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A Host-Directed Approach to the Detection of Infection in Hard-to-Heal Wounds

Wound infection is traditionally defined primarily by visual clinical signs, and secondarily by microbiological analysis of wound samples. However, these approaches have serious limitations in determining wound infection status, particularly in early phases or complex, chronic, hard-to-heal wounds....

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Autores principales: Burnet, Michael, Metcalf, Daniel G., Milo, Scarlet, Gamerith, Clemens, Heinzle, Andrea, Sigl, Eva, Eitel, Kornelia, Haalboom, Marieke, Bowler, Philip G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9601189/
https://www.ncbi.nlm.nih.gov/pubmed/36292097
http://dx.doi.org/10.3390/diagnostics12102408
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author Burnet, Michael
Metcalf, Daniel G.
Milo, Scarlet
Gamerith, Clemens
Heinzle, Andrea
Sigl, Eva
Eitel, Kornelia
Haalboom, Marieke
Bowler, Philip G.
author_facet Burnet, Michael
Metcalf, Daniel G.
Milo, Scarlet
Gamerith, Clemens
Heinzle, Andrea
Sigl, Eva
Eitel, Kornelia
Haalboom, Marieke
Bowler, Philip G.
author_sort Burnet, Michael
collection PubMed
description Wound infection is traditionally defined primarily by visual clinical signs, and secondarily by microbiological analysis of wound samples. However, these approaches have serious limitations in determining wound infection status, particularly in early phases or complex, chronic, hard-to-heal wounds. Early or predictive patient-derived biomarkers of wound infection would enable more timely and appropriate intervention. The observation that immune activation is one of the earliest responses to pathogen activity suggests that immune markers may indicate wound infection earlier and more reliably than by investigating potential pathogens themselves. One of the earliest immune responses is that of the innate immune cells (neutrophils) that are recruited to sites of infection by signals associated with cell damage. During acute infection, the neutrophils produce oxygen radicals and enzymes that either directly or indirectly destroy invading pathogens. These granular enzymes vary with cell type but include elastase, myeloperoxidase, lysozyme, and cathepsin G. Various clinical studies have demonstrated that collectively, these enzymes, are sensitive and reliable markers of both early-onset phases and established infections. The detection of innate immune cell enzymes in hard-to-heal wounds at point of care offers a new, simple, and effective approach to determining wound infection status and may offer significant advantages over uncertainties associated with clinical judgement, and the questionable value of wound microbiology. Additionally, by facilitating the detection of early wound infection, prompt, local wound hygiene interventions will likely enhance infection resolution and wound healing, reduce the requirement for systemic antibiotic therapy, and support antimicrobial stewardship initiatives in wound care.
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spelling pubmed-96011892022-10-27 A Host-Directed Approach to the Detection of Infection in Hard-to-Heal Wounds Burnet, Michael Metcalf, Daniel G. Milo, Scarlet Gamerith, Clemens Heinzle, Andrea Sigl, Eva Eitel, Kornelia Haalboom, Marieke Bowler, Philip G. Diagnostics (Basel) Review Wound infection is traditionally defined primarily by visual clinical signs, and secondarily by microbiological analysis of wound samples. However, these approaches have serious limitations in determining wound infection status, particularly in early phases or complex, chronic, hard-to-heal wounds. Early or predictive patient-derived biomarkers of wound infection would enable more timely and appropriate intervention. The observation that immune activation is one of the earliest responses to pathogen activity suggests that immune markers may indicate wound infection earlier and more reliably than by investigating potential pathogens themselves. One of the earliest immune responses is that of the innate immune cells (neutrophils) that are recruited to sites of infection by signals associated with cell damage. During acute infection, the neutrophils produce oxygen radicals and enzymes that either directly or indirectly destroy invading pathogens. These granular enzymes vary with cell type but include elastase, myeloperoxidase, lysozyme, and cathepsin G. Various clinical studies have demonstrated that collectively, these enzymes, are sensitive and reliable markers of both early-onset phases and established infections. The detection of innate immune cell enzymes in hard-to-heal wounds at point of care offers a new, simple, and effective approach to determining wound infection status and may offer significant advantages over uncertainties associated with clinical judgement, and the questionable value of wound microbiology. Additionally, by facilitating the detection of early wound infection, prompt, local wound hygiene interventions will likely enhance infection resolution and wound healing, reduce the requirement for systemic antibiotic therapy, and support antimicrobial stewardship initiatives in wound care. MDPI 2022-10-04 /pmc/articles/PMC9601189/ /pubmed/36292097 http://dx.doi.org/10.3390/diagnostics12102408 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Burnet, Michael
Metcalf, Daniel G.
Milo, Scarlet
Gamerith, Clemens
Heinzle, Andrea
Sigl, Eva
Eitel, Kornelia
Haalboom, Marieke
Bowler, Philip G.
A Host-Directed Approach to the Detection of Infection in Hard-to-Heal Wounds
title A Host-Directed Approach to the Detection of Infection in Hard-to-Heal Wounds
title_full A Host-Directed Approach to the Detection of Infection in Hard-to-Heal Wounds
title_fullStr A Host-Directed Approach to the Detection of Infection in Hard-to-Heal Wounds
title_full_unstemmed A Host-Directed Approach to the Detection of Infection in Hard-to-Heal Wounds
title_short A Host-Directed Approach to the Detection of Infection in Hard-to-Heal Wounds
title_sort host-directed approach to the detection of infection in hard-to-heal wounds
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9601189/
https://www.ncbi.nlm.nih.gov/pubmed/36292097
http://dx.doi.org/10.3390/diagnostics12102408
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