Hayajneh Audai A, Hweidi Issa M, Zytoon Ala M
Adult Health Nursing Department, Jordan University of Science and Technology, Irbid, Jordan.
Jordan Royal Medical Services, Queen Alia Heart Institute, Amman, Jordan.
Wounds. 2020 Sep;32(9):237-243. Epub 2020 Jul 14.
Biofilm in chronic wounds impedes the wound healing process. Each biofilm has differing characteristics requiring a multifaceted approach for removal while maintaining a surrounding environment conducive to wound healing.
In this study, 3 of the components in a wound cleanser are tested to determine synergy in eradicating biofilms of methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa in vitro.
The 3 components assessed for synergy were ethylenediamine tetraacetic acid sodium salts (EDTA), vicinal diols (VD; ethylhexylglycerin and octane-1,2-diol), and polyhexamethylene biguanide (PHMB). Each component was assessed individually and in combination while dissolved in a base solution. The Calgary assay method was used for biofilm growth and treatment. Kull Equation analysis for synergy was conducted using viable count results.
Synergy is defined as the interaction of components to produce a combined effect greater than the sum of their separate effects. The base solution containing all 3 components (EDTA, VD, and PHMB) reduced biofilm viability by more than 5 logs, demonstrating statistically significant synergy. The 3 components tested individually in the base solution resulted in the following: EDTA did not reduce bacteria viability; VD reduced viability by about 1 log; and PHMB reduced P aeruginosa viability by about 2.5 logs and MRSA viability by about 4 logs. Of importance, the MRSA biofilm failed to regrow in the recovery plates after combined treatment, indicating complete elimination of the biofilm bacteria.
The experimental and calculated results indicate the 3 components (VD, EDTA, and PHMB) when used together act synergistically to eradicate MRSA and P aeruginosa biofilms in vitro.
慢性伤口中的生物膜会阻碍伤口愈合过程。每种生物膜都有不同的特性，需要采用多方面的方法来清除，同时保持有利于伤口愈合的周围环境。
在本研究中，测试了一种伤口清洁剂中的3种成分，以确定其在体外根除耐甲氧西林金黄色葡萄球菌（MRSA）和铜绿假单胞菌生物膜方面的协同作用。
评估协同作用的3种成分是乙二胺四乙酸钠盐（EDTA）、邻二醇（VD；乙基己基甘油和辛烷-1,2-二醇）和聚六亚甲基双胍（PHMB）。每种成分分别以及组合溶解在基础溶液中进行评估。使用卡尔加里测定法进行生物膜生长和处理。使用活菌计数结果进行协同作用的库尔方程分析。
协同作用定义为各成分相互作用产生的联合效应大于其单独效应之和。含有所有3种成分（EDTA、VD和PHMB）的基础溶液使生物膜活力降低超过5个对数，显示出统计学上显著的协同作用。在基础溶液中单独测试的3种成分的结果如下：EDTA未降低细菌活力；VD使活力降低约1个对数；PHMB使铜绿假单胞菌活力降低约2.5个对数，使MRSA活力降低约4个对数。重要的是，联合处理后，MRSA生物膜在恢复平板中未能再生长，表明生物膜细菌被完全清除。
实验和计算结果表明，3种成分（VD、EDTA和PHMB）一起使用时在体外协同根除MRSA和铜绿假单胞菌生物膜。
