1
|
Papanikolaou GE, Gousios G, Cremers NAJ, Peters LJF. Treating Infected Non-Healing Venous Leg Ulcers with Medical-Grade Honey: A Prospective Case Series. Antibiotics (Basel) 2024; 13:614. [PMID: 39061296 PMCID: PMC11274243 DOI: 10.3390/antibiotics13070614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 06/27/2024] [Accepted: 06/28/2024] [Indexed: 07/28/2024] Open
Abstract
Venous leg ulcers (VLUs) are hard-to-heal wounds and are prone to microbial colonization. Innovative and improved therapies are thus required to resolve local infection and enhance the wound healing process. The objective of this study was to evaluate the effectiveness of medical-grade honey (MGH) for the treatment of clinically infected and non-healing VLUs. This prospective case series included nine patients with an average age of 83.4 years (range: 75-91 years) with a total of eleven VLUs, previously ineffectively treated with various products. Major risk factors for the appearance of VLUs were chronic venous insufficiency, advanced age, multiple comorbidities (particularly cardiovascular diseases), and impaired mobility. All wounds presented with local signs of infection. Upon presentation, treatment was commenced with a range of MGH-based products (L-Mesitran®). Clinical signs of infection were eliminated by MGH after 2.2 weeks on average (range: 1-4 weeks), and wounds were completely healed after 7 weeks on average (range: 3-18 weeks). No further complications or recurrences were observed. MGH has a broad-spectrum antimicrobial activity and promotes rapid healing, thus improving patients' quality of life. Moreover, MGH-based products are safe, easy to use, cost-effective, and can effectively treat VLUs alone or in combination with standard-of-care therapies.
Collapse
Affiliation(s)
| | | | - Niels A. J. Cremers
- Department of Gynecology and Obstetrics, Maastricht University Medical Centre, P. Debyelaan 25, 6229HX Maastricht, The Netherlands
- Triticum Exploitatie BV, Sleperweg 44, 6222NK Maastricht, The Netherlands;
| | | |
Collapse
|
2
|
Lardenoije CMJG, van Riel SJJM, Peters LJF, Wassen MMLH, Cremers NAJ. Medical-Grade Honey as a Potential New Therapy for Bacterial Vaginosis. Antibiotics (Basel) 2024; 13:368. [PMID: 38667044 PMCID: PMC11047503 DOI: 10.3390/antibiotics13040368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/12/2024] [Accepted: 04/14/2024] [Indexed: 04/29/2024] Open
Abstract
The prevalence of bacterial vaginosis (BV) among women of reproductive age is 29%. BV arises from a vaginal imbalance marked by reduced levels of lactic acid-producing lactobacilli and an overgrowth of pathogenic anaerobes. The multifactorial nature of BV's pathogenesis complicates its treatment. Current antibiotic therapy exhibits a recurrence rate of about 60% within a year. Recurrence can be caused by antibiotic treatment failure (e.g., due to antimicrobial resistance), the persistence of residual infections (e.g., due to biofilm formation), and re-infection. Because of the high recurrence rates, alternative therapies are required. Medical-grade honey (MGH), known for its antimicrobial and wound healing properties in wound care, emerges as a potential novel therapy for BV. MGH exerts broad-spectrum antimicrobial activity, employing multiple mechanisms to eliminate the risk of resistance. For example, the low pH of MGH and the production of hydrogen peroxide benefit the microbiota and helps restore the natural vaginal balance. This is supported by in vitro studies demonstrating that MGH has an antibacterial effect on several pathogenic bacteria involved in the pathophysiology of BV, while lactobacilli and the vaginal microenvironment can be positively affected. In contrast to antibiotics, MGH exerts anti-biofilm activity, affects the microbiome as pre- and probiotic, and modulates the vaginal microenvironment through its anti-inflammatory, anti-oxidative, physicochemical, and immunomodulatory properties. More clinical research is required to confirm the positive effect of MGH on BV and to investigate the long-term cure rate.
Collapse
Affiliation(s)
- Céline M. J. G. Lardenoije
- Department of Gynecology and Obstetrics, Maastricht University Medical Centre+, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands; (C.M.J.G.L.); (S.J.J.M.v.R.)
| | - Senna J. J. M. van Riel
- Department of Gynecology and Obstetrics, Maastricht University Medical Centre+, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands; (C.M.J.G.L.); (S.J.J.M.v.R.)
- Department of Obstetrics & Gynecology, Zuyderland Medical Centre Heerlen, Henri Dunantstraat 5, 6419 PC Heerlen, The Netherlands;
- VieCuri Medical Centre, Tegelseweg 210, 5912 BL Venlo, The Netherlands
- GROW Research Institute for Oncology and Reproduction, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands
| | | | - Martine M. L. H. Wassen
- Department of Obstetrics & Gynecology, Zuyderland Medical Centre Heerlen, Henri Dunantstraat 5, 6419 PC Heerlen, The Netherlands;
| | - Niels A. J. Cremers
- Department of Gynecology and Obstetrics, Maastricht University Medical Centre+, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands; (C.M.J.G.L.); (S.J.J.M.v.R.)
- Triticum Exploitatie BV, Sleperweg 44, 6222 NK Maastricht, The Netherlands;
| |
Collapse
|
3
|
Boekema BKHL, Chrysostomou D, Ciprandi G, Elgersma A, Vlig M, Pokorná A, Peters LJF, Cremers NAJ. Comparing the antibacterial and healing properties of medical-grade honey and silver-based wound care products in burns. Burns 2024; 50:597-610. [PMID: 37940425 DOI: 10.1016/j.burns.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/28/2023] [Accepted: 10/05/2023] [Indexed: 11/10/2023]
Abstract
Burns are a major global healthcare concern, often complicated by the presence of bacteria such as Pseudomonas aeruginosa in the wounds. Silver-based dressings are commonly used in the treatment of burns but can cause skin irritation and delay healing time. Medical-grade honey (MGH) provides an interesting alternative. This study investigated the antimicrobial effects and possible cytotoxicity of L-Mesitran Soft (MGH-gel) and its individual components, Medihoney (Manuka), Flammazine (silver sulphadiazine), and silver nitrate (AgNO3) in an ex vivo human burn wound model. Bacterial survival and wound healing parameters, including re-epithelialization and keratinocyte proliferation were assessed. L-Mesitran, Flammazine, and AgNO3 reduced P. aeruginosa numbers below detection levels. L-Mesitran Soft exhibited a significantly stronger antimicrobial effect compared to Medihoney. The individual components of L-Mesitran contributed significantly to its antibacterial efficacy, thus suggesting synergistic activities. Moreover, L-Mesitran, Flammazine, and AgNO3 slightly inhibited re-epithelialization while Medihoney treatment resulted in a complete lack of re-epithelialization and keratinocyte proliferation. Furthermore, clinical cases illustrated the effectiveness of MGH therapy in infected burns. Overall, L-Mesitran Soft had similar effects as silver-based products on bacterial load and epidermal regeneration, but outperformed Medihoney. Therefore, supplemented MGH could be used as an effective alternative to silver-based dressings for P. aeruginosa-infected burns.
Collapse
Affiliation(s)
- Bouke K H L Boekema
- Preclinical Research, Association of Dutch Burn Centers (ADBC), P.O. Box 1015, 1940 AE Beverwijk, the Netherlands; Plastic, Reconstructive and Hand Surgery, AUMC, Amsterdam, the Netherlands
| | - Daniela Chrysostomou
- Wound Clinic Health@45, Linksfield Road 45, Dowerglen, Johannesburg 1612, South Africa; Department of Health Sciences, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Guido Ciprandi
- Bambino Gesu' Children's Hospital, Research Institute Division of Plastic and Maxillofacial Surgery, Department of Surgery, Sant' Onofrio Square 4, 00165 Rome, Italy
| | - Anouk Elgersma
- Preclinical Research, Association of Dutch Burn Centers (ADBC), P.O. Box 1015, 1940 AE Beverwijk, the Netherlands
| | - Marcel Vlig
- Preclinical Research, Association of Dutch Burn Centers (ADBC), P.O. Box 1015, 1940 AE Beverwijk, the Netherlands
| | - Andrea Pokorná
- Department of Health Sciences, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic; College of Polytechnics Jihlava, Jihlava, Czech Republic
| | - Linsey J F Peters
- Triticum Exploitatie BV, Sleperweg 44, 6222 NK Maastricht, the Netherlands
| | - Niels A J Cremers
- Triticum Exploitatie BV, Sleperweg 44, 6222 NK Maastricht, the Netherlands; Department of Gynecology and Obstetrics, Maastricht University Medical Center, 6202 AZ Maastricht, the Netherlands.
| |
Collapse
|
4
|
Chatzimisios K, Tsioli V, Brellou GD, Apostolopoulou EP, Angelou V, Pratsinakis ED, Cremers NAJ, Papazoglou LG. Evaluation of the Effectiveness of Medical-Grade Honey and Hypericum Perforatum Ointment on Second-Intention Healing of Full-Thickness Skin Wounds in Cats. Animals (Basel) 2023; 14:36. [PMID: 38200767 PMCID: PMC10778018 DOI: 10.3390/ani14010036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
This study aimed to determine the effects of two topical treatments on second-intention wound healing in cats. Eight 2 × 2 cm full-thickness wounds were created, four on each side of the dorsal midline of eight laboratory cats, to receive either medical-grade honey ointment (MGH) and its control (HC), or Hypericum-based ointment (HP) and its control (HPC). MGH or HP ointment was applied to four wounds on the same side, while the remaining four were used as controls, chosen at random. Planimetry, laser Doppler flowmetry, daily physical examinations, and histologic examinations on days 0, 7, 14, and 25 were used to assess the healing of wounds. Tissue perfusion was better in the MGH-treated (2.14 ± 0.18 mm/s) and HP-treated wounds (2.02 ± 0.13 mm/s) than in the untreated controls HC (1.59 ± 0.11 mm/s) and HPC (1.60 ± 0.05 mm/s), respectively (p = 0.001). Histopathology revealed that the median edema score was lower in the MGH-treated (2; range 1-4) compared to the HC-treated wounds (3; range 2-4) on day 7 (p < 0.05). The median angiogenesis score was higher on day 7 in the MGH-treated (2; range 1-3) compared to the HP-treated wounds (2; range 1-2) (p = 0.046). The fibroblast concentration was increased in the MGH-treated wounds (3.5; range 3-4) compared to the HP-treated wounds (3; range 2-4) on day 25 (p = 0.046). MGH and HP increased tissue perfusion compared to the untreated controls. The MGH-treated wounds had histologic parameters superior to the HP-treated wounds regarding angiogenesis and fibroblast concentration in cutaneous wound healing in cats. Topical application of MGH and HP did not accelerate the healing process of feline cutaneous wounds.
Collapse
Affiliation(s)
- Kyriakos Chatzimisios
- Unit of Surgery and Obstetrics, Companion Animal Clinic, School of Veterinary Medicine, Faculty of HealthSciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece; (K.C.)
| | - Vassiliki Tsioli
- Clinic of Surgery, School of Veterinary Medicine, University of Thessaly, 224 Trikalon Street, Box Office 199, 43100 Karditsa, Greece
| | - Georgia D. Brellou
- Laboratory of Pathology, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (G.D.B.); (E.P.A.)
| | - Emmanouela P. Apostolopoulou
- Laboratory of Pathology, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (G.D.B.); (E.P.A.)
| | - Vasileia Angelou
- Unit of Surgery and Obstetrics, Companion Animal Clinic, School of Veterinary Medicine, Faculty of HealthSciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece; (K.C.)
| | - Emmanouil D. Pratsinakis
- Laboratory of Agronomy, School of Agriculture, Faculty of Agriculture, Forestry and Natural Environment, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Niels A. J. Cremers
- Department of Gynecology and Obstetrics, Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands;
- Triticum Exploitatie BV/Theomanufacturing BV, Sleperweg 44, 6222 NK Maastricht, The Netherlands
| | - Lysimachos G. Papazoglou
- Unit of Surgery and Obstetrics, Companion Animal Clinic, School of Veterinary Medicine, Faculty of HealthSciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece; (K.C.)
| |
Collapse
|
5
|
Papanikolaou GE, Gousios G, Cremers NAJ. Use of Medical-Grade Honey to Treat Clinically Infected Heel Pressure Ulcers in High-Risk Patients: A Prospective Case Series. Antibiotics (Basel) 2023; 12:antibiotics12030605. [PMID: 36978472 PMCID: PMC10044646 DOI: 10.3390/antibiotics12030605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 03/22/2023] Open
Abstract
Management of locally infected heel-pressure ulcers (HPUs) remains challenging, and given the increasing occurrence of infections resistant to antibiotic therapy and patients’ unwillingness to surgery, innovative and effective approaches must be considered. Medical-grade honey (MGH) could be an alternative therapeutic approach due to its broad-spectrum antimicrobial activity and healing properties. This study aimed to present the high effectiveness and safety of MGH for the conservative treatment of clinically infected HPUs. In this case series, we have prospectively studied nine patients with local signs of infected HPUs. In all cases, HPUs persisted for more than 4 weeks, and previous treatments with topical antibiotics or antiseptic products were ineffective. All patients were at high-risk to develop HPU infection due to their advanced age (median age of 86 years), several comorbidities, and permanent immobility. All wounds were treated with MGH products (L-Mesitran), leading to infection resolution within 3–4 weeks and complete wound healing without complication. Considering the failure of previous treatments and the chronic nature of the wounds, MGH was an effective treatment. MGH-based products are clinically and cost-effective for treating hard-to-heal pressure ulcers such as HPUs. Thus, MGH can be recommended as an alternative or complementary therapy in wound healing.
Collapse
Affiliation(s)
- Georgios E. Papanikolaou
- GP Plastic Surgery Private Practice, P. Dagkli 1, 45444 Ioannina, Greece
- Correspondence: (G.E.P.); or (N.A.J.C.); Tel.: +30-2651-607063 (G.E.P.); +31-43-325-1773 (N.A.J.C.)
| | | | - Niels A. J. Cremers
- Department of Gynecology and Obstetrics, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
- Triticum Exploitatie BV, Sleperweg 44, 6222 NK Maastricht, The Netherlands
- Correspondence: (G.E.P.); or (N.A.J.C.); Tel.: +30-2651-607063 (G.E.P.); +31-43-325-1773 (N.A.J.C.)
| |
Collapse
|
6
|
Bocoum A, van Riel SJJM, Traoré SO, Ngo Oum II EF, Traoré Y, Thera AT, Fané S, Dembele BT, Cremers NAJ. Medical-Grade Honey Enhances the Healing of Caesarean Section Wounds and Is Similarly Effective to Antibiotics Combined with Povidone-Iodine in the Prevention of Infections-A Prospective Cohort Study. Antibiotics (Basel) 2023; 12:92. [PMID: 36671293 PMCID: PMC9855001 DOI: 10.3390/antibiotics12010092] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/31/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023] Open
Abstract
Caesarean sections (CS) are becoming increasingly popular. The antibiotic resistance crisis and relentless risk of infections, especially in developing countries, demand alternative treatment options. Medical-grade honey (MGH) exerts antimicrobial and healing properties. This study aims to evaluate the effect of MGH treatment on CS wound healing and postoperative complications when compared to conventional treatment (antibiotics in combination with povidone-iodine). In this prospective cohort study, 766 CS patients were included and evenly divided into two groups. The treatment group (n = 383) received an MGH-based formulation (L-Mesitran Soft) and the control group (n = 383) received antibiotics (Amoxicillin) combined with povidone-iodine. The wound healing time and complication rate were determined for both groups, and subsequently, predisposing factors for complications among the baseline characteristics and non-patient-related parameters were determined. The baseline characteristics were similar for both study groups, supporting a homogenous distribution. Postoperative complications were experienced by 19.3% of the patients in the control group and 18.8% in the treatment (MGH) group. The treatment group experienced significantly more superficial pus discharge than the control group, while the latter experienced significantly more deeper pus discharge. BMI, age, duration of hospitalization, anesthesia, and duration of CS could affect the complication risk. MGH significantly enhanced wound healing until day 42. On average, the healing time with MGH was 19.12 ± 7.760 days versus 24.54 ± 8.168 days in the control group. MGH is a potent alternative treatment to antibiotics and povidone-iodine because while the complication risk is similar, MGH has additional benefits. MGH promotes wound healing and does not bear the risk of resistance.
Collapse
Affiliation(s)
- Amadou Bocoum
- Gynecology-Obstetrics Department, Faculty of Medicine and Odonto-Stomatology, Center Hospitalier Universitaire (CHU) Gabriel Touré, Bamako, Mali
| | - Senna J. J. M. van Riel
- Department of Obstetrics and Gynecology, Zuyderland Medical Center, 6162 BG Sittard-Geleen, The Netherlands
- Department of Gynecology and Obstetrics, Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
| | - Soumana Oumar Traoré
- Gynecology-Obstetrics Department, Faculty of Medicine and Odonto-Stomatology, Center Hospitalier Universitaire (CHU) Gabriel Touré, Bamako, Mali
| | - Elisabeth Florine Ngo Oum II
- Gynecology-Obstetrics Department, Faculty of Medicine and Odonto-Stomatology, Center Hospitalier Universitaire (CHU) Gabriel Touré, Bamako, Mali
| | - Youssouf Traoré
- Gynecology-Obstetrics Department, Faculty of Medicine and Odonto-Stomatology, Center Hospitalier Universitaire (CHU) Gabriel Touré, Bamako, Mali
| | - Augustin Tioukani Thera
- Gynecology-Obstetrics Department, Faculty of Medicine and Odonto-Stomatology, Center Hospitalier Universitaire (CHU) Gabriel Touré, Bamako, Mali
| | - Seydou Fané
- Gynecology-Obstetrics Department, Faculty of Medicine and Odonto-Stomatology, Center Hospitalier Universitaire (CHU) Gabriel Touré, Bamako, Mali
| | - Bakary Tientigui Dembele
- Department of General Surgery, Faculty of Medicine and Odonto-Stomatology, CHU Gabriel Touré, Bamako, Mali
| | - Niels A. J. Cremers
- Department of Gynecology and Obstetrics, Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
- Triticum Exploitatie BV, 6222 NK Maastricht, The Netherlands
| |
Collapse
|
7
|
Dufficy M, Takashima M, Cunninghame J, Griffin BR, McBride CA, August D, Ullman AJ. Extravasation injury management for neonates and children: A systematic review and aggregated case series. J Hosp Med 2022; 17:832-842. [PMID: 36039964 PMCID: PMC9804918 DOI: 10.1002/jhm.12951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/07/2022] [Accepted: 08/09/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Pediatric extravasation injuries are significant healthcare-associated injuries, with sometimes significant sequelae. Evidence-based guidance on management is necessary to prevent permanent injury. PURPOSE A systematic review of the literature, including aggregated case series, investigating extravasation injury management of hospitalized pediatric patients. DATA SOURCES PubMed, Cummulative Index to Nursing and Allied Health Literature (CINAHL), and Excerpta Medica database (EMBASE) were searched on December 13, 2021. STUDY SELECTION Primary research investigating extravasation injury management of hospitalized pediatric patients (to 18 years), published from 2010 onwards and in English, independently screened by two authors, with arbitration from a third author. DATA EXTRACTION Data regarding the study, patient (age, primary diagnosis), extravasation (site, presentation, outcome), and treatment (first aid, wound management) were extracted by two authors, with arbitration from a third author. DATA SYNTHESIS From an initial 1769 articles, 27 studies were included with extractable case data reported in 18 studies, resulting in 33 cases. No clinical trials were identified, instead, studies were primarily case studies (52%) of neonates (67%), with varied extravasation symptoms. Studies had good selection and ascertainment, but few met the causality and reporting requirements for quality assessments. Signs and symptoms varied, with scarring (45%) and necrosis (30%) commonly described. Diverse treatments were categorized into first aid, medical, surgical, and dressings. CONCLUSIONS Despite infiltration and extravasation injuries being common within pediatric healthcare, management interventions are under-researched, with low-quality studies and no consensus on treatments or outcomes.
Collapse
Affiliation(s)
- Mitchell Dufficy
- School of Nursing, Midwifery and Social WorkThe University of QueenslandBrisbaneQueenslandAustralia
- Centre for Children's Health ResearchChildren's Health Queensland Hospital and Health ServiceBrisbaneQueenslandAustralia
| | - Mari Takashima
- School of Nursing, Midwifery and Social WorkThe University of QueenslandBrisbaneQueenslandAustralia
- Centre for Children's Health ResearchChildren's Health Queensland Hospital and Health ServiceBrisbaneQueenslandAustralia
| | - Jacqueline Cunninghame
- School of Nursing, Midwifery and Social WorkThe University of QueenslandBrisbaneQueenslandAustralia
- Centre for Children's Health ResearchChildren's Health Queensland Hospital and Health ServiceBrisbaneQueenslandAustralia
| | - Bronwyn R. Griffin
- Centre for Children's Health ResearchChildren's Health Queensland Hospital and Health ServiceBrisbaneQueenslandAustralia
- School of Nursing and MidwiferyGriffith UniversityBrisbaneQueenslandAustralia
| | - Craig A. McBride
- School of Nursing, Midwifery and Social WorkThe University of QueenslandBrisbaneQueenslandAustralia
- Centre for Children's Health ResearchChildren's Health Queensland Hospital and Health ServiceBrisbaneQueenslandAustralia
| | - Deanne August
- School of Nursing, Midwifery and Social WorkThe University of QueenslandBrisbaneQueenslandAustralia
- Centre for Children's Health ResearchChildren's Health Queensland Hospital and Health ServiceBrisbaneQueenslandAustralia
- Grantley Stable Neonatal UnitRoyal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
| | - Amanda J. Ullman
- School of Nursing, Midwifery and Social WorkThe University of QueenslandBrisbaneQueenslandAustralia
- Centre for Children's Health ResearchChildren's Health Queensland Hospital and Health ServiceBrisbaneQueenslandAustralia
- School of Nursing and MidwiferyGriffith UniversityBrisbaneQueenslandAustralia
| |
Collapse
|
8
|
Naik PP, Chrysostomou D, Cinteza M, Pokorná A, Cremers NA. When time does not heal all wounds-the use of medical grade honey in wound healing: a case series. J Wound Care 2022; 31:548-558. [PMID: 35797263 DOI: 10.12968/jowc.2022.31.7.548] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Hard-to-heal wounds can be caused by persistent infections or an excess of inflammatory cytokines, proteases and oxidants, and can severely impact the quality of life (QoL) of patients. Due to the paucity of effective treatments and increased resistance to antibiotics, new and improved therapies are required to resolve infections and to simultaneously enhance the healing trajectory. Medical grade honey (MGH) may be a novel and effective treatment approach. METHODS In this case series, we have described six cases of hard-to-heal wounds, and discussed the effects of MGH on infection, wound healing and factors influencing patient QoL (pain, odour and exudate). In all cases, the wounds had persisted for a long period, and previous treatments had been ineffective. Most of the patients had comorbidities, and the majority of the wounds were contaminated with (multiresistant) bacteria, both of which contributed to non-healing. All wounds were treated with L-Mesitran (MGH-based wound care products, Triticum Exploitatie BV, the Netherlands) either as monotherapy or as a complementary therapy. RESULTS Hard-to-heal wounds started healing, infection was controlled and QoL was strongly improved (malodour, exudate levels and pain swiftly decreased) after the application of the MGH. All wounds healed relatively quickly, considering the severity of the wounds and general health of the patients. CONCLUSION In this study, MGH was a useful alternative or complementary therapy to antibiotics and expedited the healing of hard-to-heal wounds.
Collapse
Affiliation(s)
- Piyu Parth Naik
- Saudi German Hospitals and Clinics, Department of Dermatology, Hessa Street 331 West, Al Barsha3, Exit 36 Sheikh Zayed Road, Opposite of American School, Dubai, United Arab Emirates
| | - Daniela Chrysostomou
- Wound Clinic Health@45, Linksfield Road 45, Dowerglen, Johannesburg, South Africa
| | - Mirela Cinteza
- SC Podotim Medica SRL, RO41116267, J/35/2118/2019, Moșnița Veche, Jud Timiș, Romania
| | - Andrea Pokorná
- Department of Health Sciences, Faculty of Medicine, Masaryk University, Czech Republic.,College of Polytechnics Jihlava, Jihlava, Czech Republic
| | - Niels Aj Cremers
- Triticum Exploitatie BV, Sleperweg 44, 6222NK Maastricht, the Netherlands.,Department of Gynecology and Obstetrics, Maastricht University Medical Centre, 6202 AZ Maastricht, the Netherlands
| |
Collapse
|
9
|
A Quality Improvement Initiative to Provide Timely Central Vascular Access in a Neonatal Intensive Care Unit. Adv Neonatal Care 2022; 22:203-209. [PMID: 34407057 DOI: 10.1097/anc.0000000000000941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Timely central venous access is essential in the care of critically ill neonates. Peripherally inserted central catheters (PICCs) are the preferred form of central venous access when umbilical venous catheters cannot be placed or are discontinued. However, time delays increase risk for injury from peripheral intravenous lines and may contribute to inconsistent delivery of necessary fluids and medications. PURPOSE The aim of this quality improvement project was to decrease wait times for PICC placement in the neonatal intensive care unit (NICU). METHODS A unit-based PICC team was developed consisting of NICU nurses and attending neonatologists and implemented in 2 phases. Data were collected from chart reviews before, during, and after implementation of the team. We tracked time between PICC order and placement and number of attempts. Hospital metrics on peripheral intravenous line infiltrations and central line-associated blood stream infection were also monitored. At the end of the project, we continued tracking outcomes to determine whether gains would be sustained past the project period. RESULTS Implementation of a unit-based interdisciplinary specialty team led to a 50% reduction in mean PICC wait times from 1.2 days to 0.58 days. Benefits of the initiative were sustained past the initial project period. IMPLICATIONS FOR PRACTICE The development of a dedicated, local team played a key role in improving vascular access in the NICU. IMPLICATIONS FOR RESEARCH Proximity of specialized teams provides a solution to address gaps in care in the NICU.
Collapse
|
10
|
Parizad N, Hajimohammadi K, Hassanpour A, Goli R. Treating surgical site infection by honey antibacterial wound dressing in a neonate: a case report. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S8-S14. [PMID: 35220733 DOI: 10.12968/bjon.2022.31.4.s8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Surgical site infection (SSI) increases length of treatment, delays wound healing, increases antibiotic use and causes patient death in severe cases. This case was a boy aged 38 weeks and 4 days with a birthweight of 2100 g, a height of 42 cm and a head circumference of 32 cm. Twelve days after birth, he was admitted to hospital where a surgeon removed a sacrococcygeal teratoma. The surgical site became infected, and the infection failed to improve despite him receiving routine normal saline dressings twice a day and intravenous antibiotic therapy. The authors started treatment using an antibacterial wound dressing containing honey (Medihoney) on the SSI twice a day for a month. The infant's SSI was wholly healed after 3 months, and he was discharged from the wound treatment team in good general condition. This case shows that SSIs can be treated with honey-containing antibacterial wound gel, especially in infants who have weaker immune systems.
Collapse
Affiliation(s)
- Naser Parizad
- Assistant Professor, Patient Safety Research Center, Clinical Research Institute, Nursing & Midwifery School, Urmia University of Medical Sciences, Urmia, Iran
| | - Kazem Hajimohammadi
- Wound Manager, Imam Khomeini Teaching Hospital, Urmia University of Medical Sciences, Urmia, Iran
| | - Amireh Hassanpour
- Registered Nurse, Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Rasoul Goli
- Registered Nurse, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| |
Collapse
|
11
|
Nowak A, Nowak I. Review of harmful chemical pollutants of environmental origin in honey and bee products. Crit Rev Food Sci Nutr 2021:1-23. [PMID: 34904474 DOI: 10.1080/10408398.2021.2012752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Honey is a natural food with many pro-health properties, which comprises a wide variety of valuable ingredients. It can also be the source of chemical contaminants of environmental origin, including POPs that can contribute to adverse health effects to human. Monitoring the degree of pollution of honey/bee products with hazardous chemicals is important from a nutraceutical point of view. In the present work, overview of recent literature data on chemical pollutants in honey/bee products originating from the environment was performed. Their MLs, MRLs and EDI were discussed. It can be concluded that huge amount of research concerned on the presence of TMs and pesticides in honey. Most of the studies have shown that honey/bee products sampled from urban and industrialized areas were more contaminated than these sampled from ecological and rural locations. More pollutants were usually detected in propolis and bee pollen than in honey. Based on their research and regulations, authors stated, that most of the toxic pollutants of environmental origin in honey/bee products are at levels that do not pose a threat to the health of the potential consumer. The greatest concern relates to pesticides and TMs, because in some research MLs in individual samples were highly exceeded.
Collapse
Affiliation(s)
- Adriana Nowak
- Department of Environmental Biotechnology, Lodz University of Technology, Lodz, Poland
| | - Ireneusz Nowak
- Faculty of Law and Administration, University of Lodz, Lodz, Poland
| |
Collapse
|
12
|
Naik PP, Mossialos D, van Wijk B, Novakova P, Wagener FADTG, Cremers NAJ. Medical-Grade Honey Outperforms Conventional Treatments for Healing Cold Sores-A Clinical Study. Pharmaceuticals (Basel) 2021; 14:1264. [PMID: 34959664 PMCID: PMC8706154 DOI: 10.3390/ph14121264] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/30/2021] [Accepted: 12/02/2021] [Indexed: 02/06/2023] Open
Abstract
Cold sores are nasolabial blisters caused by herpes simplex virus (HSV) infections. Novel therapies demonstrating simultaneously antiviral activity and improved wound healing are warranted. The aim of this study was to investigate the efficacy of medical-grade honey (MGH) for treating HSV-induced cold sores. A crossover trial was performed in patients with recurrent cold sores (n = 29). The majority (65.6%) of these patients experience four or more episodes per year, thus forming a valid self-control group. In this study, patients applied an MGH-based formulation (L-Mesitran Soft) on their cold sore at the onset of symptoms (62.1%) or appearing of blister (37.9%) and compared it to their conventional treatments. After complete healing, patients filled in a questionnaire evaluating healing, pain, and itching. The average absolute healing time was 72.4% slower with conventional treatment (10.0 days) compared to MGH (5.8 days). After MGH treatment, 86.2% of all patients experienced faster objective healing (6.9% similar and 6.9% slower) and the subjective healing score was higher in 79.3% of the patients (20.7% similar). If the patients normally experience pain and itching during their cold sores, these levels were lower with MGH therapy compared to conventional treatment in 72.7% and 71.4% of the patients, respectively. Moreover, 100% of the patients prefer MGH treatment over conventional treatment and will use it again on future cold sores. MGH is a promising alternative treatment for cold sores, likely by combining both increased antiviral and wound healing activities while alleviating pain and itching.
Collapse
Affiliation(s)
- Piyu Parth Naik
- Saudi German Hospitals and Clinics, Department of Dermatology, Hessa Street 331 West, Al Barsha 3, Exit 36 Sheikh Zayed Road, Dubai P.O. Box 391093, United Arab Emirates;
| | - Dimitris Mossialos
- Department of Biochemistry and Biotechnology, University of Thessaly, Biopolis-Mezurlo, 41500 Larisa, Greece;
| | - Bas van Wijk
- Department of Dentistry, Radboud University Medical Center, Philips van Leydenlaan 25, 6525 EX Nijmegen, The Netherlands; (B.v.W.); (F.A.D.T.G.W.)
| | - Petra Novakova
- LERAM Pharmaceuticals s.r.o., Páteřní 1216/7, 63500 Brno, Czech Republic;
| | - Frank A. D. T. G. Wagener
- Department of Dentistry, Radboud University Medical Center, Philips van Leydenlaan 25, 6525 EX Nijmegen, The Netherlands; (B.v.W.); (F.A.D.T.G.W.)
| | | |
Collapse
|
13
|
Marais HJ, Glyphis ZG, Cremers NA. Medical grade honey: Hope for wounded white rhinos. Vet Anim Sci 2021; 13:100196. [PMID: 34471724 PMCID: PMC8390769 DOI: 10.1016/j.vas.2021.100196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/16/2021] [Accepted: 08/16/2021] [Indexed: 12/19/2022] Open
Abstract
South Africa is home to some of the world's most endangered wildlife, with the White rhinoceros (Cerathotherium simum) among its most threatened species due to its highly sought-after horn. Since the reproduction number is below the mortality rate, there is a decrease in rhinos year over year, urgently requiring changes and saving the survivors. In this study, the efficacy of medical grade honey (MGH) for wound care in rhinos was investigated. We presented a case series of seven rhinos with wounds of different etiologies, including gunshots and poaching. Four wounds were around the horns and three on the limbs. It was a challenge to take care and follow-up the wounds of these wild animals in their natural habitat. A well-balanced decision between the need of treatment and risk of immobilization is constantly evaluated. In the presented cases, MGH proved a novel tool with minimal intervention and maximal effectiveness. With the severity of the wounds taken into consideration, there was a rapid healing in all cases, while infection resolved when present. MGH creates a moist and anti-inflammatory wound environment, while promoting almost all aspects in the wound healing processes, such as autolytic debridement, angiogenesis and re-epithelialization. The efficacy of MGH has constantly been confirmed in other cases and literature as well. MGH forms a potent therapy for treating wounded rhinos, independent of the severity of the wound. The strong antimicrobial and healing properties make it an easy and versatile product that can be used in all kinds of wounds.
Collapse
Affiliation(s)
- Hendrik J. Marais
- Saving the Survivors, Pretoria, South Africa
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, 0110 Onderstepoort, South Africa
| | | | - Niels A.J. Cremers
- Triticum Exploitatie BV, Sleperweg 44, 6222NK Maastricht, the Netherlands
| |
Collapse
|
14
|
van Riel SJJM, Lardenoije CMJG, Oudhuis GJ, Cremers NAJ. Treating (Recurrent) Vulvovaginal Candidiasis with Medical-Grade Honey-Concepts and Practical Considerations. J Fungi (Basel) 2021; 7:jof7080664. [PMID: 34436203 PMCID: PMC8400673 DOI: 10.3390/jof7080664] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 01/04/2023] Open
Abstract
Recurrent vulvovaginal candidiasis (RVVC) is a relapsing vaginal fungal infection caused by Candida species. The prevalence varies among age populations and can be as high as 9%. Treatment options are limited, and in 57% of the cases, relapses occur within six months after fluconazole maintenance therapy, which is the current standard of care. The pathogenesis of RVVC is multifactorial, and recent studies have demonstrated that the vaginal microenvironment and activity of the immune system have a strong influence on the disease. Medical-grade honey (MGH) has protective, antimicrobial, and immunomodulatory activity and forms a putative alternative treatment. Clinical trials have demonstrated that honey can benefit the treatment of bacterial and Candida-mediated vaginal infections. We postulate that MGH will actively fight ongoing infections; eradicate biofilms; and modulate the vaginal microenvironment by its anti-inflammatory, antioxidative, and immunomodulatory properties, and subsequently may decrease the number of relapses when compared to fluconazole. The MGH formulation L-Mesitran Soft has stronger antimicrobial activity against various Candida species than its raw honey. In advance of a planned randomized controlled clinical trial, we present the setup of a study comparing L-Mesitran Soft with fluconazole and its practical considerations.
Collapse
Affiliation(s)
- Senna J. J. M. van Riel
- Department of Gynecology and Obstetrics, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands; (S.J.J.M.v.R.); (C.M.J.G.L.)
| | - Celine M. J. G. Lardenoije
- Department of Gynecology and Obstetrics, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands; (S.J.J.M.v.R.); (C.M.J.G.L.)
| | - Guy J. Oudhuis
- Department of Medical Microbiology, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6202 AZ Maastricht, The Netherlands;
| | - Niels A. J. Cremers
- Triticum Exploitatie B.V., Sleperweg 44, 6222 NK Maastricht, The Netherlands
- Correspondence: ; Tel.: +31-43-325-1773
| |
Collapse
|
15
|
Holubová A, Chlupáčová L, Cetlová L, Cremers NAJ, Pokorná A. Medical-Grade Honey as an Alternative Treatment for Antibiotics in Non-Healing Wounds-A Prospective Case Series. Antibiotics (Basel) 2021; 10:antibiotics10080918. [PMID: 34438968 PMCID: PMC8388796 DOI: 10.3390/antibiotics10080918] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/21/2021] [Accepted: 07/25/2021] [Indexed: 02/06/2023] Open
Abstract
Non-healing wounds are usually colonised by various types of bacteria. An alternative to antibiotic treatment in patients with infected wounds with local signs of inflammation may be medical-grade honey (MGH), which favourably affects the healing process with its antimicrobial, antioxidant, anti-inflammatory, and immunomodulatory properties. The objective of this study was to evaluate the effect of MGH therapy on the healing process of non-healing wounds of various aetiologies and different wound colonisations. Prospective, observation–intervention case studies (n = 9) of patients with wounds of various aetiologies (venous leg ulcers, diabetic foot ulcers, surgical wound dehiscence) are presented. All wounds were treated with MGH and the healing trajectory was rigorously and objectively monitored. In all cases, pain, odour, and exudation were quickly resolved, which led to an improvement in the quality of life of patients. Despite the proven bacterial microflora in wounds, antibiotic treatment was not necessary. The effects of MGH alleviated the signs of local infection until their complete elimination. In eight out of nine cases, the non-healing wound was completely healed. MGH has antimicrobial, anti-inflammatory, and antioxidant effects in wounds of various aetiologies and forms an effective alternative for the use of antibiotics for treating locally infected wounds.
Collapse
Affiliation(s)
- Adéla Holubová
- Faculty of Health and Social Sciences, University of Bohemia, 370 11 České Budějovice, Czech Republic
- DiaPodi Care spol. s r.o., 392 01 Soběslav, Czech Republic;
- Correspondence: ; Tel.: +420-774-672-220
| | | | - Lada Cetlová
- Department of Health Sciences, College of Polytechnics Jihlava, 586 01 Jihlava, Czech Republic; (L.C.); (A.P.)
| | | | - Andrea Pokorná
- Department of Health Sciences, College of Polytechnics Jihlava, 586 01 Jihlava, Czech Republic; (L.C.); (A.P.)
- Department of Nursing and Midwifery, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| |
Collapse
|
16
|
Martinez-Armenta C, Camacho-Rea MC, Martínez-Nava GA, Espinosa-Velázquez R, Pineda C, Gomez-Quiroz LE, López-Reyes A. Therapeutic Potential of Bioactive Compounds in Honey for Treating Osteoarthritis. Front Pharmacol 2021; 12:642836. [PMID: 33967778 PMCID: PMC8097136 DOI: 10.3389/fphar.2021.642836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/06/2021] [Indexed: 12/16/2022] Open
Abstract
Dysregulation of joint tissue homeostasis induces articular degenerative changes and musculoskeletal diseases such as osteoarthritis. This pathology represents the first cause of motor disability in individuals over 60 years of age, impacting their quality of life and the costs of health systems. Nowadays, pharmacological treatments for cartilage disease have failed to achieve full tissue regeneration, resulting in a functional loss of the joint; therefore, joint arthroplasty is the gold standard procedure to cure this pathology in severe cases of Osteoarthritis. A different treatment is the use of anti-inflammatory drugs which mitigate pain and inflammation in some degree, but without significant inhibition of disease progression. In this sense, new therapeutic alternatives based on natural compounds have been proposed to delay osteoarthritis progression, particularly those agents that regulate articular homeostasis. Preclinical studies have shown a therapeutic application of honey and its bioactive compounds, ranging from treating wounds, coughs, skin infections, and are also used as a biological stimulant by exerting antioxidant and anti-inflammatory properties. In this article, we reviewed the current medicinal applications of honey with particular emphasis on its use regulating articular homeostasis by inhibiting inflammation and oxidative stress.
Collapse
Affiliation(s)
- Carlos Martinez-Armenta
- Posgrado en Biología Experimental, Dirección de Ciencias Biológicas y de La Salud (DCBS), Universidad Autónoma Metropolitana Iztapalapa, Ciudad de México, Mexico
| | - María Carmen Camacho-Rea
- Departamento de Nutrición Animal, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
| | - Gabriela Angélica Martínez-Nava
- Laboratorio de Líquido Sinovial, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, Mexico
| | | | - Carlos Pineda
- División de Enfermedades Musculo-esqueléticas y Reumáticas, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, Mexico
| | - Luis Enrique Gomez-Quiroz
- Área de Medicina Experimental y Traslacional, Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana-Iztapalapa, Mexico City, Mexico
| | - Alberto López-Reyes
- Facultad de Ciencias de La Salud, Universidad Anáhuac México Sur, Ciudad de México, Mexico.,Laboratorio de Gerociencias, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, Mexico
| |
Collapse
|
17
|
de Groot T, Janssen T, Faro D, Cremers NAJ, Chowdhary A, Meis JF. Antifungal Activity of a Medical-Grade Honey Formulation against Candida auris. J Fungi (Basel) 2021; 7:jof7010050. [PMID: 33450974 PMCID: PMC7828376 DOI: 10.3390/jof7010050] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 01/05/2021] [Accepted: 01/09/2021] [Indexed: 02/06/2023] Open
Abstract
Candida auris is a pathogenic yeast causing outbreaks in intensive care units with high mortality rates. The treatment of C. auris colonization is challenging due to high resistance rates. A potential alternative antifungal treatment is medical-grade honey. In this study the susceptibility of C. auris and other Candida species to the medical-grade honey-based formulation L-Mesitran® Soft was investigated. The medical-grade honey formulation reduced the growth of C. auris and other Candida species in a dose-dependent manner. This inhibition was not only due to the honey component, as treatment with an identical concentration of this component only was less effective and even stimulated the growth of C. albicans and C. glabrata, supporting the interpretation that supplements in the medical-grade honey formulation enhanced the antimicrobial activity. Increasing the concentration of the honey component to 40%, as is also present in an undiluted medical-grade honey formulation, lead to a 1- to 4-log inhibition of all Candida species. Unprocessed local honey reduced the growth of nearly all Candida species more strongly than medical-grade honey. C. auris' susceptibility to the medical-grade honey formulation did not depend on geographic origin or resistance profile, although the multiresistant isolates tended to be more susceptible. Altogether, medical-grade honey formulation has a strong antifungal activity against C. auris and other Candida species. Future studies should demonstrate whether the treatment of open wounds or skin colonized with C. auris is feasible and effective in the clinical setting.
Collapse
Affiliation(s)
- Theun de Groot
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital (CWZ), 6532 SZ Nijmegen, The Netherlands; (T.J.); (D.F.); (J.F.M.)
- Correspondence: ; Tel.: +31-24-365-8677
| | - Tom Janssen
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital (CWZ), 6532 SZ Nijmegen, The Netherlands; (T.J.); (D.F.); (J.F.M.)
| | - Dirk Faro
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital (CWZ), 6532 SZ Nijmegen, The Netherlands; (T.J.); (D.F.); (J.F.M.)
| | | | - Anuradha Chowdhary
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi 110007, India;
| | - Jacques F. Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital (CWZ), 6532 SZ Nijmegen, The Netherlands; (T.J.); (D.F.); (J.F.M.)
- Centre of Expertise in Mycology Radboudumc/CWZ, 6532 SZ Nijmegen, The Netherlands
- Bioprocess Engineering and Biotechnology Graduate Program, Federal University of Paraná, Curitiba 80060-000, Brazil
| |
Collapse
|
18
|
Synergistic Antimicrobial Activity of Supplemented Medical-Grade Honey against Pseudomonas aeruginosa Biofilm Formation and Eradication. Antibiotics (Basel) 2020; 9:antibiotics9120866. [PMID: 33291554 PMCID: PMC7761815 DOI: 10.3390/antibiotics9120866] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 02/07/2023] Open
Abstract
Biofilms hinder wound healing. Medical-grade honey (MGH) is a promising therapy because of its broad-spectrum antimicrobial activity and the lack of risk for resistance. This study investigated the inhibitory and eradicative activity against multidrug-resistant Pseudomonas aeruginosa biofilms by different established MGH-based wound care formulations. Six different natural wound care products (Medihoney, Revamil, Mebo, Melladerm, L-Mesitran Ointment, and L-Mesitran Soft) were tested in vitro. Most of them contain MGH only, whereas some were supplemented. L-Mesitran Soft demonstrated the most potent antimicrobial activity (6.08-log inhibition and 3.18-log eradication). Other formulations ranged between 0.89-log and 4.80-log inhibition and 0.65-log and 1.66-log eradication. Therefore, the contribution of different ingredients of L-Mesitran Soft was investigated in more detail. The activity of the same batch of raw MGH (1.38-log inhibition and 2.35-log eradication), vitamins C and E (0.95-log inhibition and 0.94-log eradication), and all ingredients except MGH (1.69-log inhibition and 0.75-log eradication) clearly support a synergistic activity of components within the L-Mesitran Soft formulation. Several presented clinical cases illustrate its clinical antimicrobial efficacy against Pseudomonas aeruginosa biofilms. In conclusion, MGH is a potent treatment for Pseudomonas biofilms. L-Mesitran Soft has the strongest antimicrobial activity, which is likely due to the synergistic activity mediated by its supplements.
Collapse
|