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Synergism between Medihoney and rifampicin against methicillin-resistant Staphylococcus aureus (MRSA).

Müller P, Alber DG, Turnbull L, Schlothauer RC, Carter DA, Whitchurch CB, Harry EJ - PLoS ONE (2013)

Bottom Line: Combinational treatment of chronic wounds with manuka honey and common antibiotics may offer a wide range of advantages including synergistic enhancement of the antibacterial activity, reduction of the effective dose of the antibiotic, and reduction of the risk of antibiotic resistance.Methylglyoxal (MGO), believed to be the major antibacterial compound in manuka honey, did not act synergistically with rifampicin and is therefore not the sole factor responsible for the synergistic effect of manuka honey with rifampicin.Our findings support the idea that a combination of honey and antibiotics may be an effective new antimicrobial therapy for chronic wound infections.

View Article: PubMed Central - PubMed

Affiliation: The ithree institute, University of Technology Sydney (UTS), Sydney, New South Wales, Australia.

ABSTRACT
Skin and chronic wound infections caused by highly antibiotic resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) are an increasing and urgent health problem worldwide, particularly with sharp increases in obesity and diabetes. New Zealand manuka honey has potent broad-spectrum antimicrobial activity, has been shown to inhibit the growth of MRSA strains, and bacteria resistant to this honey have not been obtainable in the laboratory. Combinational treatment of chronic wounds with manuka honey and common antibiotics may offer a wide range of advantages including synergistic enhancement of the antibacterial activity, reduction of the effective dose of the antibiotic, and reduction of the risk of antibiotic resistance. The aim of this study was to investigate the effect of Medihoney in combination with the widely used antibiotic rifampicin on S. aureus. Using checkerboard microdilution assays, time-kill curve experiments and agar diffusion assays, we show a synergism between Medihoney and rifampicin against MRSA and clinical isolates of S. aureus. Furthermore, the Medihoney/rifampicin combination stopped the appearance of rifampicin-resistant S. aureus in vitro. Methylglyoxal (MGO), believed to be the major antibacterial compound in manuka honey, did not act synergistically with rifampicin and is therefore not the sole factor responsible for the synergistic effect of manuka honey with rifampicin. Our findings support the idea that a combination of honey and antibiotics may be an effective new antimicrobial therapy for chronic wound infections.

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Related in: MedlinePlus

Reversal of oxacillin resistance but not rifampicin resistance in S. aureus by Medihoney.Oxacillin resistant MRSA RPAH18 and rifampicin resistant clone 1 (Fig. 1) were streaked out on TSA plates containing no honey (TSA), 5% sugar solution (sugar), or 5% Medihoney. Inhibition zones around filter discs containing 4 µg rifampicin (rif) or 4 µg oxacillin (oxa) were measured after incubation at 37°C for 24 h.
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pone-0057679-g003: Reversal of oxacillin resistance but not rifampicin resistance in S. aureus by Medihoney.Oxacillin resistant MRSA RPAH18 and rifampicin resistant clone 1 (Fig. 1) were streaked out on TSA plates containing no honey (TSA), 5% sugar solution (sugar), or 5% Medihoney. Inhibition zones around filter discs containing 4 µg rifampicin (rif) or 4 µg oxacillin (oxa) were measured after incubation at 37°C for 24 h.

Mentions: It has been reported, that a combination of oxacillin and manuka honey can restore oxacillin susceptibility to MRSA strains [44]. In order to investigate, whether a combination of rifampicin and Medihoney can reverse rifampicin resistance, an agar disc diffusion assay was performed. The oxacillin resistant strain RPAH18 and a rifampicin resistant NCTC8325 clone (clone 1, refer to Fig. 1) were spread out on TSA plates or TSA plates containing 5% Medihoney. Sub-inhibitory concentrations of Medihoney caused the appearance of inhibition zones of 25 mm diameter around 4 µg oxacillin discs, showing the reversal of oxacillin resistance in presence of Medihoney. In contrast, no inhibition zones could be detected around 4 µg rifampicin discs on Medihoney plates (Fig. 3). Thus, unlike oxacillin, Medihoney is not able to restore rifampicin susceptibility to S.aureus that are already resistant to rifampicin.


Synergism between Medihoney and rifampicin against methicillin-resistant Staphylococcus aureus (MRSA).

Müller P, Alber DG, Turnbull L, Schlothauer RC, Carter DA, Whitchurch CB, Harry EJ - PLoS ONE (2013)

Reversal of oxacillin resistance but not rifampicin resistance in S. aureus by Medihoney.Oxacillin resistant MRSA RPAH18 and rifampicin resistant clone 1 (Fig. 1) were streaked out on TSA plates containing no honey (TSA), 5% sugar solution (sugar), or 5% Medihoney. Inhibition zones around filter discs containing 4 µg rifampicin (rif) or 4 µg oxacillin (oxa) were measured after incubation at 37°C for 24 h.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3585195&req=5

pone-0057679-g003: Reversal of oxacillin resistance but not rifampicin resistance in S. aureus by Medihoney.Oxacillin resistant MRSA RPAH18 and rifampicin resistant clone 1 (Fig. 1) were streaked out on TSA plates containing no honey (TSA), 5% sugar solution (sugar), or 5% Medihoney. Inhibition zones around filter discs containing 4 µg rifampicin (rif) or 4 µg oxacillin (oxa) were measured after incubation at 37°C for 24 h.
Mentions: It has been reported, that a combination of oxacillin and manuka honey can restore oxacillin susceptibility to MRSA strains [44]. In order to investigate, whether a combination of rifampicin and Medihoney can reverse rifampicin resistance, an agar disc diffusion assay was performed. The oxacillin resistant strain RPAH18 and a rifampicin resistant NCTC8325 clone (clone 1, refer to Fig. 1) were spread out on TSA plates or TSA plates containing 5% Medihoney. Sub-inhibitory concentrations of Medihoney caused the appearance of inhibition zones of 25 mm diameter around 4 µg oxacillin discs, showing the reversal of oxacillin resistance in presence of Medihoney. In contrast, no inhibition zones could be detected around 4 µg rifampicin discs on Medihoney plates (Fig. 3). Thus, unlike oxacillin, Medihoney is not able to restore rifampicin susceptibility to S.aureus that are already resistant to rifampicin.

Bottom Line: Combinational treatment of chronic wounds with manuka honey and common antibiotics may offer a wide range of advantages including synergistic enhancement of the antibacterial activity, reduction of the effective dose of the antibiotic, and reduction of the risk of antibiotic resistance.Methylglyoxal (MGO), believed to be the major antibacterial compound in manuka honey, did not act synergistically with rifampicin and is therefore not the sole factor responsible for the synergistic effect of manuka honey with rifampicin.Our findings support the idea that a combination of honey and antibiotics may be an effective new antimicrobial therapy for chronic wound infections.

View Article: PubMed Central - PubMed

Affiliation: The ithree institute, University of Technology Sydney (UTS), Sydney, New South Wales, Australia.

ABSTRACT
Skin and chronic wound infections caused by highly antibiotic resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) are an increasing and urgent health problem worldwide, particularly with sharp increases in obesity and diabetes. New Zealand manuka honey has potent broad-spectrum antimicrobial activity, has been shown to inhibit the growth of MRSA strains, and bacteria resistant to this honey have not been obtainable in the laboratory. Combinational treatment of chronic wounds with manuka honey and common antibiotics may offer a wide range of advantages including synergistic enhancement of the antibacterial activity, reduction of the effective dose of the antibiotic, and reduction of the risk of antibiotic resistance. The aim of this study was to investigate the effect of Medihoney in combination with the widely used antibiotic rifampicin on S. aureus. Using checkerboard microdilution assays, time-kill curve experiments and agar diffusion assays, we show a synergism between Medihoney and rifampicin against MRSA and clinical isolates of S. aureus. Furthermore, the Medihoney/rifampicin combination stopped the appearance of rifampicin-resistant S. aureus in vitro. Methylglyoxal (MGO), believed to be the major antibacterial compound in manuka honey, did not act synergistically with rifampicin and is therefore not the sole factor responsible for the synergistic effect of manuka honey with rifampicin. Our findings support the idea that a combination of honey and antibiotics may be an effective new antimicrobial therapy for chronic wound infections.

Show MeSH
Related in: MedlinePlus