total of 115 subjects with a positive preoperative screen for SA nasal colonization prior to orthopedic surgery completed a questionnaire to assess for SA risk factors: these subjects served as our cases. An additional 476 controls completed similar questionnaires. Data collected included demographic, health, and lifestyle information. Multivariable logistic regression was used to generate odds ratios (OR) for risk of SA colonization.. Several risk factors were identified. Male sex (OR 2.3; 95% confidence interval [CI], [1.4-3.8]) and diabetes (OR 3.8 [1.8-7.8]) significantly increased the risk of SA colonization. Older age, visiting public places (OR 0.2 [0.1-0.3]), recent antibiotic use (OR 0.2 [0.1-0.6]), and the presence of facial hair (OR 0.3 [0.1-0.6]) significantly lowered the risk of SA colonization.. By identifying patients who may be at greater risk of SA colonization, we can better streamline our presurgical techniques to help reduce risk of surgical site infections and improve patient outcomes.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Carrier State; Case-Control Studies; Child; Diabetes Mellitus; Female; Humans; Male; Middle Aged; Mupirocin; Nose; Orthopedic Procedures; Preoperative Care; Risk Factors; Staphylococcal Infections; Staphylococcus aureus; Surgical Wound Infection; Young Adult

Peritonitis and exit-site infections (ESI) are major causes of technique failure and morbidity in peritoneal dialysis (PD) patients. Topical mupirocin on the exit-site has been shown to reduce such complications and prolong life in PD. Since the year 2000, such an approach has been adopted for our new incident PD population. We now report the results of this new protocol. We also studied the effect of co-morbidity on peritonitis occurrence.. A total of 740 incident PD patients were studied. Patients were divided into two groups based on year of entry into PD (Group 1 from January 1998-December 1999 without topical mupirocin and Group 2 from January 2000-March 2004 with topical mupirocin). Variables studied included gender, age, diabetic status, ischaemic heart disease, peripheral vascular disease, cerebrovascular disease and serum albumin.. Topical mupirocin at the exit-site has led to a significant reduction in peritonitis rate (0.443 vs 0.339 episodes/patient-year; P<0.0005) and ESI (0.168 vs 0.156 episodes/patient-year; P<0.005) attributed primarily to the significant reduction in Staphylococcus aureus infections. There was an unexpected finding of lower Pseudomonas aeruginosa peritonitis in the mupirocin group (P<0.005). Stepwise multiple logistic regression analysis revealed that only mupirocin application and serum albumin were significant predictors of peritonitis.. Our study, although limited by its retrospective nature, demonstrated that topical mupirocin was associated with a significant reduction in ESI and peritonitis with unexpected findings of lower Pseudomonas peritonitis. Serum albumin prior to the initiation of PD was a strong predictor of subsequent peritonitis. Mupirocin, with its low toxicity, ease of application and demonstrable beneficial effect in reducing ESI and peritonitis is now used on all incident PD patients.

Topics: Administration, Topical; Anti-Bacterial Agents; Cardiovascular Diseases; Catheters, Indwelling; Cohort Studies; Diabetes Mellitus; Humans; Incidence; Middle Aged; Mupirocin; Ointments; Peritoneal Dialysis, Continuous Ambulatory; Peritonitis; Retrospective Studies; Singapore; Staphylococcal Infections