title: Reactive oxygen: A novel antimicrobial mechanism for targeting biofilm-associated infection.
abstract: Reactive oxygen species (ROS) is a novel therapeutic strategy for topical or local application to wounds, mucosa or internal structures where there may be heavy bacterial bioburden with biofilm and chronic inflammation. Bacterial biofilms are a significant problem in clinical settings owing to their increased tolerance towards conventionally prescribed antibiotics and their propensity for selection of further antibacterial resistance. There is therefore a pressing need for the development of alternative therapeutic strategies that can improve antibiotic efficacy towards biofilms. ROS has been successful in treating chronic wounds and in clearing multidrug-resistant organisms, including methicillin-resistant Staphylococcus aureus (MRSA), and carbapenemase-producing isolates from wounds and vascular line sites. There is significant antifungal activity of ROS against planktonic and biofilm forms. Nebulised ROS has been evaluated in limited subjects to assess reductions in bioburden in chronically colonised respiratory tracts. The antibiofilm activity of ROS could have great implications for the treatment of a variety of persistent respiratory conditions. Use of ROS on internal prosthetic devices shows promise. A variety of novel delivery mechanisms are being developed to apply ROS activity to different anatomical sites.
authors.affiliation: Hampshire Hospitals NHS Foundation Trust, UK; University of Southampton Faculty of Medicine, Southampton, UK. Electronic address: matthew.dryden@hhft.nhs.uk.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Dryden
authors.affiliation: Imperial College London, London, UK; University of Manchester, Manchester, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cooke
authors.affiliation: Academic Unit of Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton, UK; Southampton NIHR Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK; Department of Otolaryngology/Head & Neck Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
authors.forename: Rami J
authors.initials: RJ
authors.lastname: Salib
authors.affiliation: Academic Unit of Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton, UK.
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Holding
authors.affiliation: Academic Unit of Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton, UK.
authors.forename: Timothy
authors.initials: T
authors.lastname: Biggs
authors.affiliation: Academic Unit of Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton, UK.
authors.forename: Ali A
authors.initials: AA
authors.lastname: Salamat
authors.affiliation: Academic Unit of Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton, UK; Southampton NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
authors.forename: Raymond N
authors.initials: RN
authors.lastname: Allan
authors.affiliation: Academic Unit of Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton, UK.
authors.forename: Rachel S
authors.initials: RS
authors.lastname: Newby
authors.affiliation: Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
authors.forename: Fenella
authors.initials: F
authors.lastname: Halstead
authors.affiliation: Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
authors.forename: Beryl
authors.initials: B
authors.lastname: Oppenheim
authors.affiliation: School of Chemical Engineering, University of Birmingham, Edgbaston B15 2TT, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hall
authors.affiliation: Mycology Reference Centre Manchester, Centre for Respiratory Medicine and Allergy, University of Manchester and University Hospital of Manchester, Manchester M23 9LT, UK.
authors.forename: Sophie C
authors.initials: SC
authors.lastname: Cox
authors.affiliation: School of Chemical Engineering, University of Birmingham, Edgbaston B15 2TT, UK.
authors.forename: Liam M
authors.initials: LM
authors.lastname: Grover
authors.affiliation: Mycology Reference Centre Manchester, Centre for Respiratory Medicine and Allergy, University of Manchester and University Hospital of Manchester, Manchester M23 9LT, UK.
authors.forename: Zain
authors.initials: Z
authors.lastname: Al-Hindi
authors.affiliation: Mycology Reference Centre Manchester, Centre for Respiratory Medicine and Allergy, University of Manchester and University Hospital of Manchester, Manchester M23 9LT, UK.
authors.forename: Lilyann
authors.initials: L
authors.lastname: Novak-Frazer
authors.affiliation: Mycology Reference Centre Manchester, Centre for Respiratory Medicine and Allergy, University of Manchester and University Hospital of Manchester, Manchester M23 9LT, UK.
authors.forename: Malcolm D
authors.initials: MD
authors.lastname: Richardson
mesh_terms: D000287:Administration, Topical; D000818:Animals; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects*; D001424:Bacterial Infections / Q000188:drug therapy*; D018441:Biofilms / Q000187:drug effects*; D004353:Drug Evaluation, Preclinical; D005658:Fungi / Q000187:drug effects; D006801:Humans; D017382:Reactive Oxygen Species / Q000627:therapeutic use*; D014946:Wound Infection / Q000188:drug therapy*
chemical_list: D000891:Anti-Infective Agents, Local; D017382:Reactive Oxygen Species
keywords: Biofilm; Chronic wounds; Cystic fibrosis; Prosthetic device infection; Reactive oxygen species