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Platelet-rich plasma as an additional therapeutic option for infected wounds with multi-drug resistant bacteria: in vitro antibacterial activity study

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Infected wounds, such as diabetic foot infections, are mostly polymicrobial and microorganisms have high resistance rates to antimicrobials. Infected wounds in diabetic patients have high cost, morbidity, and mortality rates. Based on these facts, there is a need for supportive localized treatment options such as platelet-rich plasma (PRP) implementations. Demonstrating the in vitro antimicrobial effect, our aim was to lead up to clinical trials of localized PRP implementations in infected wounds such as diabetic foot infections. In this study, we aimed to demonstrate the in vitro antibacterial activity of PRP against methicilin-resistant Staphylococcus aureus (MRSA) and three more multi-drug resistant bacteria species that are important and hard-to-treat in wound infections.

Materials and methods

In vitro antimicrobial activity of autologous PRP, platelet-poor plasma (PPP), and phosphate-buffered saline (PBS) on methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus spp., extended spectrum beta lactamase producing Klebsiella pneumoniae, and carbapenem-resistant Pseudomonas aeruginosa was compared by assessment of bacterial growth on agar plates and antimicrobial susceptibility test results.

Results

When compared to control group, PRP and PPP significantly suppressed bacterial growth of MRSA, K. pneumoniae, and P. aeruginosa at 1st, 2nd, 5th, and 10th hours of incubation (p < 0.05). VRE was the only bacteria that PRP and PPP showed limited activity against. When compared to PPP, PRP showed higher activity against MRSA, K. pneumoniae, and P. aeruginosa. However, the differences between PRP and PPP were statistically significant only against MRSA and P. aeruginosa at the first hour of incubation.

Conclusions

Emerging PRP and other platelet-derived products seem to be promising alternative tools besides antibiotic treatment, debridement, negative pressure wound therapy, hyperbaric oxygen therapy, and other treatment options for treating diabetic foot infections.

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Author information

Authors and Affiliations

  1. Department of Infectious Disease, Sultan Abdulhamid Han Training and Education Hospital, University of Health Science, Istanbul, Turkey

    Rıza Aytaç Çetinkaya & Ercan Yenilmez

  2. Department of Surgery, NYU Winthrop Hospital, 222 Station Plaza North, Suite 603, Mineola, Long Island, NY, 11501, USA

    Patrizio Petrone

  3. Blood and Training Center, Gulhane Training and Education Hospital, University of Health Science, Ankara, Turkey

    Soner Yılmaz

  4. Department of Microbiology, Kars Harakani State Hospital, Kars, Turkey

    Bayhan Bektöre

  5. Department of Microbiology, Transfusion Center, Okmeydani Research and Training Hospital, Kasimpasa Campus, University of Health Sciences, Istanbul, Turkey

    Berksan Şimsek

  6. Department of Microbiology, Transfusion Center, Balıkesir State Hospital, Balıkesir, Turkey

    Tuğba Kula Atik

  7. Department of Microbiology, Bilim University, Istanbul, Turkey

    Mustafa Özyurt

  8. Department of War Surgery, Gulhane Training and Research Hospital, Ankara, Turkey

    Aytekin Ünlü

  9. New York Medical College, New York, USA

    Patrizio Petrone

Authors
  1. Rıza Aytaç Çetinkaya
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  2. Ercan Yenilmez
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  3. Patrizio Petrone
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  4. Soner Yılmaz
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  5. Bayhan Bektöre
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  6. Berksan Şimsek
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  7. Tuğba Kula Atik
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  8. Mustafa Özyurt
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  9. Aytekin Ünlü
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Corresponding author

Correspondence to Patrizio Petrone.

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Conflict of interest

Riza Aytac Cetinkaya, Ercan Yenilmez, Patrizio Petrone, Soner Yılmaz, Bayhan Bektore, Berksan Simsek, Tugba Kula Atik, Mustafa Ozyurt, and Aytekin Ünlü declare that they have not conflict of interest.

Informed consent

The study was approved by the Institutional Ethics Committee of Haydarpasa Numune Training and Research Hospital on March 13, 2017.

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Çetinkaya, R.A., Yenilmez, E., Petrone, P. et al. Platelet-rich plasma as an additional therapeutic option for infected wounds with multi-drug resistant bacteria: in vitro antibacterial activity study. Eur J Trauma Emerg Surg 45, 555–565 (2019). https://doi.org/10.1007/s00068-018-0957-0

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  • DOI: https://doi.org/10.1007/s00068-018-0957-0

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