Efficacy of Wound Cleansers on Wound-Specific Organisms Using In Vitro and Ex Vivo Biofilm Models
Efficacy of Wound Cleansers on Wound-Specific Organisms Using In Vitro and Ex Vivo Biofilm Models
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DOI：
10.25270/wmp.2020.11.3142
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发表时间：
2020-11-01
影响因子：
1.2
通讯作者：
Salamone, Joseph C.
中科院分区：
文献类型：
--
作者：
McMahon, Rebecca E.;Salamone, Ann Beal;Salamone, Joseph C.
生物膜被认为是不愈合伤口中慢性炎症的来源。目得：在本研究中，使用卡尔加里最小生物膜根除浓度（MBEC）和离体猪皮肤外植体（PDE）模型对铜绿假单胞菌、耐甲氧西林金黄色葡萄球菌（MRSA）和白色念珠菌生物膜检查了几种伤口清洁剂的临床前抗生物膜功效。方法：在MBEC模型生物膜上测试了基于表面活性剂的清洁剂和包含离子银、次氯酸（HOCl）、次氯酸钠（NaOCl）和聚双胍（PHMB）的基于抗微生物剂的清洁剂，施加时间为10分钟。然后在成熟的PDE生物膜上测试选择的清洁剂，施加10分钟，然后施加清洁剂浸泡的纱布。进一步扩展PDE模型，以包括清洁剂的单次和每日应用，以模拟每日和72小时敷料更换。研究结果：在MBEC模型中，与银、表面活性剂和盐水清洁剂相比，基于PHMB和HOCl的清洁剂使未成熟MRSA、白色念珠菌和铜绿假单胞菌生物膜再生长减少> 3倍。主要差异可以在PDE模型中阐明，其中，在每日应用后，1种基于PHMB的清洁剂显示出统计学显著的减少（3-8 CFU/mL对数减少），而基于NaOCl的清洁剂在2种微生物中显示出显著减少（3- 5CFU/mL对数减少，铜绿假单胞菌和MRSA）。另一种基于PHMB的清洁剂显示铜绿假单胞菌的统计学显著的31 og CFU/mL减少。其余清洁剂与生理盐水对照组无统计学显著差异。结论：结果证实，这些研究的结果存在模型依赖性差异，表明产品筛选模型选择的重要性。结果表明，1 PHMB基清洁剂在减少成熟铜绿假单胞菌、MRSA和白色念珠菌生物膜方面是有效的，并且持续的抗微生物剂存在对于减少或消除这些成熟生物膜是必要的。
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 > 3x 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.