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Beta-haemolytic Streptococcus is a Gram-positive microorganism that is found in burn wounds and provokes graft failure. Streptococcus pyogenes toxins increase the depth and severity of burn wounds. Topical antimicrobial agents can be used to treat burn wounds and improve results after burn infection. However, there are few studies exploring the antimicrobial action of silver sulfadiazine against S pyogenes. This study aimed to evaluate 1% silver sulfadiazine antimicrobial activity against S pyogenes. We isolated eight S pyogenes samples from adult patients at the Hospital Provincial de Rosario, Rosario, Argentina. Six samples were from burn wounds and two from blood culture. The outcomes were compared with the topical antimicrobial agents 2% mupirocin and 1% fusidic acid cream. We tested and compared the susceptibility of S pyogenes with these topical antimicrobial agents using agar well diffusion assays and minimum bactericidal concentration tests. The results show that the 1% silver sulfadiazine cream has an inhibitory effect on S pyogenes similar to that of 2% mupirocin and 1% fusidic acid cream. Considering its greater antimicrobial spectrum, silver sulfadiazine is a valid alternative to control many infections associated with wounds and burns, including those caused by S pyogenes.
Authors (clockwise from top left): Cecilia Casabonne, Agustina González, Virginia Aquili and Claudia Balagué
A complex patient with multiple disease states knocks at my door looking for solutions to a troubling medical issue. “Am I up to the task?” you may ask. “Can I help her attain a satisfactory outcome and improve her quality of life?” This case study outlines the clinical approach and successful management of a woman with rheumatoid arthritis who presented with a leg ulcer of 3 years’ duration.
Author:
Steven Jreige
Steve Jreige is a Wound Care Nurse,
private practice, Sydney, Australia
Prevention, management and treatment strategies
Key points
● PU prevention includes: pressure reduction/ redistribution; friction and shear reduction; skin care; and nutrition
● DFU prevention includes; pressure redistribution; prescribing appropriate footware; nail care; emollient use
● Managing the underlying cause of the ulcer is key to treatment
● PU or DFU prevention: both must be tailored to the individual patient
● Ulcers should be monitored at least once a week to assess progress
Authors:
Karen Ousey, University of Huddersfield, England; Paul Chadwick, College of Podiatry, London, England; Arkadiusz Jawień, Collegium Medicum, University of Nicolaus Copernicus, Bydgoszcz, Poland; Gulnaz Tariq, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates; Harikrishna K Ragavan Nair, Kuala Lumpur Hospital, Malaysia; José Luis Lázaro-Martínez, Diabetic Foot Unit, Universidad Complutense de Madrid, Spain; Kylie Sandy-Hodgetts, School of Human Sciences, University of Western Australia, Australia; Paulo Alves, Institute of Health Sciences, Catholic University of Portugal, Portugal; Stephanie Wu, Dr William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, United States; Zena Moore, Royal College of Surgeons in Ireland, Dublin, Republic of Ireland
Review panel: Andrea Pokorná, Masaryk University, Czech Republic; Anna Polak, Jerzy Kukuczka Academy of Physical Education in Katowice, Poland; David Armstrong, Keck School of Medicine of University of Southern California, United States; Hiromi Sanada, University of Tokyo, Japan; Joon Pio Hong, Asan Medical Centre, University of Ulsan, South Korea; Leanne Atkin, University of Huddersfield, England; Nick Santamaria, University of Melbourne and Royal Melbourne Hospital, New South Wales, Australia; Peta Tehan, University of Newcastle, Australia; Ralf Lobmann, Klinikum Stuttgart, Germany.
Authors:
Karen Ousey, University of Huddersfield, England; Paul Chadwick, College of Podiatry, London, England; Arkadiusz Jawień, Collegium Medicum, University of Nicolaus Copernicus, Bydgoszcz, Poland; Gulnaz Tariq, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates; Harikrishna K Ragavan Nair, Kuala Lumpur Hospital, Malaysia; José Luis Lázaro-Martínez, Diabetic Foot Unit, Universidad Complutense de Madrid, Spain; Kylie Sandy-Hodgetts, School of Human Sciences, University of Western Australia, Australia; Paulo Alves, Institute of Health Sciences, Catholic University of Portugal, Portugal; Stephanie Wu, Dr William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, United States; Zena Moore, Royal College of Surgeons in Ireland, Dublin, Republic of Ireland
Review panel:
Andrea Pokorná, Masaryk University, Czech Republic; Anna Polak, Jerzy Kukuczka Academy of Physical Education in Katowice, Poland; David Armstrong, Keck School of Medicine of University of Southern California, United States; Hiromi Sanada, University of Tokyo, Japan; Joon Pio Hong, Asan Medical Centre, University of Ulsan, South Korea; Leanne Atkin, University of Huddersfield, England; Nick Santamaria, University of Melbourne and Royal Melbourne Hospital, New South Wales, Australia; Peta Tehan, University of Newcastle, Australia; Ralf Lobmann, Klinikum Stuttgart, Germany.
