Generic placeholder image

Current Clinical Pharmacology


ISSN (Print): 1574-8847
ISSN (Online): 2212-3938

Review Article

Effects of Probiotics in the Management of Infected Chronic Wounds: From Cell Culture to Human Studies

Author(s): Lorenzo Brognara*, Luca Salmaso, Antonio Mazzotti, Alberto Di Martino, Cesare Faldini and Omar Cauli

Volume 15, Issue 3, 2020

Page: [193 - 206] Pages: 14

DOI: 10.2174/1574884714666191111130630

Price: $65


Background: Chronic wounds are commonly associated with polymicrobial biofilm infections. In the last years, the extensive use of antibiotics has generated several antibiotic-resistant variants. To overcome this issue, alternative natural treatments have been proposed, including the use of microorganisms like probiotics. The aim of this manuscript was to review current literature concerning the application of probiotics for the treatment of infected chronic wounds.

Methods: Relevant articles were searched in the Medline database using PubMed and Scholar, using the keywords “probiotics” and “wound” and “injuries”, “probiotics” and “wound” and “ulcer”, “biofilm” and “probiotics” and “wound”, “biofilm” and “ulcer” and “probiotics”, “biofilm” and “ulcer” and “probiotics”, “probiotics” and “wound”.

Results: The research initially included 253 articles. After removal of duplicate studies, and selection according to specific inclusion and exclusion criteria, 19 research articles were included and reviewed, accounting for 12 in vitro, 8 in vivo studies and 2 human studies (three articles dealing with animal experiments included also in vitro testing). Most of the published studies about the effects of probiotics for the treatment of infected chronic wounds reported a partial inhibition of microbial growth, biofilm formation and quorum sensing.

Discussion: The application of probiotics represents an intriguing option in the treatment of infected chronic wounds with multidrug-resistant bacteria; however, current results are difficult to compare due to the heterogeneity in methodology, laboratory techniques, and applied clinical protocols. Lactobacillus plantarum currently represents the most studied strain, showing a positive application in burns compared to guideline treatments, and an additional mean in chronic wound infections.

Conclusions: Although preliminary evidence supports the use of specific strains of probiotics in certain clinical settings such as infected chronic wounds, large, long-term clinical trials are still lacking, and further research is needed.

Keywords: Probiotics, wound care, infection, antibiotic resistance, wound healing, cutaneous wound.

Graphical Abstract
Ohashi Y, Ushida K. Health-beneficial effects of probiotics: Its mode of action. Anim Sci J 2009; 80(4): 361-71.
[] [PMID: 20163595]
Krutmann J. Pre- and probiotics for human skin. J Dermatol Sci 2009; 54(1): 1-5.
[] [PMID: 19203862]
Xu Z, Hsia HC. The impact of microbial communities on wound healing: A review. Ann Plast Surg 2018; 81(1): 113-23.
[] [PMID: 29746280]
Shokri D, Khorasgani MR, Mohkam M, Fatemi SM, Ghasemi Y, Taheri-Kafrani A. The inhibition effect of Lactobacilli against growth and biofilm formation of Pseudomonas aeruginosa. Probiotics Antimicrob Proteins 2018; 10(1): 34-42.
[] [PMID: 28293865]
Kadam S, Shai S, Shahane A, Kaushik KS. Recent advances in non-conventional antimicrobial approaches for chronic wound biofilms: Have we found the ‘Chink in the Armor’? Biomedicines 2019; 7(2)E35
[] [PMID: 31052335]
Mihai MM, Preda M, Lungu I, Gestal MC, Popa MI, Holban AM. Nanocoatings for chronic wound repair-modulation of microbial colonization and biofilm formation. Int J Mol Sci 2018; 19(4)E1179
[] [PMID: 29649179]
Ong JS, Taylor TD, Yong CC, et al. Lactobacillus plantarum USM8613 aids in wound healing and suppresses Staphylococcus aureus infection at wound sites. Probiotics Antimicrob Proteins 2019.
[PMID: 30659503]
Parinaz GHADAM. Turk J Med Sci 2016; 46: 1188-96.
[] [PMID: 27513424]
Valdéz JC, Peral MC, Rachid M, Santana M, Perdigón G. Interference of Lactobacillus plantarum with Pseudomonas aeruginosa in vitro and in infected burns: The potential use of probiotics in wound treatment. Clin Microbiol Infect 2005; 11(6): 472-9.
[] [PMID: 15882197]
Ramos AN, Cabral ME, Noseda D, Bosch A, Yantorno OM, Valdez JC. Antipathogenic properties of Lactobacillus plantarum on Pseudomonas aeruginosa: The potential use of its supernatants in the treatment of infected chronic wounds. Wound Repair Regen 2012; 20(4): 552-62.
[] [PMID: 22642376]
Ramos AN, Sesto CME, Arena ME, Arrighi CF, Arroyo Aguilar AA, Valdéz JC. Compounds from Lactobacillus plantarum culture supernatants with potential pro-healing and anti-pathogenic properties in skin chronic wounds. Pharm Biol 2015; 53(3): 350-8.
[] [PMID: 25347359]
Manna S, Ghosh AK, Mandal SM. Curd-peptide based novel hydrogel inhibits biofilm formation, quorum sensing, swimming mortility of multi-antibiotic resistant clinical isolates and accelerates wound healing activity. Front Microbiol 2019; 10: 951.
[] [PMID: 31139155]
Onbas T, Osmanagaoglu O, Kiran F. Potential properties of Lactobacillus plantarum F-10 as a bio-control strategy for wound infections. Probiotics Antimicrob Proteins 2018.
[PMID: 30523603]
Vågesjö E, Öhnstedt E, Mortier A, et al. Accelerated wound healing in mice by on-site production and delivery of CXCL12 by transformed lactic acid bacteria. Proc Natl Acad Sci USA 2018; 115(8): 1895-900.
[] [PMID: 29432190]
Lopes EG, Moreira DA, Gullón P, Gullón B, Cardelle-Cobas A, Tavaria FK. Topical application of probiotics in skin: Adhesion, antimicrobial and antibiofilm in vitro assays. J Appl Microbiol 2017; 122(2): 450-61.
[] [PMID: 27862685]
Li Z, Behrens AM, Ginat N, et al. Biofilm-inspired encapsulation of probiotics for the treatment of complex infections. Adv Mater 2018; 30(51)e1803925
[] [PMID: 30328144]
Jebur MSh. Therapeutic efficacy of Lactobacillus acidophilus against bacterial isolates from burn wounds. N Am J Med Sci 2010; 2(12): 586-91.
[] [PMID: 22558572]
Huseini HF, Rahimzadeh G, Fazeli MR, Mehrazma M, Salehi M. Evaluation of wound healing activities of kefir products. Burns 2012; 38(5): 719-23.
[] [PMID: 22237053]
Brachkova MI, Marques P, Rocha J, Sepodes B, Duarte MA, Pinto JF. Alginate films containing Lactobacillus plantarum as wound dressing for prevention of burn infection. J Hosp Infect 2011; 79(4): 375-7.
[] [PMID: 22000853]
Gan BS, Kim J, Reid G, Cadieux P, Howard JC. Lactobacillus fermentum RC-14 inhibits Staphylococcus aureus infection of surgical implants in rats. J Infect Dis 2002; 185(9): 1369-72.
[] [PMID: 12001060]
Argenta A, Satish L, Gallo P, Liu F, Kathju S. Local application of probiotic bacteria prophylaxes against sepsis and death resulting from burn wound infection. PLoS One 2016; 11(10)e0165294
[] [PMID: 27780258]
Satish L, Gallo PH, Johnson S, Yates CC, Kathju S. Local probiotic therapy with Lactobacillus plantarum mitigates scar formation in rabbits after burn injury and Infection. Surg Infect (Larchmt) 2017; 18(2): 119-27.
[] [PMID: 27788042]
Peral MC, Rachid MM, Gobbato NM, Huaman Martinez MA, Valdez JC. Interleukin-8 production by polymorphonuclear leukocytes from patients with chronic infected leg ulcers treated with Lactobacillus plantarum. Clin Microbiol Infect 2010; 16(3): 281-6.
[] [PMID: 19519855]
Maria C. Peral MAHM, Juan C Valdez. Bacteriotherapy with Lactobacillus plantarum in burns. Int Wound J 2009; 6(1): 73-81.
Sikorska H, Smoragiewicz W. Role of probiotics in the prevention and treatment of meticillin-resistant Staphylococcus aureus infections. Int J Antimicrob Agents 2013; 42(6): 475-81.
[] [PMID: 24071026]
Sonal Sekhar M, Unnikrishnan MK, Vijayanarayana K, Rodrigues GS, Mukhopadhyay C. Topical application/formulation of probiotics: Will it be a novel treatment approach for diabetic foot ulcer? Med Hypotheses 2014; 82(1): 86-8.
[] [PMID: 24296233]
Hussain MB. Role of honey in topical and systemic bacterial infections. J Altern Complement Med 2018; 24(1): 15-24.
[] [PMID: 28837361]
Cohen PA. Probiotic safety-no guarantees. JAMA Intern Med 2018; 178(12): 1577-8.
[] [PMID: 30242393]

Rights & Permissions Print Export Cite as
© 2022 Bentham Science Publishers | Privacy Policy