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In vitro data – addressing the WHO crisis bacteria

On 27 February 2017, the World Health Organization published its first-ever list of antibiotic-resistant “priority pathogens” – a catalogue of 12 families of bacteria that pose the greatest threat to human health.​​

Antimicrobial resistance is one of the most urgent health risks of our time and threatens to undo a century of medical progress.

Dr Tedros Adhanom Ghebreyesus, WHO Director-General

The development of multi-drug resistance in already difficult to treat pathogens has prompted the WHO to declare a list of crisis bacteria.

Matoke’s Reactive Oxygen® technology has been shown to be active against all these crisis bacteria through different laboratories including Public Health England.

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What is it
Priority 1: CRITICAL
Acinetobacter baumannii, carbapenem-resistant
Largely associated with hospital infections and infected soldiers in combat zones. Gained notoriety in Iraq where it caused a high incidence of multi drug resistant bloodstream infections
Priority 1: CRITICAL
Pseudomonas aeruginosa, carbapenem-resistant
The most common infection in patients who have been hospitalised longer than one week. Associated with pneumonia and sepsis. Highly opportunistic - often found in cystic fibrosis patients and in burn wounds
Priority 1: CRITICAL
Enterobacteriaceae, carbapenem-resistant, ESBL-producing
Large family of gram-negative bacteria. Including most famously Yersinia Pestis (better known as the Plague or Black Death), also Salmonella and Shigella amongst others
Priority 2: HIGH
Enterococcus faecium, vancomycin-resistant
A leading cause of multi-drug resistant enterococcal infections in the United States. In a study of ICU's it was found between 80% and 90% of device-associated infections (due to central lines, urinary drainage catheters and ventilators) were vancomycin and ampicillin resistant E.faecium. ¹ Can lead to UTI's, neonatal meningitis and endocarditis
Priority 2: HIGH
Staphylococcus aureus, methicillin-resistant, vancomycin-intermediate and resistant
Common cause of skin infections including abscesses, pimples, impetigo, boils, scalded skin syndrome, respiratory infections such as sinusitis and food poisoning. Can cause life threatening conditions such as pneumonia, meningitis, osteomyelitis, endocarditis and sepsis
Priority 2: HIGH
Helicobacter pylori, clarithromycin-resistant
A primary cause of heartburn, reflux disorders, gastritis and ulcers of both the stomach and the duodenum. H.Pylori can also lead to stomach cancer
Priority 2: HIGH
Campylobacter spp., fluoroquinolone-resistant
A genus of gram-negative bacteria. Main natural reservoir is poultry. Humans often become infected from eating contaminated food or coming into direct contact with infected animals. Widely recognised as the leading cause of bacterial foodborne diarrheal disease worldwide. Symptoms range from mild to serious
Priority 2: HIGH
Salmonellae, fluoroquinolone-resistant
Causes Salmonella - a common bacterial disease affecting the intestinal tract. Most common cause of infection is contaminated water or food
Priority 2: HIGH
Neisseria gonorrhoeae, cephalosporin-resistant, fluoroquinolone-resistant
STI causing gonorrhoea, as well as other forms of gonococcal disease such as disseminated gonococcemia, septic arthritis, and gonococcal ophthalmia neonatorum
Priority 3: MEDIUM
Streptococcus pneumoniae, penicillin-non-susceptible
A major cause of Pneumonia, the main cause of community acquired pneumonia and meningitis in children and the elderly² and of septicemia in HIV patients. Also associated with bronchitis, rhinitis, acute sinusitis, otitis media, conjunctivitis, meningitis, sepsis, osteomyelitis, septic arthritis, endocarditis, peritonitis, pericarditis, cellulitis, and brain abscess
Priority 3: MEDIUM
Haemophilus influenzae, ampicillin-resistant
Mistakenly considered to be the cause of influenza until 1933, when the viral cause became apparent. Still colloquially known as bacterial influenza, repsonsible for bacteremia, pneumonia, epiglottitis and acute bacterial meningitis
Priority 3: MEDIUM
Shigella spp., fluoroquinolone-resistant
One of the leading bacterial causes of diarrhea worldwide, causing an estimated 80-165million cases, number of deaths is estimated between 74,000 and 600,000 per year. One of the top four pathogens that cause moderate-to-severe diarrhea in African and South Asian children³

Electron Microscopy images of Reactive Oxygen® killing Acinetobacter baumanii and MRSA, both WHO crisis pathogens

Time kill curves for Reactive Oxygen® against MRSA and Acinetobacter, showing rapid and complete bacterial kill

MRSA time kill

Acinetobacter time kill

Time kill data showing in vitro efficacy Reactive Oxygen®. Microbiology testing and analysis conducted by Public Health England at Porton Down.

Clinical case studies

Reactive Oxygen® technology has been used with great success in a considerable number of clinical cases and in a wide variety of clinical settings.

Peripheral vascular disease

A 77 year old patient with peripheral vascular disease presented with an infected sloughy discharging leg ulcer which was not healing. Samples were collected for microbiology and the ulcer washed with saline to remove slough. The microbiology sample showed a mixed growth of organsims which included MRSA, resistant coliforms and Pseudomonas aeruginosa. The vascular surgery team were keen to start broad spectrum intravenous antibiotics with meropenem (a last resort agent). As the patient did not have sepsis or spreading infection, antibiotics were withheld and topical treatment with Reactive Oxygen® was commenced. By day 10 the ulcer was clean and showed health healing granulation tissue.​

Dryden M, Milward G, Saeed K. Infection prevention in wounds with Surgihoney.
J Hosp Infect. 2014 Oct;88(2):121-2. doi: 10.1016/j.jhin.2014.07.008. Epub 2014 Aug 1.​

Day 1
Day 4
Day 10

Surgical wound

A neonate who had had abdominal surgery shows (Day 0) early infection and granuloma caused by MRSA at the edge of the wound.

The wound was treated regularly with only Reactive Oxygen® without systemic antibiotics. The result by day 19 was complete healing with scarring and eradication of MRSA.

Day 0
Day 19

Necrotising Fasciitis with Multi-Drug Resistant Colonisers #1

A 70 year old patient had returned from India and diagnosed with necrotising fasciitis.

Surgical debridement and IV antibiotics to treat causative organisms Staph. aureus and Strep.pyogenes. Soft tissue also colonised with pan-resistant Klebsiella pneumoniae exhibiting NDM and OXA 48 beta lactamases in urine and soft tissue. Soft tissue treated with Reactive Oxygen®.

Dryden M, Milward G, Saeed K. Infection prevention in wounds with Surgihoney.
J Hosp Infect. 2014 Oct;88(2):121-2. doi: 10.1016/j.jhin.2014.07.008. Epub 2014 Aug 1.​

Day 1 - necrotising lesions infected with multi-resistant bacteria
Day 1 - necrotising lesions infected with multi-resistant bacteria
After debridement. Open lesions colonised with pan-resistant Gram negatives
After debridement. Open lesions colonised with pan-resistant Gram negatives

Necrotising Fasciitis with Multi-Drug Resistant Colonisers #2

Swabs showed complete eradication of the multiply resistant Gram-negatives which would have presented a major infection control risk to the hospital. The wound was successfully resolved and avoided limb amputation.

Dryden M, Milward G, Saeed K. Infection prevention in wounds with Surgihoney.
J Hosp Infect. 2014 Oct;88(2):121-2. doi: 10.1016/j.jhin.2014.07.008. Epub 2014 Aug 1.​

After further Reactive Oxygen® treatment and skin grafting

Vascular long line

A 48 year old business executive with breast cancer had a central vascular long line in place for chemotherapy. After a work trip to Greece, the patient presented to the clinic, concerned about redness around the line exit site.

A microbiological sample showed a pan-resistant Klebsiella pneumonia (carbapenemase producer). There was a risk of bacteraemia and sepsis from the line with little option to treat with antibiotics. The patient was likely to become more immunosuppressed around the next round of chemotherapy.

The line site was treated with Reactive Oxygen®. The redness settled and the multi-resistant organism was eradicated.

Dryden M, Milward G, Saeed K. Infection prevention in wounds with Surgihoney.
J Hosp Infect. 2014 Oct;88(2):121-2. doi: 10.1016/j.jhin.2014.07.008. Epub 2014 Aug 1.​

Multiple fractures of tibia

An 18-year-old girl run over by a tractor suffered multiple fractures of the tibia. Image 1 shows that the soft tissue has become heavily colonised and infected with resistant coliforms and there is a risk of infection proceeding down the pins which could result in infection of the bone and loss of the limb.

After daily treatment of the soft tissue with Reactive Oxygen®, image 2 shows a reduction in inflammation, control of microbial growth and prevention of deep seating infection.

Image 1
Image 2