Abstract
Chronic wound infections are difficult to manage because of the biofilm formation in the wound environment. New measures for eliminating infections are necessary to increase the chance of wound healing. Apitherapy may be the new solution. The aim of this study was to assess the prevalence of wound infection factors and to examine the impact of Manuka honey and ethanol extract of propolis on biofilm formation of Proteus mirabilis isolated from chronic wound infections. According to the findings, the most frequent factors of infection are Staphylococcus aureus (46.1%), Pseudomonas aeruginosa (35.0%), and Proteus mirabilis (10.6%). Minimal inhibitory concentration and minimal bactericidal concentration values were assigned using the microbroth dilution test according to the Clinical and Laboratory Standards Institute. Biofilm of Proteus mirabilis isolates was formed in 96-well polystyrene plates and treated with Manuka honey (concentrations from 1.88% to 30.0%) and ethanol extract of propolis (1.0% to 40.0%). After 24 h, the biofilm viability was expressed by formazan absorbance (λ = 470 nm). Manuka honey reduced the biofilm viability in all, and ethanol extract of propolis in most, of the concentrations tested. Ethanol extract of propolis at the concentrations of 20.0% and 40.0%, reduced biofilm viability stronger than ethanol itself. With these results comes the conclusion that these substances can reduce biofilm formation.
Highlights
The definition of a chronic wound is not clearly outlined in the literature or clinical practice
We focused on chronic wounds related to diabetes and pressure lesions
Bacteriology of chronic wound infections is being constantly monitored by scientist and clinicians all over the world, and the vast majority of articles have reported that the most prevalent bacteria isolated from chronic wounds were S. aureus, S. epidermidis, and other coagulase-negative staphylococci, as well as Streptococcus spp., P. aeruginosa, and other Gram-negative rods [9,30,31,32]
Summary
The definition of a chronic wound is not clearly outlined in the literature or clinical practice. Chronic wounds do not heal in a standard time because the healing process does not progress. A wound is presumed chronic after two to eight weeks of a prolonged healing process [1,2,3,4]. We focused on chronic wounds related to diabetes (diabetic foot ulcers) and pressure lesions. During their lifetime, 12.0 to 25.0% of diabetic patients will develop ulcerations. Patients suffering from pressure lesions total from 2.0% to 25.0% of hospitalized patients [4]
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