Multidrug-resistant organisms, wounds and topical antimicrobial protection.
Multidrug-resistant organisms (MDROs) are increasingly implicated in both acute and chronic wound infections. The limited therapeutic options are further compromised by the fact that wound bacteria often co-exist within a biofilm community which enhances bacterial tolerance to antibiotics. As a consequence, topical antiseptics may be an important consideration for minimising the opportunity for wound infections involving MDROs. The objective of this research was to investigate the antimicrobial activity of a silver-containing gelling fibre dressing against a variety of MDROs in free-living and biofilm states, using stringent in vitro models designed to simulate a variety of wound conditions. MDROs included Acinetobacter baumannii, community-associated methicillin-resistant Staphylococcus aureus, and extended-spectrum beta-lactamase-producing bacteria. Clostridium difficile was also included in the study because it carries many of the characteristics seen in MDROs and evidence of multidrug resistance is emerging. Sustained in vitro antimicrobial activity of the silver-containing dressing was shown against 10 MDROs in a simulated wound fluid over 7 days, and inhibitory and bactericidal effects against both free-living and biofilm phenotypes were also consistently shown in simulated colonised wound surface models. The in vitro data support consideration of the silver-containing gelling fibre dressing as part of a protocol of care in the management of wounds colonised or infected with MDROs.
Infection Prevention R&D, ConvaTec Global Development Centre, First Avenue, Deeside Industrial Park, Deeside, Flintshire CH5 2NU, UK. phil.bowler@convatec.com
Philip G
PG
Bowler
Sarah
S
Welsby
Victoria
V
Towers
Rebecca
R
Booth
Andrea
A
Hogarth
Victoria
V
Rowlands
Alexis
A
Joseph
Samantha A
SA
Jones
D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001458:Bandages; D018441:Biofilms / Q000187:drug effects*; D052978:Disk Diffusion Antimicrobial Tests; D024901:Drug Resistance, Multiple, Bacterial; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000254:growth & development; D006094:Gram-Positive Bacteria / Q000187:drug effects / Q000254:growth & development; D006801:Humans; D008826:Microbial Sensitivity Tests; D008954:Models, Biological; D012680:Sensitivity and Specificity; D018030:Silver Compounds / Q000494:pharmacology*; D014946:Wound Infection / Q000188:drug therapy / Q000382:microbiology
D000900:Anti-Bacterial Agents; D018030:Silver Compounds