Centre of Excellence in Biofilm Science and Technologies (CEBST), 5D Health Protection Group Ltd, Liverpool Bio-innovation Hub, Liverpool, UK.
Adv Exp Med Biol. 2018;1057:101-110. doi: 10.1007/5584_2017_134.
The aetiology of delayed wound healing characteristic of a chronic wound is relatively unknown but is thought to be due to a combination of the patient's underlying pathophysiology and external factors including infection and biofilm formation. The invasion of the wound by the hosts' resident microbiome and exogenous microorganisms can lead to biofilm formation. Biofilms have increased tolerance to antimicrobial interventions and constitute a concern to chronic wound healing. Consequently, anti-biofilm technologies with proven efficacy in areas outside of wound care need evaluation to determine whether their efficacy could be relevant to the control of biofilms in wounds. The aim of this study was to assess the anti-biofilm capabilities of tetrasodium EDTA (t-EDTA) as a stand-alone liquid and when incorporated in low concentrations into wound dressing prototypes. Results demonstrated that a low concentration of t-EDTA (4%) solution was able to kill Staphylococcus aureus, methicillin-resistant S. aureus (MRSA), S. epidermidis, Pseudomonas aeruginosa and Enterococcus faecalis within in vitro biofilms after a 24-h contact time. The incorporation of low levels of t-EDTA into prototype fibrous wound dressings resulted in a 3-log reduction of bacteria demonstrating its microbicidal ability. Furthermore, hydrogels incorporating only a 0.2% concentration of t-EDTA (at preservative levels) caused a small reduction in biofilm. In conclusion, these studies show that t-EDTA as a stand-alone agent is an effective anti-biofilm agent in vitro. We have demonstrated that t-EDTA is compatible with numerous wound dressing platforms. EDTA could provide an essential tool to manage biofilm-related infections and should be considered as an anti-biofilm agent alone or in combination with other antimicrobials or technologies for increased antimicrobial performance in recalcitrant wounds.
慢性伤口愈合延迟的病因相对未知,但据认为是由于患者潜在的病理生理学和外部因素(包括感染和生物膜形成)的共同作用。宿主常驻微生物组和外源性微生物对伤口的侵袭可导致生物膜形成。生物膜对抗菌干预的耐受性增加,是慢性伤口愈合的一个关注点。因此,需要评估在伤口护理以外领域具有已证明疗效的抗生物膜技术,以确定其疗效是否与控制伤口中的生物膜相关。本研究旨在评估四钠乙二胺四乙酸(t-EDTA)作为独立液体以及以低浓度掺入伤口敷料原型时的抗生物膜能力。结果表明,低浓度的 t-EDTA(4%)溶液在 24 小时接触时间后能够杀死金黄色葡萄球菌、耐甲氧西林金黄色葡萄球菌(MRSA)、表皮葡萄球菌、铜绿假单胞菌和粪肠球菌的体外生物膜内的细菌。将低浓度的 t-EDTA 掺入原型纤维状伤口敷料中可导致细菌减少 3 个对数,证明其具有杀菌能力。此外,仅含有 0.2%浓度 t-EDTA(在防腐剂水平)的水凝胶可导致生物膜略有减少。总之,这些研究表明,t-EDTA 作为一种独立的试剂在体外是一种有效的抗生物膜试剂。我们已经证明 t-EDTA 与许多伤口敷料平台兼容。EDTA 可以为管理生物膜相关感染提供重要工具,并且应被视为单独的抗生物膜剂或与其他抗菌剂或技术联合使用,以提高在顽固伤口中的抗菌性能。