Abstract
Neisseria gonorrhoeae bacteria are acknowledged as an urgent threat to human health because this species has developed resistances to all of the antibiotics used clinically to treat its infections. N. gonorrhoeae causes the sexually transmitted disease gonorrhoea, but also causes blindness when the bacteria infect the eyes. Infants are particularly susceptible, acquiring the infection from their mothers at birth. We have shown that the monoglyceride monocaprin rapidly kills N. gonorrhoeae and other bacterial species and is non-irritating in ocular assays. Here we show that the physical and chemical properties of monocaprin make it ideal for use in a thickened eye drop formulation to combat eye infections. Monocaprin-containing formulations were assessed using analytical techniques and for antimicrobial activity in vitro and in ex vivo infections. Monocaprin-containing formulations retained activity after three years and are non-irritating, unlike preparations of povidone iodine in our assays. A recommended formulation for further development and investigation is 0.25% monocaprin in 1% HPMC with 1% polysorbate 20.
Highlights
Neonatorum at b irth[15]
We have identified that monocaprin is able to kill N. gonorrhoeae, including clinical isolates of N. gonorrhoeae, the related species Neisseria meningitidis, which can cause eye infections, and other keratitis causing bacteria, including Chlamydia trachomatis, another major cause of ophthalmia n eonatorum[1,3,16]
Monocaprin has been shown to retain its antimicrobial activity in artificial tear fluid, is devoid of corneal and conjunctival irritation, kills all bacteria present within 2 min, and N. gonorrhoeae have been unable to develop resistance to monocaprin[1,2]
Summary
Neonatorum at b irth[15]. The infection can progress rapidly, with the bacteria perforating the globe of the eye and causing blindness within 24 h4–5,15. At this concentration of polysorbate 20, the monocaprin was completely in solution in the HPMC polymer-based formulations, but this was not the case in the CMC-based formulations (Fig. 2).
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