1887

Abstract

is an opportunistic human pathogen of increasing concern, due to its ability to cause aggressive pulmonary infections (especially in cystic fibrosis patients), as well as skin and soft tissue infections. is intrinsically drug resistant and treatment regimens are lengthy, consisting of multiple antibiotics with severe side effects and poor patient success rates. New and novel strategies are urgently required to combat these infections. One such strategy thus far overlooked for mycobacteria is manuka honey. For millennia manuka honey has been shown to have wide ranging medicinal properties, which have more recently been identified for its broad spectrum of antimicrobial activity. Here we demonstrate that manuka honey can be used to inhibit and a variety of drug resistant clinical isolates . We also demonstrate using a microbroth dilution checkerboard assay that manuka honey works synergistically with amikacin, which is one of the current front line antibiotics used for treatment of infections. This was further validated using an inhalation model, where we showed that with the addition of manuka honey, the amikacin dosage can be lowered whilst increasing its efficacy. These findings demonstrate the utility of manuka honey for incorporation into nebulised antibiotic treatment for respiratory infections, in particular . These results pave the way for a change of strategy for management, offering new therapeutic options for this deadly infection.

  • This is an open-access article distributed under the terms of the Creative Commons Attribution License. This article was made open access via a Publish and Read agreement between the Microbiology Society and the corresponding author’s institution.
Loading

Article metrics loading...

/content/journal/micro/10.1099/mic.0.001237
2022-09-07
2024-03-28
Loading full text...

Full text loading...

/deliver/fulltext/micro/168/9/mic001237.html?itemId=/content/journal/micro/10.1099/mic.0.001237&mimeType=html&fmt=ahah

References

  1. Luthra S, Rominski A, Sander P. The role of antibiotic-target-modifying and antibiotic-modifying enzymes in Mycobacterium abscessus drug resistance. Front Microbiol 2018; 9:1–13 [View Article]
    [Google Scholar]
  2. Lopeman RC, Harrison J, Desai M, Cox JAG. Mycobacterium abscessus: environmental bacterium turned clinical nightmare. Microorganisms 2019; 7:E90 [View Article]
    [Google Scholar]
  3. Bryant JM, Grogono DM, Greaves D, Foweraker J, Roddick I et al. Whole-genome sequencing to identify transmission of Mycobacterium abscessus between patients with cystic fibrosis: a retrospective cohort study. Lancet 2013; 381:1551–1560 [View Article]
    [Google Scholar]
  4. Lee M-R, Sheng W-H, Hung C-C, Yu C-J, Lee L-N et al. Mycobacterium abscessus complex infections in humans. Emerg Infect Dis 2015; 21:1638–1646 [View Article]
    [Google Scholar]
  5. Minias A, Żukowska L, Lach J, Jagielski T, Strapagiel D et al. Subspecies-specific sequence detection for differentiation of Mycobacterium abscessus complex. Sci Rep 2020; 10:1–9 [View Article]
    [Google Scholar]
  6. Haworth CS, Banks J, Capstick T, Fisher AJ, Gorsuch T et al. British thoracic society guideline for the management of non-tuberculous mycobacterial pulmonary disease (NTM-PD). BMJ Open Respir Res 2017; 4:e000242 [View Article]
    [Google Scholar]
  7. Novosad SA, Beekmann SE, Polgreen PM, Mackey K, Winthrop KL et al. Treatment of Mycobacterium abscessus Infection. Emerg Infect Dis 2016; 22:511–514 [View Article] [PubMed]
    [Google Scholar]
  8. Jeon K, Kwon OJ, Lee NY, Kim B-J, Kook Y-H et al. Antibiotic treatment of Mycobacterium abscessus lung disease: A retrospective analysis of 65 patients. Am J Respir Crit Care Med 2009; 180:896–902 [View Article] [PubMed]
    [Google Scholar]
  9. Victoria L, Gupta A, Gómez JL, Robledo J. Mycobacterium abscessus complex: a review of recent developments in an emerging pathogen. Front Cell Infect Microbiol 2021; 11:1–8 [View Article]
    [Google Scholar]
  10. Nolan VC, Harrison J, Cox JAG. Dissecting the antimicrobial composition of honey. Antibiotics 2019; 8:1–16 [View Article]
    [Google Scholar]
  11. Lu J, Carter DA, Turnbull L, Rosendale D, Hedderley D et al. The effect of New Zealand kanuka, manuka and clover honeys on bacterial growth dynamics and cellular morphology varies according to the species. PLoS One 2013; 8:e55898 [View Article] [PubMed]
    [Google Scholar]
  12. Cokcetin NN, Pappalardo M, Campbell LT, Brooks P, Carter DA et al. The antibacterial activity of Australian Leptospermum honey correlates with methylglyoxal levels. PLoS One 2016; 11:1–13 [View Article]
    [Google Scholar]
  13. Adams CJ, Manley-Harris M, Molan PC. The origin of methylglyoxal in New Zealand manuka (Leptospermum scoparium) honey. Carbohydr Res 2009; 344:1050–1053 [View Article] [PubMed]
    [Google Scholar]
  14. Hermanns R, Mateescu C, Thrasyvoulou A, Tananaki C, Wagener FADTG et al. Defining the standards for medical grade honey. Journal of Apicultural Research 2020; 59:125–135 [View Article]
    [Google Scholar]
  15. Youngberg DM. Honey-based dressings and wound care. J Wound Ostomy Continence Nurs 2009; 36:588–589 [View Article] [PubMed]
    [Google Scholar]
  16. Kamaruzaman NA, Sulaiman SA, Kaur G, Yahaya B. Inhalation of honey reduces airway inflammation and histopathological changes in a rabbit model of ovalbumin-induced chronic asthma. BMC Complement Altern Med 2014; 14:1–11 [View Article]
    [Google Scholar]
  17. Efem SEE. Clinical observations on the wound healing properties of honey. Br J Surg 1988; 75:679–681 [View Article] [PubMed]
    [Google Scholar]
  18. Dunford C, Cooper R, Molan P, White R. The use of honey in wound treatment. Nurs Stand 2000; 15:63–68
    [Google Scholar]
  19. Nolan VC, Harrison J, Wright JEE, Cox JAG. Clinical significance of manuka and medical-grade honey for antibiotic-resistant infections: a systematic review. Antibiotics 2020; 9:1–24 [View Article]
    [Google Scholar]
  20. Weng Y-W, Huang C-K, Sy C-L, Wu K-S, Tsai H-C et al. Treatment for Mycobacterium abscessus complex-lung disease. J Formos Med Assoc 2020; 119:S58–S66 [View Article]
    [Google Scholar]
  21. Ailiyaer Y, Wang X, Zhang Y, Li C, Li T et al. A prospective trial of nebulized amikacin in the treatment of bronchiectasis exacerbation. Respiration 2018; 95:327–333 [View Article]
    [Google Scholar]
  22. Olivier KN, Shaw PA, Glaser TS, Bhattacharyya D, Fleshner M et al. Inhaled amikacin for treatment of refractory pulmonary nontuberculous mycobacterial disease. Ann Am Thorac Soc 2014; 11:30–35 [View Article] [PubMed]
    [Google Scholar]
  23. Jenkins R, Wootton M, Howe R, Cooper R. A demonstration of the susceptibility of clinical isolates obtained from cystic fibrosis patients to manuka honey. Arch Microbiol 2015; 197:597–601 [View Article] [PubMed]
    [Google Scholar]
  24. Luyt C-E, Clavel M, Guntupalli K, Johannigman J, Kennedy JI et al. Pharmacokinetics and lung delivery of PDDS-aerosolized amikacin (NKTR-061) in intubated and mechanically ventilated patients with nosocomial pneumonia. Crit Care 2009; 13:R200 [View Article] [PubMed]
    [Google Scholar]
  25. Adékambi T, Drancourt M. Mycobacterium bolletii respiratory infections. Emerg Infect Dis 2009; 15:302–305 [View Article]
    [Google Scholar]
  26. Dubois V, Viljoen A, Laencina L, Le Moigne V, Bernut A et al. MmpL8MAB controls Mycobacterium abscessus virulence and production of a previously unknown glycolipid family. Proc Natl Acad Sci U S A 2018; 115:E10147–E10156 [View Article]
    [Google Scholar]
  27. Bernut A, Viljoen A, Dupont C, Sapriel G, Blaise M et al. Insights into the smooth-to-rough transitioning in Mycobacterium bolletii unravels a functional Tyr residue conserved in all mycobacterial MmpL family members. Mol Microbiol 2016; 99:866–883 [View Article]
    [Google Scholar]
  28. Roberts AEL, Powell LC, Pritchard MF, Thomas DW, Jenkins RE. Anti-pseudomonad activity of manuka honey and antibiotics in a specialized ex vivo model simulating cystic fibrosis lung infection. Front Microbiol 2019; 10:1–10 [View Article]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/micro/10.1099/mic.0.001237
Loading
/content/journal/micro/10.1099/mic.0.001237
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error