Microbiology and Infection Research Group, Cardiff School of Health Sciences, Cardiff Metropolitan University, Llandaff, UK.
School of Science Technology Engineering and Mathematics, University of Washington Bothell, Bothell, Washington, USA.
J Appl Microbiol. 2022 Jan;132(1):715-724. doi: 10.1111/jam.15239. Epub 2021 Aug 10.
The effectiveness of commercially available wound dressings and a HOCl gel formulation was tested against two- and five-species biofilms in a dynamic in vitro chronic wound infection model.
Two-species biofilms (Pseudomonas aeruginosa and Staphylococcus aureus) were cultured using a biofilm flow device and treated with wound dressings containing silver, iodine, polyhexamethylene biguanide, crystal violet or HOCl gel at 5 h. Five-species biofilms (P. aeruginosa, S. aureus, Enterococcus faecalis, Streptococcus pyogenes and Escherichia coli) were similarly cultured and treated with HOCl gel at 5 and 24 h. Multidose experiments used two- and five-species biofilms with HOCl applied at 24, 48 and 72 h.
None of the treatments completely disrupted the biofilms and, with the exception of silver, bacteria recovered in number post-treatment. HOCl was most effective when applied to 24 h established biofilms with most activity against P. aeruginosa. Recovery post-treatment was negligible with HOCl applied at 24 h and multiple doses indicated that bacteria were not becoming tolerant to treatment.
Realistic models are necessary to test the effectiveness of antimicrobial wound treatments to ensure findings are clinically translatable. HOCl gel shows promise as a new topical antimicrobial for wounds, especially due to its ability to inhibit P. aeruginosa.
This study highlights a need for robust in vitro data to support development and use of wound treatments that can only be obtained from the refinement of realistic infection models. Furthermore, it indicates the potential use of HOCl gel for chronic wound management.
本研究旨在利用动态体外慢性伤口感染模型，测试市售伤口敷料和次氯酸（HOCl）凝胶制剂对两种和五种细菌生物膜的疗效。
使用生物膜流动装置培养两种细菌生物膜（铜绿假单胞菌和金黄色葡萄球菌），并在 5 小时时用含银、碘、聚六亚甲基双胍、结晶紫或 HOCl 凝胶的伤口敷料进行处理。类似地培养五种细菌生物膜（铜绿假单胞菌、金黄色葡萄球菌、粪肠球菌、化脓性链球菌和大肠杆菌），并在 5 和 24 小时时用 HOCl 凝胶进行处理。多剂量实验使用 24、48 和 72 小时时施加 HOCl 的两种和五种细菌生物膜。
除银外，没有一种处理方法能完全破坏生物膜，而且在处理后细菌数量有所恢复。HOCl 对 24 小时形成的生物膜最有效，对铜绿假单胞菌的活性最强。24 小时时施加 HOCl 后，细菌恢复量可忽略不计，多次施加表明细菌对治疗没有产生耐药性。
为了确保研究结果具有临床可转化性，有必要使用现实模型来测试抗菌伤口处理的有效性。HOCl 凝胶作为一种新的局部抗菌药物，对伤口有一定的应用前景，特别是因为其能抑制铜绿假单胞菌。
本研究强调了需要有稳健的体外数据来支持伤口处理方法的开发和应用，而这些数据只能通过对现实感染模型的改进来获得。此外，它表明了 HOCl 凝胶在慢性伤口管理中的潜在用途。
