Antimicrobial Activity of Silver-Containing Surgical Dressings in an In vitro Direct Inoculation Simulated Wound Fluid Model Against a Range of Gram-Positive and Gram-Negative Bacteria.

Abstract

Background: Surgical site infections can lead to serious complications and present a huge economic burden. Established wound infections can be difficult to eradicate so preventative measures, including antimicrobial dressings, are advantageous. Materials and Methods: The antimicrobial activity of an ionic silver, ethylenediaminetetraacetic acid (EDTA) and benzethonium chloride-containing (ISEB) surgical cover dressing (SCD) was compared with two other silver-containing SCDs (silver sulfate and ionic silver carboxymethylcellulose [CMC]) and a non-silver-containing CMC SCD control using an in vitro model. The dressings were tested against a range of gram-positive and gram-negative bacteria found in wound environments, including antibiotic resistant strains, using a direct inoculation simulated wound fluid (SWF) model. Dressings were fully hydrated with SWF and inoculated with a final concentration of 1 × 106 colony forming units (CFU) per 10 microliter of the challenge organisms. Dressings were incubated at 35°C ± 3°C for up to seven days; total viable counts (TVCs) were performed to determine bacterial bioburden. Results: All challenge organism levels remained high for the CMC SCD control and silver sulfate SCD throughout the test period. A greater than 95% reduction in TVCs was observed by four hours for all challenge organisms for the ISEB SCD, with non-detectable levels (<70 CFU per dressing) reached within 24 hours and sustained throughout the test period. Antimicrobial activity was less rapid with ionic silver CMC SCD, with 9 of 11 challenge organisms reaching undetectable levels within 6 to 72 hours. Conclusions: A more rapid antimicrobial activity was observed for the ISEB SCD compared with other dressings tested within this in vitro model.