title: A simple and effective approach for the treatment of chronic wound infections caused by multiple antibiotic resistant Escherichia coli.
abstract: Antimicrobial resistance is a major problem in present-day therapy. Despite the advent of newer antimicrobial agents with a broad spectrum of activity, multiple antibiotic resistant pathogens are difficult to eliminate from infected sites. The present study was carried out to develop an approach, using citric acid as a sole antimicrobial agent, for the treatment of chronic wound infections caused by multiresistant Escherichia coli (MAREC). A total of 34 cases of chronic wound infections yielding MAREC isolates on culture were studied. The antibacterial effect of citric acid against MAREC was evaluated in vitro by broth dilution method. Three percent citric acid gel was applied to each wound once daily until it healed completely. All 34 isolates were inhibited by citric acid with minimum inhibitory concentrations in the range of 1500-2000 microg/ml. Topical application of 3% citric acid to wounds 7-42 times resulted in elimination of MAREC from infected sites and successful healing of wounds in all 34 patients. This treatment modality was simple, reliable, non-toxic and effective. Hence, the use of citric acid for the cost-effective treatment of wound infections caused by MAREC is recommended.
authors.affiliation: Department of Microbiology, MIMSR Medical College, Latur, India. dr_bsnagoba@yahoo.com
authors.forename: B S
authors.initials: BS
authors.lastname: Nagoba
authors.forename: B J
authors.initials: BJ
authors.lastname: Wadher
authors.forename: A K
authors.initials: AK
authors.lastname: Rao
authors.forename: G D
authors.initials: GD
authors.lastname: Kore
authors.forename: A V
authors.initials: AV
authors.lastname: Gomashe
authors.forename: A B
authors.initials: AB
authors.lastname: Ingle
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019343:Citric Acid / Q000494:pharmacology / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial; D004926:Escherichia coli / Q000187:drug effects* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000382:microbiology*; D005782:Gels / Q000627:therapeutic use; D006801:Humans; D008826:Microbial Sensitivity Tests; D016896:Treatment Outcome; D014946:Wound Infection / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D005782:Gels; D019343:Citric Acid