Use of photodynamic inactivation for in vitro reduction of prevalent bacteria in Fournier’s Gangrene

Vol. 43 (x): 2017 November 11.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2017.0312


ORIGINAL ARTICLE

Nalisson Marques Pereira 1, Luciano Santos Feitosa 1, Ricardo Scarparo Navarro 1, Dora Inés Kozusny- Andreani 1, Naacia Marques Pereira Carvalho 1
1 Departamento de Engenharia Biomédica, Universidade Brasil, São Paulo, SP, Brasil

ABSTRACT

Fournier’s Gangrene (FG) is an infectious disease caused by several synergic microbes, with high morbidity and mortality rates; therefore, the search for new less invasive and mutilating treatments, with faster recovery, has been proposed. Surgical intervention, the use of several systemic and topic antibiotics, and hyperbaric oxygen therapy are currently the best approach for the treatment of these patients. The use of Photody­namic Inactivation (PDI) aims to lower morbidity and mortality, by reducing bacterial microbiota and speeding wound healing. In the present study, viable bacteria were separated in four groups: Group L-/F- (no irradiation with red laser and absence of me­thylene blue photosensitizer), Group L-/F+ (no irradiation with red laser and presence of methylene blue), Group L+/F- (irradiation with red laser and absence of methylene blue) and L+/F+ (irradiation with red laser associated to methylene blue). In all groups, exposure time to treatment was 5, 10 and 15 minutes. The concentration of methylene blue photosensitizer was 0.1mg/L, and the dose of red laser (660nm wave length) was 176.9mW/cm2. Following irradiation, the reduction of number of bacteria was evalua­ted, and the results were expressed in colony forming units (CFU) and as exponential reduction. As the main results, in the L+/F+ group, there were no Clostridium perfrin­gens and Staphylococcus aureus CFUs and there was a reduction of Escherichia coli that was not observed in the other groups.

Keywords: Fournier Gangrene; Methylene Blue; Clostridium perfringens

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