Mycobacterium ulcerans, the etiological agent in Buruli and related
ulcers, is a major threat to public health in many tropical countries. Recommended treatment that is accessible and affordable for affected individuals includes surgical
debridement and combination
antibiotics. The potential benefits in the use of antimicrobial
wound dressings has not been demonstrated to date, and consequently the efficacy of a
silver-containing absorbent dressing was investigated against a pathogenic
wound mycobacterium using stringent in vitro models. The in vitro models were designed to simulate a variety of challenging
wound conditions. Mycobacterium fortuitum was used as a fast-growing surrogate for M. ulcerans, a physiologically similar but slower-growing and more significant
wound pathogen. Collectively, the studies showed that the
silver-containing dressing was bactericidal against M. fortuitum, it maintained killing effect over a prolonged period (7 days) under conditions simulating excessive exudate, and killed an average of 100% of the bacterial population inoculated directly beneath the dressing in a simulated, colonized, shallow
wound model. Based on the in vitro data generated in the current research, use of the
silver-containing dressing as part of a protocol-of-care in the management of Buruli and related
ulcers may help to alleviate
wound infection caused by pathogenic mycobacteria, improve quality of life, and provide
infection protection in endemic and at-risk regions. .