{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T11:13:17Z","timestamp":1781003597277,"version":"3.54.1"},"reference-count":68,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004242","name":"Princess Nourah Bint Abdulrahman University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004242","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Surgical site infections (SSIs) are a significant cause of morbidity and mortality, often complicated by multidrug-resistant (MDR) pathogens and biofilm formation. This study evaluates the potential of a natural nanoemulsion containing chitosan, lavender, and curcumin, in combination with antimicrobial drugs, for treating SSIs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A comprehensive approach combining phenotypic and genotypic analyses, along with <jats:italic>in vitro<\/jats:italic> and <jats:italic>in vivo<\/jats:italic> studies, was used to assess the efficacy and safety of the combination therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The most common SSI pathogens identified were <jats:italic>Staphylococcus aureus<\/jats:italic>, <jats:italic>Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa,<\/jats:italic> and <jats:italic>Acinetobacter baumannii<\/jats:italic>, with 50% exhibiting MDR, biofilm formation, and multiple virulence factors. Chitosan nanoemulsion showed the lowest minimum inhibitory concentration (MIC) (300\u2013500 \u03bcg\/mL), although it exceeded the cytotoxicity safety threshold (200 \u03bcg\/mL). However, it significantly enhanced the antimicrobial activity of amikacin, resensitizing resistant strains at safe concentrations. The combination therapy of amikacin and chitosan nanoemulsion demonstrated superior efficacy in reducing bacterial loads in both Gram-negative and Gram-positive infections. <jats:italic>In vivo<\/jats:italic> studies showed near-complete bacterial clearance by day 12. Histopathological analysis revealed enhanced wound healing, reduced inflammation, and restored tissue function. The combination of amikacin and chitosan nanoemulsion presents a promising therapeutic strategy for managing SSIs caused by MDR pathogens, improving bacterial eradication and wound healing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study highlights chitosan nanoemulsion as an adjuvant therapy to combat antimicrobial resistance, enhance antibiotic efficacy, and improve SSI treatment outcomes. Further clinical studies are needed to optimize its use in patient care.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphar.2025.1617184","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T05:54:08Z","timestamp":1751435648000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Advanced therapeutic strategy for managing surgical site infections with natural nanoemulsion-antimicrobial combination"],"prefix":"10.3389","volume":"16","author":[{"given":"Fatma","family":"Alshehri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nada K.","family":"Alharbi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AbdelNaser","family":"Zaid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amira H.","family":"Eltrawy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shereen","family":"Fawzy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attia M.","family":"Gabr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sawsan A.","family":"Zaitone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majid","family":"Alhomrani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulhakeem S.","family":"Alamri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasha A.","family":"Mosbah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rana","family":"Elshimy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdallah Tageldein","family":"Mansour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud M.","family":"Bendary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1265027","DOI":"10.3389\/fcimb.2023.1265027","article-title":"Partnering essential oils with antibiotics: proven therapies against bovine Staphylococcus aureus mastitis","volume":"13","author":"Abd El-Hamid","year":"2023","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"423","DOI":"10.2147\/IDR.S228089","article-title":"Acinetobacter baumannii efflux pumps and antibiotic resistance","volume":"13","author":"Abdi","year":"2020","journal-title":"Infect. drug Resist."},{"key":"B3","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1080\/21505594.2015.1030101","article-title":"Klebsiella pneumoniae and the pyogenic liver abscess: implications and association of the presence of rpmA genes and expression of hypermucoviscosity","volume":"6","author":"Alc\u00e1ntar-Curiel","year":"2015","journal-title":"Virulence"},{"key":"B4","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1016\/j.taap.2009.02.020","article-title":"Interactions of silver nanoparticles with primary mouse fibroblasts and liver cells","volume":"236","author":"Arora","year":"2009","journal-title":"Toxicol. Appl. Pharmacol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"119","DOI":"10.3390\/antibiotics9030119","article-title":"Insights into acinetobacter baumannii: a review of microbiological, virulence, and resistance traits in a threatening nosocomial pathogen","volume":"9","author":"Ayoub Moubareck","year":"2020","journal-title":"Antibiot. Basel, Switz."},{"key":"B6","volume-title":"Theory and practice of histological techniques","author":"Bancroft","year":"2007"},{"key":"B7","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1001\/jamasurg.2017.0904","article-title":"Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017","volume":"152","author":"Berr\u00edos-Torres","year":"2017","journal-title":"JAMA Surg."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1567","DOI":"10.1093\/bjs\/znad302","article-title":"The threat of antimicrobial resistance in surgical care: the surgeon's role and ownership of antimicrobial stewardship","volume":"110","author":"Birgand","year":"2023","journal-title":"Br. J. Surg."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/s0732-8893(01)00242-5","article-title":"Emergence of methicillin-resistant Staphylococcus aureus as a community pathogen","volume":"40","author":"Bukharie","year":"2001","journal-title":"Diagnostic Microbiol. Infect. Dis."},{"key":"B10","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1017\/ice.2023.67","article-title":"Strategies to prevent surgical site infections in acute-care hospitals: 2022 update","volume":"44","author":"Calderwood","year":"2023","journal-title":"Infect. control Hosp. Epidemiol."},{"key":"B11","first-page":"131","article-title":"Tests for the identification of bacteria","volume-title":"Mackie and McCartney practical medical microbiology","author":"Collee","year":"1996"},{"key":"B12","doi-asserted-by":"publisher","first-page":"93","DOI":"10.3390\/antibiotics14010093","article-title":"Chemical characterization and antimicrobial activity of essential oils and nanoemulsions of Eugenia uniflora and Psidium guajava","volume":"14","author":"Dos-Santos","year":"2025","journal-title":"Antibiot. Basel, Switz."},{"key":"B13","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1016\/j.patbio.2012.10.004","article-title":"Virulence profiles and antibiotic susceptibility patterns of Klebsiella pneumoniae strains isolated from different clinical specimens","volume":"61","author":"El Fertas-Aissani","year":"2013","journal-title":"Pathologie-biologie"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1447","DOI":"10.3390\/antibiotics11101447","article-title":"New insights into Listeria monocytogenes antimicrobial resistance, virulence attributes and their prospective correlation","volume":"11","author":"Elsayed","year":"2022","journal-title":"Antibiotics"},{"key":"B15","unstructured":"Breakpoint tables for interpretation of MICs and zone diameters\n          \n          \n          2028"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1266","DOI":"10.26355\/eurrev_201902_17020","article-title":"The role of the hospital environment in the healthcare-associated infections: a general review of the literature","volume":"23","author":"Facciol\u00e0","year":"2019","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"B17","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1099\/jmm.0.001183","article-title":"Bacterial quantification in tissue homogenates from in vivo pharmacodynamic studies using growth curves","volume":"69","author":"Georgiou","year":"2020","journal-title":"J. Med. Microbiol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"464","DOI":"10.3390\/antibiotics12030464","article-title":"Tamarindus indica extract as a promising antimicrobial and antivirulence therapy","volume":"12","author":"Ghaly","year":"2023","journal-title":"Antibiot. (Basel)"},{"key":"B19","doi-asserted-by":"publisher","first-page":"186","DOI":"10.3390\/pharmaceutics17020186","article-title":"Antimicrobial and antibiofilm activity of chitosan nanoparticles against Staphylococcus aureus strains isolated from bovine mastitis milk","volume":"17","author":"Godoy","year":"2025","journal-title":"Pharmaceutics"},{"key":"B20","doi-asserted-by":"publisher","first-page":"140","DOI":"10.14744\/tjtes.2022.55726","article-title":"Histopathological investigation of the effect of chitosan on oral mucous wound healing in experimentally established diabetic rats","volume":"29","author":"G\u00fcr","year":"2023","journal-title":"Ulusal travma ve acil cerrahi derg"},{"key":"B68","doi-asserted-by":"publisher","first-page":"174","DOI":"10.3389\/fcimb.2019.00174","article-title":"Characterization of the in vitro, ex vivo, and in vivo Efficacy of the Antimicrobial Peptide DPK-060 Used for Topical Treatment","volume":"9","author":"H\u00e5kansson","year":"2019","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1086\/646436","article-title":"CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections","volume":"13","author":"Horan","year":"1992","journal-title":"Infect. control Hosp. Epidemiol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1038\/nrmicro818","article-title":"Pathogenic Escherichia coli","volume":"2","author":"Kaper","year":"2004","journal-title":"Nat. Rev. Microbiol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1007\/s12178-018-9498-8","article-title":"Centers for disease control and prevention 2017 guidelines for prevention of surgical site infections: review and relevant recommendations","volume":"11","author":"Keely Boyle","year":"2018","journal-title":"Curr. Rev. Musculoskelet. Med."},{"key":"B24","doi-asserted-by":"publisher","first-page":"8","DOI":"10.51867\/scimundi.5.1.2","article-title":"The role of Pseudomonas aeruginosa in surgical site infections in Sub-Saharan Africa","volume":"5","author":"Kindiki","year":"2025","journal-title":"Sci. Mundi"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1763","DOI":"10.1001\/jama.298.15.1763","article-title":"Invasive methicillin-resistant Staphylococcus aureus infections in the United States","volume":"298","author":"Klevens","year":"2007","journal-title":"JAMA"},{"key":"B26","doi-asserted-by":"publisher","first-page":"mgen000474","DOI":"10.1099\/mgen.0.000474","article-title":"Epigenomics, genomics, resistome, mobilome, virulome and evolutionary phylogenomics of carbapenem-resistant Klebsiella pneumoniae clinical strains","volume":"6","author":"Kopotsa","year":"2020","journal-title":"Microb. genomics"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1960","DOI":"10.3390\/molecules24101960","article-title":"Chitosan-based (Nano)materials for novel biomedical applications","volume":"24","author":"Kravanja","year":"2019","journal-title":"Mol. Basel, Switz."},{"key":"B28","volume-title":"Performance standards for antimicrobial susceptibility testing","author":"Lewis","year":"2025"},{"key":"B29","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-319-31991-9_46","article-title":"Diagnosis and management of wound infections","volume-title":"Critical limb ischemia","author":"Lora","year":"2017"},{"key":"B30","doi-asserted-by":"publisher","first-page":"2289769","DOI":"10.1080\/21505594.2023.2289769","article-title":"Pathogenicity and virulence of Acinetobacter baumannii: factors contributing to the fitness in healthcare settings and the infected host","volume":"15","author":"Lucidi","year":"2024","journal-title":"Virulence"},{"key":"B31","volume-title":"Brock biology of microorganisms","author":"Madigan","year":"2018"},{"key":"B32","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","article-title":"Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance","volume":"18","author":"Magiorakos","year":"2012","journal-title":"Clin. Microbiol. Infect. official Publ. Eur. Soc. Clin. Microbiol. Infect. Dis."},{"key":"B33","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/S0196-6553(99)70088-X","article-title":"Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee","volume":"27","author":"Mangram","year":"1999","journal-title":"American Journal of Infection Control"},{"key":"B34","doi-asserted-by":"publisher","first-page":"5889","DOI":"10.3390\/ijms20235889","article-title":"Chitosan as a wound dressing starting material: antimicrobial properties and mode of action","volume":"20","author":"Matica","year":"2019","journal-title":"Int. J. Mol. Sci."},{"key":"B35","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.3390\/polym16101351","article-title":"Recent applications of chitosan and its derivatives in antibacterial, anticancer, wound healing, and tissue engineering fields","volume":"16","author":"Mawazi","year":"2024","journal-title":"Polymers"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1032","DOI":"10.1128\/JCM.38.3.1032-1035.2000","article-title":"Multiplex PCR for detection of genes for Staphylococcus aureus enterotoxins, exfoliative toxins, toxic shock syndrome toxin 1, and methicillin resistance","volume":"38","author":"Mehrotra","year":"2000","journal-title":"J. Clin. Microbiol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1002\/vms3.647","article-title":"Determination of frequency, multiple antibiotic resistance index and resistotype of salmonella spp. in chicken meat collected from southeast of Iran","volume":"8","author":"Mir","year":"2022","journal-title":"Veterinary Med. Sci."},{"key":"B38","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1186\/s12906-016-1128-7","article-title":"Wound healing potential of lavender oil by acceleration of granulation and wound contraction through induction of TGF-\u03b2 in a rat model","volume":"16","author":"Mori","year":"2016","journal-title":"BMC complementary Altern. Med."},{"key":"B39","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1007\/s11274-023-03745-7","article-title":"Curcumin clarithromycin nano-form: a promising agent to fight Helicobacter pylori infections","volume":"39","author":"Mosallam","year":"2023","journal-title":"World J. Microbiol. Biotechnol."},{"key":"B40","doi-asserted-by":"publisher","first-page":"1524","DOI":"10.1557\/s43578-021-00226-1","article-title":"Potency of a novel synthesized Ag-eugenol nanoemulsion for treating some bacterial and fungal pathogens","volume":"36","author":"Mosallam","year":"2021","journal-title":"J. Mater. Res."},{"key":"B41","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1128\/CMR.11.1.142","article-title":"Diarrheagenic Escherichia coli","volume":"11","author":"Nataro","year":"1998","journal-title":"Clin. Microbiol. Rev."},{"key":"B42","volume-title":"(NICE Guideline, No. 125) Surgical site infections: prevention and treatment","year":"2020"},{"key":"B43","first-page":"118","article-title":"Molecular identification and detection of virulence genes among Pseudomonas aeruginosa isolated from different infectious origins","volume":"4","author":"Nikbin","year":"2012","journal-title":"Iranian Journal of Microbiology"},{"key":"B44","doi-asserted-by":"publisher","first-page":"1551","DOI":"10.1093\/jac\/dkg301","article-title":"Synergism, antagonism, and the FIC index","volume":"51","author":"Odds","year":"2003","journal-title":"J. Antimicrob. Chemother."},{"key":"B45","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.3390\/pharmaceutics16091115","article-title":"Synthesis, characterization, and biological evaluation of chitosan nanoparticles cross-linked with phytic acid and loaded with colistin against extensively drug-resistant bacteria","volume":"16","author":"Pacheco","year":"2024","journal-title":"Pharmaceutics"},{"key":"B46","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1128\/CMR.18.4.657-686.2005","article-title":"Extended-spectrum beta-lactamases: a clinical update","volume":"18","author":"Paterson","year":"2005","journal-title":"Clin. Microbiol. Rev."},{"key":"B47","doi-asserted-by":"publisher","first-page":"20091","DOI":"10.3390\/molecules191220091","article-title":"The chemistry of curcumin: from extraction to therapeutic agent","volume":"19","author":"Priyadarsini","year":"2014","journal-title":"Mol. Basel, Switz."},{"key":"B48","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1038\/s41392-022-01056-1","article-title":"Pseudomonas aeruginosa: pathogenesis, virulence factors, antibiotic resistance, interaction with host, technology advances and emerging therapeutics","volume":"7","author":"Qin","year":"2022","journal-title":"Sig Transduct. Target Ther."},{"key":"B49","doi-asserted-by":"publisher","first-page":"e55193","DOI":"10.7759\/cureus.55193","article-title":"Chitosan-based biomaterial in wound healing: a review","volume":"16","author":"Rajinikanth","year":"2024","journal-title":"Cureus"},{"key":"B50","doi-asserted-by":"publisher","first-page":"615","DOI":"10.3390\/jfb3030615","article-title":"Biocompatibility of chitosan carriers with application in drug delivery","volume":"3","author":"Rodrigues","year":"2012","journal-title":"J. Funct. Biomaterials"},{"key":"B51","volume-title":"Molecular cloning: a laboratory manual","author":"Sambrook","year":"2001"},{"key":"B52","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1007\/s15010-024-02313-x","article-title":"Impact of multidrug resistance on the virulence and fitness of Pseudomonas aeruginosa: a microbiological and clinical perspective","volume":"52","author":"Sendra","year":"2024","journal-title":"Infection"},{"key":"B53","doi-asserted-by":"publisher","first-page":"1653","DOI":"10.1002\/ptr.6101","article-title":"Echinacea plants as antioxidant and antibacterial agents: from traditional medicine to biotechnological applications","volume":"32","author":"Sharifi-Rad","year":"2018","journal-title":"Phytotherapy Res. PTR"},{"key":"B54","doi-asserted-by":"publisher","first-page":"3761","DOI":"10.1128\/JCM.00977-11","article-title":"Molecular typing and virulence analysis of serotype K1 Klebsiella pneumoniae strains isolated from liver abscess patients and stool samples from noninfectious subjects in Hong Kong, Singapore, and Taiwan","volume":"49","author":"Siu","year":"2011","journal-title":"J. Clin. Microbiol."},{"key":"B55","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1111\/j.1600-0463.2007.apm_630.x","article-title":"Quantification of biofilm in microtiter plates: overview of testing conditions and practical recommendations for assessment of biofilm production by staphylococci","volume":"115","author":"Stepanovi\u0107","year":"2007","journal-title":"APMIS"},{"key":"B56","doi-asserted-by":"publisher","first-page":"149","DOI":"10.3109\/03009734.2014.899279","article-title":"Combination antibiotic therapy for multidrug-resistant Gram-negative bacteria","volume":"119","author":"T\u00e4ngd\u00e9n","year":"2014","journal-title":"Upsala J. Med. Sci."},{"key":"B57","doi-asserted-by":"publisher","first-page":"121","DOI":"10.2436\/20.1501.01.270","article-title":"Distribution of virulence genes involved in biofilm formation in multi-drug resistant Acinetobacter baumannii clinical isolates","volume":"19","author":"Thummeepak","year":"2016","journal-title":"Int. Microbiol. official J. Span. Soc. Microbiol."},{"key":"B58","doi-asserted-by":"publisher","first-page":"3473","DOI":"10.1099\/mic.0.26541-0","article-title":"Attachment to and biofilm formation on abiotic surfaces by Acinetobacter baumannii: involvement of a novel chaperone-usher pili assembly system","volume":"149","author":"Tomaras","year":"2003","journal-title":"Microbiology"},{"key":"B59","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.jhin.2012.12.014","article-title":"Prevention of surgical site infections in orthopaedic surgery and bone trauma: State-of-the-art update","volume":"84","author":"U\u00e7kay","year":"2013","journal-title":"J. Hosp. Infect."},{"key":"B60","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1089\/scd.2021.0124","article-title":"Histology scoring system for murine cutaneous wounds","volume":"30","author":"van de Vyver","year":"2021","journal-title":"Stem cells Dev."},{"key":"B61","doi-asserted-by":"crossref","first-page":"842","DOI":"10.2460\/javma.1977.171.09.842","article-title":"Ketamine and xylazine for surgical anesthesia in rats","volume":"171","author":"Van Pelt","year":"1977","journal-title":"Journal of the American Veterinary Medical Association"},{"key":"B62","doi-asserted-by":"publisher","first-page":"59","DOI":"10.3390\/antibiotics9020059","article-title":"Bacterial biofilm and its role in the pathogenesis of disease","volume":"9","author":"Vestby","year":"2020","journal-title":"Antibiot. Basel, Switz."},{"key":"B63","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1128\/jb.173.2.697-703.1991","article-title":"16S ribosomal DNA amplification for phylogenetic study","volume":"173","author":"Weisburg","year":"1991","journal-title":"J. Bacteriol."},{"key":"B64","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1038\/nprot.2007.521","article-title":"Agar and broth dilution methods to determine the minimal inhibitory concentration (MIC) of antimicrobial substances","volume":"3","author":"Wiegand","year":"2007","journal-title":"Nat. Protoc."},{"key":"B65","volume-title":"Global guidelines for the prevention of surgical site infection","year":"2018"},{"key":"B66","doi-asserted-by":"publisher","first-page":"894667","DOI":"10.3389\/fbioe.2022.894667","article-title":"Applications of chitosan and its derivatives in skin and soft tissue diseases","volume":"10","author":"Xia","year":"2022","journal-title":"Front. Bioeng. Biotechnol."},{"key":"B67","doi-asserted-by":"publisher","first-page":"115","DOI":"10.53365\/nrfhh\/177602","article-title":"Chitosan: a natural anti-inflammatory and wound healing agent\u2014A brief update","volume":"4","author":"Zosangpuii","year":"2024","journal-title":"Nat. Resour. Hum. Health"}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2025.1617184\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T05:54:12Z","timestamp":1751435652000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2025.1617184\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,2]]},"references-count":68,"alternative-id":["10.3389\/fphar.2025.1617184"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2025.1617184","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,2]]},"article-number":"1617184"}}