Halstead, Fenella (2017) Developing novel topical antimicrobial agents for the treatment of biofilm infections. PhD thesis, University of Warwick.

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Abstract

Background
Bacterial wound infections (especially those involving biofilms) represent a major challenge to healthcare, and are responsible for significant morbidity and mortality. Owing to the rise in antimicrobial resistance, there is renewed interest in alternative antimicrobial agents for treatment of wound infections, where prevention of colonisation largely relies on topically applied biocides.

Objectives
The aim was to investigate the antibacterial activity of acetic acid (AA), following on from preliminary testing, and small-scale use on burns patients. This led on to the testing of additional products (SurgihoneyRO (SH1) and blue light (BL)), for which no prior evaluation (against biofilms) had been performed.

Methods
In vitro experiments were performed to test the antimicrobial activity of the agents against bacteria growing planktonically and as biofilms. Comparisons were also made to a range of commercially-available antimicrobial dressings (AMDs) and medical honeys. Results were assessed through measurement of biofilm biomass, and biofilm seeding using a crystal violet assay.

Results
All agents were effective against biofilms of a large panel of clinically important nosocomial wound pathogens. AA could prevent biofilm formation at concentrations of ≤0.31%, and eradication of mature biofilms was observed after 3 hours of exposure. SH1 prevented biofilm formation of 16 bacterial isolates at dilutions (from neat) of 1:2 to 1:128. Mature biofilms were highly susceptible to BL, with significant reduction in seeding observed for all isolates.

Conclusions
All of the test antimicrobial agents have shown promise in vitro for the treatment and eradication of biofilm infections caused by a range of important wound pathogens. However, there are still some unanswered questions. Clinical trials are planned, and it remains to be seen whether the in vitro findings will translate to the in vivo setting, where there is a complex interplay between host and pathogen, and many other factors that influence biofilm presence and persistence.

Item Type:	Thesis or Dissertation (PhD)
Subjects:	R Medicine > RM Therapeutics. Pharmacology
Library of Congress Subject Headings (LCSH):	Wounds and injuries -- Infections, Biofilms, Anti-infective agents -- Development, Burns and scalds -- Treatment
Official Date:	June 2017
Dates:	Date Event June 2017 Submitted
Institution:	University of Warwick
Theses Department:	Warwick Medical School
Thesis Type:	PhD
Publication Status:	Unpublished
Supervisor(s)/Advisor:	Waterfield, Nicholas R.
Sponsors:	National Institute for Health Research (Great Britain). Surgical Reconstruction and Microbiology Research Centre ; University of Birmingham ; University of Aston in Birmingham ; Scar Free Burns Research Centre
Format of File:	pdf
Extent:	66 leaves : illustrations, charts
Language:	eng

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