Explore the vast range of titles available.

A wound is damage of a tissue usually caused by laceration of a membrane, generally the skin. Wound healing is accomplished in three stages in healthy individuals, including inflammatory, proliferative, and remodeling stages. Healing of wounds normally starts from the inflammatory phase and ends up in the remodeling phase, but chronic wounds remain in an inflammatory stage and do not show progression due to some specific reasons. Chronic wounds are classified in different categories, such as diabetic foot ulcer (DFU), venous leg ulcers (VLU) and pressure ulcer (PU), surgical site infection (SSI), abscess, or trauma ulcers. Globally, the incidence rate of DFU is 1–4 % and prevalence rate is 5.3–10.5 %. However, colonization of pathogenic bacteria at the wound site is associated with wound chronicity. Most chronic wounds contain more than one bacterial species and produce a synergetic effect that results in previously non-virulent bacterial species becoming virulent and causing damage to the host. While investigating bacterial diversity in chronic wounds, Staphylococcus, Pseudomonas, Peptoniphilus, Enterobacter, Stenotrophomonas, Finegoldia, and Serratia were found most frequently in chronic wounds. Recently, it has been observed that bacteria in chronic wounds develop biofilms that contribute to a delay in healing. In a mature biofilm, bacteria grow slowly due to deficiency of nutrients that results in the resistance of bacteria to antibiotics. The present review reflects the reasons why acute wounds become chronic. Interesting findings include the bacterial load, which forms biofilms and shows high-level resistance toward antibiotics, which is a threat to human health in general and particularly to some patients who have acute wounds.

Chronic wounds, such as diabetic foot ulcers, venous leg ulcers, and pressure sores, pose a significant clinical challenge due to ongoing inflammation, biofilm development, and impaired tissue regeneration. Standard wound care methods often fail to address these complex barriers, highlighting the need for innovative solutions. Nanorobotics has emerged as a groundbreaking platform, enabling programmable, multifunctional systems capable of active navigation, biofilm penetration, modulation of the microenvironment, and targeted therapeutic delivery. This review systematically covers the design principles and functional components of micro-/nanorobots, including propulsion techniques, sensing and actuation mechanisms, and biomimetic surface modifications. We also examine their therapeutic potential in wound healing, focusing on drug delivery optimization, biofilm disruption, reduction of oxidative stress, immune regulation, and tissue regeneration support. The integration of nanorobotics with intelligent wound care systems offers real-time monitoring and closed-loop interventions, initiating a new era of \"smart wound management.\" Finally, we address translational challenges such as biosafety, large-scale manufacturing, and regulatory pathways, and provide perspectives on future advancements toward clinically practical, intelligent nanorobotic wound therapies.

This study explored the effects of Moist Exposed Burn Ointment (MEBO) on the healing process of pressure-induced wounds. Using a stage IV pressure ulcer model established in 42 rats, divided equally into a control gel group and an MEBO group, we investigated the efficacy of MEBO through topical application. The control group received Carbomer gel, while the MEBO group was treated with MEBO until complete wound healing. Results showed that MEBO significantly accelerated wound healing compared to the control group. Histological analysis, including hematoxylin and eosin (HE) staining and Masson’s trichrome staining, revealed enhanced epithelialization and collagen deposition in the MEBO group. Furthermore, 16S rRNA sequencing indicated that MEBO reduced microbial diversity at the wound site and reshaped the microbial composition. Notably, The increased abundance of Acinetobacter and Staphylococcus, coupled with a reduction in Pseudomonas, may reflect a shift in the wound microbiome that could be conducive to healing. However, the exact role of these microbial shifts in promoting wound healing requires further investigation, as microbial dynamics in wound environments are complex and context-dependent. These findings suggest that MEBO facilitates wound healing by optimizing the wound microbiome, thereby offering a promising therapeutic approach for managing pressure ulcers.

Background Non-surgical chronic wounds, including diabetes-related foot diseases (DRFD), pressure injuries (PIs) and venous leg ulcers (VLU), are common hard-to-heal wounds. Wound evolution partly depends on microbial colonisation or infection, which is often confused by clinicians, thereby hampering proper management. Current routine microbiology investigation of these wounds is based on in vitro culture, focusing only on a limited panel of the most frequently isolated bacteria, leaving a large part of the wound microbiome undocumented. Methods A literature search was conducted on original studies published through October 2022 reporting metagenomic next generation sequencing (mNGS) of chronic wound samples. Studies were eligible for inclusion if they applied 16 S rRNA metagenomics or shotgun metagenomics for microbiome analysis or diagnosis. Case reports, prospective, or retrospective studies were included. However, review articles, animal studies, in vitro model optimisation, benchmarking, treatment optimisation studies, and non-clinical studies were excluded. Articles were identified in PubMed, Google Scholar, Web of Science, Microsoft Academic, Crossref and Semantic Scholar databases. Results Of the 3,202 articles found in the initial search, 2,336 articles were removed after deduplication and 834 articles following title and abstract screening. A further 14 were removed after full text reading, with 18 articles finally included. Data were provided for 3,628 patients, including 1,535 DRFDs, 956 VLUs, and 791 PIs, with 164 microbial genera and 116 species identified using mNGS approaches. A high microbial diversity was observed depending on the geographical location and wound evolution. Clinically infected wounds were the most diverse, possibly due to a widespread colonisation by pathogenic bacteria from body and environmental microbiota. mNGS data identified the presence of virus (EBV) and fungi ( Candida and Aspergillus species), as well as Staphylococcus and Pseudomonas bacteriophages. Conclusion This study highlighted the benefit of mNGS for time-effective pathogen genome detection. Despite the majority of the included studies investigating only 16 S rDNA, ignoring a part of viral, fungal and parasite colonisation, mNGS detected a large number of bacteria through the included studies. Such technology could be implemented in routine microbiology for hard-to-heal wound microbiota investigation and post-treatment wound colonisation surveillance.

Pressure injuries (PIs) are common in individuals with spinal cord injury (SCI) and increase the risk of infections, including urinary tract infections (UTIs), which may prolong hospitalisation. However, the role of PIs in the development of postoperative UTIs remains unclear. In this exploratory study, we investigated the relationship between the PI microbiome and urinary bacteria, and examined whether perioperative bacteriuria predicts prolonged hospital stay in patients undergoing reconstructive PI surgery. In this cohort study, 21 male patients with SCI and advanced-stage PIs undergoing reconstructive surgery were evaluated. Microbiome and urinary cytokine profiles were analysed at two postoperative time points: day 3 (early postoperative phase) and day 15 (after completion of antibiotic therapy). DNA from skin, PI tissue, and urine was analysed using 16S rRNA gene sequencing. Asymptomatic bacteriuria was present in 48% of patients on day 3 and 38% on day 15. Dominant urinary bacteria included Enterococcus , Klebsiella , Streptococcus , and Escherichia , which were associated with elevated urinary cytokine levels. High bacterial load (≥ 100,000 bacteria/mL) in urine on day 3 correlated with increased UTI incidence and frequency, although hospitalisation duration was unaffected. By day 15, urinary bacterial load was no longer associated with UTI incidence. The microbiota of PIs and adjacent skin were distinct from urinary microbiota, indicating minimal cross-contamination. Early perioperative high bacterial load is associated with increased urinary inflammation and a higher risk of postoperative UTIs in patients with SCI undergoing PI reconstruction. These findings support early infection monitoring and targeted preventive strategies to improve postoperative outcomes.

This study investigated whether there are differences in the composition of the cutaneous microbiome of the unaffected skin between patients with pressure ulcers compared with those without pressure ulcers. The cutaneous microbiome of the unaffected skin of 15 patients with sacral pressure ulcers compared to 15 patients without pressure ulcers was analysed. It demonstrated that the inter-individual variation in skin microbiota of patients with pressure ulcers was significantly higher (P = 0.01). The abundance of 23 species was significantly different with Staphylococcus aureus and unclassified Enterococcus the most abundant species in patients with pressure ulcers. Random Forest models showed that eight species were associated with pressure ulcers occurrence in 81% of the patients. A subset of four species gave the strongest interaction. The presence of unclassified Enterococcus had the highest association with pressure ulcer occurrence. This study is the first to demonstrate that the cutaneous microbiome is altered in patients with pressure ulcers.

Background: There is a critical number of bacteria above which tissue responds with infection. This balance of 10 5 or fewer bacteria/g tissue is also required for wound healing to proceed normally. This study evaluated whether a chronic wound once in bacterial balance can maintain that balance over time. Methods: Serial biopsies for bacterial analyses were obtained weekly during a blinded, placebo-controlled cytokine clinical trial of pressure ulcers. To enter the trial ulcers had to be debrided and have a bacterial count of 10 5 or fewer bacteria/g tissue with no β-hemolytic streptococci. Results: In all, 96% of cultures (350/363) remained at <10 2 bacteria/g tissue over the 5-week trial; 3% had 10 2 to 10 5, and only 1% had >10 5 bacteria/g tissue. Conclusion: Chronic pressure ulcers, once debrided and brought into bacterial balance, will remain in bacterial balance if cared for and kept free of necrotic tissue.

Background Stutzerimonas is a recently proposed genus comprising strains formerly classified as Pseudomonas stutzeri . The genus includes at least 16 identified species. Stutzerimonas nitrititolerans , previously known as Pseudomonas nitrititolerans , was initially isolated from a bioreactor. Only one case of human infection has been reported to date, and its pathogenicity remains unknown. Case presentation We present a case of community-acquired S. nitrititolerans bacteremia in a 77-year-old Japanese man with a sacral pressure ulcer. On admission for cerebral infarction, empirical ampicillin/sulbactam was administered because of an infected sacral pressure ulcer. Blood cultures revealed Gram-negative bacilli. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry was unable to identify the species, but 16 S ribosomal RNA gene sequencing identified the isolate NR5426 as S. nitrititolerans . Despite negative results for common carbapenem-resistance genes, the strain showed possible metallo-beta-lactamase production. The patient was treated with piperacillin/tazobactam and recovered. Conclusions This case confirms that S. nitrititolerans can cause infection in humans and highlights the antimicrobial susceptibility profile and the treatment strategy for infections caused by this rare bacterium. Further studies are required to determine its resistance mechanisms and the clinical implications.

Bloodstream infections are associated with high morbidity and mortality. Accurate identification of blood isolates to the species level and identification of the source of infection and/or the portal of entry are crucial for optimal management of these infections. These investigations—in addition to clinical findings and laboratory and imaging studies—are central to informing and directing efficient and effective diagnostic examinations and to choosing the optimal antimicrobial regimen. Four case studies that demonstrate the importance of identifying the causative agents and the source of infection are discussed to illustrate the central importance of microbiological findings in the diagnosis of bacteremia and bloodstream infections associated with infections at other sites.

Pressure ulcers (PUs) frequently occur in individuals with limited mobility including patients that are hospitalized or obese. PUs are challenging to resolve when infected by antibiotic-resistant bacteria, particularly methicillin-resistant Staphylococcus aureus (MRSA). In this study, we investigated the potential of repurposing auranofin to treat pressure ulcers infected with MRSA. Auranofin’s in vitro activity against strains of S. aureus (including MRSA) was not affected in the presence of higher bacterial inoculum (10 7 CFU/mL) or by lowering the pH in standard media to simulate the environment present on the surface of the skin. Additionally, S. aureus did not develop resistance to auranofin after repeated exposure for two weeks via a multi-step resistance selection experiment. In contrast, S. aureus resistance to mupirocin emerged rapidly. Moreover, auranofin exhibited a long postantibiotic effect (PAE) in vitro against three strains of S. aureus tested. Remarkably, topical auranofin completely eradicated MRSA (8-log 10 reduction) in infected PUs of obese mice after just four days of treatment. This was superior to both topical mupirocin (1.96-log 10 reduction) and oral clindamycin (1.24-log 10 reduction), which are used to treat infected PUs clinically. The present study highlights auranofin’s potential to be investigated further as a treatment for mild-to-moderate PUs infected with S. aureus .