title: Ozonated saline shows activity against planktonic and biofilm growing Staphylococcus aureus in vitro: a potential irrigant for infected wounds.
abstract: Infections associated with deep wounds require extensive surgical and medical care. New adjunctive treatments are required to aid in the eradication of the bacterial biofilms found on infected wounds and, in particular, any underlying hardware. Ozone has been used as a safe and efficient disinfectant in water treatment plants for many years. The purpose of this study is to investigate the anti-biofilm potential of ozonated saline against biofilms of Staphylococcus aureus, a microorganism commonly implicated in wound infections. A custom-made bacterial biofilm bioreactor was used to grow S. aureus biofilms on discs of medical grade titanium alloy. An ozone generator was connected in-line and biofilms and planktonic bacteria were exposed to ozone in saline. Cytotoxicity was assessed against primary ovine osteoblasts in the same system. In tests against planktonic S. aureus, a 99% reduction in bacterial numbers was detected within 15 minutes of exposure. S. aureus biofilms were significantly more resistant to ozone, although complete eradication of the biofilm was eventually achieved within 5 hours. Ozonated saline was not found to be cytotoxic to primary ovine osteoblasts. Ozonated saline may be suitable as an adjuvant therapy to treat patients as an instillation fluid for wound irrigation and sterilisation.
authors.affiliation: AO Research Institute Davos, AO Foundation, Davos Platz, Switzerland.
authors.forename: Hayder
authors.initials: H
authors.lastname: Al-Saadi
authors.affiliation: AO Research Institute Davos, AO Foundation, Davos Platz, Switzerland.
authors.forename: Inga
authors.initials: I
authors.lastname: Potapova
authors.affiliation: AO Research Institute Davos, AO Foundation, Davos Platz, Switzerland.
authors.forename: Edward Tj
authors.initials: ET
authors.lastname: Rochford
authors.affiliation: AO Research Institute Davos, AO Foundation, Davos Platz, Switzerland. fintan.moriarty@aofoundation.org.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Moriarty
authors.affiliation: Traumatologie Klinik St. Anna, Luzern, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Messmer
mesh_terms: D000818:Animals; D018441:Biofilms / Q000187:drug effects*; D010006:Osteoblasts / Q000187:drug effects; D010083:Oxidants, Photochemical / Q000494:pharmacology*; D010126:Ozone / Q000494:pharmacology*; D010933:Plankton / Q000187:drug effects* / Q000502:physiology; D012756:Sheep; D012965:Sodium Chloride / Q000494:pharmacology*; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000502:physiology; D007507:Therapeutic Irrigation
chemical_list: D010083:Oxidants, Photochemical; D012965:Sodium Chloride; D010126:Ozone
keywords: Biofilm; Infection; Instillation