Silver, biofilms and wounds: resistance revisited

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Steven L Percival1, Anne-Marie Salisbury1, Rui Chen1

  • 1a R&D Department, Centre of Excellence in Biofilm Science (CEBS) , 5D Health Protection Group Ltd , Liverpool Bio-Innovation Hub , Liverpool , UK.

Critical Reviews in Microbiology
|February 23, 2019
PubMed

Insights

Overuse of silver in healthcare products may lead to bacterial resistance, but current evidence for this concern in wound care is limited. More research is needed to understand silver

Area of Science:

  • Microbiology
  • Antimicrobial Resistance
  • Wound Care

Background:

  • Silver is incorporated into numerous healthcare products, notably wound dressings.
  • Concerns exist regarding the overuse of silver, potentially leading to bacterial tolerance or resistance and cross-resistance to antibiotics.

Purpose of the Study:

  • To review the current evidence on silver resistance in bacteria isolated from medical settings.
  • To assess the clinical significance of silver resistance in wound care.
  • To highlight the need for further research on silver's effects on microbial tolerance and biofilms.

Main Methods:

  • Literature review of studies documenting silver resistance in clinical bacterial isolates.
  • Analysis of existing data on silver's efficacy and potential for resistance development.
  • Examination of the complexities surrounding silver tolerance in bacterial biofilms.

Main Results:

  • Limited studies document silver resistance in bacteria from medical situations, with reported levels generally being low.
  • Currently, there is minimal clinical evidence to support silver resistance as a significant growing health concern in wound care.
  • Data regarding the impact of silver on biofilms and biofilm tolerance to silver is sparse and complex.

Conclusions:

  • Further research is essential to determine optimal therapeutic silver concentrations for microbial eradication.
  • Sub-therapeutic silver levels might contribute to enhanced microbial tolerance, warranting further investigation.
  • While concerns about silver resistance exist, substantial clinical evidence is lacking, particularly in wound care; more studies are needed to substantiate these concerns and explore biofilm interactions.
Keywords:
Silverbiofilmresistancewound care

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