体外和离体生物膜模型研究创面清洁剂对创面特定病原体的疗效。

Efficacy of Wound Cleansers on Wound-Specific Organisms Using In Vitro and Ex Vivo Biofilm Models.

机构信息

Rochal Industries, San Antonio, Texas.

iFyber, Ithaca, New York.

出版信息

Wound Manag Prev. 2020 Nov;66(11):31-42.

PMID:33206627

Abstract

UNLABELLED

Biofilms are believed to be a source of chronic inflammation in non-healing wounds.

PURPOSE

In this study, the pre-clinical anti-biofilm efficacy of several wound cleansers was examined using the Calgary minimum biofilm eradication concentration (MBEC) and ex vivo porcine dermal explant (PDE) models on Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus (MRSA), and Candida albicans biofilms.

METHODS

A surfactant-based cleanser and antimicrobial-based cleansers containing ionic silver, hypochlorous acid (HOCl), sodium hypochlorite (NaOCl), and polyhexamethylene biguanide (PHMB) were tested on the MBEC model biofilms with a 10-minute application time. Select cleansers were then tested on the mature PDE biofilms with 10-minute applications followed by the application of cleanser-soaked gauze. The PDE model was further expanded to include single and daily applications of the cleansers to mimic daily and 72-hour dressing changes.

RESULTS

In the MBEC model, PHMB- and HOCl-based cleansers reduced immature MRSA, C albicans, and P aeruginosa biofilm regrowth by > 3× when compared with silver, surfactant, and saline cleansers. The major differences could be elucidated in the PDE model in which, after daily application, 1 PHMB-based cleanser showed a statistically significant reduction (3-8 CFU/mL log reduction) in all mature biofilms tested, while a NaOCl-based cleanser showed significant reduction in 2 microorganisms (3-5 CFU/mL log reduction, P aeruginosa and MRSA).The other PHMB-based cleanser showed a statistically significant 3 log CFU/mL reduction in P aeruginosa. The remaining cleansers showed no statistically significant difference from the saline control.

CONCLUSION

Results confirm that there are model-dependent differences in the outcomes of these studies, suggesting the importance of model selection for product screening. The results indicate that 1 PHMB-based cleanser was effective in reducing mature P aeruginosa, MRSA, and C albicans biofilms and that sustained antimicrobial presence was necessary to reduce or eliminate these mature biofilms.

摘要

目的

本研究采用卡尔加里最低生物膜清除浓度（MBEC）和体外猪皮真皮（PDE）模型，检测了几种伤口清洁剂在铜绿假单胞菌、耐甲氧西林金黄色葡萄球菌（MRSA）和白色念珠菌生物膜中的临床前抗生物膜效果。

方法

用一种基于表面活性剂的清洁剂和一种含有离子银、次氯酸（HOCl）、次氯酸钠（NaOCl）和聚六亚甲基双胍（PHMB）的基于抗菌剂的清洁剂在 10 分钟应用时间的 MBEC 模型生物膜上进行测试。然后，选择的清洁剂在成熟的 PDE 生物膜上进行测试，应用 10 分钟，然后应用浸有清洁剂的纱布。PDE 模型进一步扩展到包括清洁剂的单次和每日应用，以模拟每日和 72 小时的换敷料。

结果

在 MBEC 模型中，与银、表面活性剂和生理盐水清洁剂相比，基于 PHMB 和 HOCl 的清洁剂可使未成熟的 MRSA、C 白色念珠菌和 P 铜绿假单胞菌生物膜的再生长减少> 3×。在 PDE 模型中可以更清楚地阐明主要差异，其中，经过每日应用，1 种基于 PHMB 的清洁剂对所有测试的成熟生物膜显示出统计学上显著的减少（3-8 CFU/mL 对数减少），而基于 NaOCl 的清洁剂对 2 种微生物（P 铜绿假单胞菌和 MRSA 的 3-5 CFU/mL 对数减少）显示出显著减少。另一种基于 PHMB 的清洁剂对 P 铜绿假单胞菌显示出统计学上显著的 3 对数 CFU/mL 减少。其余清洁剂与生理盐水对照无统计学差异。