Julie Irish, Dee Carter, Shona Blair School of Molecular and - - PowerPoint PPT Presentation

Julie Irish, Dee Carter, Shona Blair School of Molecular and Microbial Biosciences University of Sydney, Australia

Healing history of honey Healing history of honey

Egyptians were the first beekeepers Bee symbol was used to represent the Pharaohs

Antimicrobial activity of honey Antimicrobial activity of honey

Low water activity

~ 80% sugars

Low pH

gluconic acid pH ~ 3.2 - 4.5

Hydrogen peroxide

glucose oxidase + H2O

Floral factors

Leptospermum honey

Conditions traditionally treated Conditions traditionally treated with honey with honey

Gastroenteritis Throat infections Influenza Schistosomiasis Asthma Diphtheria Contraception Wound infections Insect bites Burns Ulcers Eye infections Abscesses Syphilis Honey was used medicinally until ~1940s…

Antibiotics largely replaced Antibiotics largely replaced the medicinal use of honey the medicinal use of honey

1940s: antibiotics enthusiastically adopted by 1940s: antibiotics enthusiastically adopted by modern medicine modern medicine -

• saved millions of lives

saved millions of lives However, antibiotics were (and still However, antibiotics were (and still are) one of the most are) one of the most over prescribed

• ver prescribed

classes of drugs classes of drugs They are also used extensively They are also used extensively (and (and incorrectly) incorrectly) in animal feed in animal feed

Antibiotics… don’t pack the Antibiotics… don’t pack the same punch they once did same punch they once did

Today, almost all important Today, almost all important pathogens have at least some level pathogens have at least some level

• f
• f antibiotic resistance

antibiotic resistance The overuse of antibiotics has led to the The overuse of antibiotics has led to the emergence of drug resistant microorganisms emergence of drug resistant microorganisms – – some of the most dangerous some of the most dangerous SUPERBUGS SUPERBUGS

Superbugs Superbugs are: are: Microbes that have evolved to have Microbes that have evolved to have multi drug multi drug resistance resistance (probably from over use of (probably from over use of antibiotics) antibiotics) Pathogens that are inherently resistant to Pathogens that are inherently resistant to modern antibiotics and/or difficult to treat modern antibiotics and/or difficult to treat

• Fungal pathogens

Fungal pathogens Microbes living in consortia or Microbes living in consortia or biofilms biofilms

What are What are superbugs superbugs? ?

Where do Where do superbugs superbugs come from? come from?

Every time you use antibiotics you select for resistant bacteria

Where do Where do superbugs superbugs come from? come from?

Every time you use antibiotics you select for resistant bacteria

Where do Where do superbugs superbugs come from? come from?

Every time you use antibiotics you select for resistant bacteria eg Golden Staph

Could antimicrobial Could antimicrobial honey be a sweet honey be a sweet solution against some solution against some

• f these bugs?
• f these bugs?

Superbugs Superbugs… …

Very difficult to treat with Very difficult to treat with conventional medicine conventional medicine -

• sometimes impossible

sometimes impossible

Gram positive Gram positive Gram negative Gram negative

Staphylococcus aureus Pseudomonas MRSA (Golden Staph) Proteus Propionibacterium Enterobacter Streptococcus Escherichia Enterococcus Klebsiella VRE Acinetobacter Citrobacter Morganella Serratia Pasteurella Yersinia

Honey kills drug resistant Honey kills drug resistant pathogens pathogens

(Molan; Cooper; Blair; Gralton; Irish)

Honey Honey vs vs methicillin methicillin-

• resistant

resistant Staphylococcus aureus Staphylococcus aureus

Methicillin Methicillin-

• resistant

resistant Staphylococcus aureus Staphylococcus aureus

• MRSA or “golden Staph”

MRSA or “golden Staph” Huge global problem Huge global problem 20 clinical isolates of MRSA 20 clinical isolates of MRSA MIC honey: 4% MIC honey: 4% MIC artificial honey: > 25% MIC artificial honey: > 25%

Honey Honey vs vs multi multi-

• drug resistant

drug resistant wound infecting pathogens wound infecting pathogens

94 clinical isolates of Gram 94 clinical isolates of Gram-

• negative

negative bacteria bacteria -

• many from the “top 3” families of

many from the “top 3” families of problematic hospital pathogens problematic hospital pathogens MIC honey: 7 MIC honey: 7 – – 15% 15% MIC artificial honey: >20% MIC artificial honey: >20%

Honey Honey vs vs Candida Candida

Thrush caused by the yeast Candida Wound infections – immunocompromised Eukaryotic cells Drug resistance

Honey Honey vs vs Candida Candida

38 clinical isolates Sensitivity to honey depends on

• species of Candida
• type of honey

Honey with hydrogen peroxide activity is more effective than

• ther types

10% honey 10% honey 15% honey 15% honey

Honey Honey vs vs Dermatophytes Dermatophytes

Control Control

MIC honey: 10 MIC honey: 10 -

• 20%

20% MIC artificial honey: >30% MIC artificial honey: >30% Tinea Tinea -

• most common fungal

most common fungal infection in the general infection in the general population population Caused by dermatophytes Caused by dermatophytes Problematic for the Problematic for the immunocompromised immunocompromised patient patient

Major role in pathogenesis of acne Major role in pathogenesis of acne Affects 85% of teenagers, 11% of adults Affects 85% of teenagers, 11% of adults Antibiotic resistance Antibiotic resistance Adverse drug effects Adverse drug effects

Propionibacterium acnes Propionibacterium acnes

Honey has not been tested Honey has not been tested against medically important against medically important anaerobes anaerobes

Honey Honey vs vs Propionibacterium acnes Propionibacterium acnes

Control plate Control plate Honey plate Honey plate

MIC honey: 9 MIC honey: 9-

• 14%

14% MIC artificial honey: > 30% MIC artificial honey: > 30%

Honey Honey vs vs ‘Flesh eating’ bacteria ‘Flesh eating’ bacteria

Honey treatment of Fournier’s gangrene Honey:

controlled infection faster healing no fatalities

Conventional treatment:

increased need for surgery fatalities

Honey cures Honey cures superbug superbug infection infection

88 year old woman Extensive leg ulcers for more than 50 years Recurrent Golden Staph infections

Week 5 of honey dressings Week 10 of honey dressings

Honey is grossly underutilised Honey is grossly underutilised in modern medicine in modern medicine

Antibiotic resistance Antibiotic resistance -

• largest

largest problem facing modern medicine problem facing modern medicine Honey is incredibly broad Honey is incredibly broad spectrum spectrum

• Gram

Gram-

• positive and Gram

positive and Gram-

• negative

negative

• Multi drug resistant pathogens

Multi drug resistant pathogens

• Fungal pathogens

Fungal pathogens

• Biofilms

Biofilms

Conclusions Conclusions

Honey should be seriously considered as a wound dressing Honey should be seriously considered as a Honey should be seriously considered as a wound dressing wound dressing

Broad spectrum Broad spectrum antimicrobial agent antimicrobial agent

• drug resistant microbes

drug resistant microbes Ideal dressing properties Ideal dressing properties Stimulates healing Stimulates healing Excellent prophylaxis Excellent prophylaxis Particularly effective for Particularly effective for burns, ulcers and burns, ulcers and infected wounds infected wounds No reported side effects No reported side effects Very cost effective Very cost effective Honey type is important Honey type is important

Acknowledgments Acknowledgments

Dee Carter Dee Carter Shona Shona Blair Blair Jan Jan Gralton Gralton John Hills John Hills

The University of Sydney, Australia The University of Sydney, Australia

Peter Peter Molan Molan

University of University of Waikato Waikato, New Zealand , New Zealand

Rose Cooper and Ken Jones Rose Cooper and Ken Jones

University of Wales Institute, Cardiff, UK University of Wales Institute, Cardiff, UK

Rob Manning Rob Manning

(Dept of Ag, WA) (Dept of Ag, WA)

Medihoney Medihoney Comvita Comvita RIRDC RIRDC Westmead, Concord and RPA Hospitals Westmead, Concord and RPA Hospitals