The antibacterial effect of topical ozone on the treatment of MRSA skin infection

Abstract

Skin can be infected by many types of microorganisms, most commonly by gram‑positive strains of Staphylococcus and Streptococcus spp. Treatment of Staphylococcus aureus (S. aureus) infections, particularly that of methicillin resistant Staphylococcus aureus (MRSA), is a challenge in clinical practice. Ozone therapy has proven to be one of the strongest antiseptics against the majority of microorganisms involved in skin infections. The purpose of the present study was to evaluate the microbicidal effects of topical ozone therapy on S. aureus and MRSA, and determine the clinical efficacy of ozone therapy on patients with MRSA skin infection. Microbicidal effects of ozonated oil and ozonated water were determined by plating and Kirby Bauer methods. Clinical efficacy and safety of topical ozone were evaluated in two cases with skin MRSA infection. The killing rates of ozonated oil for S. aureus and MRSA were greater when compared with the control oil group. Almost 100% of S. aureus were eliminated by ozonated oil following 5 min. Almost 100% MRSA were eliminated by ozonated oil following 15 min. In addition, 100% S. aureus and 100% MRSA were eliminated by ozonated water in 1 min. The inhibition zone diameters of ozonated oil for S. aureus and MRSA were 17 and 13 mm, respectively, which were significantly larger than the control group. Both cases of skin MRSA infection were completely healed with ozone therapy. In conclusion, ozone therapy is a potential treatment for S. aureus and MRSA skin infection as it has great efficacy, few side effects and low‑costs.

Figure 1.

Killing rate of ozonated oil for S. aureus and MRSA. (A and B) Almost 100% S. aureus were killed in 5 min by ozonated oil. Almost 100% MRSA were killed within 15 min by ozonated oil. S. aureus, Staphylococcus aureus; MRSA, methicillin resistant Staphylococcus aureus.

Figure 2.

Killing rate of ozonated water for S. aureus and MRSA. The ozonated water can sterilize 100% S. aureus and 100% MRSA in one minute. S. aureus, Staphylococcus aureus; MRSA, methicillin resistant Staphylococcus aureus.

Figure 3.

The inhibition zone diameters of ozoned oil for S. aureus and MRSA. The inhibition zone diameters of ozonated oil for S. aureus and MRSA were 17 and 13 mm, respectively. ****P<0.0001. S. aureus, Staphylococcus aureus; MRSA, methicillin resistant Staphylococcus aureus.

Figure 4.

Topical application of ozone therapy on left calf muscle MRSA infection. (A) The lesion before ozone therapy. (B) The lesion after removing necrotic tissue and pus secretion. (C) The lesion after topical application of ozone therapy for one month. (D) The lesion after topical application of ozone therapy for two months. MRSA, methicillin resistant Staphylococcus aureus.

Figure 5.

Drug sensitive test and PCR test confirmed skin MRSA infection. (A) The results of drug sensitive test of the first case. (B) The results of drug sensitive test of the second case. (C) The melting curve of PCR test confirmed the MRSA infection of the first case. (D) The melting curve of PCR test confirmed the MRSA infection of the second case. PCR, polymerase chain reaction; MRSA, methicillin resistant Staphylococcus aureus.

Figure 6.

Topical application of ozone therapy on the left-hand MRSA infection. (A) The lesion before ozone therapy. (B) The lesion after topical application of ozone therapy for 12 days. MRSA, methicillin resistant Staphylococcus aureus.