title: Skin and wound decontamination of multidrug-resistant bacteria by cold atmospheric plasma coagulation.
abstract: OBJECTIVE
  Novel concepts to limit the spread of multidrug-resistant bacteria (MDR) are urgently needed. Since treatment with cold atmospheric plasma (CAP) has shown significant antibacterial properties, the purpose of this study was to evaluate the ability of CAP to eliminate MDR- compared to non-MDR-pathogens in chronic wounds.
  
  
  METHODS
  Eleven patients with 18 heavily colonized wounds were treated with a CE-certified commercial argon-based CAP source for 10 s/cm(2) in one session. The antimicrobial efficacy was assessed by calculating the microbial load before and after treatment.
  
  
  RESULTS
  A single CAP treatment reduced MDR in all wounds. In 14 treatments (63.6 %) and for 16 pathogens (66.7 %), a 100 % reduction of the bacterial load was observed. For 11 of 17 (64.7 %) MDR-pathogens and for 5 of 7 (71.4 %) other non-MDR-pathogens, complete eradication was achieved. The remaining 8 treatments showed reductions of 77.5 ± 18.6 % and the remaining pathogens a reduction of 74.8 ± 25.7 %.
  
  
  CONCLUSIONS
  As proof of principle, argon-based CAP serves as a potent treatment modality that was shown to limit MDR microbial colonization. The possible role of CAP in clinical MDR decontamination must be evaluated in clinical trials with repeated plasma treatment embedded in a comprehensive hygienic decontamination concept.
authors.affiliation: Department of Dermatology of the Ernst Moritz Arndt University, Greifswald, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Daeschlein
authors.forename: Matthias
authors.initials: M
authors.lastname: Napp
authors.forename: Stine
authors.initials: S
authors.lastname: Lutze
authors.forename: Andreas
authors.initials: A
authors.lastname: Arnold
authors.forename: Sebastian
authors.initials: S
authors.lastname: von Podewils
authors.forename: Denis
authors.initials: D
authors.lastname: Guembel
authors.forename: Michael
authors.initials: M
authors.lastname: Jünger
mesh_terms: D057908:Argon Plasma Coagulation / Q000295:instrumentation* / Q000379:methods*; D001424:Bacterial Infections / Q000382:microbiology / Q000628:therapy*; D058491:Bacterial Load; D003114:Colony-Forming Units Assay; D004203:Disinfection / Q000379:methods*; D024901:Drug Resistance, Multiple, Bacterial; D004867:Equipment Design; D006801:Humans; D014946:Wound Infection / Q000382:microbiology / Q000628:therapy*