title: A pilot study investigating lactic acid bacterial symbionts from the honeybee in inhibiting human chronic wound pathogens.
abstract: Treatment and management of chronic wounds is a large burden on the health sector and causes substantial suffering for the patients. We believe that 13 lactic acid bacteria (LAB) symbionts isolated from the honey crop of the honeybee are important players in the antimicrobial action of honey, by producing antimicrobial substances and can be used in combination with heather honey as an effective treatment in wound management. A total of 22 patients with chronic ulcers were included; culture-dependent and molecular-based (MALDI-MS and 16S rRNA gene sequencing) techniques were used to identify bacteria from chronic wounds. These clinical isolates were used for in vitro antimicrobial testing with standardised viable LAB and sterilised heather honey mixture. Twenty of the patients' wounds were polymicrobial and 42 different species were isolated. Patient isolates that were tested in vitro were inhibited by the LAB and honey combination with inhibitory zones comparable with different antibiotics. LAB and heather honey in combination presents a new topical option in chronic wound management because of the healing properties of honey, antimicrobial metabolite production from the LAB and their bactericidal effect on common chronic wound pathogens. This new treatment may be a stepping stone towards an alternative solution to antibiotics.
authors.affiliation: Department of Laboratory Medicine Lund, Section of Medical Microbiology, Lund University, Lund, Sweden. eile.butler@med.lu.se.
authors.forename: Éile
authors.initials: É
authors.lastname: Butler
authors.affiliation: Blekinge Wound Healing Centre, Blekinge Hospital, Karlshamn, Sweden.
authors.forename: Rut F
authors.initials: RF
authors.lastname: Oien
authors.affiliation: Division of Nursing Science, Sophiahemmet University, Stockholm, Sweden.
authors.forename: Christina
authors.initials: C
authors.lastname: Lindholm
authors.affiliation: Department of Laboratory Medicine Lund, Section of Medical Microbiology, Lund University, Lund, Sweden.
authors.forename: Tobias C
authors.initials: TC
authors.lastname: Olofsson
authors.affiliation: Labmedicin, Region Skåne, Clinical Microbiology, Lund, Sweden.
authors.forename: Bo
authors.initials: B
authors.lastname: Nilson
authors.affiliation: Department of Laboratory Medicine Lund, Section of Medical Microbiology, Lund University, Lund, Sweden.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Vásquez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000898:Antibiosis; D001419:Bacteria; D001516:Bees / Q000382:microbiology*; D001691:Biological Therapy; D002908:Chronic Disease / Q000628:therapy; D005260:Female; D006722:Honey / Q000382:microbiology*; D006801:Humans; D019344:Lactic Acid / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013559:Symbiosis; D014647:Varicose Ulcer / Q000628:therapy*; D014945:Wound Healing / Q000502:physiology; D014947:Wounds and Injuries / Q000382:microbiology / Q000628:therapy*
chemical_list: D000890:Anti-Infective Agents; D019344:Lactic Acid
keywords: Antimicrobial activity; Chronic wounds; Honey; Honeybee; Lactic acid bacteria; Microbial characterisation