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. 2023 Aug 28;13(1):14087.
doi: 10.1038/s41598-023-39363-4.

Treatment of antibiotic-resistant bacteria colonizing diabetic foot ulcers by OLED induced antimicrobial photodynamic therapy

Marta Piksa  1 , Wojciech Fortuna  1   2 , Cheng Lian  3 , Małgorzata Gacka  4 , Ifor D W Samuel  3 , Katarzyna Matczyszyn  5 , Krzysztof J Pawlik  6
Affiliations

Treatment of antibiotic-resistant bacteria colonizing diabetic foot ulcers by OLED induced antimicrobial photodynamic therapy

Marta Piksa et al. Sci Rep. .

Abstract

We evaluate the efficacy of antimicrobial Photodynamic Therapy (APDT) for inactivating a variety of antibiotic-resistant clinical strains from diabetic foot ulcers. Here we are focused on APDT based on organic light-emitting diodes (OLED). The wound swabs from ten patients diagnosed with diabetic foot ulcers were collected and 32 clinical strains comprising 22 bacterial species were obtained. The isolated strains were identified with the use of mass spectrometry coupled with a protein profile database and tested for antibiotic susceptibility. 74% of isolated bacterial strains exhibited adaptive antibiotic resistance to at least one antibiotic. All strains were subjected to the APDT procedure using an OLED as a light source and 16 µM methylene blue as a photosensitizer. APDT using the OLED led to a large reduction in all cases. For pathogenic bacteria, the reduction ranged from 1.1-log to > 8 log (Klebsiella aerogenes, Enterobacter cloaca, Staphylococcus hominis) even for high antibiotic resistance (MRSA 5-log reduction). Opportunistic bacteria showed a range from 0.4-log reduction for Citrobacter koseri to > 8 log reduction for Kocuria rhizophila. These results show that OLED-driven APDT is effective against pathogens and opportunistic bacteria regardless of drug resistance.

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Conflict of interest statement

IDWS is a founder and shareholder of Lustre Skin Ltd which sells products for skincare, including a wearable light source for the treatment of acne.

Figures

Figure 1
Figure 1
The mechanism of photodynamic action. Absorption of light energy by a photosensitizer leads to the generation of reactive oxygen species (ROS) considered as main antimicrobial agent.
Figure 2
Figure 2
The reduction via OLED-based antimicrobial photodynamic therapy of bacteria isolated from diabetic foot ulcers: (a) pathogenic, (b) gram-positive opportunistic pathogenic, (c) gram-negative opportunistic pathogenic bacteria. The results for each bacterial species are presented in three bars: red (C)—control—non-treated bacterial culture, grey (MB)—bacteria growth in the dark in presence of methylene blue concentration 16 µM (5 µg/mL), and empty blue bars (APDT)—bacteria treated with 16 µM (5 µg/mL) methylene blue and irradiated through 3 h. The results are shown as log reduction of bacteria load to expose the differences between the growth in the MB and APDT samples. Each bar in the graph represents three biological replicates each consisting of three technical replicates (n = 9). Error bars represent standard deviation. T-test with the two tailed distribution and equal variance was performed using Excel 2013, Microsoft Office 2013 (ns non-statistical, *p-value < 0.05, **p-value < 0.01). Graphs were made and edited in GraphPad Prism 5.
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