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Updated: May 25, 2026

Live/Dead Staining for Quantifying Viable but Not Culturable Cells in Manuka Honey-Treated Wound-Causing Bacteria
Published on: April 25, 2025
Manuka honey inhibits the development of Streptococcus pyogenes biofilms and causes reduced expression of two
Sarah E Maddocks1, Marta Salinas Lopez1, Richard S Rowlands1
1Cardiff Metropolitan University, Western Avenue, Cardiff CF5 2YB, UK.
Abstract:
Streptococcus pyogenes (group A Streptococcus; GAS) is always of clinical significance in wounds where it can initiate infection, destroy skin grafts and persist as a biofilm. Manuka honey has broad spectrum antimicrobial activity and its use in the clinical setting is beginning to gain acceptance with the continuing emergence of antibiotic resistance and the inadequacy of established systemic therapies; novel inhibitors may affect clinical practice. In this study, the effect of manuka honey on S. pyogenes (M28) was investigated in vitro with planktonic and biofilm cultures using MIC, MBC, microscopy and aggregation efficiency. Bactericidal effects were found in both planktonic cultures and biofilms, although higher concentrations of manuka honey were needed to inhibit biofilms. Abrogation of adherence and intercellular aggregation was observed. Manuka honey permeated 24 h established biofilms of S. pyogenes, resulting in significant cell death and dissociation of cells from the biofilm. Sublethal concentrations of manuka honey effectively prevented the binding of S. pyogenes to the human tissue protein fibronectin, but did not inhibit binding to fibrinogen. The observed inhibition of fibronectin binding was confirmed by a reduction in the expression of genes encoding two major fibronectin-binding streptococcal surface proteins, Sof and SfbI. These findings indicate that manuka honey has potential in the topical treatment of wounds containing S. pyogenes.
Insights
Manuka honey shows potential for treating wounds infected with Streptococcus pyogenes. It effectively kills bacteria in planktonic and biofilm cultures and prevents bacterial adherence to human tissues.
Area of Science:
- Microbiology
- Wound Healing
- Natural Products
Background:
- Streptococcus pyogenes (group A Streptococcus; GAS) is a significant pathogen in wound infections, contributing to biofilm formation and resistance to conventional therapies.
- The rise of antibiotic resistance necessitates the exploration of novel antimicrobial agents for clinical use.
Purpose of the Study:
- To investigate the in vitro efficacy of Manuka honey against Streptococcus pyogenes (M28) in both planktonic and biofilm states.
- To assess Manuka honey's impact on bacterial adherence, biofilm structure, and virulence factor gene expression.
Main Methods:
- Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) assays.
- Microscopy to visualize biofilm penetration and cell death.
- Assessment of bacterial aggregation and fibronectin/fibrinogen binding.
- Quantitative gene expression analysis for fibronectin-binding proteins (SfbI, Sof).
Main Results:
- Manuka honey demonstrated bactericidal effects on both planktonic and biofilm cultures of S. pyogenes, with higher concentrations required for biofilms.
- Significant abrogation of bacterial adherence and intercellular aggregation was observed.
- Manuka honey effectively permeated established biofilms, causing cell death and dissociation.
- Sublethal concentrations inhibited fibronectin binding by preventing the expression of Sof and SfbI genes.
Conclusions:
- Manuka honey exhibits potent antimicrobial activity against S. pyogenes, including established biofilms.
- It disrupts key bacterial adhesion mechanisms, specifically fibronectin binding, which is crucial for virulence.
- These findings support the potential of Manuka honey as a topical therapeutic agent for S. pyogenes-infected wounds.
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