In 2009, New Delhi metallo-beta-lactamase 1 (NDM-1) strains emerged as a global problem. Individuals who were previously hospitalized in India or Pakistan, where the resistance-causing enzyme that is carried by bacteria is widespread, repeatedly brought the superbug to the UK.
NDM-1, an enzyme capable of destroying antibiotics, even powerful antibiotics, can cause infections in hospitalized patients that have common infections, such as urinary tract, blood, lung and wound infections. Infections with NDM-1 can vary from being mild to potentially life threatening or even fatal depending on which part of the body is affected, and the patient’s general health.
New data presented at the European Wound Management Association (EWMA) conference by The Health Protection Agency (HPA) and Smith & Nephew has demonstrated that ACTICOAT™ dressings eliminate (in vitro) superbugs that contain the antibiotic resistance enzyme New Delhi metallo-beta-lactamase 1 (NDM-1). The ACTICOAT dressing is an extremely efficacious antimicrobial barrier dressing, which could prove beneficial in preventing wound infections with the highly resistant bacteria carrying the NDM-1 enzyme.
The widespread and inappropriate use of antibiotics worldwide has resulted in a growing problem of antibiotic resistance. NDM-1 is encoded for by sections of bacterial DNA known as plasmids that can be transferred between different types of bacteria, meaning that more than one type of bacteria can acquire this type of resistance, which is most often seen in Klebsiella pneumoniae and E.coli. The majority of NDM-1 bacteria are largely resistant to many types of antibiotics, both b-lactam and non-b-lactam antibiotics, which leads to major problems in treating patients with severe infections of these superbugs.
So far, scientists have been largely unaware about the superbug’s resistance to silver compounds, yet in a recent study researchers evaluated the antibacterial efficacy of nanocrystalline silver dressings to various bacteria that carried NDM-1, and discovered that all 3 ACTICOAT dressings they assessed achieved a reduction of >99.99% in 5 strains of NDM-1 within 30 minutes.
The researchers note that all dressing types maintained their activity for between 2 and 4 hours, which shows the relevance of these products in terms of preventing wound infections of these highly resistant superbugs. NDM-1 bacteria are called ‘superbugs’ because they produce enzymes that have become resistant to various powerful antibiotics (carbapenems). This has caused a major public health concern as carbapenems are one of the most potent antibiotics available, and are frequently used for treating infections with multiresistant Gram-negative bacteria, which are resistant to normal antibiotics.
Prof. David Livermore, Professor of Medical Microbiology at East Anglia University underlines the significance of these results, stating: “The emergence of carbapenem resistance is deeply disturbing and, since there are few antibiotics in reserve behind the carbapenems, it presents a major global health concern. We have identified bacteria with NDM resistance in over 150 patients in the UK and these numbers are rising. These data demonstrate that new types of dressing can kill bacteria carrying NDM-1 and this might be useful in preventing wound infections.”
Health care providers are presented with a major challenge in managing infected wounds that do not heal as it means employing more intensive treatment options, extended hospital stays, re-admissions as well as surgical interventions. ACTICOAT™ dressings promote healing in infected wounds and under appropriate usage they provide an effective and cost-effective option for managing these types of wounds. Nanocrystalline silver ACTICOAT dressings have already been successfully used to manage MRSA infections, where their efficacy has been proven with cost benefits to both patients and the healthcare system.
Simon Beard, Smith & Nephew declared:
“These results demonstrate how topical antimicrobial agents can help to tackle the problems of multiple antibiotic resistance. The fact that the nanocrystalline silver in ACTICOAT dressings has been demonstrated in vitro to be an effective antimicrobial agent against NDM-1 carrying strains within 30 minutes highlights the role for using ACTICOAT as an intervention in tackling infections in wounds.”
Written By Petra Rattue