Treating locally infected wounds with topical probiotics? Finally.

There have been early peeks at the role of using lactobacillus and other kinder and gentler species to battle more hostile ones in chronic wounds. Now a new manuscript from Italian colleagues Venosi and coworkers provides tantalizing new peeks into the metabolomic profile of a patient treated with topical probiotics. Enjoy.

Infected chronic ischemic wound topically treated with a multi-strain probiotic formulation: a novel tailored treatment strategy

Abstract

Background: A wide debate is ongoing regarding the role of cutaneous dysbiosis in the pathogenesis and evolution of difficult-to-treat chronic wounds. Nowadays, probiotic treatment considered as an useful tool to counteract dysbio- sis but the evidence in regard to their therapeutic use in the setting of difficult-to-treat cutaneous ulcers is still poor.

Aim: clinical report: An 83-year-old woman suffering a critical limb ischemia and an infected difficult-to-treat ulcer- ated cutaneous lesion of the right leg, was complementary treated with local application of a mixture of probiotic bacteria.

Methods: Microbiological and metabolomic analysis were conducted on wound swabs obtained before and after bacteriotherapy.

Results: During the treatment course, a progressive healing of the lesion was observed with microbiological resolution of the polymicrobial infection of the wound. Metabolomic analysis showed a significant difference in the local concentration of propionate, 2-hydroxyisovalerate, 2-oxoisocaproate, 2,3-butanediol, putrescine, thymine, and trimethylamine before and after bacteriotherapy.

Conclusion: The microbiological and metabolomic results seem to confirm the usefulness of complementary pro- biotic treatment in difficult-to-treat infected wounds. Further investigations are needed to confirm these preliminary findings.

Keywords: Bacteriotherapy, Topical probiotic, Metabolomic, Wound, Wound care, Wound healing, Antimicrobial resistance

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