title: Albumin reduces the antibacterial activity of polyhexanide-biguanide-based antiseptics against Staphylococcus aureus and MRSA.
abstract: BACKGROUND
  Wound infection is one of the major complications in acute and chronic wound healing. Antiseptic solutions and wound irrigating agents are routinely used for therapy and prevention in healthcare today. Even if wound exudate contains total protein concentrations up to 9.3% and albumin concentrations up to 2.7% its influence to the antibacterial efficacy of these agents is barely investigated.
  
  
  METHODS
  This study analyzed the antibacterial effect of polyhexanide biguanide (PHMB) agents (PHMB-concentration 0.005-0.1%) against Staphylococcus aureus and methicillin-resistant-S. aureus (MRSA) after 2min incubation in presents of albumin in different concentrations (0-3%) in a standardized quantitative suspension assay.
  
  
  RESULTS
  A significant decrease of the antibacterial activity against S. aureus was shown for a PHMB-concentration of 0.005% from 0.3% albumin (p<0.05), respectively highly significant from 0.75% (p<0.01) on. Thereby the loss of antimicrobial effect was presented as a linear correlation to the rising concentration of albumin. Furthermore a reduction of the antibacterial activity against MRSA in comparison to S. aureus was presented, for albumin concentrations from 3% on highly significant (p<0.01).
  
  
  CONCLUSIONS
  The study showed that albumin causes a significant decrease of the antibacterial potency of PHMB-based antiseptics. Furthermore a diminished potency of the investigated substances for MRSA-contaminated wounds must be taken in consideration. If in vitro experiments show a significant decrease of antibacterial efficacy in the presence of albumin a sufficient activity of PHMB-based agents in clinical practice, especially in cases of exuding wounds or dried-up exudates, cannot be expected.
authors.affiliation: Department of Plastic Surgery, Ruhr-University Bochum, Bochum, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Kapalschinski
authors.forename: H M
authors.initials: HM
authors.lastname: Seipp
authors.forename: A B
authors.initials: AB
authors.lastname: Onderdonk
authors.forename: O
authors.initials: O
authors.lastname: Goertz
authors.forename: A
authors.initials: A
authors.lastname: Daigeler
authors.forename: A
authors.initials: A
authors.lastname: Lahmer
authors.forename: M
authors.initials: M
authors.lastname: Lehnhardt
authors.forename: T
authors.initials: T
authors.lastname: Hirsch
mesh_terms: D000418:Albumins / Q000494:pharmacology*; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001645:Biguanides / Q000494:pharmacology*; D015169:Colony Count, Microbial; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D013211:Staphylococcus aureus / Q000187:drug effects*
chemical_list: D000418:Albumins; D000900:Anti-Bacterial Agents; D001645:Biguanides
keywords: Albumin; Antibacterial activity; Antiseptics; MRSA; Polyhexanide-biguanide; Staphylococcus aureus