Risk and clinical impact of bacterial resistance/susceptibility to silver-based wound dressings: a systematic review

Abstract

Objective: To perform a systematic review of the literature on bacterial resistance, tolerance and susceptibility of silver within the context of wound therapy using silver-based dressings. Methods: A literature search was carried out using PubMed, Embase and Cochrane Library databases, the focus was whether results from microbiological experimental in vitro tests with reference strains and clinical wound isolates are reflected in clinical practice with regards to their ‘resistance’ profiles, comparable with those observed for antibiotics. The search results were allocated to six categories: resistance and resistance mechanism, in vitro tests with standard strains and wound isolates, prevalence and incidence, impact on clinical practice and impact on antibiotic therapy as well as reviews, expert opinions and consensus. Results: Based on all findings of the literature, it cannot be confirmed that a related clinical resistance to silver-ions in silver-based dressings has clinical impact, although endogenous and exogenous genetic resistance patterns have been described and intensively investigated. A translation of these genetic resistance-expression structures to phenotypic appearances, similar to those known for antibiotics, has not been demonstrated for silver in the literature. Conclusion: It can be concluded that there is no definitive evidence available and further studies should be conducted.

Clinical Study on the Efficacy of Silver Ion Dressing Combined with Prontosan Gel Dressing in the Treatment of Diabetic Foot Ulcers and the Effect on Serum Inflammatory Factors

“…Silver ion dressings contain rapidly absorbent and water-locking alginate fibres that draw wound exudate and microorganisms into the dressing and remove them by removing the dressing, reducing impregnation damage to the wound and surrounding skin. Alginate fibres absorb exudate and form a gel, providing a humid microacidic environment to stimulate local vascular proliferation, promote granulation tissue growth, accelerate wound healing, and retain the release of active substances from the exudate, facilitating self-soluble wound debridement [ 21 , 22 ]. Prontosan gel dressing contains the surfactants undecylenamidopropyl betaine and polihexanide, which are highly compatible with antimicrobial dressings such as silver ions.…”

Insights into Shape-Based Silver Nanoparticles: A Weapon to Cope with Pathogenic Attacks

“…The lack of experimental evidence suggested additional studies over bacterial and AgNPs interactions. One of the critical reviews by Dissemond et al . published over risk and clinical impact of bacterial resistance/susceptibility toward AgNPs in wound dressing concluded no proof for Ag + resistance by bacteria with clinical relevance, which urges researchers to do additional investigation.…”

“…The lack of experimental evidence suggested additional studies over bacterial and AgNPs interactions. One of the critical reviews by Dissemond et al 314 271 Multistimulus-responsive smart supramolecular hydrogels with AgNPs coated on cytidine-5-monophosphatecapped β-FeOOH nanohybrids demonstrated activity against Candida albicans. 303 AgNPs-silica plates functioned as a fungicide to control the growth of Fusarium oxysporum.…”

Properties, mechanism and applications of diamond as an antibacterial material

“…The formed nanocomposite displayed high bactericidal activity toward the Gram-negative E. coli bacterial strain at very low concentration in the cultivation media [219] (Figure 4). As concerns are developing concerning the rise of bacterial resistance against Silver [30,[220][221][222][223][224][225][226][227][228][229][230][231] and Copper [229,[232][233][234][235][236][237][238][239][240][241][242][243][244] as well as concerns about the impact of heavy metal on the spread and development of antibiotic resistance genes [120,245] recently, the creation of diamond composites with Cu and/or Ag NPs immobilised of their surface could be a valid strategy to avoid this resistances to develop and to reduce the needed amount of Cu and Ag to display satisfactory antibacterial properties.…”