Biofilm and Infected Wounds

By Janet Wolfson, PT, CLWT, CWS, CLT-LANA As I was commuting in to work a few Saturdays ago, I listened to The People’s Pharmacy on NPR. The topic was non-pharmacological treatment of infection, so being a wound care professional, I immediately started thinking of the ways I treat wound infections. In addition to oral, topical or IV antibiotics, as a PT there are modalities available to me to treat wound infections. The advantage of using these modalities is that treatments are effective across a broad spectrum of bacteria without the risk of resistance. Really! These treatments include ultrasound, electrical stimulation and laser or light-emitting diode (LED) therapy.

By Lydia A. Meyers RN, MSN, CWCN Wound infections are discussed in the media and are a major reason for admission into the hospital. With the importance in health care today to decrease costs, I was encouraged to do research into where infections come from and the causes for hospitalization and death among wound patients. In the current data I found there is information showing how the government has increased surveillance related to reportable admission to hospital in relation to infections in wounds by home health and hospice organizations.

The concept of wound hygiene has grown traction recently as clinicians increasingly adopt an antibiofilm-oriented approach to wound care. Despite the increase in recognition of wound hygiene as a four-step protocol, many definitions for wound care terminology evolve as clinical understanding grows and new wound care protocols continue to emerge.

Treatment of chronic and complex wounds complicated by biofilm formed by pathogens remains a tremendous challenge for the health care industry. Recent increases in infections mediated by drug-resistant bacterial and fungal pathogens highlight the need for new antimicrobial therapies. The application of topical agents with antimicrobial and antiseptic properties is gaining traction as an alternative to antibiotic prescriptions.

Wound healing is often accompanied by bacterial infection. Many clinicians use antibiotics to treat wound infections. However, the overreliance on antibiotics is becoming an increasing concern for many global health organizations because it contributes to widespread antibiotic resistance. Excessive use of synthetic antibiotics leads to drug resistance, which poses a substantial threat to human health.

Antibiotic resistance is considered a significant public health concern by multiple international organizations. The US Centers for Disease Control and Prevention estimate that approximately 35,000 deaths occur in the United States each year related to antibiotic resistance. Moreover, the agency predicts that millions more deaths will occur in the coming decades. By 2050, it is estimated that the number of deaths resulting from drug-resistant infections will surpass 10 million, which equates to one person dying every three seconds. The total global cost to economic output related to these deaths is estimated at US $100 trillion.

Centuries ago, science took a back seat to superstition. Infectious diseases were seen as a sign of supernatural powers or the wrath of God. We now know that it was smallpox that led to the downfall of the Aztecs. We also know that bubonic plague was not a divine punishment, but it was caused by bacteria transmitted by fleas on rodents traveling on trading ships.

Antibiotic resistance is a growing health threat, not just in the United States, but throughout the world. Health care professionals are facing problems with antibiotic resistance, as well as with resistance to other antimicrobial agents. The Centers for Disease Control and Prevention (CDC) noted in 2019 that “more than 2.8 million antibiotic-resistant infections occur in the United States (US) each year, and more than 35,000 people die as a result.” The CDC lists 18 current threats, with three on the watch list as emerging causes of antibiotic resistance. Many of the bacteria on this threat list are found in chronically stalled wounds. Therefore, wound clinicians must be good stewards of antimicrobial treatments to prevent contributing to an already worsening problem.

By the WoundSource Editors With an associated cost of $3.5 billion to $10 billion spent annually on surgical site infections (SSIs) and complications in the United States, it is important to know how to assess for surgical wound complications. There is a difference between the normal cascade response and a brewing infection. Symptoms of infection are often the first clue that there is more occurring in the wound than meets the eye.

By Jeffrey M. Levine MD, AGSF, CWS-P You are looking at an amazing image of a dime-sized biofilm of Pseudomonas aeruginosa, grown and photographed by Scott Chimileski – a biologist, photographer, and writer at the Kolter Lab at Harvard Medical School.