title: In vitro activity of an engineered honey, medical-grade honeys, and antimicrobial wound dressings against biofilm-producing clinical bacterial isolates.
abstract: OBJECTIVE
  Honey is recognised to be a good topical wound care agent owing to a broad-spectrum of antimicrobial activity combined with healing properties. Surgihoney RO (SH1) is a product based on honey that is engineered to produce enhanced reactive oxygen species (ROS) and has been reported to be highly antimicrobial. The objective was to investigate the ability of the engineered honey and its comparators to prevent biofilm formation in vitro.
  
  
  METHODS
  We tested the ability of three medical-grade honeys SH1, Activon manuka honey (MH) and Medihoney manuka honey (Med), alongside five antimicrobial dressings (AMDs) to prevent the formation of biofilms by 16 isolates. Honeys were serially double diluted from 1:3 down to 1:6144 and the lowest dilution achieving a statistically significant reduction in biomass of at least 50%, compared with untreated controls, was recorded.
  
  
  RESULTS
  Although all the honeys were antibacterial and were able to prevent the formation of biofilms, SH1 was the most potent, with efficacy at lower dilutions than the medical honeys for five isolates, and equivalent dilutions for a further six. Additionally, SH1 was superior in antibacterial potency to three commercially available AMDs that contain honey.
  
  
  CONCLUSIONS
  SH1 is effective at preventing bioflms from forming and is superior to medical honeys and AMDs in in vitro tests.
  
  
  BACKGROUND
  Surgihoney RO was provided free of charge for testing by Matoke Holdings, UK and the hospital pharmacy provided the other honeys and dressings. This paper presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
authors.affiliation: Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.|NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK.|Institute of Microbiology and Infection, School of Biosciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
authors.forename: F D
authors.initials: FD
authors.lastname: Halstead
authors.affiliation: NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK.|Institute of Microbiology and Infection, School of Biosciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
authors.forename: M A
authors.initials: MA
authors.lastname: Webber
authors.affiliation: Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.|NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK.|Institute of Microbiology and Infection, School of Biosciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
authors.forename: M
authors.initials: M
authors.lastname: Rauf
authors.affiliation: Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.|NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK.|Institute of Microbiology and Infection, School of Biosciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
authors.forename: R
authors.initials: R
authors.lastname: Burt
authors.affiliation: Department of Microbiology and Infection, Hampshire Hospitals NHS Foundation Trust, UK.|Rare and Imported Pathogens Department, Public Health England, Porton Down, UK.
authors.forename: M
authors.initials: M
authors.lastname: Dryden
authors.affiliation: Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.|NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK.
authors.forename: B A
authors.initials: BA
authors.lastname: Oppenheim
mesh_terms: D040981:Acinetobacter baumannii / Q000187:drug effects; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D000890:Anti-Infective Agents / Q000494:pharmacology*; D018441:Biofilms / Q000187:drug effects*; D002478:Cells, Cultured / Q000187:drug effects*; D004926:Escherichia coli / Q000187:drug effects; D006722:Honey; D006801:Humans; D007711:Klebsiella pneumoniae / Q000187:drug effects; D008826:Microbial Sensitivity Tests; D011550:Pseudomonas aeruginosa / Q000187:drug effects; D013211:Staphylococcus aureus / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents
keywords: antibacterial; biofilms; honey; hydrogen peroxide; wounds