Octenidine: antimicrobial activity and clinical efficacy

Concerted efforts by healthcare professionals and heightened public awareness has reduced the incidence of hospital-acquired infections in recent years. For example, the number of reports of meticillinresistant Staphylococcus aureus (MRSA) bacteraemia in England declined by 52% between January and March 2009, and January and March 2011. Similarly, the number of Clostridium difficile infections declined by 65% between the quarterly average during 2007/8 and January to March 2011 (Health Protection Agency [HPA], 2011). Nevertheless, English trusts reported 334 and 4827 cases of MRSA bacteraemia and Clotridium difficile infection respectively between January and March 2011 (HPA, 2011). Clearly, healthcare professionals, and society more generally, cannot yet lower their bacteriological guards. Secondly, skin wounds typically harbour a diverse population of bacteria. In one study (James et al, 2008), Staphylococcus was the bacterial genus most frequently isolated from wounds, recovered from 65% of chronic wounds and 60% of acute wounds. Nevertheless, 13 different bacterial genera infected chronic wounds, compared with six genera isolated from acute wounds (James et al, 2008). Another study (Dowd et al, 2008), using sophisticated molecular analytical techniques, isolated numerous genera, including Staphylococcus, Pseudomonas, Peptoniphilus, Enterobacter, Stenotrophomonas, Finegoldia and Serratia species from biofilms in chronic wounds. Each wound type differed in the characteristic bacterial population. For example, 62% of bacterial types isolated from pressure ulcers were anaerobes, compared with almost 30% from diabetic foot ulcers. Molecular analysis also identified bacteria that are not usually recognised as wound pathogens, including Abiotrophia para-adiacens and Rhodopseudomonas species (Dowd et al, 2008). Therefore, a broad spectrum of action is a prerequisite for antibacterial wound care products and decolonisation.