Effects of silver-based wound dressings on the bacterial flora in chronic leg ulcers and its susceptibility in vitro to silver.
Silver-based dressings have been used extensively in wound management in recent years, but data on their antimicrobial activity in the clinical setting are limited. In order to explore their effects on chronic leg ulcer flora, 14 ulcers were cultured after at least 3 weeks treatment with Aquacel Ag(®) or Acticoat(®). Phenotypic and genetic silver resistance were investigated in a total of 56 isolates. Silver-based dressings had a limited effect on primary wound pathogens, which were present in 79% of the cultures before, and 71% after, treatment. One silver-resistant Enterobacter cloacae strain was identified (silver nitrate minimal inhibitory concentration (MIC) > 512 mg/l, positive for silE, silS and silP). Further studies in vitro showed that inducible silver-resistance was more frequent in Enterobacteriaceae with cephalosporin-resistance and that silver nitrate had mainly a bacteriostatic effect on Staphylococcus aureus. Monitoring of silver resistance should be considered in areas where silver is used extensively.
Department of Medical Sciences, Section of Bacteriology, Uppsala University, Sweden. susanne.sutterlin@medsci.uu.se
Susanne
S
Sütterlin
Eva
E
Tano
Agneta
A
Bergsten
Anna-Britta
AB
Tallberg
Asa
A
Melhus
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001458:Bandages; D002266:Carboxymethylcellulose Sodium / Q000627:therapeutic use; D018550:Cephalosporin Resistance; D002908:Chronic Disease; D004337:Drug Carriers / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D016972:Enterobacter cloacae / Q000235:genetics; D005798:Genes, Bacterial; D006801:Humans; D007711:Klebsiella pneumoniae / Q000235:genetics; D007871:Leg Ulcer / Q000188:drug therapy / Q000382:microbiology*; D008826:Microbial Sensitivity Tests; D011091:Polyesters / Q000627:therapeutic use; D011095:Polyethylenes / Q000627:therapeutic use; D011550:Pseudomonas aeruginosa / Q000235:genetics; D017422:Sequence Analysis, DNA; D012835:Silver Nitrate / Q000627:therapeutic use*; D013211:Staphylococcus aureus / Q000235:genetics
C117408:Acticoat; D000900:Anti-Bacterial Agents; D004337:Drug Carriers; D011091:Polyesters; D011095:Polyethylenes; D012835:Silver Nitrate; D002266:Carboxymethylcellulose Sodium