Tahir Shamaila, Parvin Farhana, Wang Matthew, Deva Anand K, Vickery Karen, Hu Honghua
Macquarie Medical School, Macquarie University, Sydney, NSW 2109, Australia.
Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia.
J Antimicrob Chemother. 2024 Dec 2;79(12):3178-3185. doi: 10.1093/jac/dkae338.
Biofilm is the major challenge in chronic wound management. Instilling a wound cleansing solution aids in wound bed cleaning and infectious pathogen elimination. Negative pressure wound therapy (NPWT) improves the wound-healing process. This study investigated the efficacy of two antimicrobials (Vashe Wound Cleanser and Prontosan Wound Irrigation Solution) against a multispecies bacterial biofilm with or without NPWT in an in vitro wound model.
A mixed multispecies biofilm containing Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pyogenes, and Acinetobacter baumannii was developed and verified by scanning electron microscopy and fluorescent in situ hybridization. The efficacy of Vashe and Prontosan against multispecies biofilm with or without NPWT was evaluated by colony-forming unit (cfu) of each species and total bacterial number, and visually confirmed by live/dead stain and confocal microscopy.
Prontosan reduced biofilm cell numbers significantly: 6 instils over 24 h resulting in 3.86 ± 0.14 cfu log10 reduction without NPWT and 4.75 ± 0.13 cfu log10 reduction combined with NPWT (P < 0.01) and 12 instils over 48 h resulting in 5.24 ± 0.11 cfu log10 reduction without NPWT and biofilm eradication with NPWT (P < 0.001). NPWT alone or combined with Vashe failed to reduce multispecies biofilm numbers significantly over 24 or 48 h.
Prontosan significantly reduced biofilm cell numbers, with better efficacy over 48 than 24 h, emphasizing the necessity for persistent and robust treatment. NPWT enhanced the effectiveness of Prontosan instillation. However, NPWT alone or combined with Vashe showed limited efficacy and difficulty when combating the multispecies biofilm in vitro.
生物膜是慢性伤口处理中的主要挑战。灌注伤口清洁溶液有助于清洁伤口床并消除感染性病原体。负压伤口治疗（NPWT）可改善伤口愈合过程。本研究在体外伤口模型中研究了两种抗菌剂（Vashe伤口清洁剂和普朗托桑伤口冲洗液）在有或无NPWT情况下对多菌种细菌生物膜的疗效。
通过扫描电子显微镜和荧光原位杂交技术构建并验证了一种包含金黄色葡萄球菌、铜绿假单胞菌、化脓性链球菌和鲍曼不动杆菌的混合多菌种生物膜。通过各菌种的菌落形成单位（cfu）和总细菌数评估Vashe和普朗托桑在有或无NPWT情况下对多菌种生物膜的疗效，并通过活/死染色和共聚焦显微镜进行视觉确认。
普朗托桑显著减少了生物膜细胞数量：在24小时内灌注6次，无NPWT时导致cfu对数减少量为3.86±0.14，联合NPWT时为4.75±0.13（P<0.01）；在48小时内灌注12次，无NPWT时导致cfu对数减少量为5.24±0.11，联合NPWT时生物膜被根除（P<0.001）。单独使用NPWT或与Vashe联合使用在24或48小时内均未能显著减少多菌种生物膜数量。
普朗托桑显著减少了生物膜细胞数量，48小时的疗效优于24小时，强调了持续有力治疗的必要性。NPWT增强了普朗托桑灌注的效果。然而，单独使用NPWT或与Vashe联合使用在体外对抗多菌种生物膜时显示出有限的疗效和困难。
