Julie Irish, Dee Carter, Shona Blair School of Molecular and Microbial Biosciences University of Sydney, Australia
Healing history of honey Healing history of honey Bee symbol was used to represent the Pharaohs Egyptians were the first beekeepers
Antimicrobial activity of honey Antimicrobial activity of honey Low water activity Hydrogen peroxide ~ 80% sugars glucose oxidase + H 2 O Low pH Floral factors gluconic acid Leptospermum honey pH ~ 3.2 - 4.5
Conditions traditionally treated Conditions traditionally treated with honey with honey Gastroenteritis Wound infections Throat infections Insect bites Influenza Burns Schistosomiasis Ulcers Asthma Eye infections Diphtheria Abscesses Contraception 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 - - saved millions of lives saved millions of lives modern medicine However, antibiotics were (and still However, antibiotics were (and still are) one of the most over prescribed over prescribed are) one of the most classes of drugs classes of drugs They are also used extensively (and (and They are also used extensively incorrectly) in animal feed in animal feed incorrectly)
Antibiotics… don’t pack the Antibiotics… don’t pack the same punch they once did same punch they once did 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 SUPERBUGS SUPERBUGS some of the most dangerous Today, almost all important Today, almost all important pathogens have at least some level pathogens have at least some level of antibiotic resistance antibiotic resistance of
What are superbugs superbugs? ? What are Superbugs are: are: Superbugs Microbes that have evolved to have multi drug multi drug Microbes that have evolved to have resistance (probably from over use of (probably from over use of resistance 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 biofilms biofilms Microbes living in consortia or
Where do superbugs superbugs come from? come from? Where do Every time you use antibiotics you select for resistant bacteria
Where do superbugs superbugs come from? come from? Where do Every time you use antibiotics you select for resistant bacteria
Where do superbugs superbugs come from? come from? Where do Every time you use antibiotics you select for resistant bacteria eg Golden Staph
Superbugs… … Superbugs Very difficult to treat with Very difficult to treat with conventional medicine - - conventional medicine sometimes impossible sometimes impossible Could antimicrobial Could antimicrobial honey be a sweet honey be a sweet solution against some solution against some of these bugs? of these bugs?
Honey kills drug resistant Honey kills drug resistant pathogens pathogens Gram positive Gram negative Gram positive Gram negative Staphylococcus aureus Pseudomonas MRSA (Golden Staph) Proteus Propionibacterium Enterobacter Streptococcus Escherichia Enterococcus Klebsiella VRE Acinetobacter Citrobacter Morganella Serratia Pasteurella Yersinia (Molan; Cooper; Blair; Gralton; Irish)
Honey vs vs methicillin methicillin- -resistant resistant Honey Staphylococcus aureus Staphylococcus aureus Methicillin- -resistant resistant Staphylococcus aureus Staphylococcus aureus Methicillin - 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 vs vs multi multi- -drug resistant drug resistant Honey wound infecting pathogens wound infecting pathogens 94 clinical isolates of Gram- -negative negative 94 clinical isolates of Gram bacteria - - many from the “top 3” families of many from the “top 3” families of bacteria problematic hospital pathogens problematic hospital pathogens MIC honey: 7 – – 15% 15% MIC honey: 7 MIC artificial honey: >20% MIC artificial honey: >20%
Honey vs vs Candida Candida Honey Thrush caused by the yeast Candida Wound infections – immunocompromised Eukaryotic cells Drug resistance
Honey vs vs Candida Candida Honey 38 clinical isolates Sensitivity to honey depends on - species of Candida - type of honey Honey with hydrogen peroxide activity is more effective than other types
Honey vs vs Dermatophytes Dermatophytes Honey Tinea - - most common fungal most common fungal Tinea infection in the general infection in the general population population Control Control Caused by dermatophytes Caused by dermatophytes Problematic for the Problematic for the 10% honey 10% honey immunocompromised patient patient immunocompromised MIC honey: 10 - - 20% 20% MIC honey: 10 MIC artificial honey: >30% MIC artificial honey: >30% 15% honey 15% honey
Propionibacterium acnes Propionibacterium acnes 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 Honey has not been tested Honey has not been tested against medically important against medically important anaerobes anaerobes
Honey vs vs Propionibacterium acnes Propionibacterium acnes Honey Control plate Honey plate Control plate Honey plate MIC honey: 9- -14% 14% MIC honey: 9 MIC artificial honey: > 30% MIC artificial honey: > 30%
Honey vs vs ‘Flesh eating’ bacteria ‘Flesh eating’ bacteria Honey Honey treatment of Fournier’s gangrene Honey: controlled infection faster healing no fatalities Conventional treatment: increased need for surgery fatalities
Honey cures superbug superbug infection infection Honey cures 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 - - largest largest Antibiotic resistance 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 Honey should be seriously considered as a Honey should be seriously considered as a wound dressing wound dressing wound dressing Particularly effective for Particularly effective for Broad spectrum Broad spectrum burns, ulcers and burns, ulcers and antimicrobial agent antimicrobial agent infected wounds infected wounds -drug resistant microbes drug resistant microbes - Ideal dressing properties Ideal dressing properties No reported side effects No reported side effects Stimulates healing Stimulates healing Very cost effective Very cost effective Excellent prophylaxis Excellent prophylaxis Honey type is important Honey type is important
Acknowledgments Acknowledgments Dee Carter Dee Carter Rob Manning Rob Manning (Dept of Ag, WA) (Dept of Ag, WA) Shona Blair Blair Shona Medihoney Medihoney Jan Gralton Gralton Jan Comvita Comvita John Hills John Hills The University of Sydney, Australia The University of Sydney, Australia RIRDC RIRDC Peter Molan Molan Peter University of Waikato Waikato, New Zealand , New Zealand University of Rose Cooper and Ken Jones Rose Cooper and Ken Jones University of Wales Institute, Cardiff, UK University of Wales Institute, Cardiff, UK Westmead, Concord and RPA Hospitals Westmead, Concord and RPA Hospitals
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