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Key Summary Points
Why carry out this study? |
Multidrug-resistant (MDR) bacteria are on the rise and have been identified in wound bacterial isolates from Ukrainian war victims treated in Ukraine and across Europe. There is a high risk that this will exacerbate the further spread of these MDR bacteria. Few antimicrobial options are left for these patients. |
Does ILP100, a drug candidate accelerating healing of skin wounds (composed of a Limosilactobacillus reuteri expressing human chemokine CXCL12), have antimicrobial effects on MDR bacteria? |
What was learned from the study? |
ILP100 may have a better antimicrobial effect than clinically relevant antibiotics. |
ILP100 demonstrated potent antimicrobial effects against a range of infectious bacteria, including MDR isolates. This result was confirmed in three different and relevant antimicrobial susceptibility assays. |
ILP100 effectively eliminated MDR wound pathogens, which reveals a promising strategy for the development of new classes of urgently needed antimicrobials. |
Introduction
The development of antimicrobial resistance and the increased incidence of multidrug-resistant (MDR) healthcare-associated infections are exacerbated by geopolitical conflicts [1]. In agreement with this, extreme MDR Gram-negative infectious bacteria, including hypervirulent pan-resistant (PDR) isolates, were detected among wound isolates from hospitalized patients in Ukraine following the Russian invasion [2, 3]. The spread of MDR strains throughout Europe has been confirmed, as identical carbapenem-resistant clones of Acinetobacter baumannii found at Ukrainian military hospitals were detected in injured Ukrainian soldiers treated in German hospitals [4, 5–6].
Difficult wounds have greater risks of acquiring infections that require antibiotic treatment. There are today limited means to accelerate wound healing. In fact, there are no suitable treatments to wounds inflicted during armed conflicts, as available therapies are based on growth factors or stem cells with very limited shelf life requiring an unbroken cold chain. ILP100 (emilimogene sigulatibac) is a first-in-class drug candidate with a demonstrated favorable and well-tolerated safety profile, and accelerated healing of 6–10 days in the different cohorts of a first-in-human, double blinded, randomized controlled clinical trial [7]. ILP100 comprises genetically modified, freeze-dried Limosilactobacillus reuteri and has a good stability and shelf life at 25 °C, making it suited for wide use especially during logistically challenging situations. The drug candidate is currently being evaluated in a phase 2 clinical trial in diabetic foot ulcers, and the mechanism of action involves...