Antibacterial Honey: in-vitro Activity Against Clinical Isolates of MRSA, VRE, and Other Multiresistant Gram-negative Organisms

Author(s): 
Narelle May George; Keith F. Cutting

Disclosure: Mr. Cutting has acted as a paid consultancy for Medihoney and Dermasciences.

The media regularly reminds both the public and healthcare professionals of the dangers infection poses to good health, in particular the difficulties in successfully treating infection caused by multiresistant microorganisms.The development of bacterial resistance to antibiotic therapy is understood to be a natural occurrence. The emergence of resistant strains of bacteria and the ensuing management challenges are compounded by the fact that the development of new antibiotics has decreased in recent years.1 This situation prompts revisiting traditional approaches to infection management and use of those antimicrobials where the emergence of resistant strains has not been demonstrated and is highly unlikely to occur.

More recently, interest in honey as a therapeutic agent has undergone a renaissance. Molan,2 in a review article on honey used as a wound dressing, eloquently presented an array of supportive evidence ranging from case studies to randomized controlled trials that clearly indicates the value of honey in wound care—particularly its antibacterial activity.Molan concludes that the antibacterial activity of honey “rapidly clears infection and protects wounds from becoming infected.”2 This statement brings into sharp belief the antibacterial potency of honey and its value as a therapeutic agent in wound care. This notion is supported in a 2005 report the Australian government commissioned that states “honey has been successfully used on infections not responding to standard antiseptic and antibiotic therapy” and that the full potential of honey will be recognized as the number of antibiotic resistant bacteria increases.3

The antibacterial activity of honey has been related to 4 properties (Figure 1).

 

Honey appears to offer distinct advantages over “traditional” antibiotic therapy. Nonetheless, it is important to remember that although natural honey from the comb is antibacterial, it is not medical grade and should not be used in wound care. Medical grade honey is filtered, gamma irradiated, and produced under exacting standards of hygiene.

All honeys are not the same and do not possess the same therapeutic advantages; therefore, honey should not be considered as a generic term.6 Medihoney Antibacterial Honey (Medihoney Pty LTD, Richlands, Australia) is a standardized medical honey that is available in many countries including Australia, United Kingdom, Finland, Germany, Austria, and Turkey. It is selected for its antibacterial activity and predominantly sourced from Leptospermum species. Sterility of products is validated against international standards and products are manufactured to meet international quality system requirements. The antibacterial activity of Medihoney is validated for the shelf life of the product, complying with the European Medical Device Directive. The Maori (Polynesian settlers of New Zealand) vernacular name for Leptospermum honey is manuka, the name by which it is more popularly known.

Although the antibacterial activity of honey is recognized, potency varies between types.7 Relevant microbiological data is required in order to better understand the antibacterial activity of specific types of medical honey—particularly its impact on resistant bacterial strains.

Aim. An in-vitro study was initiated in order to gain insight into the antibacterial activity of Medihoney antibacterial honey against a range of multiresistant organisms. Methods A challenge set of 130 clinical isolates with multiple antibiotic resistances was prepared (Figure 2).

 

References: 

References

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2. Molan PC.The evidence supporting the use of honey as a wound dressing. Int J Low Extrem Wounds. 2006;5(1):40–54.

3. Davis C. The use of Australian honey in moist wound management. A report for the Rural Industries Research and Development Corporation. Kingston, Australia. October 2005. Publication No. W05/159. Project No. DAQ-232A.

4. Lusby PE, Coombes A, Wilkinson JM. Honey: a potent agent for wound healing? J Wound Ostomy Continence Nurs. 2002;29(6):295–300.

5. Blair S.Honey and drug resistant pathogens. Presented at: Joint Scientific Meeting of The Australian Society for Microbiology; July 2000; Cairns, Australia.

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8. Murray PR, Baron EJ, Jorgensen JH, Pfaller MA,Yolken RH. Manual of Clinical Microbiology. 8th ed.Washington, DC:ASM Press; 2003.

9. National Committee for Clinical Laboratory Standards. Methods for dilution: antimicrobial susceptibility tests for bacteria that grow aerobically. 5th ed. Wayne, Pa: Approved Standard M7-A5, NCCLS; 2000.

10. Dutka-Malen S, Evers S, Courvalin P. Detection of glycopeptide resistance genotypes and identification to the species level of clinically relevant enterococci by PCR. J Clin Microbiol. 1995;33(1):24–27.

11. Cooper RA, Molan PC, Harding KG. The sensitivity to honey of gram-positive cocci of clinical significance isolated from wounds. J Appl Microbiol. 2002;93(5):857–863.

12. Allen KL,Hutchinson G,Molan PC.The potential for usinghoney to treat wounds infected with MRSA and VRE. Presented at: First World Wound Healing Congress; September 10–13, 2000; Melbourne,Australia.

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17. Johnson DW, van Eps C, Mudge DW, et al. Randomized, controlled trial of topical exit-site application of honey (Medihoney) versus mupirocin for the prevention of catheter-associated infections in hemodialysis patients. J Am Soc Nephrol. 2005;16(5):1456–1462.

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19. Sesso R, Barbosa D, Leme IL, et al. Staphylococcus aureus prophylaxis in hemodialysis patients using central venous catheter: effect of mupirocin ointment. J Am Soc Nephrol. 1998;9(6):1085–1092.

20. Johnson DW, MacGinley R, Kay TD, et al. A randomized controlled trial of topical exit site mupirocin application in patients with tunnelled, cuffed haemodialysis catheters. Nephrol Dial Transplant. 2002;17(10):1802–1807.



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