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Antibiotics
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Honey: A Sweet Solution to the Growing Problem of Antimicrobial...
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Honey: A Sweet Solution to the Growing Problem of Antimicrobial Resistance

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Novel Antimicrobial Agents".

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 25643

Special Issue Editors

Dr. Niels A.J. Cremers

E-Mail Website
Guest Editor
1. Department of Obstetrics and Gynecology, Maastricht University, Maastricht, The Netherlands
2. Triticum Exploitatie BV, 6222 NK Maastricht, The Netherlands
Interests: medical-grade honey; wound healing; microbiology; biofilms; antimicrobial resistance; candidiasis; complementary and alternative medicine
Special Issues, Collections and Topics in MDPI journals
Dr. Frank Wagener

E-Mail Website
Guest Editor
Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
Interests: craniofacial biology; medical-grade honey wound repair; fibrosis; inflammation; cytoprotective mechanisms
Special Issues, Collections and Topics in MDPI journals
Dr. Dimitris Mossialos

E-Mail Website
Guest Editor
Department of Biochemistry & Biotechnology, University of Thessaly, GR-41221 Larissa, Greece
Interests: development of diagnostic molecular tools; antimicrobial activity; mode of action and microbiome of honey bee products; biodeterioration of cultural heritage
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Antimicrobial resistance is a leading cause of death worldwide, ahead of both HIV/AIDS and malaria. The increase in antimicrobial resistance is inversely related to the development of new antimicrobial agents. Resistance towards new classes of antibiotics can emerge within one year of their development, limiting the commercial interest in discovering new antibiotics. Without antibiotics, routine medical treatments, such as organ transplants and hip replacements, become increasingly difficult to perform, and problems such as infected wounds become potentially life threatening. Antibiotic stewardship and discovering effective alternatives are crucial to controlling resistant infections. Traditional natural medicines may constitute potent alternative antimicrobial agents.

Medical-grade honey has broad-spectrum antimicrobial activity via multiple mechanisms, making it very effective, even against multi- or pan-resistant microorganisms existing in biofilms. In contrast to modern antibiotics, no resistance towards honey has been found over five millennia. Honey can also be combined with antibiotics and other agents, enhancing each other’s antimicrobial activity.

Medical-grade honey can be used for the treatment of various infections. More studies that support the wide applicability and efficacy of MGH are needed. Studies investigating the antimicrobial and anti-biofilm activity of unprocessed honey and MGH against (resistant) microbial infections are welcome for submission to this Special Issue. Various formats are permitted (reviews, original research, case series, animal, and laboratory studies), as long as the ethical standards are followed.

Dr. Niels A.J. Cremers
Dr. Frank Wagener
Dr. Dimitris Mossialos
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • medical-grade honey
  • antimicrobial activity
  • biofilms
  • infections
  • wound care
  • non-conventional treatments

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Published Papers (6 papers)

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Research

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14 pages, 2028 KiB  
Article
Ginger-Enriched Honey Attenuates Antibiotic Resistant Pseudomonas aeruginosa Quorum Sensing Virulence Factors and Biofilm Formation
by Wen-Jie Ng, Chin-Lu Hing, Choon-Boq Loo, Ee-Khang Hoh, Ian-Lung Loke and Kah-Yaw Ee
Antibiotics 2023, 12(7), 1123; https://doi.org/10.3390/antibiotics12071123 - 28 Jun 2023
Cited by 1 | Viewed by 2340
Abstract
Quorum sensing (QS) in Pseudomonas aeruginosa plays an essential role in virulence factors, biofilm formation as well as antibiotic resistance. Approaches that target virulence factors are known to be more sustainable than antibiotics in weakening the infectivity of bacteria. Although honey has been [...] Read more.
Quorum sensing (QS) in Pseudomonas aeruginosa plays an essential role in virulence factors, biofilm formation as well as antibiotic resistance. Approaches that target virulence factors are known to be more sustainable than antibiotics in weakening the infectivity of bacteria. Although honey has been shown to exert antipseudomonal activities, the enhancement of such activity in ginger-enriched honey is still unknown. The main objective of this study was to determine the impacts of honey and ginger-enriched honey on the QS virulence factors and biofilm formation of antibiotic resistant P. aeruginosa clinical isolates. Outcomes showed honey and/or ginger-enriched honey significantly reduced the protease activity, pyocyanin production and exotoxin A concentration of the isolates. The swarming and swimming motility together with biofilm formation in all clinical isolates were also significantly inhibited by both honey samples. Notable morphological alteration of bacterial cells was also observed using scanning electron microscopy. A principal component analysis (PCA) managed to distinguish the untreated group and treatment groups into two distinct clusters, although honey and ginger-enriched honey groups were not well differentiated. This study revealed the effectiveness of honey including ginger-enriched honey to attenuate QS virulence factors and biofilm formation of P. aeruginosa. Full article
(This article belongs to the Special Issue Honey: A Sweet Solution to the Growing Problem of Antimicrobial Resistance)
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13 pages, 3363 KiB  
Article
Impact of Mt. Olympus Honeys on Virulence Factors Implicated in Pathogenesis Exerted by Pseudomonas aeruginosa
by Eleni Tsavea, Paraskevi Tzika, Eleni Katsivelou, Anna Adamopoulou, Marios Nikolaidis, Grigorios D. Amoutzias and Dimitris Mossialos
Antibiotics 2023, 12(6), 998; https://doi.org/10.3390/antibiotics12060998 - 1 Jun 2023
Cited by 3 | Viewed by 2343
Abstract
The aim of this study was to examine the impact of twenty honey samples, harvested in Mt. Olympus (Greece), on the virulence factors implicated in P. aeruginosa pathogenesis. Six key virulence factors (protease and elastase activity, pyocyanin and pyoverdine concentration, biofilm formation, and [...] Read more.
The aim of this study was to examine the impact of twenty honey samples, harvested in Mt. Olympus (Greece), on the virulence factors implicated in P. aeruginosa pathogenesis. Six key virulence factors (protease and elastase activity, pyocyanin and pyoverdine concentration, biofilm formation, and swimming motility) were selected in order to assess the effect of the tested honeys compared with Manuka honey. All tested honeys demonstrated a significant inhibition of protease and elastase activity compared with the control. Six and thirteen honeys exerted superior protease (no inhibition zone) and elastase (values lower than 55%) activity, respectively, compared with Manuka honey. Seventeen tested honeys exhibited reduced pyoverdine production compared with the control; all tested honeys, except for one, showed an inhibitory effect on pyocyanin production compared with the control. Regarding swimming motility, nine tested honeys demonstrated significantly higher inhibition compared with Manuka honey. Honey concentrations (6% v/v and 8% v/v) had the most profound impact, as they reduced biofilm formation to less than 20% compared with the control. Overall, our data demonstrate a significant inhibition of the virulence factors in the tested Mt. Olympus honeys, highlighting the strong antimicrobial activity against P. aeruginosa, an antibiotic-resistant pathogen of growing concern, which is implicated in severe nosocomial infections globally. Full article
(This article belongs to the Special Issue Honey: A Sweet Solution to the Growing Problem of Antimicrobial Resistance)
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13 pages, 3440 KiB  
Article
Use of Medical-Grade Honey to Treat Clinically Infected Heel Pressure Ulcers in High-Risk Patients: A Prospective Case Series
by Georgios E. Papanikolaou, Georgios Gousios and Niels A. J. Cremers
Antibiotics 2023, 12(3), 605; https://doi.org/10.3390/antibiotics12030605 - 17 Mar 2023
Cited by 6 | Viewed by 8087
Abstract
Management of locally infected heel-pressure ulcers (HPUs) remains challenging, and given the increasing occurrence of infections resistant to antibiotic therapy and patients’ unwillingness to surgery, innovative and effective approaches must be considered. Medical-grade honey (MGH) could be an alternative therapeutic approach due to [...] Read more.
Management of locally infected heel-pressure ulcers (HPUs) remains challenging, and given the increasing occurrence of infections resistant to antibiotic therapy and patients’ unwillingness to surgery, innovative and effective approaches must be considered. Medical-grade honey (MGH) could be an alternative therapeutic approach due to its broad-spectrum antimicrobial activity and healing properties. This study aimed to present the high effectiveness and safety of MGH for the conservative treatment of clinically infected HPUs. In this case series, we have prospectively studied nine patients with local signs of infected HPUs. In all cases, HPUs persisted for more than 4 weeks, and previous treatments with topical antibiotics or antiseptic products were ineffective. All patients were at high-risk to develop HPU infection due to their advanced age (median age of 86 years), several comorbidities, and permanent immobility. All wounds were treated with MGH products (L-Mesitran), leading to infection resolution within 3–4 weeks and complete wound healing without complication. Considering the failure of previous treatments and the chronic nature of the wounds, MGH was an effective treatment. MGH-based products are clinically and cost-effective for treating hard-to-heal pressure ulcers such as HPUs. Thus, MGH can be recommended as an alternative or complementary therapy in wound healing. Full article
(This article belongs to the Special Issue Honey: A Sweet Solution to the Growing Problem of Antimicrobial Resistance)
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16 pages, 1258 KiB  
Article
Medical-Grade Honey Enhances the Healing of Caesarean Section Wounds and Is Similarly Effective to Antibiotics Combined with Povidone-Iodine in the Prevention of Infections—A Prospective Cohort Study
by Amadou Bocoum, Senna J. J. M. van Riel, Soumana Oumar Traoré, Elisabeth Florine Ngo Oum II, Youssouf Traoré, Augustin Tioukani Thera, Seydou Fané, Bakary Tientigui Dembele and Niels A. J. Cremers
Antibiotics 2023, 12(1), 92; https://doi.org/10.3390/antibiotics12010092 - 5 Jan 2023
Cited by 7 | Viewed by 3120
Abstract
Caesarean sections (CS) are becoming increasingly popular. The antibiotic resistance crisis and relentless risk of infections, especially in developing countries, demand alternative treatment options. Medical-grade honey (MGH) exerts antimicrobial and healing properties. This study aims to evaluate the effect of MGH treatment on [...] Read more.
Caesarean sections (CS) are becoming increasingly popular. The antibiotic resistance crisis and relentless risk of infections, especially in developing countries, demand alternative treatment options. Medical-grade honey (MGH) exerts antimicrobial and healing properties. This study aims to evaluate the effect of MGH treatment on CS wound healing and postoperative complications when compared to conventional treatment (antibiotics in combination with povidone-iodine). In this prospective cohort study, 766 CS patients were included and evenly divided into two groups. The treatment group (n = 383) received an MGH-based formulation (L-Mesitran Soft) and the control group (n = 383) received antibiotics (Amoxicillin) combined with povidone-iodine. The wound healing time and complication rate were determined for both groups, and subsequently, predisposing factors for complications among the baseline characteristics and non-patient-related parameters were determined. The baseline characteristics were similar for both study groups, supporting a homogenous distribution. Postoperative complications were experienced by 19.3% of the patients in the control group and 18.8% in the treatment (MGH) group. The treatment group experienced significantly more superficial pus discharge than the control group, while the latter experienced significantly more deeper pus discharge. BMI, age, duration of hospitalization, anesthesia, and duration of CS could affect the complication risk. MGH significantly enhanced wound healing until day 42. On average, the healing time with MGH was 19.12 ± 7.760 days versus 24.54 ± 8.168 days in the control group. MGH is a potent alternative treatment to antibiotics and povidone-iodine because while the complication risk is similar, MGH has additional benefits. MGH promotes wound healing and does not bear the risk of resistance. Full article
(This article belongs to the Special Issue Honey: A Sweet Solution to the Growing Problem of Antimicrobial Resistance)
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19 pages, 2585 KiB  
Article
Qualitative Characterization and Antifungal Activity of Romanian Honey and Propolis
by Mihaela Laura Vică, Mirel Glevitzky, Gabriela-Alina Dumitrel, Roxana Bostan, Horea Vladi Matei, Yordanka Kartalska and Maria Popa
Antibiotics 2022, 11(11), 1552; https://doi.org/10.3390/antibiotics11111552 - 4 Nov 2022
Cited by 11 | Viewed by 2086
Abstract
The purpose of this study was to review the physicochemical characterization of Romanian honey and propolis and their antifungal effect on different strains. As an indicator of environmental pollution, lead exceeded the allowed limits in two study areas. The relationship between the acidity [...] Read more.
The purpose of this study was to review the physicochemical characterization of Romanian honey and propolis and their antifungal effect on different strains. As an indicator of environmental pollution, lead exceeded the allowed limits in two study areas. The relationship between the acidity and electrical conductivity of polyfloral honey and the antioxidant activity with the total content of phenolics and flavonoids was investigated. The antifungal activity of 13 polyfloral honey and propolis samples from North-West and Central Romania and 12 samples from Alba County was investigated against six fungal strains: Aspergillus niger, Aspergillus flavus, Candida albicans, Penicillium chrysogenum, Rhizopus stolonifer, Fusarium oxysporum. All honey and propolis samples exhibited an antifungal effect. The most sensitive strains were P. chrysogenum and R. stolonifer for honey and P. chrysogenum and F. oxisporumn for propolis. A two-way analysis of variance was used to evaluate the correlations between the diameter of the inhibition zones for the strains and the propolis extracts. Statistical analysis demonstrated that the diameter of the inhibition zone was influenced by the strain type and the geographical origin of honey and propolis. Pearson’s correlation coefficient shows a significant positive linear relationship between the diameter of the inhibition zone and the flavonoid and phenol concentration of honey and propolis, respectively. Full article
(This article belongs to the Special Issue Honey: A Sweet Solution to the Growing Problem of Antimicrobial Resistance)
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Review

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34 pages, 2638 KiB  
Review
Physicochemical Characteristics and Bioactive Compounds of Different Types of Honey and Their Biological and Therapeutic Properties: A Comprehensive Review
by Mohammad A. Al-Kafaween, Mohammad Alwahsh, Abu Bakar Mohd Hilmi and Dina H. Abulebdah
Antibiotics 2023, 12(2), 337; https://doi.org/10.3390/antibiotics12020337 - 6 Feb 2023
Cited by 22 | Viewed by 6247
Abstract
Honey is considered to be a functional food with health-promoting properties. However, its potential health benefits can be affected by individual composition that varies between honey types. Although studies describing the health benefits of Tualang honey (TH), Kelulut honey (KH), and Sidr honey [...] Read more.
Honey is considered to be a functional food with health-promoting properties. However, its potential health benefits can be affected by individual composition that varies between honey types. Although studies describing the health benefits of Tualang honey (TH), Kelulut honey (KH), and Sidr honey (SH) are scarce, these honey types showed a comparable therapeutic efficacy to Manuka honey (MH). The purpose of this review is to characterise the physicochemical, biological, and therapeutic properties of TH, KH, and SH. Findings showed that these honeys have antibacterial, antifungal, antiviral, antioxidant, antidiabetic, antiobesity, anticancer, anti-inflammatory and wound-healing properties and effects on the cardiovascular system, nervous system, and respiratory system. The physicochemical characteristics of TH, KH, and SH were compared with MH and discussed, and results showed that they have high-quality contents and excellent biological activity sources. Flavonoids and polyphenols, which act as antioxidants, are two main bioactive molecules present in honey. The activity of honey depends on the type of bee, sources of nectar, and the geographic region where the bees are established. In conclusion, TH, KH, and SH could be considered as natural therapeutic agents for various medicinal purposes compared with MH. Therefore, TH, KH, and SH have a great potential to be developed for modern medicinal use. Full article
(This article belongs to the Special Issue Honey: A Sweet Solution to the Growing Problem of Antimicrobial Resistance)
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