期刊
BIOMEDICINES
卷 10, 期 11, 页码 -出版社
MDPI
DOI: 10.3390/biomedicines10112751
关键词
antimicrobials; antiseptics; wound infection; organic challenge; wound exudate; DIN-EN-13727
资金
- HHU Open Access Fund, University and State Library (ULB), Heinrich-Heine-University (HHU), Duesseldorf [ULBD-22-11504]
- Initiative Chronic Wounds (ICW e.V.
- Quedlinburg, Germany)
The study found that current standard methods do not fully consider the impact of wound microenvironments on the efficacy of antimicrobial agents, and there are also differences in the antimicrobial effects against different bacteria. The composition of the challenge substance is more important than pure concentration.
Current standards insufficiently acknowledge the influence of the wound micro-environment on the efficacy of antimicrobial agents. To address this, octenidine/phenoxyethanol, polyhexanide, povidone-iodine, and sodium-hypochloride/hypochlorous acid solutions were submitted to standard-based (DIN-EN-13727) or modified peptide-based challenges and compared to a simulated clinical reference using human acute or chronic wound exudate (AWF/CWF). Antimicrobial efficacy against S. aureus and P. aeruginosa was compared using a quantitative suspension method. Agreement between methods were investigated using Bland-Altman (B&A) analysis. Different substances and challenges demonstrated diverging results, depending on class and concentration of agent and challenge. Highly concentrated antiseptics maintained a high efficacy under complex challenges, while especially chlorine-based irrigation solutions showed a remarkably reduced antimicrobial effect. Composition of challenge substance proved more relevant than pure concentration. Therefore, the current standard challenge conditions did not adequately reflect the wound micro-environment with over- or under-estimating antimicrobial efficacy, whilst the modified peptide-challenge showed a higher level of agreement with simulated realistic conditions (AWF/CWF). The results emphasize that a one-fits-all approach is not feasible to generalize antimicrobial efficacy, as certain aspects of the complex micro-environment pose a differing influence on varying agents. Based on these results, revision and target focused adaptation of the current standards should be considered.
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