Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
J Trauma Acute Care Surg. 2012 Sep;73(3):661-7. doi: 10.1097/TA.0b013e31825c149c.
Since the beginning of the conflicts in the Middle East, US Army physicians have noted a high rate of multidrug-resistant Acinetobacter baumannii infections among US soldiers wounded and initially treated in Iraq. In this study, we investigated the use of ultraviolet C (UVC) light for prevention of multidrug-resistant A. baumannii wound infections using mouse models.
Partial-thickness skin abrasions and full-thickness burns in mice were infected with a multidrug-resistant A. baumannii isolate recovered from a wounded US soldier deployed to Iraq. The luxCDABE operon, which was contained in plasmid pMF 385, was cloned into the A. baumannii strain. This allowed real-time monitoring of the extent of infection in mice using bioluminescence imaging. UVC light was delivered to the mouse wounds at 30 minutes after the inoculation of A. baumannii. Groups of infected mouse wounds without being exposed to UVC served as the controls.
In vitro studies demonstrated that A. baumannii cells were inactivated at UVC exposures much lower than those needed for a similar effect on mammalian cells. It was observed in animal studies that UVC (3.24 J/cm(2) for abrasions and 2.59 J/cm(2) for burns) significantly reduced the bacterial burdens in UVC-treated wounds by approximately 10-fold compared with nontreated controls (p = 0.004 for abrasions, p = 0.019 for burns). DNA lesions were observed by immunofluorescence in mouse skin abrasions immediately after a UVC exposure of 3.24 J/cm(2); however, the lesions were extensively repaired within 72 hours.
These results suggested that UVC may be useful in preventing combat-related wound infections.
自中东冲突开始以来,美国陆军军医注意到在伊拉克受伤并初步接受治疗的美国士兵中,耐多药鲍曼不动杆菌感染率很高。在这项研究中,我们使用小鼠模型研究了紫外线 C(UVC)光在预防耐多药鲍曼不动杆菌伤口感染中的作用。
将从部署到伊拉克的受伤美国士兵身上分离出的耐多药鲍曼不动杆菌分离株感染小鼠的部分厚度皮肤擦伤和全厚度烧伤。luxCDABE 操纵子包含在质粒 pMF385 中,克隆到鲍曼不动杆菌株中。这使得使用生物发光成像实时监测小鼠感染的程度成为可能。在接种鲍曼不动杆菌 30 分钟后,将 UVC 光递送至小鼠伤口。未暴露于 UVC 的感染小鼠伤口组作为对照。
体外研究表明,与对哺乳动物细胞产生类似效果所需的暴露相比,UVC 使鲍曼不动杆菌细胞失活所需的暴露要低得多。动物研究表明,与未处理的对照组相比,UVC(擦伤时为 3.24 J/cm2,烧伤时为 2.59 J/cm2)可使 UVC 处理的伤口中的细菌负荷减少约 10 倍(擦伤时 p = 0.004,烧伤时 p = 0.019)。在 UVC 暴露 3.24 J/cm2 后立即对小鼠皮肤擦伤进行免疫荧光观察到 DNA 损伤;然而,损伤在 72 小时内得到了广泛修复。
这些结果表明 UVC 可能有助于预防与战斗相关的伤口感染。