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Delarbre D, Lavrard P, Elias A, Bossi V, Kacel I, Janvier F, Fournier PE. Bacterial DNA enrichment for low-inoculum fracture-related infection diagnostic using high-throughput sequencing. Diagn Microbiol Infect Dis 2024; 110:116411. [PMID: 39018934 DOI: 10.1016/j.diagmicrobio.2024.116411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 06/20/2024] [Accepted: 06/20/2024] [Indexed: 07/19/2024]
Abstract
One of the main barriers for the implementation of metagenomic sequencing in routine diagnosis of infectious diseases is the presence of host DNA. While several enrichment methods are likely to overcome this issue, their effectiveness for specimens such as bone in the case of chronic infections remains to be determined. We compared the relevance of two methods for bacterial DNA enrichment when compared to a reference protocol during pretreatment of bone samples from fracture-related infections before HTS by both Illumina Miseq and Oxford Nanopore Technology (ONT). The bacterial/human DNA ratio was higher for either protocols than the reference technique (p = 0.00012), without any significant difference between them. HTS sensitivity over culture ranged from 21.7 % to 85 %. The ability of the studied protocols to improve the bacterial/human DNA ratio depends on the sequencing technique employed. In this context, there is room for improvement in enhancing the sensitivity of HTS for diagnostic purpose.
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Affiliation(s)
- David Delarbre
- Division of Internal Medicine and Infectious Diseases, Military Teaching Hospital Sainte-Anne, 2, boulevard Sainte-Anne, BP 600, Cedex 9, 83800, Toulon, France; Aix-Marseille Université, Institut de Recherche pour le Développement (IRD), UMR (VITROME), Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France.
| | - Philippe Lavrard
- Aix-Marseille Université, Institut de Recherche pour le Développement (IRD), UMR (VITROME), Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France; Institut Méditerranée-Infection, Marseille, France
| | - Antoine Elias
- Centre Hospitalier Intercommunal Toulon - La Seyne sur Mer (C.H.I.T.S.), Toulon, France
| | | | - Idir Kacel
- Institut Méditerranée-Infection, Marseille, France
| | - Fréderic Janvier
- Division of microbiology, Military Teaching Hospital Sainte-Anne, 2, boulevard Sainte-Anne, BP 600, Cedex 9, 83800, Toulon, France
| | - Pierre-Edouard Fournier
- Aix-Marseille Université, Institut de Recherche pour le Développement (IRD), UMR (VITROME), Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France; Institut Méditerranée-Infection, Marseille, France
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Debs P, Boutin RD, Smith SE, Babic M, Blankenbaker D, Chandra V, Murphey M, Thottacherry E, Kreulen C, Fayad LM. Chronic Nonspinal Osteomyelitis in Adults: Consensus Recommendations on Percutaneous Bone Biopsies from the Society of Academic Bone Radiologists. Radiology 2024; 311:e231348. [PMID: 38625010 PMCID: PMC11070610 DOI: 10.1148/radiol.231348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
The diagnosis and management of chronic nonspinal osteomyelitis can be challenging, and guidelines regarding the appropriateness of performing percutaneous image-guided biopsies to acquire bone samples for microbiological analysis remain limited. An expert panel convened by the Society of Academic Bone Radiologists developed and endorsed consensus statements on the various indications for percutaneous image-guided biopsies to standardize care and eliminate inconsistencies across institutions. The issued statements pertain to several commonly encountered clinical presentations of chronic osteomyelitis and were supported by a literature review. For most patients, MRI can help guide management and effectively rule out osteomyelitis when performed soon after presentation. Additionally, in the appropriate clinical setting, open wounds such as sinus tracts and ulcers, as well as joint fluid aspirates, can be used for microbiological culture to determine the causative microorganism. If MRI findings are positive, surgery is not needed, and alternative sites for microbiological culture are not available, then percutaneous image-guided biopsies can be performed. The expert panel recommends that antibiotics be avoided or discontinued for an optimal period of 2 weeks prior to a biopsy whenever possible. Patients with extensive necrotic decubitus ulcers or other surgical emergencies should not undergo percutaneous image-guided biopsies but rather should be admitted for surgical debridement and intraoperative cultures. Multidisciplinary discussion and approach are crucial to ensure optimal diagnosis and care of patients diagnosed with chronic osteomyelitis.
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Affiliation(s)
- Patrick Debs
- From The Russell H. Morgan Department of Radiology and Radiological Science (P.D., L.M.F.), and Departments of Orthopaedic Surgery (L.M.F.) and Oncology (L.M.F.), The Johns Hopkins University Medical Institutions, 600 N Wolfe St, JHOC 3014, Baltimore, MD 21287; Department of Radiology (R.D.B.) and Division of Vascular Surgery, Department of Surgery (V.C.), Stanford University School of Medicine, Palo Alto, Calif; Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (S.E.S.); Infectious Disease Department, Cleveland Clinic, Cleveland, Ohio (M.B.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.B.); Musculoskeletal Imaging and Neuroradiology, ACR Institute for Radiologic Pathology, Silver Spring, Md (M.M.); Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, Calif (E.T.); and Department of Orthopaedic Surgery, University of California-Davis, Sacramento, Calif (C.K.)
| | - Robert D Boutin
- From The Russell H. Morgan Department of Radiology and Radiological Science (P.D., L.M.F.), and Departments of Orthopaedic Surgery (L.M.F.) and Oncology (L.M.F.), The Johns Hopkins University Medical Institutions, 600 N Wolfe St, JHOC 3014, Baltimore, MD 21287; Department of Radiology (R.D.B.) and Division of Vascular Surgery, Department of Surgery (V.C.), Stanford University School of Medicine, Palo Alto, Calif; Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (S.E.S.); Infectious Disease Department, Cleveland Clinic, Cleveland, Ohio (M.B.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.B.); Musculoskeletal Imaging and Neuroradiology, ACR Institute for Radiologic Pathology, Silver Spring, Md (M.M.); Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, Calif (E.T.); and Department of Orthopaedic Surgery, University of California-Davis, Sacramento, Calif (C.K.)
| | - Stacy E Smith
- From The Russell H. Morgan Department of Radiology and Radiological Science (P.D., L.M.F.), and Departments of Orthopaedic Surgery (L.M.F.) and Oncology (L.M.F.), The Johns Hopkins University Medical Institutions, 600 N Wolfe St, JHOC 3014, Baltimore, MD 21287; Department of Radiology (R.D.B.) and Division of Vascular Surgery, Department of Surgery (V.C.), Stanford University School of Medicine, Palo Alto, Calif; Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (S.E.S.); Infectious Disease Department, Cleveland Clinic, Cleveland, Ohio (M.B.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.B.); Musculoskeletal Imaging and Neuroradiology, ACR Institute for Radiologic Pathology, Silver Spring, Md (M.M.); Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, Calif (E.T.); and Department of Orthopaedic Surgery, University of California-Davis, Sacramento, Calif (C.K.)
| | - Maja Babic
- From The Russell H. Morgan Department of Radiology and Radiological Science (P.D., L.M.F.), and Departments of Orthopaedic Surgery (L.M.F.) and Oncology (L.M.F.), The Johns Hopkins University Medical Institutions, 600 N Wolfe St, JHOC 3014, Baltimore, MD 21287; Department of Radiology (R.D.B.) and Division of Vascular Surgery, Department of Surgery (V.C.), Stanford University School of Medicine, Palo Alto, Calif; Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (S.E.S.); Infectious Disease Department, Cleveland Clinic, Cleveland, Ohio (M.B.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.B.); Musculoskeletal Imaging and Neuroradiology, ACR Institute for Radiologic Pathology, Silver Spring, Md (M.M.); Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, Calif (E.T.); and Department of Orthopaedic Surgery, University of California-Davis, Sacramento, Calif (C.K.)
| | - Donna Blankenbaker
- From The Russell H. Morgan Department of Radiology and Radiological Science (P.D., L.M.F.), and Departments of Orthopaedic Surgery (L.M.F.) and Oncology (L.M.F.), The Johns Hopkins University Medical Institutions, 600 N Wolfe St, JHOC 3014, Baltimore, MD 21287; Department of Radiology (R.D.B.) and Division of Vascular Surgery, Department of Surgery (V.C.), Stanford University School of Medicine, Palo Alto, Calif; Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (S.E.S.); Infectious Disease Department, Cleveland Clinic, Cleveland, Ohio (M.B.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.B.); Musculoskeletal Imaging and Neuroradiology, ACR Institute for Radiologic Pathology, Silver Spring, Md (M.M.); Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, Calif (E.T.); and Department of Orthopaedic Surgery, University of California-Davis, Sacramento, Calif (C.K.)
| | - Venita Chandra
- From The Russell H. Morgan Department of Radiology and Radiological Science (P.D., L.M.F.), and Departments of Orthopaedic Surgery (L.M.F.) and Oncology (L.M.F.), The Johns Hopkins University Medical Institutions, 600 N Wolfe St, JHOC 3014, Baltimore, MD 21287; Department of Radiology (R.D.B.) and Division of Vascular Surgery, Department of Surgery (V.C.), Stanford University School of Medicine, Palo Alto, Calif; Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (S.E.S.); Infectious Disease Department, Cleveland Clinic, Cleveland, Ohio (M.B.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.B.); Musculoskeletal Imaging and Neuroradiology, ACR Institute for Radiologic Pathology, Silver Spring, Md (M.M.); Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, Calif (E.T.); and Department of Orthopaedic Surgery, University of California-Davis, Sacramento, Calif (C.K.)
| | - Mark Murphey
- From The Russell H. Morgan Department of Radiology and Radiological Science (P.D., L.M.F.), and Departments of Orthopaedic Surgery (L.M.F.) and Oncology (L.M.F.), The Johns Hopkins University Medical Institutions, 600 N Wolfe St, JHOC 3014, Baltimore, MD 21287; Department of Radiology (R.D.B.) and Division of Vascular Surgery, Department of Surgery (V.C.), Stanford University School of Medicine, Palo Alto, Calif; Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (S.E.S.); Infectious Disease Department, Cleveland Clinic, Cleveland, Ohio (M.B.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.B.); Musculoskeletal Imaging and Neuroradiology, ACR Institute for Radiologic Pathology, Silver Spring, Md (M.M.); Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, Calif (E.T.); and Department of Orthopaedic Surgery, University of California-Davis, Sacramento, Calif (C.K.)
| | - Elizabeth Thottacherry
- From The Russell H. Morgan Department of Radiology and Radiological Science (P.D., L.M.F.), and Departments of Orthopaedic Surgery (L.M.F.) and Oncology (L.M.F.), The Johns Hopkins University Medical Institutions, 600 N Wolfe St, JHOC 3014, Baltimore, MD 21287; Department of Radiology (R.D.B.) and Division of Vascular Surgery, Department of Surgery (V.C.), Stanford University School of Medicine, Palo Alto, Calif; Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (S.E.S.); Infectious Disease Department, Cleveland Clinic, Cleveland, Ohio (M.B.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.B.); Musculoskeletal Imaging and Neuroradiology, ACR Institute for Radiologic Pathology, Silver Spring, Md (M.M.); Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, Calif (E.T.); and Department of Orthopaedic Surgery, University of California-Davis, Sacramento, Calif (C.K.)
| | - Christopher Kreulen
- From The Russell H. Morgan Department of Radiology and Radiological Science (P.D., L.M.F.), and Departments of Orthopaedic Surgery (L.M.F.) and Oncology (L.M.F.), The Johns Hopkins University Medical Institutions, 600 N Wolfe St, JHOC 3014, Baltimore, MD 21287; Department of Radiology (R.D.B.) and Division of Vascular Surgery, Department of Surgery (V.C.), Stanford University School of Medicine, Palo Alto, Calif; Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (S.E.S.); Infectious Disease Department, Cleveland Clinic, Cleveland, Ohio (M.B.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.B.); Musculoskeletal Imaging and Neuroradiology, ACR Institute for Radiologic Pathology, Silver Spring, Md (M.M.); Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, Calif (E.T.); and Department of Orthopaedic Surgery, University of California-Davis, Sacramento, Calif (C.K.)
| | - Laura M Fayad
- From The Russell H. Morgan Department of Radiology and Radiological Science (P.D., L.M.F.), and Departments of Orthopaedic Surgery (L.M.F.) and Oncology (L.M.F.), The Johns Hopkins University Medical Institutions, 600 N Wolfe St, JHOC 3014, Baltimore, MD 21287; Department of Radiology (R.D.B.) and Division of Vascular Surgery, Department of Surgery (V.C.), Stanford University School of Medicine, Palo Alto, Calif; Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (S.E.S.); Infectious Disease Department, Cleveland Clinic, Cleveland, Ohio (M.B.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.B.); Musculoskeletal Imaging and Neuroradiology, ACR Institute for Radiologic Pathology, Silver Spring, Md (M.M.); Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, Calif (E.T.); and Department of Orthopaedic Surgery, University of California-Davis, Sacramento, Calif (C.K.)
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Gómez-Alonso IS, Betanzos-Cabrera G, Moreno-Lafont MC, Cancino-Diaz ME, García-Pérez BE, Cancino-Diaz JC. Non-biofilm-forming Staphylococcus epidermidis planktonic cell supernatant induces alterations in osteoblast biological function. Sci Rep 2024; 14:1807. [PMID: 38245549 PMCID: PMC10799936 DOI: 10.1038/s41598-024-51899-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/10/2024] [Indexed: 01/22/2024] Open
Abstract
Staphylococcal biofilms significantly contribute to prosthetic joint infection (PJI). However, 40% of S. epidermidis PJI isolates do not produce biofilms, which does not explain the role of biofilms in these cases. We studied whether the supernatant from planktonic S. epidermidis alters osteoblast function. Non-biofilm-forming S. epidermidis supernatants (PJI- clinical isolate, healthy skin isolate (HS), and ATCC12228 reference strain) and biofilm-forming supernatants (PJI+ clinical isolate, ATCC35984 reference strain, and Staphylococcus aureus USA300 reference strain) were included. Osteoblasts stimulated with supernatants from non-biofilm-forming isolates for 3, 7, and 14 days showed significantly reduced cellular DNA content compared with unstimulated osteoblasts, and apoptosis was induced in these osteoblasts. Similar results were obtained for biofilm-forming isolates, but with a greater reduction in DNA content and higher apoptosis. Alkaline phosphatase activity and mineralization were significantly reduced in osteoblasts treated with supernatants from non-biofilm-forming isolates compared to the control at the same time points. However, the supernatants from biofilm-forming isolates had a greater effect than those from non-biofilm-forming isolates. A significant decrease in the expression of ATF4, RUNX2, ALP, SPARC, and BGLAP, and a significant increase in RANK-L expression were observed in osteoblasts treated with both supernatants. These results demonstrate that the supernatants of the S. epidermidis isolate from the PJI- and HS (commensal) with a non-biofilm-forming phenotype alter the function of osteoblasts (apoptosis induction, failure of cell differentiation, activation of osteoblasts, and induction of bone resorption), similar to biofilm-forming isolates (PJI+, ATCC35984, and S. aureus USA300), suggesting that biofilm status contributes to impaired osteoblast function and that the planktonic state can do so independently of biofilm production.
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Affiliation(s)
- Itzia Sidney Gómez-Alonso
- Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Manuel Carpio, Plutarco Elías Calles, Miguel Hidalgo, 11350, Mexico City, Mexico
| | - Gabriel Betanzos-Cabrera
- Área Académica de Nutrición, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Carretera Pachuca-Actopan Camino a Tilcuautla S/N., Pueblo San Juan Tilcuautla, 42160, Pachuca Hidalgo, Mexico
| | - Martha Cecilia Moreno-Lafont
- Departamento de Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Manuel Carpio, Plutarco Elías Calles, Miguel Hidalgo, 11350, Mexico City, Mexico
| | - Mario Eugenio Cancino-Diaz
- Departamento de Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Manuel Carpio, Plutarco Elías Calles, Miguel Hidalgo, 11350, Mexico City, Mexico
| | - Blanca Estela García-Pérez
- Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Manuel Carpio, Plutarco Elías Calles, Miguel Hidalgo, 11350, Mexico City, Mexico
| | - Juan Carlos Cancino-Diaz
- Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Manuel Carpio, Plutarco Elías Calles, Miguel Hidalgo, 11350, Mexico City, Mexico.
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Casillo A, D’Angelo C, Imbimbo P, Monti DM, Parrilli E, Lanzetta R, Gomez d’Ayala G, Mallardo S, Corsaro MM, Duraccio D. Aqueous Extracts from Hemp Seeds as a New Weapon against Staphylococcus epidermidis Biofilms. Int J Mol Sci 2023; 24:16026. [PMID: 38003214 PMCID: PMC10671263 DOI: 10.3390/ijms242216026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
This study investigated the antibiofilm activity of water-soluble extracts obtained under different pH conditions from Cannabis sativa seeds and from previously defatted seeds. The chemical composition of the extracts, determined through GC-MS and NMR, revealed complex mixtures of fatty acids, monosaccharides, amino acids and glycerol in ratios depending on extraction pH. In particular, the extract obtained at pH 7 from defatted seeds (Ex7d) contained a larger variety of sugars compared to the others. Saturated and unsaturated fatty acids were found in all of the analysed extracts, but linoleic acid (C18:2) was detected only in the extracts obtained at pH 7 and pH 10. The extracts did not show cytotoxicity to HaCaT cells and significantly inhibited the formation of Staphylococcus epidermidis biofilms. The exception was the extract obtained at pH 10, which appeared to be less active. Ex7d showed the highest antibiofilm activity, i.e., around 90%. Ex7d was further fractionated by HPLC, and the antibiofilm activity of all fractions was evaluated. The 2D-NMR analysis highlighted that the most active fraction was largely composed of glycerolipids. This evidence suggested that these molecules are probably responsible for the observed antibiofilm effect but does not exclude a possible synergistic contribution by the other components.
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Affiliation(s)
- Angela Casillo
- Department of Chemical Sciences, University of Naples “Federico II”, Via Cintia 21, 80126 Napoli, Italy; (A.C.); (C.D.); (P.I.); (D.M.M.); (E.P.); (R.L.); (M.M.C.)
| | - Caterina D’Angelo
- Department of Chemical Sciences, University of Naples “Federico II”, Via Cintia 21, 80126 Napoli, Italy; (A.C.); (C.D.); (P.I.); (D.M.M.); (E.P.); (R.L.); (M.M.C.)
| | - Paola Imbimbo
- Department of Chemical Sciences, University of Naples “Federico II”, Via Cintia 21, 80126 Napoli, Italy; (A.C.); (C.D.); (P.I.); (D.M.M.); (E.P.); (R.L.); (M.M.C.)
| | - Daria Maria Monti
- Department of Chemical Sciences, University of Naples “Federico II”, Via Cintia 21, 80126 Napoli, Italy; (A.C.); (C.D.); (P.I.); (D.M.M.); (E.P.); (R.L.); (M.M.C.)
| | - Ermenegilda Parrilli
- Department of Chemical Sciences, University of Naples “Federico II”, Via Cintia 21, 80126 Napoli, Italy; (A.C.); (C.D.); (P.I.); (D.M.M.); (E.P.); (R.L.); (M.M.C.)
| | - Rosa Lanzetta
- Department of Chemical Sciences, University of Naples “Federico II”, Via Cintia 21, 80126 Napoli, Italy; (A.C.); (C.D.); (P.I.); (D.M.M.); (E.P.); (R.L.); (M.M.C.)
| | - Giovanna Gomez d’Ayala
- Institute of Polymers, Composites and Biomaterials (IPCB)-CNR, Via Campi Flegrei 34, 80078 Pozzuoli, Italy;
| | - Salvatore Mallardo
- Institute of Polymers, Composites and Biomaterials (IPCB)-CNR, Via Campi Flegrei 34, 80078 Pozzuoli, Italy;
| | - Maria Michela Corsaro
- Department of Chemical Sciences, University of Naples “Federico II”, Via Cintia 21, 80126 Napoli, Italy; (A.C.); (C.D.); (P.I.); (D.M.M.); (E.P.); (R.L.); (M.M.C.)
| | - Donatella Duraccio
- Institute of Sciences and Technologies for Sustainable Energy and Mobility (STEMS)-CNR, Strada Delle Cacce 73, 10135 Torino, Italy;
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Rimoldi SG, Brioschi D, Curreli D, Salari F, Pagani C, Tamoni A, Longobardi C, Bosari R, Rizzo A, Landonio S, Coen M, Passerini M, Gismondo MR, Gori A, Manzotti A. Traditional Cultures versus Next Generation Sequencing for Suspected Orthopedic Infection: Experience Gained from a Reference Centre. Antibiotics (Basel) 2023; 12:1588. [PMID: 37998790 PMCID: PMC10668678 DOI: 10.3390/antibiotics12111588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 10/25/2023] [Accepted: 10/31/2023] [Indexed: 11/25/2023] Open
Abstract
(Background) The diagnosis and the antimicrobial treatment of orthopedic infection are challenging, especially in cases with culture-negative results. New molecular methods, such as next-generation sequencing (NGS), promise to overcome some limitations of the standard culture, such as the detection of difficult-to-grow bacteria. However, data are scarce regarding the impact of molecular techniques in real-life scenarios. (Methods) We included cases of suspected orthopedic infection treated with surgery from May 2021 to September 2023. We combined traditional cultures with NGS. For NGS, we performed a metagenomic analysis of ribosomal 16s, and we queried dedicated taxonomic libraries to identify the species. To avoid false positive results, we set a cut-off of 1000 counts of the percentage of frequency of reads. (Results) We included 49 patients in our study. Our results show the presence of bacteria in 36/49 (73%) and 29/49 (59%) cases studied with NGS and traditional cultures, respectively. The concordance rate was 61%. Among the 19/49 discordant cases, in 11/19 cases, cultures were negative and NGS positive; in 4/19, cultures were positive and NGS negative; and in the remaining 4/19, different species were detected by traditional cultures and NGS. (Conclusions) Difficult-to-grow microorganisms, such as slow-growing anaerobic bacteria, were better detected by NGS compared to traditional culture in our study. However, more data to distinguish between true pathogens and contaminants are needed. NGS can be an additional tool to be used for the diagnosis of orthopedic infections and the choice of appropriate antimicrobial therapy.
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Affiliation(s)
- Sara Giordana Rimoldi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, “L. Sacco” University Hospital, Via Giovanni Battista Grassi n. 74, 20157 Milan, Italy; (S.G.R.)
| | - Davide Brioschi
- Orthopedic Unit, ASST Fatebenefratelli Sacco, “L. Sacco” University Hospital, Via Giovanni Battista Grassi n. 74, 20157 Milan, Italy
| | - Daniele Curreli
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, “L. Sacco” University Hospital, Via Giovanni Battista Grassi n. 74, 20157 Milan, Italy; (S.G.R.)
| | - Federica Salari
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, “L. Sacco” University Hospital, Via Giovanni Battista Grassi n. 74, 20157 Milan, Italy; (S.G.R.)
| | - Cristina Pagani
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, “L. Sacco” University Hospital, Via Giovanni Battista Grassi n. 74, 20157 Milan, Italy; (S.G.R.)
| | - Alessandro Tamoni
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, “L. Sacco” University Hospital, Via Giovanni Battista Grassi n. 74, 20157 Milan, Italy; (S.G.R.)
| | - Concetta Longobardi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, “L. Sacco” University Hospital, Via Giovanni Battista Grassi n. 74, 20157 Milan, Italy; (S.G.R.)
| | - Raffaella Bosari
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, “L. Sacco” University Hospital, Via Giovanni Battista Grassi n. 74, 20157 Milan, Italy; (S.G.R.)
| | - Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, “L. Sacco” University Hospital, Via Giovanni Battista Grassi n. 74, 20157 Milan, Italy; (S.G.R.)
| | - Simona Landonio
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, “L. Sacco” University Hospital, Via Giovanni Battista Grassi n. 74, 20157 Milan, Italy (M.C.)
| | - Massimo Coen
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, “L. Sacco” University Hospital, Via Giovanni Battista Grassi n. 74, 20157 Milan, Italy (M.C.)
| | - Matteo Passerini
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, “L. Sacco” University Hospital, Via Giovanni Battista Grassi n. 74, 20157 Milan, Italy (M.C.)
- Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza n. 35, 20122 Milan, Italy
| | - Maria Rita Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, “L. Sacco” University Hospital, Via Giovanni Battista Grassi n. 74, 20157 Milan, Italy; (S.G.R.)
| | - Andrea Gori
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, “L. Sacco” University Hospital, Via Giovanni Battista Grassi n. 74, 20157 Milan, Italy (M.C.)
- Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza n. 35, 20122 Milan, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Via Francesco Sforza n. 35, 20122 Milan, Italy
| | - Alfonso Manzotti
- Orthopedic Unit, ASST Fatebenefratelli Sacco, “L. Sacco” University Hospital, Via Giovanni Battista Grassi n. 74, 20157 Milan, Italy
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Ghalayani Esfahani A, Sartori M, Bregoli C, Fiocchi J, Biffi CA, Tuissi A, Giavaresi G, Presentato A, Alduina R, De Luca A, Cabrini A, De Capitani C, Fini M, Gruppioni E, Lavorgna M, Ronca A. Bactericidal Activity of Silver-Doped Chitosan Coatings via Electrophoretic Deposition on Ti 6Al 4V Additively Manufactured Substrates. Polymers (Basel) 2023; 15:4130. [PMID: 37896373 PMCID: PMC10610813 DOI: 10.3390/polym15204130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/13/2023] [Accepted: 10/15/2023] [Indexed: 10/29/2023] Open
Abstract
Prosthetic reconstruction can serve as a feasible alternative, delivering both functional and aesthetic benefits to individuals with hand and finger injuries, frequent causes of emergency room visits. Implant-related infections pose significant challenges in arthroplasty and osteosynthesis procedures, contributing to surgical failures. As a potential solution to this challenge, this study developed a new class of silver (Ag)-doped chitosan (CS) coatings via electrophoretic deposition (EPD) on osseointegrated prostheses for infection therapy. These coatings were successfully applied to additively manufactured Ti6Al4V ELI samples. In the initial phase, the feasibility of the composite coating was assessed using the Thermogravimetric Analysis (TGA) and Attenuated Total Reflection (ATR) techniques. The optimized structures exhibited impressive water uptake in the range of 300-360%. Codeposition with an antibacterial agent proved effective, and scanning electron microscopy (SEM) was used to examine the coating morphology. Biologically, CS coatings demonstrated cytocompatibility when in direct contact with a fibroblast cell line (L929) after 72 h. When exposed to the Staphylococcus epidermidis strain (ATCC 12228), these coatings inhibited bacterial growth and biofilm formation within 24 h. These findings underscore the significant potential of this approach for various applications, including endoprostheses like hip implants, internal medical devices, and transcutaneous prostheses such as osseointegrated limb prosthetics for upper and lower extremities.
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Affiliation(s)
- Arash Ghalayani Esfahani
- Institute for Polymers, Composites and Biomaterials (IPCB), National Research Council (Consiglio Nazionale delle Ricerche) (CNR), Via Gaetano Previati, 1/E, 23900 Lecco, Italy; (A.C.); (C.D.C.); (M.L.); (A.R.)
| | - Maria Sartori
- Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, Via Di Barbiano, 1/10, 40136 Bologna, Italy; (M.S.); (G.G.); (A.D.L.)
| | - Chiara Bregoli
- Institute of Condensed Matter Chemistry and Technologies for Energy (ICMATE), National Research Council (Consiglio Nazionale delle Ricerche) (CNR), Via Gaetano Previati, 1/E, 23900 Lecco, Italy; (C.B.); (J.F.); (C.A.B.); (A.T.)
| | - Jacopo Fiocchi
- Institute of Condensed Matter Chemistry and Technologies for Energy (ICMATE), National Research Council (Consiglio Nazionale delle Ricerche) (CNR), Via Gaetano Previati, 1/E, 23900 Lecco, Italy; (C.B.); (J.F.); (C.A.B.); (A.T.)
| | - Carlo Alberto Biffi
- Institute of Condensed Matter Chemistry and Technologies for Energy (ICMATE), National Research Council (Consiglio Nazionale delle Ricerche) (CNR), Via Gaetano Previati, 1/E, 23900 Lecco, Italy; (C.B.); (J.F.); (C.A.B.); (A.T.)
| | - Ausonio Tuissi
- Institute of Condensed Matter Chemistry and Technologies for Energy (ICMATE), National Research Council (Consiglio Nazionale delle Ricerche) (CNR), Via Gaetano Previati, 1/E, 23900 Lecco, Italy; (C.B.); (J.F.); (C.A.B.); (A.T.)
| | - Gianluca Giavaresi
- Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, Via Di Barbiano, 1/10, 40136 Bologna, Italy; (M.S.); (G.G.); (A.D.L.)
| | - Alessandro Presentato
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, Viale delle Scienze, Bd. 16, 90128 Palermo, Italy; (A.P.); (R.A.)
| | - Rosa Alduina
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, Viale delle Scienze, Bd. 16, 90128 Palermo, Italy; (A.P.); (R.A.)
| | - Angela De Luca
- Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, Via Di Barbiano, 1/10, 40136 Bologna, Italy; (M.S.); (G.G.); (A.D.L.)
| | - Alessia Cabrini
- Institute for Polymers, Composites and Biomaterials (IPCB), National Research Council (Consiglio Nazionale delle Ricerche) (CNR), Via Gaetano Previati, 1/E, 23900 Lecco, Italy; (A.C.); (C.D.C.); (M.L.); (A.R.)
| | - Cristina De Capitani
- Institute for Polymers, Composites and Biomaterials (IPCB), National Research Council (Consiglio Nazionale delle Ricerche) (CNR), Via Gaetano Previati, 1/E, 23900 Lecco, Italy; (A.C.); (C.D.C.); (M.L.); (A.R.)
| | - Milena Fini
- Scientific Directorate, IRCCS Istituto Ortopedico Rizzoli, Via Di Barbiano, 1/10, 40136 Bologna, Italy;
| | - Emanuele Gruppioni
- INAIL Centro Protesi, Via Rabuina 14, Vigorso di Budrio, 40054 Bologna, Italy;
| | - Marino Lavorgna
- Institute for Polymers, Composites and Biomaterials (IPCB), National Research Council (Consiglio Nazionale delle Ricerche) (CNR), Via Gaetano Previati, 1/E, 23900 Lecco, Italy; (A.C.); (C.D.C.); (M.L.); (A.R.)
| | - Alfredo Ronca
- Institute for Polymers, Composites and Biomaterials (IPCB), National Research Council (Consiglio Nazionale delle Ricerche) (CNR), Via Gaetano Previati, 1/E, 23900 Lecco, Italy; (A.C.); (C.D.C.); (M.L.); (A.R.)
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Kramer TS, Soriano A, Tedeschi S, Chen AF, Tattevin P, Senneville E, Gomez-Junyent J, Birlutiu V, Petersdorf S, de Brito VD, Gonzalez IS, Belden KA, Wouthuyzen-Bakker M. Should We Use Rifampicin in Periprosthetic Joint Infections Caused by Staphylococci When the Implant Has Been Exchanged? A Multicenter Observational Cohort Study. Open Forum Infect Dis 2023; 10:ofad491. [PMID: 37901121 PMCID: PMC10604993 DOI: 10.1093/ofid/ofad491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 10/10/2023] [Indexed: 10/31/2023] Open
Abstract
Background Previous studies demonstrated the efficacy of a rifampicin-based regimen in the treatment of acute staphylococcal periprosthetic joint infections (PJIs) treated with surgical debridement. However, evidence is lacking to support the use of rifampicin in cases where the implant is exchanged during revision. Methods We included all consecutive cases of staphylococcal PJIs treated from January 2013 to December 2018 with revision surgery in this international, retrospective, multicenter observational cohort study. PJI was defined according to the European Bone and Joint Infection Society diagnostic criteria. A relapse or reinfection during follow-up, the need for antibiotic suppressive therapy, the need for implant removal, and PJI-related death were defined as clinical failure. Cases without reimplantation or with follow-up <12 months were excluded. Results A total of 375 cases were included in the final analysis, including 124 1-stage exchanges (33.1%) and 251 2-stage exchanges (66.9%). Of those, 101 cases failed (26.9%). There was no statistically significant difference in failure of patients receiving rifampicin (22.5%, 42/187) and those not receiving rifampicin (31.4%, 59/188; P = .051). A subanalysis of chronic PJIs treated by 2-stage exchange arthroplasty demonstrated a lower failure rate in cases treated with rifampicin (15%) compared with the no-rifampicin group (35.5%; P = .005). In this subgroup, the use of rifampicin and an antibiotic holiday of >2 weeks were independent predictors of clinical success (odds ratio [OR], 0.36; 95% CI, 0.15-0.88; and OR, 0.19; 95% CI, 0.04-0.90; respectively). Conclusions Combination treatment with rifampicin increases treatment success in patients with chronic staphylococcal PJI treated with 2-stage exchange arthroplasty.
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Affiliation(s)
- Tobias Siegfried Kramer
- Institute for Hygiene and Environmental Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
- Clinic for Orthopedic Surgery and Traumatology, Evangelisches Waldkrankenhaus Berlin, Berlin, Deutschland
- LADR der Laborverbund Dr. Kramer & Kollegen, Geesthacht, Germany
| | - Alex Soriano
- Department of Infectious Diseases, University of Barcelona, IDIBAPS, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Sarah Tedeschi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universistaria di Bologna, Bologna, Italy
| | - Antonia F Chen
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Pierre Tattevin
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - Eric Senneville
- French National Referent Centre for Complex Bone and Joint Infections, CRIOAC Lille-Tourcoing, Lille, France
| | - Joan Gomez-Junyent
- Department of Infectious Diseases, Hospital del Mar, Infectious Pathology and Antimicrobial Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Barcelona, Spain
| | - Victoria Birlutiu
- County Clinical Emergency Hospital of Sibiu, Faculty of Medicine, Lucian Blaga University of Sibiu, Romania
| | - Sabine Petersdorf
- Institute for Medical Laboratory Diagnostics, Helios University Clinic Wuppertal, Wuppertal, Germany
| | - Vicens Diaz de Brito
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Deu, Sant Boi (Barcelona), Spain
| | - Ignacio Sancho Gonzalez
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de Navarra, Pamplona, España
| | - Katherine A Belden
- Division of Infectious Diseases, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Marjan Wouthuyzen-Bakker
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Bajaj A, Abutoama M, Isaacs S, Abuleil MJ, Yaniv K, Kushmaro A, Modic M, Cvelbar U, Abdulhalim I. Biofilm growth monitoring using guided wave ultralong-range Surface Plasmon Resonance: A proof of concept. Biosens Bioelectron 2023; 228:115204. [PMID: 36913883 DOI: 10.1016/j.bios.2023.115204] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 03/01/2023] [Accepted: 03/05/2023] [Indexed: 03/15/2023]
Abstract
Unwelcomed biofilms are problematic in food industries, surgical devices, marine applications, and wastewater treatment plants, essentially everywhere where there is moisture. Very recently, label-free advanced sensors such as localized and extended surface plasmon resonance (SPR) have been explored as tools for monitoring biofilm formation. However, conventional noble metal SPR substrates suffer from low penetration depth (100-300 nm) into the dielectric medium above the surface, preventing the reliable detection of large entities of single or multi-layered cell assemblies like biofilms which can grow up to a few micrometers or more. In this study, we propose using a plasmonic insulator-metal-insulator (IMI) structure (SiO2-Ag-SiO2) with a higher penetration depth based on a diverging beam single wavelength format of Kretschmann configuration in a portable SPR device. An SPR line detection algorithm for locating the reflectance minimum of the device helps to view changes in refractive index and accumulation of the biofilm in real-time down to 10-7 RIU precision. The optimized IMI structure exhibits strong penetration dependence on wavelength and incidence angle. Within the plasmonic resonance, different angles penetrate different depths, showing a maximum near the critical angle. At the wavelength of 635 nm, a high penetration depth of more than 4 μm was obtained. Compared to a thin gold film substrate, for which the penetration depth is only ∼200 nm, the IMI substrate provides more reliable results. The average thickness of the biofilm after 24 h of growth was found to be between 6 and 7 μm with ∼63% live cell volume, as estimated from confocal microscopic images using an image processing tool. To explain this saturation thickness, a graded index biofilm structure is proposed in which the refractive index decreases with the distance from the interface. Furthermore, when plasma-assisted degeneration of biofilms was studied in a semi-real-time format, there was almost no effect on the IMI substrate compared to the gold substrate. The growth rate over the SiO2 surface was higher than on gold, possibly due to differences between surface charge effects. On the gold, the excited plasmon generates an oscillating cloud of electrons, while for the SiO2 case, this does not happen. This methodology can be utilized to detect and characterize biofilms with better signal reliability with respect to concentration and size dependence.
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Affiliation(s)
- Aabha Bajaj
- Ilse Katz Institute for Nanoscale Science and Technology, Ben-Gurion University of the Negev, Beer-Sheva, 84105, Israel
| | - Mohammad Abutoama
- Department of Electro-optics and Photonics Engineering, ECE School, Ben-Gurion University of the Negev, Beer-Sheva, 84105, Israel
| | - Sivan Isaacs
- Department of Electro-optics and Photonics Engineering, ECE School, Ben-Gurion University of the Negev, Beer-Sheva, 84105, Israel
| | - Marwan J Abuleil
- Department of Electro-optics and Photonics Engineering, ECE School, Ben-Gurion University of the Negev, Beer-Sheva, 84105, Israel
| | - Karin Yaniv
- Avram and Stella Goldstein-Goren Department of Biotechnology Engineering, Faculty of Engineering Sciences, Ben-Gurion University of the Negev, Beer-Sheva, 84105, Israel
| | - Ariel Kushmaro
- Ilse Katz Institute for Nanoscale Science and Technology, Ben-Gurion University of the Negev, Beer-Sheva, 84105, Israel; Avram and Stella Goldstein-Goren Department of Biotechnology Engineering, Faculty of Engineering Sciences, Ben-Gurion University of the Negev, Beer-Sheva, 84105, Israel; School of Sustainability and Climate Change, Ben-Gurion University of the Negev, Beer-Sheva, 84105, Israel
| | - Martina Modic
- Department of Gaseous Electronics (F6), Jožef Stefan Institute, Jamova cesta 39, SI-1000, Ljubljana, Slovenia
| | - Uroš Cvelbar
- Department of Gaseous Electronics (F6), Jožef Stefan Institute, Jamova cesta 39, SI-1000, Ljubljana, Slovenia
| | - Ibrahim Abdulhalim
- Ilse Katz Institute for Nanoscale Science and Technology, Ben-Gurion University of the Negev, Beer-Sheva, 84105, Israel; Department of Electro-optics and Photonics Engineering, ECE School, Ben-Gurion University of the Negev, Beer-Sheva, 84105, Israel.
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9
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Wouthuyzen-Bakker M, Scheper H. Rifampicin in periprosthetic joint infections: where do we stand and where are we headed? Expert Rev Anti Infect Ther 2023:1-7. [PMID: 37141111 DOI: 10.1080/14787210.2023.2211263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
INTRODUCTION A periprosthetic joint infection (PJI) is a major complication of arthroplasty. Treatment of PJI consists of surgical debridement with or without the exchange of the implant and long-term antimicrobial treatment. Rifampicin is regarded as one of the cornerstones of antimicrobial treatment for staphylococcal PJI, but the exact role of rifampicin for PJI in different clinical scenarios remains to be elucidated. AREAS COVERED In this perspective article, an overview is provided of in vitro, in vivo and clinical studies that were the basis of the current guidelines and recommendations for rifampicin use in daily practice for PJI. Controversial issues on indication, dosing, timing, duration and antibiotic drug interactions will be addressed. Finally, the most urgent clinical questions on rifampicin use that need answering in the nearby future will be formulated. EXPERT OPINION Many inquiries remain concerning the exact indications and clinical use of rifampicin in PJI. Randomized controlled trials are needed to answer these questions.
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Affiliation(s)
- Marjan Wouthuyzen-Bakker
- Department of medical microbiology and infection prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Henk Scheper
- Department of infectious diseases, Leiden University Medical Center, University of Leiden, Leiden, The Netherlands
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10
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Brown MA, Morgan SB, Donachie GE, Horton KL, Pavord ID, Arancibia-Cárcamo CV, Hinks TSC. Epithelial immune activation and intracellular invasion by non-typeable Haemophilus influenzae. Front Cell Infect Microbiol 2023; 13:1141798. [PMID: 37180449 PMCID: PMC10167379 DOI: 10.3389/fcimb.2023.1141798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/04/2023] [Indexed: 05/16/2023] Open
Abstract
Type-2 low asthma affects 30-50% of people with severe asthma and includes a phenotype characterized by sputum neutrophilia and resistance to corticosteroids. Airways inflammation in type-2 low asthma or COPD is potentially driven by persistent bacterial colonization of the lower airways by bacteria such as non-encapsulated Haemophilus influenzae (NTHi). Although pathogenic in the lower airways, NTHi is a commensal of the upper airways. It is not known to what extent these strains can invade airway epithelial cells, persist intracellularly and activate epithelial cell production of proinflammatory cytokines, and how this differs between the upper and lower airways. We studied NTHi infection of primary human bronchial epithelial cells (PBECs), primary nasal epithelial cells (NECs) and epithelial cell lines from upper and lower airways. NTHi strains differed in propensity for intracellular and paracellular invasion. We found NTHi was internalized within PBECs at 6 h, but live intracellular infection did not persist at 24 h. Confocal microscopy and flow cytometry showed NTHi infected secretory, ciliated and basal PBECs. Infection of PBECs led to induction of CXCL8, interleukin (IL)-1β, IL-6 and TNF. The magnitude of cytokine induction was independent of the degree of intracellular invasion, either by differing strains or by cytochalasin D inhibition of endocytosis, with the exception of the inflammasome-induced mediator IL-1β. NTHi-induced activation of TLR2/4, NOD1/2 and NLR inflammasome pathways was significantly stronger in NECs than in PBECs. These data suggest that NTHi is internalized transiently by airway epithelial cells and has capacity to drive inflammation in airway epithelial cells.
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Affiliation(s)
- Mary A. Brown
- Respiratory Medicine Unit and National Institute for Health Research Oxford Biomedical Research Centre, Experimental Medicine Division, Nuffield Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Sophie B. Morgan
- Respiratory Medicine Unit and National Institute for Health Research Oxford Biomedical Research Centre, Experimental Medicine Division, Nuffield Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Gillian E. Donachie
- Respiratory Medicine Unit and National Institute for Health Research Oxford Biomedical Research Centre, Experimental Medicine Division, Nuffield Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Katie L. Horton
- School of Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton, United Kingdom
| | - Ian D. Pavord
- Respiratory Medicine Unit and National Institute for Health Research Oxford Biomedical Research Centre, Experimental Medicine Division, Nuffield Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Carolina V. Arancibia-Cárcamo
- Translational Gastroenterology Unit, Nuffield Department of Medicine, Experimental Medicine, University of Oxford, Oxford, United Kingdom
| | - Timothy S. C. Hinks
- Respiratory Medicine Unit and National Institute for Health Research Oxford Biomedical Research Centre, Experimental Medicine Division, Nuffield Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
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Louail R, Florin F, Bernard S, Michaud JB, Breton J, Achamrah N, Tavolacci MP, Coëffier M, Ribet D. Invasion of intestinal cells by Staphylococcus warneri, a member of the human gut microbiota. Gut Pathog 2023; 15:4. [PMID: 36707889 PMCID: PMC9881306 DOI: 10.1186/s13099-022-00528-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/20/2022] [Indexed: 01/28/2023] Open
Abstract
Coagulase negative staphylococci (CoNS) are a heterogeneous group of bacteria that colonize different types of human epithelia. These bacteria have a highly variable pathogenic potential ranging from avirulent species to major nosocomial pathogens. Staphylococcus warneri is a CoNS species considered to be nonpathogenic. Here, we identify that S. warneri is a natural member of both human and mouse gut microbiota. In addition, we demonstrate that this bacterium is able to get internalized into human cells. We show that S. warneri efficiently invades several human cell types and, more specifically, intestinal epithelial cells, using actin-dependent mechanisms. In contrast to bona fide pathogens, S. warneri does not actively replicate within intestinal cells or resist killing by macrophages. Together, our results highlight that bacteria from the human gut microbiota that are not associated with a high pathogenic potential, can actively invade intestinal cells and may, in this way, impact intestinal physiology.
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Affiliation(s)
- Robin Louail
- grid.7429.80000000121866389Univ Rouen Normandie, INSERM, ADEN UMR1073, Nutrition, inflammation and microbiota-gut-brain axis, 76000 Rouen, France
| | - Franklin Florin
- grid.7429.80000000121866389Univ Rouen Normandie, INSERM, ADEN UMR1073, Nutrition, inflammation and microbiota-gut-brain axis, 76000 Rouen, France
| | - Sophie Bernard
- grid.10400.350000 0001 2108 3034Univ Rouen Normandie, PRIMACEN, HeRacLeS INSERM US51 CNRS UAR2026, 76000 Rouen, France
| | - Jean-Baptiste Michaud
- grid.7429.80000000121866389Univ Rouen Normandie, INSERM, ADEN UMR1073, Nutrition, inflammation and microbiota-gut-brain axis, 76000 Rouen, France
| | - Jonathan Breton
- grid.7429.80000000121866389Univ Rouen Normandie, INSERM, ADEN UMR1073, Nutrition, inflammation and microbiota-gut-brain axis, 76000 Rouen, France
| | - Najate Achamrah
- grid.7429.80000000121866389Univ Rouen Normandie, INSERM, ADEN UMR1073, Nutrition, inflammation and microbiota-gut-brain axis, 76000 Rouen, France ,grid.41724.340000 0001 2296 5231CHU Rouen, Department of Nutrition, 76000 Rouen, France ,grid.41724.340000 0001 2296 5231CHU Rouen, CIC-CRB 1404, 76000 Rouen, France
| | - Marie-Pierre Tavolacci
- grid.7429.80000000121866389Univ Rouen Normandie, INSERM, ADEN UMR1073, Nutrition, inflammation and microbiota-gut-brain axis, 76000 Rouen, France ,grid.41724.340000 0001 2296 5231CHU Rouen, CIC-CRB 1404, 76000 Rouen, France
| | - Moïse Coëffier
- grid.7429.80000000121866389Univ Rouen Normandie, INSERM, ADEN UMR1073, Nutrition, inflammation and microbiota-gut-brain axis, 76000 Rouen, France ,grid.41724.340000 0001 2296 5231CHU Rouen, Department of Nutrition, 76000 Rouen, France ,grid.41724.340000 0001 2296 5231CHU Rouen, CIC-CRB 1404, 76000 Rouen, France
| | - David Ribet
- grid.7429.80000000121866389Univ Rouen Normandie, INSERM, ADEN UMR1073, Nutrition, inflammation and microbiota-gut-brain axis, 76000 Rouen, France ,grid.10400.350000 0001 2108 3034INSERM UMR1073 – Université de Rouen, UFR Santé, 22 Boulevard Gambetta, 76183 Rouen Cedex, France
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12
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Saeed SI, Vivian L, Zalati CWSCW, Sani NIM, Aklilu E, Mohamad M, Noor AAM, Muthoosamy K, Kamaruzzaman NF. Antimicrobial activities of graphene oxide against biofilm and intracellular Staphylococcus aureus isolated from bovine mastitis. BMC Vet Res 2023; 19:10. [PMID: 36641476 PMCID: PMC9840331 DOI: 10.1186/s12917-022-03560-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/23/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND S. aureus is one of the causative agents of bovine mastitis. The treatment using conventional antimicrobials has been hampered due to the development of antimicrobial resistance and the ability of the bacteria to form biofilms and localize inside the host cells. OBJECTIVES Here, the efficacy of graphene oxide (GO), a carbon-based nanomaterial, was tested against the biofilms and intracellular S. aureus invitro. Following that, the mechanism for the intracellular antimicrobial activities and GO toxicities was elucidated. METHODS GO antibiofilm properties were evaluated based on the disruption of biofilm structure, and the intracellular antimicrobial activities were determined by the survival of S. aureus in infected bovine mammary cells following GO exposure. The mechanism for GO intracellular antimicrobial activities was investigated using endocytosis inhibitors. GO toxicity towards the host cells was assessed using a resazurin assay. RESULTS At 100 ug/mL, GO reduced between 30 and 70% of S. aureus biofilm mass, suggesting GO's ability to disrupt the biofilm structure. At 200 ug/mL, GO killed almost 80% of intracellular S. aureus, and the antimicrobial activities were inhibited when cells were pre-treated with cytochalasin D, suggesting GO intracellular antimicrobial activities were dependent on the actin-polymerization of the cell membrane. At < 250 ug/mL, GO enhanced the viability of the Mac-T cell, and cells were only affected at higher dosages. CONCLUSION The in vitro efficacy of GO against S. aureus in vitro suggested the compound could be further tested in Vivo to zrecognize its potential as one of the components of bovine mastitis therapy.
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Affiliation(s)
- Shamsaldeen Ibrahim Saeed
- grid.444465.30000 0004 1757 0587Nanotechnology in Veterinary Medicine (NanoVet) Research Group, Faculty of Veterinary Medicine, University Malaysia Kelantan, Kelantan 16100 Pengkalan Chepa, Malaysia ,grid.442411.60000 0004 0447 7033Faculty of Veterinary Science, University of Nyala, PO Box 155, Nyala, South Darfur State Sudan
| | - Liang Vivian
- grid.444465.30000 0004 1757 0587Nanotechnology in Veterinary Medicine (NanoVet) Research Group, Faculty of Veterinary Medicine, University Malaysia Kelantan, Kelantan 16100 Pengkalan Chepa, Malaysia
| | - C. W. Salma C. W. Zalati
- grid.444465.30000 0004 1757 0587Nanotechnology in Veterinary Medicine (NanoVet) Research Group, Faculty of Veterinary Medicine, University Malaysia Kelantan, Kelantan 16100 Pengkalan Chepa, Malaysia
| | - Nani Izreen Mohd Sani
- grid.444465.30000 0004 1757 0587Nanotechnology in Veterinary Medicine (NanoVet) Research Group, Faculty of Veterinary Medicine, University Malaysia Kelantan, Kelantan 16100 Pengkalan Chepa, Malaysia
| | - Erkihun Aklilu
- grid.444465.30000 0004 1757 0587Nanotechnology in Veterinary Medicine (NanoVet) Research Group, Faculty of Veterinary Medicine, University Malaysia Kelantan, Kelantan 16100 Pengkalan Chepa, Malaysia
| | - Maizan Mohamad
- grid.444465.30000 0004 1757 0587Nanotechnology in Veterinary Medicine (NanoVet) Research Group, Faculty of Veterinary Medicine, University Malaysia Kelantan, Kelantan 16100 Pengkalan Chepa, Malaysia
| | - An’ Amt Mohamed Noor
- grid.444465.30000 0004 1757 0587Faculty of Bioengineering and Technology, Universiti Malaysia Kelantan, 17700 Jeli, Malaysia
| | - Kasturi Muthoosamy
- grid.440435.20000 0004 1802 0472Nanotechnology Research Group, Centre of Nanotechnology and Advanced Materials, University of Nottingham Malaysia, 43500 Semenyih, Selangor Malaysia
| | - Nor Fadhilah Kamaruzzaman
- grid.444465.30000 0004 1757 0587Nanotechnology in Veterinary Medicine (NanoVet) Research Group, Faculty of Veterinary Medicine, University Malaysia Kelantan, Kelantan 16100 Pengkalan Chepa, Malaysia
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Asghar S, Khan IU, Salman S, Khalid SH, Ashfaq R, Vandamme TF. Plant-derived nanotherapeutic systems to counter the overgrowing threat of resistant microbes and biofilms. Adv Drug Deliv Rev 2021; 179:114019. [PMID: 34699940 DOI: 10.1016/j.addr.2021.114019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/03/2021] [Accepted: 10/19/2021] [Indexed: 12/17/2022]
Abstract
Since antiquity, the survival of human civilization has always been threatened by the microbial infections. An alarming surge in the resistant microbial strains against the conventional drugs is quite evident in the preceding years. Furthermore, failure of currently available regimens of antibiotics has been highlighted by the emerging threat of biofilms in the community and hospital settings. Biofilms are complex dynamic composites rich in extracellular polysaccharides and DNA, supporting plethora of symbiotic microbial life forms, that can grow on both living and non-living surfaces. These enforced structures are impervious to the drugs and lead to spread of recurrent and non-treatable infections. There is a strong realization among the scientists and healthcare providers to work out alternative strategies to combat the issue of drug resistance and biofilms. Plants are a traditional but rich source of effective antimicrobials with wider spectrum due to presence of multiple constituents in perfect synergy. Other than the biocompatibility and the safety profile, these phytochemicals have been repeatedly proven to overcome the non-responsiveness of resistant microbes and films via multiple pathways such as blocking the efflux pumps, better penetration across the cell membranes or biofilms, and anti-adhesive properties. However, the unfavorable physicochemical attributes and stability issues of these phytochemicals have hampered their commercialization. These issues of the phytochemicals can be solved by designing suitably constructed nanoscaled structures. Nanosized systems can not only improve the physicochemical features of the encapsulated payloads but can also enhance their pharmacokinetic and therapeutic profile. This review encompasses why and how various types of phytochemicals and their nanosized preparations counter the microbial resistance and the biofouling. We believe that phytochemical in tandem with nanotechnological innovations can be employed to defeat the microbial resistance and biofilms. This review will help in better understanding of the challenges associated with developing such platforms and their future prospects.
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Ohlmeier M, Alrustom F, Citak M, Salber J, Gehrke T, Frings J. What Is the Mid-term Survivorship of Infected Rotating-hinge Implants Treated with One-stage-exchange? Clin Orthop Relat Res 2021; 479:2714-2722. [PMID: 34153008 PMCID: PMC8726537 DOI: 10.1097/corr.0000000000001868] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 06/01/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Despite the growing number of studies reporting on periprosthetic joint infection (PJI), there is little information on one-stage exchange arthroplasty for the revision of infected rotating-hinge prostheses, which can be among the most difficult PJI presentations to treat. QUESTIONS/PURPOSES After one-stage direct exchange revision for an infected rotating-hinge TKA prosthesis, and using a multimodal approach for infection control, we asked: (1) What is the survivorship free from repeat revision for infection and survivorship free from reoperation for any cause? (2) What is the clinical outcome, based on the Oxford Knee Score, of these patients at the latest follow-up? METHODS Between January 2011 and December 2017, we treated 101 patients with infected rotating-hinge knee prostheses at our hospital. All patients who underwent a one-stage exchange using another rotating-hinge implant were potentially eligible for this retrospective study. During that period, we generally used a one-stage approach when treating PJIs. Eighty-three percent (84 of 101) of patients were treated with one-stage exchange, and the remainder were treated with two-stage exchange. Of the 84 treated with one-stage exchange, eight patients died of unrelated causes and were therefore excluded, one patient declined to participate in the study, and another eight patients were lost before the minimum study follow-up of 2 years or had incomplete datasets, leaving 80% (67 of 84) for analysis in this study. The included study population consisted of 60% males (40 of 67) with a mean age of 64 ± 8 years and a mean (range) BMI of 30 ± 6 kg/m2 (21 to 40). The mean number of prior surgeries was 4 ± 2 (1 to 9) on the affected knee. Fifteen percent (10 of 67) of knees had a preoperative joint communicating sinus tract, and 66% (44 of 67) had experienced a prior PJI on the affected knee. The antimicrobial regimen was chosen based on the advice of our infectious disease consultant and individually adapted for the organism cultured. The mean follow-up duration was 6 ± 2 years. Kaplan-Meier survivorship analysis was performed using the endpoints of survivorship free from repeat revision for infection and survivorship free from all-cause revision. The functional outcome was assessed using the Oxford Knee Score (on a 12- to 60-point scale, with lower scores representing less pain and greater function), obtained by interviewing patients for this study at their most recent follow-up visit. Preoperative scores were not obtained. RESULTS The Kaplan-Meier analysis demonstrated an overall survivorship free from reoperation for any cause of 75% (95% CI 64% to 87%) at the mean follow-up of 6 years postoperatively. Survivorship free from any repeat operative procedure for infection was 90% (95% CI 83% to 97%) at 6 years. The mean postoperative Oxford Knee Score was 37 ± 11 points. CONCLUSION With an overall revision rate of about 25% at 6 years and the limited functional results based on the poor Oxford Knee Scores, patients should be counseled to have modest expectations concerning postoperative pain and function level after one-stage exchange of an infected rotating-hinge arthroplasty. Nevertheless, patients may be informed about a reasonable chance of PJI eradication and might opt for this approach as a means to try to avoid high transfemoral amputation or joint arthrodesis, which in this population often is associated with the inability to ambulate at all. Regarding the relatively high number of patients with aseptic loosening, future studies might focus on implant design of revision knee systems as well. A longer course of oral antibiotics after such procedures may also be warranted to limit the chance of reinfection but requires further study. LEVEL OF EVIDENCE Level IV, therapeutic study.
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Affiliation(s)
- Malte Ohlmeier
- Department of Orthopedic Surgery, Helios ENDO-Klinik, Hamburg, Germany
| | - Fadi Alrustom
- Department of Orthopedic Surgery, Helios ENDO-Klinik, Hamburg, Germany
| | - Mustafa Citak
- Department of Orthopedic Surgery, Helios ENDO-Klinik, Hamburg, Germany
| | - Jochen Salber
- Department of Surgery, Ruhr-University Bochum, Bochum, Germany
| | - Thorsten Gehrke
- Department of Orthopedic Surgery, Helios ENDO-Klinik, Hamburg, Germany
| | - Jannik Frings
- Department of Orthopedic Surgery, Helios ENDO-Klinik, Hamburg, Germany
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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15
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Esteban J, Vallet-Regí M, Aguilera-Correa JJ. Antibiotics- and Heavy Metals-Based Titanium Alloy Surface Modifications for Local Prosthetic Joint Infections. Antibiotics (Basel) 2021; 10:1270. [PMID: 34680850 PMCID: PMC8532710 DOI: 10.3390/antibiotics10101270] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/05/2021] [Accepted: 10/13/2021] [Indexed: 01/04/2023] Open
Abstract
Prosthetic joint infection (PJI) is the second most common cause of arthroplasty failure. Though infrequent, it is one of the most devastating complications since it is associated with great personal cost for the patient and a high economic burden for health systems. Due to the high number of patients that will eventually receive a prosthesis, PJI incidence is increasing exponentially. As these infections are provoked by microorganisms, mainly bacteria, and as such can develop a biofilm, which is in turn resistant to both antibiotics and the immune system, prevention is the ideal approach. However, conventional preventative strategies seem to have reached their limit. Novel prevention strategies fall within two broad categories: (1) antibiotic- and (2) heavy metal-based surface modifications of titanium alloy prostheses. This review examines research on the most relevant titanium alloy surface modifications that use antibiotics to locally prevent primary PJI.
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Affiliation(s)
- Jaime Esteban
- Clinical Microbiology Department, Jiménez Díaz Foundation Health Research Institute, Autonomous University of Madrid, Av. Reyes Católicos 2, 28040 Madrid, Spain
- Networking Research Centre on Infectious Diseases (CIBER-ID), 28029 Madrid, Spain
| | - María Vallet-Regí
- Department of Chemistry in Pharmaceutical Sciences, Research Institute Hospital 12 de Octubre (i+12), School of Pharmacy, Complutense University of Madrid, Pza. Ramón y Cajal s/n, 28040 Madrid, Spain
- Networking Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain
| | - John J Aguilera-Correa
- Networking Research Centre on Infectious Diseases (CIBER-ID), 28029 Madrid, Spain
- Department of Chemistry in Pharmaceutical Sciences, Research Institute Hospital 12 de Octubre (i+12), School of Pharmacy, Complutense University of Madrid, Pza. Ramón y Cajal s/n, 28040 Madrid, Spain
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Bortman J, Schefer A. Acute Propionibacterium acnes Infection After Carpal Tunnel Release. JOURNAL OF HAND SURGERY GLOBAL ONLINE 2021; 3:306-310. [PMID: 35415578 PMCID: PMC8991871 DOI: 10.1016/j.jhsg.2021.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 06/22/2021] [Indexed: 11/29/2022] Open
Abstract
Propionibacterium acnes (P. acnes) is a gram-positive, anaerobic, commensal organism found on nonglabrous skin, including the face, scalp, chest, and axilla. Recently, P. acnes is one of the more frequently recognized organisms causing postoperative infections in implant surgery of the shoulder, second to only Staphylococcus aureus (S. aureus), yet it is a rare postoperative complication of the wrist and hand. Multiple factors, including slow growth, multiorganism involvement, and selective growth media, complicate attributing a primary infection to P. acnes. We present a case of primary, acute P. acnes infection after carpal tunnel decompression, demonstrating the need for considering P. acnes for persistent postoperative hand and wrist infections.
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Affiliation(s)
- Jeffrey Bortman
- New York Medical College School of Medicine, Westchester Medical Center, Valhalla, NY
| | - Alan Schefer
- Department of Orthopedic Surgery, CareMount Medical, Mount Kisco, NY
- Corresponding author: Alan Schefer, MD, Department of Orthopedic Surgery, CareMount Medical, 90 South Bedford Rd, Mount Kisco, NY 10549.
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17
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Bogut A, Magryś A. The road to success of coagulase-negative staphylococci: clinical significance of small colony variants and their pathogenic role in persistent infections. Eur J Clin Microbiol Infect Dis 2021; 40:2249-2270. [PMID: 34296355 PMCID: PMC8520507 DOI: 10.1007/s10096-021-04315-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 07/09/2021] [Indexed: 01/14/2023]
Abstract
Bacterial small colony variants represent an important aspect of bacterial variability. They are naturally occurring microbial subpopulations with distinctive phenotypic and pathogenic traits, reported for many clinically important bacteria. In clinical terms, SCVs tend to be associated with persistence in host cells and tissues and are less susceptible to antibiotics than their wild-type (WT) counterparts. The increased tendency of SCVs to reside intracellularly where they are protected against the host immune responses and antimicrobial drugs is one of the crucial aspects linking SCVs to recurrent or chronic infections, which are difficult to treat. An important aspect of the SCV ability to persist in the host is the quiescent metabolic state, reduced immune response and expression a changed pattern of virulence factors, including a reduced expression of exotoxins and an increased expression of adhesins facilitating host cell uptake. The purpose of this review is to describe in greater detail the currently available data regarding CoNS SCV and, in particular, their clinical significance and possible mechanisms by which SCVs contribute to the pathogenesis of the chronic infections. It should be emphasized that in spite of an increasing clinical significance of this group of staphylococci, the number of studies unraveling the mechanisms of CoNS SCVs formation and their impact on the course of the infectious process is still scarce, lagging behind the studies on S. aureus SCVs.
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Affiliation(s)
- Agnieszka Bogut
- Chair and Department of Medical Microbiology, Medical University of Lublin, ul. Chodźki 1, 20-093, Lublin, Poland
| | - Agnieszka Magryś
- Chair and Department of Medical Microbiology, Medical University of Lublin, ul. Chodźki 1, 20-093, Lublin, Poland.
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18
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Shen J, Sun D, Fu J, Wang S, Wang X, Xie Z. Management of surgical site infection post-open reduction and internal fixation for tibial plateau fractures. Bone Joint Res 2021; 10:380-387. [PMID: 34218687 PMCID: PMC8333030 DOI: 10.1302/2046-3758.107.bjr-2020-0175.r2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AIMS In contrast to operations performed for other fractures, there is a high incidence rate of surgical site infection (SSI) post-open reduction and internal fixation (ORIF) done for tibial plateau fractures (TPFs). This study investigates the effect of induced membrane technique combined with internal fixation for managing SSI in TPF patients who underwent ORIF. METHODS From April 2013 to May 2017, 46 consecutive patients with SSI post-ORIF for TPFs were managed in our centre with an induced membrane technique. Of these, 35 patients were included for this study, with data analyzed in a retrospective manner. RESULTS All participants were monitored for a mean of 36 months (24 to 62). None were subjected to amputations. A total of 21 patients underwent two-stage surgeries (Group A), with 14 patients who did not receive second-stage surgery (Group B). Group A did not experience infection recurrence, and no implant or cement spacer loosening was noted in Group B for at least 24 months of follow-up. No significant difference was noted in the Lower Extremity Functional Scale (LEFS) and the Hospital for Special Surgery Knee Score (HSS) between the two groups. The clinical healing time was significantly shorter in Group B (p<0.001). Those with longer duration of infection had poorer functional status (p<0.001). CONCLUSION Management of SSI post-ORIF for TPF with induced membrane technique combined with internal fixation represents a feasible mode of treatment with satisfactory outcomes in terms of infection control and functional recovery. Cite this article: Bone Joint Res 2021;10(7):380-387.
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Affiliation(s)
- Jie Shen
- National & Regional United Engineering Laboratory of Tissue Engineering, Department of Orthopaedics, Southwest Hospital, Army Medical University, Chongqing, China
| | - Dong Sun
- National & Regional United Engineering Laboratory of Tissue Engineering, Department of Orthopaedics, Southwest Hospital, Army Medical University, Chongqing, China
| | - Jingshu Fu
- National & Regional United Engineering Laboratory of Tissue Engineering, Department of Orthopaedics, Southwest Hospital, Army Medical University, Chongqing, China
| | - Shulin Wang
- National & Regional United Engineering Laboratory of Tissue Engineering, Department of Orthopaedics, Southwest Hospital, Army Medical University, Chongqing, China
| | - Xiaohua Wang
- National & Regional United Engineering Laboratory of Tissue Engineering, Department of Orthopaedics, Southwest Hospital, Army Medical University, Chongqing, China
| | - Zhao Xie
- National & Regional United Engineering Laboratory of Tissue Engineering, Department of Orthopaedics, Southwest Hospital, Army Medical University, Chongqing, China
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Di Bonaventura G, Pompilio A. In Vitro Antimicrobial Susceptibility Testing of Biofilm-Growing Bacteria: Current and Emerging Methods. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1369:33-51. [PMID: 33963526 DOI: 10.1007/5584_2021_641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The antibiotic susceptibility of bacterial pathogens is typically determined based on planktonic cells, as recommended by several international guidelines. However, most of chronic infections - such as those established in wounds, cystic fibrosis lung, and onto indwelling devices - are associated to the formation of biofilms, communities of clustered bacteria attached onto a surface, abiotic or biotic, and embedded in an extracellular matrix produced by the bacteria and complexed with molecules from the host. Sessile microorganisms show significantly increased tolerance/resistance to antibiotics compared with planktonic counterparts. Consequently, antibiotic concentrations used in standard antimicrobial susceptibility tests, although effective against planktonic bacteria in vitro, are not predictive of the concentrations required to eradicate biofilm-related infections, thus leading to treatment failure, chronicization and removal of material in patients with indwelling medical devices.Meeting the need for the in vitro evaluation of biofilm susceptibility to antibiotics, here we reviewed several methods proposed in literature highlighting their advantages and limitations to guide scientists towards an appropriate choice.
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Affiliation(s)
- Giovanni Di Bonaventura
- Department of Medical, Oral and Biotechnological Sciences, and Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy. .,Laboratory of Clinical Microbiology, Chieti, Italy.
| | - Arianna Pompilio
- Department of Medical, Oral and Biotechnological Sciences, and Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Laboratory of Clinical Microbiology, Chieti, Italy
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20
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Staphylococcus aureus Internalization in Osteoblast Cells: Mechanisms, Interactions and Biochemical Processes. What Did We Learn from Experimental Models? Pathogens 2021; 10:pathogens10020239. [PMID: 33669789 PMCID: PMC7922271 DOI: 10.3390/pathogens10020239] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/12/2021] [Accepted: 02/17/2021] [Indexed: 02/07/2023] Open
Abstract
Bacterial internalization is a strategy that non-intracellular microorganisms use to escape the host immune system and survive inside the human body. Among bacterial species, Staphylococcus aureus showed the ability to interact with and infect osteoblasts, causing osteomyelitis as well as bone and joint infection, while also becoming increasingly resistant to antibiotic therapy and a reservoir of bacteria that can make the infection difficult to cure. Despite being a serious issue in orthopedic surgery, little is known about the mechanisms that allow bacteria to enter and survive inside the osteoblasts, due to the lack of consistent experimental models. In this review, we describe the current knowledge about S. aureus internalization mechanisms and various aspects of the interaction between bacteria and osteoblasts (e.g., best experimental conditions, bacteria-induced damages and immune system response), focusing on studies performed using the MG-63 osteoblastic cell line, the best traditional (2D) model for the study of this phenomenon to date. At the same time, as it has been widely demonstrated that 2D culture systems are not completely indicative of the dynamic environment in vivo, and more recent 3D models—representative of bone infection—have also been investigated.
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21
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Rifampin, Rifapentine, and Rifabutin Are Active against Intracellular Periprosthetic Joint Infection-Associated Staphylococcus epidermidis. Antimicrob Agents Chemother 2021; 65:AAC.01275-20. [PMID: 33199387 DOI: 10.1128/aac.01275-20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 11/10/2020] [Indexed: 11/20/2022] Open
Abstract
Staphylococcus epidermidis is a major cause of periprosthetic joint infection (PJI); its intracellular persistence within osteoblasts may compromise therapy if that therapy is not intracellularly active. The intracellular activity of rifampin, rifapentine, and rifabutin was assessed against five rifampin-susceptible and two rifampin-resistant S. epidermidis isolates. Compared to no treatment, treatment resulted in a ≥2-fold log10 reduction of intracellular rifampin-susceptible, but not rifampin-resistant, S. epidermidis These findings show activity of rifampin, rifapentine, and rifabutin against intraosteoblast PJI-associated S. epidermidis.
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Abstract
PURPOSE S. epidermidis is an ocular pathogen and a leading cause of keratitis. It produces hemolysins and at least 3 proteases. The purpose of the present study is to compare the secretion of hemolysins and proteases between 28 ocular isolates and one non-ocular strain and to determine their relationship to ocular virulence in selected strains using a rabbit model of infection. MATERIALS AND METHODS Culture supernatants were compared for protease production and hemolysis. Selected strains were injected into rabbit corneas and their virulence and pathology recorded. The major protease activity in a virulent strain was identified and the gene was cloned and expressed as a recombinant protein. The corneal toxicity of this protease was determined. Antibodies to the native protease were generated and tested for neutralizing activity in vivo and in vitro. The corneal pathology of the S. epidermidis protease was compared to the pathology of S. aureus V8 protease. RESULTS Strains that exhibited the least protease activity in vitro caused significantly less ocular pathology in vivo (p ≤ 0.003). Strains that were hemolytic and secreted a major protease had numerically higher SLE scores. This protease was identified as the serine protease Esp. The recombinant Esp protease caused extensive pathology when injected into the corneal stroma (7.62 ± 0.33). Antibody generated against native Esp did not neutralize the activity of the protease in vivo or in vitro. The antibody reacted with Esp proteases secreted by other S. epidermidis strains. S. epidermidis Esp protease and its homologue in S. aureus caused similar ocular pathology when injected in the rabbit corneal stroma. CONCLUSION Hemolysins and proteases seem to be important in corneal pathology caused by S. epidermidis infections. The Esp protease mediates significant corneal damage. S. epidermidis Esp and S. aureus V8 protease caused similar and extensive edema in rabbit corneas.
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Raue S, Fan SH, Rosenstein R, Zabel S, Luqman A, Nieselt K, Götz F. The Genome of Staphylococcus epidermidis O47. Front Microbiol 2020; 11:2061. [PMID: 32983045 PMCID: PMC7477909 DOI: 10.3389/fmicb.2020.02061] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/05/2020] [Indexed: 12/21/2022] Open
Abstract
The skin colonizing coagulase-negative Staphylococcus epidermidis causes nosocomial infections and is an important opportunistic and highly adaptable pathogen. To gain more insight into this species, we sequenced the genome of the biofilm positive, methicillin susceptible S. epidermidis O47 strain (hereafter O47). This strain belongs to the most frequently isolated sequence type 2. In comparison to the RP62A strain, O47 can be transformed, which makes it a preferred strain for molecular studies. S. epidermidis O47’s genome has a single chromosome of about 2.5 million base pairs and no plasmid. Its oriC sequence has the same directionality as S. epidermidis RP62A, S. carnosus, S. haemolyticus, S. saprophyticus and is inverted in comparison to Staphylococcus aureus and S. epidermidis ATCC 12228. A phylogenetic analysis based on all S. epidermidis genomes currently available at GenBank revealed that O47 is closest related to DAR1907. The genome of O47 contains genes for the typical global regulatory systems known in staphylococci. In addition, it contains most of the genes encoding for the typical virulence factors for S. epidermidis but not for S. aureus with the exception of a putative hemolysin III. O47 has the typical S. epidermidis genetic islands and several mobile genetic elements, which include staphylococcal cassette chromosome (SCC) of about 54 kb length and two prophages φO47A and φO47B. However, its genome has no transposons and the smallest number of insertion sequence (IS) elements compared to the other known S. epidermidis genomes. By sequencing and analyzing the genome of O47, we provide the basis for its utilization in genetic and molecular studies of biofilm formation.
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Affiliation(s)
- Stefan Raue
- Institute for Bioinformatics and Medical Informatics, University of Tübingen, Tübingen, Germany.,Microbial Genetics, Interfaculty Institute of Microbiology and Infection Medicine Tübingen (IMIT), University of Tübingen, Tübingen, Germany
| | - Sook-Ha Fan
- Microbial Genetics, Interfaculty Institute of Microbiology and Infection Medicine Tübingen (IMIT), University of Tübingen, Tübingen, Germany
| | - Ralf Rosenstein
- Infection Biology, Interfaculty Institute for Microbiology and Infection Medicine Tübingen (IMIT), University of Tübingen, Tübingen, Germany
| | - Susanne Zabel
- Institute for Bioinformatics and Medical Informatics, University of Tübingen, Tübingen, Germany
| | - Arif Luqman
- Microbial Genetics, Interfaculty Institute of Microbiology and Infection Medicine Tübingen (IMIT), University of Tübingen, Tübingen, Germany.,Biology Department, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia
| | - Kay Nieselt
- Institute for Bioinformatics and Medical Informatics, University of Tübingen, Tübingen, Germany
| | - Friedrich Götz
- Microbial Genetics, Interfaculty Institute of Microbiology and Infection Medicine Tübingen (IMIT), University of Tübingen, Tübingen, Germany
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Wouthuyzen-Bakker M, Sebillotte M, Huotari K, Escudero Sánchez R, Benavent E, Parvizi J, Fernandez-Sampedro M, Barbero JM, Garcia-Cañete J, Trebse R, Del Toro M, Diaz-Brito V, Sanchez M, Scarborough M, Soriano A. Lower Success Rate of Débridement and Implant Retention in Late Acute versus Early Acute Periprosthetic Joint Infection Caused by Staphylococcus spp. Results from a Matched Cohort Study. Clin Orthop Relat Res 2020; 478:1348-1355. [PMID: 32106134 PMCID: PMC7319375 DOI: 10.1097/corr.0000000000001171] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 01/30/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND Surgical débridement, antibiotics and implant retention (DAIR) is currently recommended by international guidelines for both early acute (postsurgical) and late acute (hematogenous) periprosthetic joint infections (PJIs). However, due to a different pathogenesis of infection, a different treatment strategy may be needed. QUESTIONS/PURPOSES (1) Compared with early acute PJIs, are late acute PJIs associated with a higher risk of DAIR failure? (2) When stratified by microorganism, is the higher risk of failure in late acute PJI associated with Staphylocococcus aureus infection? (3) When analyzing patients with S. aureus infection, what factors are independently associated with DAIR failure? METHODS In this multicenter observational study, early acute and late acute PJIs treated with DAIR were retrospectively evaluated and matched according to treating center, year of diagnosis, and infection-causing microorganism. If multiple matches were available, the early acute PJI diagnosed closest to the late acute PJI was selected. A total of 132 pairs were included. Treatment success was defined as a retained implant during follow-up without the need for antibiotic suppressive therapy. RESULTS Late acute PJIs had a lower treatment success (46% [60 of 132]) compared with early acute PJIs (76% [100 of 132]), OR 3.9 [95% CI 2.3 to 6.6]; p < 0.001), but the lower treatment success of late acute PJIs was only observed when caused by Staphylococcus spp (S. aureus: 34% versus 75%; p < 0.001; coagulase-negative staphylococci: 46% versus 88%; p = 0.013, respectively). On multivariable analysis, late acute PJI was the only independent factor associated with an unsuccessful DAIR when caused by S. aureus (OR 4.52 [95% CI 1.79 to 11.41]; p < 0.001). CONCLUSIONS Although DAIR seems to be a successful therapeutic strategy in the management of early acute PJI, its use in late acute PJI should be reconsidered when caused by Staphylococcus spp. Our results advocate the importance of isolating the causative microorganism before surgery. LEVEL OF EVIDENCE Level III, therapeutic study.
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Affiliation(s)
- Marjan Wouthuyzen-Bakker
- M. Wouthuyzen-Bakker, Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Marine Sebillotte
- M. Sebillotte, Department of Infectious Diseases and Intensive Care Medicine, Rennes University Hospital, Rennes, France
| | - Kaisa Huotari
- K. Huotari, Inflammation center, Infectious Diseases, Peijas Hospital, Helsinki University Hospital and University of Helsinki, Finland
| | - Rosa Escudero Sánchez
- R. Escudero-Sánchez, Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Eva Benavent
- E. Benavent, Infectious Disease Service, IDIBELL-Hospital Universitari Bellvitge, Barcelona, Spain
| | - Javad Parvizi
- J. Parvizi, Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Marta Fernandez-Sampedro
- M. Fernandez-Sampedro, Infectious Diseases Unit, Department of Medicine, Hospital Universitario Marques de Valdecilla-IDIVAL, Cantabria, Spain
| | - José Maria Barbero
- J. M. Barbero, Department of Internal Medicine, Hospital Universitario Principe de Asturias, Madrid, Spain
| | - Joaquín Garcia-Cañete
- J. Garcia-Cañete, Department of Internal Medicine-Emergency, IIS-Fundación Jiménez Díaz, UAM, Madrid, Spain
| | - Rihard Trebse
- R. Trebse, Service for Bone Infections, Valdoltra Orthopaedic Hospital, Ankaran, Slovenia
| | - Maria Del Toro
- M. Del Toro, Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain
| | - Vicens Diaz-Brito
- V. Diaz-Brito, Infectious Diseases Unit, Parc Sanitari Sant Joan de Deu, Sant Boi, Barcelona, Spain
| | - Marisa Sanchez
- M. Sanchez, Infectious Diseases Section, Internal Medicine Service, Hospital Italiano de Buenos Aires, Argentina
| | - Matthew Scarborough
- M. Scarborough, Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, England
| | - Alex Soriano
- A. Soriano, Service of Infectious Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain
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25
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Niche specialization and spread of Staphylococcus capitis involved in neonatal sepsis. Nat Microbiol 2020; 5:735-745. [PMID: 32341568 DOI: 10.1038/s41564-020-0676-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 01/28/2020] [Indexed: 12/14/2022]
Abstract
The multidrug-resistant Staphylococcus capitis NRCS-A clone is responsible for sepsis in preterm infants in neonatal intensive care units (NICUs) worldwide. Here, to retrace the spread of this clone and to identify drivers of its specific success, we investigated a representative collection of 250 S. capitis isolates from adults and newborns. Bayesian analyses confirmed the spread of the NRCS-A clone and enabled us to date its emergence in the late 1960s and its expansion during the 1980s, coinciding with the establishment of NICUs and the increasing use of vancomycin in these units, respectively. This dynamic was accompanied by the acquisition of mutations in antimicrobial resistance- and bacteriocin-encoding genes. Furthermore, combined statistical tools and a genome-wide association study convergently point to vancomycin resistance as a major driver of NRCS-A success. We also identified another S. capitis subclade (alpha clade) that emerged independently, showing parallel evolution towards NICU specialization and non-susceptibility to vancomycin, indicating convergent evolution in NICU-associated pathogens. These findings illustrate how the broad use of antibiotics can repeatedly lead initially commensal drug-susceptible bacteria to evolve into multidrug-resistant clones that are able to successfully spread worldwide and become pathogenic for highly vulnerable patients.
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26
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Bongiorno D, Musso N, Lazzaro LM, Mongelli G, Stefani S, Campanile F. Detection of methicillin-resistant Staphylococcus aureus persistence in osteoblasts using imaging flow cytometry. Microbiologyopen 2020; 9:e1017. [PMID: 32237200 PMCID: PMC7221431 DOI: 10.1002/mbo3.1017] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 02/01/2020] [Accepted: 02/10/2020] [Indexed: 11/10/2022] Open
Abstract
Methicillin-resistant S. aureus has been reported as the main pathogen involved in chronic infections, osteomyelitis, and prosthetic joint infections. The host/pathogen interaction is dynamic and requires several changes to promote bacterial survival. Here, we focused on the internalization and persistence behavior of well-characterized Staphylococcus aureus invasive strains belonging to the main ST-MRSA-SCCmec clones. To overcome the limitations of the cell culture method, we comparatively analyzed the ability of internalization within human MG-63 osteoblasts with imaging flow cytometry (IFC). After evaluation by cell culture assay, the MRSA clones in the study were all able to readily internalize at 3h postinfection, the persistence of intracellular bacteria was evaluated at 24h both by routine cell culture and IFC assay, after vancomycin-BODIPY staining. A statistical difference of persistence was found in ST5-SCCmecII (26.59%), ST228-SCCmecI (20.25%), ST8-SCCmecIV (19.52%), ST239-SCCmecIII (47.82%), and ST22-SCCmecIVh (50.55%) showing the same ability to internalize as ATCC12598 (51%), the invasive isolate used as control strain for invasion and persistence assays. We demonstrated that the intracellular persistence process depends on the total number of infected cells. Comparing our data obtained by IFC with those of the cell culture assay, we obtained greater reproducibility rates and a number of intracellular bacteria, with the advantage of analyzing live host cells. Moreover, with some limitations related to the lack of whole-genome sequencing analysis, we validated the different proclivities to persist in the main Italian HA-MRSA invasive isolates and our results highlighted the heterogeneity of the different clones to persist during cell infection.
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Affiliation(s)
- Dafne Bongiorno
- Department of Biomedical and Biotechnological Sciences (BIOMETEC), Medical Molecular Microbiology and Antibiotic Resistance Laboratory (MMARLab), University of Catania, Catania, Italy
| | - Nicolò Musso
- Bio-nanotech Research and Innovation Tower (BRIT), University of Catania, Catania, Italy
| | - Lorenzo Mattia Lazzaro
- Department of Biomedical and Biotechnological Sciences (BIOMETEC), Medical Molecular Microbiology and Antibiotic Resistance Laboratory (MMARLab), University of Catania, Catania, Italy
| | - Gino Mongelli
- Department of Biomedical and Biotechnological Sciences (BIOMETEC), Medical Molecular Microbiology and Antibiotic Resistance Laboratory (MMARLab), University of Catania, Catania, Italy
| | - Stefania Stefani
- Department of Biomedical and Biotechnological Sciences (BIOMETEC), Medical Molecular Microbiology and Antibiotic Resistance Laboratory (MMARLab), University of Catania, Catania, Italy.,Bio-nanotech Research and Innovation Tower (BRIT), University of Catania, Catania, Italy
| | - Floriana Campanile
- Department of Biomedical and Biotechnological Sciences (BIOMETEC), Medical Molecular Microbiology and Antibiotic Resistance Laboratory (MMARLab), University of Catania, Catania, Italy
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27
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Abad L, Josse J, Tasse J, Lustig S, Ferry T, Diot A, Laurent F, Valour F. Antibiofilm and intraosteoblastic activities of rifamycins against Staphylococcus aureus: promising in vitro profile of rifabutin. J Antimicrob Chemother 2020; 75:1466-1473. [DOI: 10.1093/jac/dkaa061] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 01/28/2020] [Accepted: 01/30/2020] [Indexed: 12/14/2022] Open
Abstract
Abstract
Background
Targeting biofilm-embedded and intraosteoblastic Staphylococcus aureus, rifampicin gained a pivotal role in bone and joint infection (BJI) treatment. Two other rifamycins, rifabutin and rifapentine, may represent better-tolerated alternatives, but their activity against bacterial reservoirs associated with BJI chronicity has never been evaluated.
Objectives
To evaluate the activities of rifampicin, rifabutin and rifapentine in osteoblast infection models.
Methods
Using three S. aureus isolates, rifamycins were compared regarding: (i) their intracellular activity in ‘acute’ (24 h) and ‘chronic’ (7 days) osteoblast infection models at 0.1× MIC, 1× MIC, 10× MIC and 100× MIC, while impacting infection-induced cytotoxicity (MTT assay), intracellular phenol-soluble modulin (PSM) secretion (RT–PCR), resistance selection and small colony variant (SCV) emergence; and (ii) their minimal biofilm eradication concentration (MBEC) and their MIC to prevent biofilm formation (bMIC).
Results
At 0.1× MIC, only rifabutin significantly reduced intracellular inoculum and PSM secretion. All rifamycins allowed a 50% reduction of intraosteoblastic inoculum at higher concentrations, with no difference between acute and chronic infection models, while reducing infection-induced cytotoxicity and PSM secretion. Dose-dependent emergence of intracellular SCVs was observed for all molecules. No intracellular emergence of resistance was detected. bMICs were equivalent for all molecules, but MBEC90s of rifapentine and rifabutin were 10- to 100-fold lower than those of rifampicin, respectively.
Conclusions
All rifamycins are efficient in reducing the S. aureus intraosteoblastic reservoir while limiting infection-induced cytotoxicity, with a higher activity of rifabutin at low concentrations. All molecules prevent biofilm formation, but only rifapentine and rifabutin consistently reduce formed biofilm-embedded bacteria for all isolates. The activity of rifabutin at lower doses highlights its therapeutic potential.
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Affiliation(s)
- Lélia Abad
- CIRI – Centre International de Recherche en Infectiologie, Inserm, U1111, Université´ Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, F-69007 Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
- Laboratoire de bactériologie, Institut des Agents Infectieux, French National Reference Center for Staphylococci, Hospices Civils de Lyon, Lyon, France
| | - Jérôme Josse
- CIRI – Centre International de Recherche en Infectiologie, Inserm, U1111, Université´ Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, F-69007 Lyon, France
| | - Jason Tasse
- CIRI – Centre International de Recherche en Infectiologie, Inserm, U1111, Université´ Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, F-69007 Lyon, France
| | - Sébastien Lustig
- Université Claude Bernard Lyon 1, Lyon, France
- Centres de Référence pour la prise en charge des Infections ostéoarticulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
- Department de chirurgie orthopédique, Hospices Civils de Lyon, Lyon, France
| | - Tristan Ferry
- CIRI – Centre International de Recherche en Infectiologie, Inserm, U1111, Université´ Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, F-69007 Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
- Centres de Référence pour la prise en charge des Infections ostéoarticulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
- Département maladies infectieuses et tropicales, Hospices Civils de Lyon, Lyon, France
| | - Alan Diot
- CIRI – Centre International de Recherche en Infectiologie, Inserm, U1111, Université´ Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, F-69007 Lyon, France
| | - Frédéric Laurent
- Laboratoire de bactériologie, Institut des Agents Infectieux, French National Reference Center for Staphylococci, Hospices Civils de Lyon, Lyon, France
- CIRI – Centre International de Recherche en Infectiologie, Inserm, U1111, Université´ Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, F-69007 Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
- Laboratoire de bactériologie, Institut des Agents Infectieux, French National Reference Center for Staphylococci, Hospices Civils de Lyon, Lyon, France
- Centres de Référence pour la prise en charge des Infections ostéoarticulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Florent Valour
- CIRI – Centre International de Recherche en Infectiologie, Inserm, U1111, Université´ Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, F-69007 Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
- Centres de Référence pour la prise en charge des Infections ostéoarticulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
- Département maladies infectieuses et tropicales, Hospices Civils de Lyon, Lyon, France
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Seebach E, Kubatzky KF. Chronic Implant-Related Bone Infections-Can Immune Modulation be a Therapeutic Strategy? Front Immunol 2019; 10:1724. [PMID: 31396229 PMCID: PMC6664079 DOI: 10.3389/fimmu.2019.01724] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 07/09/2019] [Indexed: 12/14/2022] Open
Abstract
Chronic implant-related bone infections are a major problem in orthopedic and trauma-related surgery with severe consequences for the affected patients. As antibiotic resistance increases in general and because most antibiotics have poor effectiveness against biofilm-embedded bacteria in particular, there is a need for alternative and innovative treatment approaches. Recently, the immune system has moved into focus as the key player in infection defense and bone homeostasis, and the targeted modulation of the host response is becoming an emerging field of interest. The aim of this review was to summarize the current knowledge of impaired endogenous defense mechanisms that are unable to prevent chronicity of bone infections associated with a prosthetic or osteosynthetic device. The presence of foreign material adversely affects the immune system by generating a local immune-compromised environment where spontaneous clearance of planktonic bacteria does not take place. Furthermore, the surface structure of the implant facilitates the transition of bacteria from the planktonic to the biofilm stage. Biofilm formation on the implant surface is closely linked to the development of a chronic infection, and a misled adaption of the immune system makes it impossible to effectively eliminate biofilm infections. The interaction between the immune system and bone cells, especially osteoclasts, is extensively studied in the field of osteoimmunology and this crosstalk further aggravates the course of bone infection by shifting bone homeostasis in favor of bone resorption. T cells play a major role in various chronic diseases and in this review a special focus was therefore set on what is known about an ineffective T cell response. Myeloid-derived suppressor cells (MDSCs), anti-inflammatory macrophages, regulatory T cells (Tregs) as well as osteoclasts all suppress immune defense mechanisms and negatively regulate T cell-mediated immunity. Thus, these cells are considered to be potential targets for immune therapy. The success of immune checkpoint inhibition in cancer treatment encourages the transfer of such immunological approaches into treatment strategies of other chronic diseases. Here, we discuss whether immune modulation can be a therapeutic tool for the treatment of chronic implant-related bone infections.
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Affiliation(s)
- Elisabeth Seebach
- Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg, Germany
| | - Katharina F Kubatzky
- Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg, Germany
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29
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Josse J, Valour F, Maali Y, Diot A, Batailler C, Ferry T, Laurent F. Interaction Between Staphylococcal Biofilm and Bone: How Does the Presence of Biofilm Promote Prosthesis Loosening? Front Microbiol 2019; 10:1602. [PMID: 31379772 PMCID: PMC6653651 DOI: 10.3389/fmicb.2019.01602] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 06/26/2019] [Indexed: 12/19/2022] Open
Abstract
With the aging of population, the number of indications for total joint replacement is continuously increasing. However, prosthesis loosening can happen and is related to two major mechanisms: (1) aseptic loosening due to prosthesis micromotion and/or corrosion and release of wear particles from the different components of the implanted material and (2) septic loosening due to chronic prosthetic joint infection (PJI). The “aseptic” character of prosthesis loosening has been challenged over the years, especially considering that bacteria can persist in biofilms and be overlooked during diagnosis. Histological studies on periprosthetic tissue samples reported that macrophages are the principle cells associated with aseptic loosening due to wear debris. They produce cytokines and favor an inflammatory environment that induces formation and activation of osteoclasts, leading to bone resorption and periprosthetic osteolysis. In PJIs, the presence of infiltrates of polymorphonuclear neutrophils is a major criterion for histological diagnosis. Neutrophils are colocalized with osteoclasts and zones of osteolysis. A similar inflammatory environment also develops, leading to bone resorption through osteoclasts. Staphylococcus aureus, Staphylococcus epidermidis, and Staphylococcus lugdunensis are the main staphylococci observed in PJIs. They share the common feature to form biofilm. For S. aureus and S. epidermidis, the interaction between biofilm and immunes cells (macrophages and polymorphonuclear neutrophils) differs regarding the species. Indeed, the composition of extracellular matrix of biofilm seems to impact the interaction with immune cells. Recent papers also reported the major role of myeloid-derived suppressor cells in biofilm-associated PJIs with S. aureus. These cells prevent lymphocyte infiltration and facilitate biofilm persistence. Moreover, the role of T lymphocytes is still unclear and potentially underestimates. In this review, after introducing the cellular mechanism of aseptic and septic loosening, we will focus on the interrelationships between staphylococcal biofilm, immune cells, and bone cells.
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Affiliation(s)
- Jérôme Josse
- CIRI - Centre International de Recherche en Infectiologie, Inserm U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires Complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Florent Valour
- CIRI - Centre International de Recherche en Infectiologie, Inserm U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires Complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Service de Chirurgie Orthopédique, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Yousef Maali
- CIRI - Centre International de Recherche en Infectiologie, Inserm U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Alan Diot
- CIRI - Centre International de Recherche en Infectiologie, Inserm U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Cécile Batailler
- Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires Complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Service de Maladies Infectieuses, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Tristan Ferry
- CIRI - Centre International de Recherche en Infectiologie, Inserm U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires Complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Service de Chirurgie Orthopédique, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Frédéric Laurent
- CIRI - Centre International de Recherche en Infectiologie, Inserm U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires Complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Laboratoire de Bactériologie, Institut des Agents Infectieux, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
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30
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Luqman A, Ebner P, Reichert S, Sass P, Kabagema-Bilan C, Heilmann C, Ruth P, Götz F. A new host cell internalisation pathway for SadA-expressing staphylococci triggered by excreted neurochemicals. Cell Microbiol 2019; 21:e13044. [PMID: 31099148 PMCID: PMC6771854 DOI: 10.1111/cmi.13044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 04/23/2019] [Accepted: 05/08/2019] [Indexed: 12/17/2022]
Abstract
Staphylococcus aureus is a facultative intracellular pathogen that invades a wide range of professional and nonprofessional phagocytes by triggering internalisation by interaction of surface‐bound adhesins with corresponding host cell receptors. Here, we identified a new concept of host cell internalisation in animal‐pathogenic staphylococcal species. This new mechanism exemplified by Staphylococcus pseudintermedius ED99 is not based on surface‐bound adhesins but is due to excreted small neurochemical compounds, such as trace amines (TAs), dopamine (DOP), and serotonin (SER), that render host cells competent for bacterial internalisation. The neurochemicals are produced by only one enzyme, the staphylococcal aromatic amino acid decarboxylase (SadA). Here, we unravelled the mechanism of how neurochemicals trigger internalisation into the human colon cell line HT‐29. We found that TAs and DOP are agonists of the α2‐adrenergic receptor, which, when activated, induces a cascade of reactions involving a decrease in the cytoplasmic cAMP level and an increase in F‐actin formation. The signalling cascade of SER follows a different pathway. SER interacts with 5HT receptors that trigger F‐actin formation without decreasing the cytoplasmic cAMP level. The neurochemical‐induced internalisation in host cells is independent of the fibronectin‐binding protein pathway and has an additive effect. In a sadA deletion mutant, ED99ΔsadA, internalisation was decreased approximately threefold compared with that of the parent strain, and treating S. aureus USA300 with TAs increased internalisation by approximately threefold.
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Affiliation(s)
- Arif Luqman
- Microbial Genetics, Interfaculty Institute of Microbiology and Infection Medicine Tübingen (IMIT), University of Tübingen, Tübingen, Germany.,Biology Department, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia.,Microbiology Division, Generasi Biologi Indonesia (Genbinesia) Foundation, Gresik, Indonesia
| | - Patrick Ebner
- Microbial Genetics, Interfaculty Institute of Microbiology and Infection Medicine Tübingen (IMIT), University of Tübingen, Tübingen, Germany
| | - Sebastian Reichert
- Microbial Genetics, Interfaculty Institute of Microbiology and Infection Medicine Tübingen (IMIT), University of Tübingen, Tübingen, Germany
| | - Peter Sass
- Microbial Bioactive Compounds, Interfaculty Institute of Microbiology and Infection Medicine Tübingen (IMIT), University of Tübingen, Tübingen, Germany
| | | | - Christine Heilmann
- Institute of Medical Microbiology, University Hospital of Münster, Münster, Germany
| | - Peter Ruth
- Institute for Pharmacy, University of Tübingen, Tübingen, Germany
| | - Friedrich Götz
- Microbial Genetics, Interfaculty Institute of Microbiology and Infection Medicine Tübingen (IMIT), University of Tübingen, Tübingen, Germany
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31
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Inaba H, Nomura R, Kato Y, Takeuchi H, Amano A, Asai F, Nakano K, Lamont RJ, Matsumoto-Nakano M. Adhesion and invasion of gingival epithelial cells by Porphyromonas gulae. PLoS One 2019; 14:e0213309. [PMID: 30870452 PMCID: PMC6417775 DOI: 10.1371/journal.pone.0213309] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 02/18/2019] [Indexed: 12/20/2022] Open
Abstract
Porphyromonas gulae, an animal periodontal pathogen, possess fimbriae classified into three genotypes (A-C) based on the diversity of fimA genes encoding FimA. Accumulating evidence suggests that P. gulae strains with type C fimbriae are more virulent as compared to those with other types. The ability of these organisms to adhere to and invade gingival epithelial cells has yet to be examined. P. gulae showed the greatest levels of adhesion and invasion at a multiplicity of infection of 100 for 90 min. P. gulae type C and some type B strains invaded gingival epithelial cells at significantly greater levels than the other strains, at the same level of efficiency as P. gingivalis with type II fimbriae. Adhesion and invasion of gingival epithelial cells by P. gulae were inhibited by cytochalasin D and sodium azide, indicating the requirements of actin polymerization and energy metabolism for those activities. Invasion within gingival epithelial cells was blocked by staurosporine, whereas those inhibitors showed little effects on adhesion, while nocodazole and cycloheximide had negligible effects on either adhesion or invasion. P. gulae proteases were found to be essential for adhesion and invasion of gingival epithelial cells, while its DNA and RNA, and protein synthesis were unnecessary for those activities. Additionally, α5β1 integrin antibodies significantly inhibited adhesion and invasion by P. gulae. This is the first report to characterize P. gulae adhesion and invasion of human gingival epithelial cells.
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Affiliation(s)
- Hiroaki Inaba
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- * E-mail:
| | - Ryota Nomura
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita-Osaka, Japan
| | - Yukio Kato
- Department of Veterinary Public Health II, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
| | - Hiroki Takeuchi
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, Suita-Osaka, Japan
| | - Atsuo Amano
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, Suita-Osaka, Japan
| | - Fumitoshi Asai
- Department of Pharmacology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita-Osaka, Japan
| | - Richard J. Lamont
- Department of Oral Immunology and Infectious Diseases, School of Dentistry, University of Louisville, Louisville, KY, United States of America
| | - Michiyo Matsumoto-Nakano
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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32
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Naik BI, Roger C, Ikeda K, Todorovic MS, Wallis SC, Lipman J, Roberts JA. Comparative total and unbound pharmacokinetics of cefazolin administered by bolus versus continuous infusion in patients undergoing major surgery: a randomized controlled trial. Br J Anaesth 2018; 118:876-882. [PMID: 28505360 DOI: 10.1093/bja/aex026] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2017] [Indexed: 01/04/2023] Open
Abstract
Background. Perioperative administration of cefazolin reduces the incidence of perioperative infections. Intraoperative re-dosing of cefazolin is commonly given between 2 and 5 h after the initial dose. This study was undertaken to determine whether intraoperative continuous infusions of cefazolin achieve better probability of target attainment (PTA) and fractional target attainment (FTA) than intermittent dosing. Methods. Patients undergoing major surgery received cefazolin 2 g before surgical incision. They were subsequently randomized to receive either an intermittent bolus (2 g every 4 h) or continuous infusion (500 mg h -1 ) of cefazolin until skin closure. Blood samples were analysed for total and unbound cefazolin concentrations using a validated chromatographic method. Population pharmacokinetic modelling was performed using Pmetrics ® software. Calculations of PTA and FTA were performed for common pathogens. Results. Ten patients were enrolled in each arm. A two-compartment linear model best described the time course of the total plasma cefazolin concentrations. The covariates that improved the model were body weight and creatinine clearance. Protein binding varied with time [mean (range) 69 (44-80)%] with a fixed 21% unbound value of cefazolin used for the simulations (120 min post-initial dosing). Mean ( sd ) central volume of distribution was 5.73 (2.42) litres, and total cefazolin clearance was 4.72 (1.1) litres h -1 . Continuous infusions of cefazolin consistently achieved better drug exposures and FTA for different weight and creatinine clearances, particularly for less susceptible pathogens. Conclusions. Our study demonstrates that intraoperative continuous infusions of cefazolin increase the achievement of target plasma concentrations, even with lower infusion doses. Renal function and body weight are important when considering the need for alternative dosing regimens. Clinical trial registration. NCT02058979.
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Affiliation(s)
- B I Naik
- Department of Anesthesiology, PO Box 800710, Charlottesville, VA, 22908, USA.,Department of Neurosurgery, University of Virginia, Charlottesville, VA, USA
| | - C Roger
- Burns, Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - K Ikeda
- Department of Anesthesiology, PO Box 800710, Charlottesville, VA, 22908, USA
| | - M S Todorovic
- Department of Anesthesiology, Washington University, St Louis, MO, USA
| | - S C Wallis
- Burns, Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - J Lipman
- Burns, Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Queensland, Australia.,Department of Intensive Care Medicine
| | - J A Roberts
- Burns, Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Queensland, Australia.,Departments of Pharmacy and Intensive Care Medicine, Royal Brisbane and Women's Hospital.,Centre for Translational Anti-infective Pharmacodynamics, The University of Queensland, Brisbane, Queensland, Australia
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33
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Ricciardelli A, Casillo A, Papa R, Monti DM, Imbimbo P, Vrenna G, Artini M, Selan L, Corsaro MM, Tutino ML, Parrilli E. Pentadecanal inspired molecules as new anti-biofilm agents against Staphylococcus epidermidis. BIOFOULING 2018; 34:1110-1120. [PMID: 30698031 DOI: 10.1080/08927014.2018.1544246] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 10/30/2018] [Accepted: 10/30/2018] [Indexed: 06/09/2023]
Abstract
Staphylococcus epidermidis, a harmless human skin colonizer, is a significant nosocomial pathogen in predisposed hosts because of its capability to form a biofilm on indwelling medical devices. In a recent paper, the purification and identification of the pentadecanal produced by the Antarctic bacterium Pseudoalteromonas haloplanktis TAC125, able to impair S. epidermidis biofilm formation, were reported. Here the authors report on the chemical synthesis of pentadecanal derivatives, their anti-biofilm activity on S. epidermidis, and their action in combination with antibiotics. The results clearly indicate that the pentadecanal derivatives were able to prevent, to a different extent, biofilm formation and that pentadecanoic acid positively modulated the antimicrobial activity of the vancomycin. The cytotoxicity of these new anti-biofilm molecules was tested on two different immortalized eukaryotic cell lines in view of their potential applications.
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Affiliation(s)
| | - Angela Casillo
- a Chemical Sciences , University of Naples "Federico II" , Naples , Italy
| | - Rosanna Papa
- b Department of Public Health and Infectious Diseases , Sapienza University , Rome , Italy
| | - Daria Maria Monti
- a Chemical Sciences , University of Naples "Federico II" , Naples , Italy
| | - Paola Imbimbo
- a Chemical Sciences , University of Naples "Federico II" , Naples , Italy
| | - Gianluca Vrenna
- b Department of Public Health and Infectious Diseases , Sapienza University , Rome , Italy
| | - Marco Artini
- b Department of Public Health and Infectious Diseases , Sapienza University , Rome , Italy
| | - Laura Selan
- b Department of Public Health and Infectious Diseases , Sapienza University , Rome , Italy
| | | | - Maria Luisa Tutino
- a Chemical Sciences , University of Naples "Federico II" , Naples , Italy
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Magana M, Sereti C, Ioannidis A, Mitchell CA, Ball AR, Magiorkinis E, Chatzipanagiotou S, Hamblin MR, Hadjifrangiskou M, Tegos GP. Options and Limitations in Clinical Investigation of Bacterial Biofilms. Clin Microbiol Rev 2018; 31:e00084-16. [PMID: 29618576 PMCID: PMC6056845 DOI: 10.1128/cmr.00084-16] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Bacteria can form single- and multispecies biofilms exhibiting diverse features based upon the microbial composition of their community and microenvironment. The study of bacterial biofilm development has received great interest in the past 20 years and is motivated by the elegant complexity characteristic of these multicellular communities and their role in infectious diseases. Biofilms can thrive on virtually any surface and can be beneficial or detrimental based upon the community's interplay and the surface. Advances in the understanding of structural and functional variations and the roles that biofilms play in disease and host-pathogen interactions have been addressed through comprehensive literature searches. In this review article, a synopsis of the methodological landscape of biofilm analysis is provided, including an evaluation of the current trends in methodological research. We deem this worthwhile because a keyword-oriented bibliographical search reveals that less than 5% of the biofilm literature is devoted to methodology. In this report, we (i) summarize current methodologies for biofilm characterization, monitoring, and quantification; (ii) discuss advances in the discovery of effective imaging and sensing tools and modalities; (iii) provide an overview of tailored animal models that assess features of biofilm infections; and (iv) make recommendations defining the most appropriate methodological tools for clinical settings.
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Affiliation(s)
- Maria Magana
- Department of Clinical Microbiology, Athens Medical School, Aeginition Hospital, Athens, Greece
| | - Christina Sereti
- Department of Clinical Microbiology, Athens Medical School, Aeginition Hospital, Athens, Greece
- Department of Microbiology, Thriassio General Hospital, Attiki, Greece
| | - Anastasios Ioannidis
- Department of Clinical Microbiology, Athens Medical School, Aeginition Hospital, Athens, Greece
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Greece
| | - Courtney A Mitchell
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Anthony R Ball
- Gliese 623b, Mendon, Massachusetts, USA
- GAMA Therapeutics LLC, Pepperell, Massachusetts, USA
| | - Emmanouil Magiorkinis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens-Goudi, Greece
| | | | - Michael R Hamblin
- Harvard-MIT Division of Health Science and Technology, Cambridge, Massachusetts, USA
- Department of Dermatology, Harvard Medical School, Boston, Massachusetts, USA
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Maria Hadjifrangiskou
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - George P Tegos
- Gliese 623b, Mendon, Massachusetts, USA
- GAMA Therapeutics LLC, Pepperell, Massachusetts, USA
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35
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Czuba U, Quintana R, De Pauw-Gillet MC, Bourguignon M, Moreno-Couranjou M, Alexandre M, Detrembleur C, Choquet P. Atmospheric Plasma Deposition of Methacrylate Layers Containing Catechol/Quinone Groups: An Alternative to Polydopamine Bioconjugation for Biomedical Applications. Adv Healthc Mater 2018; 7:e1701059. [PMID: 29577666 DOI: 10.1002/adhm.201701059] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 12/22/2017] [Indexed: 01/08/2023]
Abstract
Bioconjugation of enzymes on coatings based on polydopamine (PDA) layers is an appealing approach to control biological responses on biomedical implant surfaces. As alternative to PDA wet deposition, a fast, solvent-free, and dynamic deposition approach based on atmospheric-pressure plasma dielectric barrier discharge process is considered to deposit on metallic surfaces acrylic-based interlayers containing highly chemically reactive catechol/quinone groups. A biomimetic approach based on covalent immobilization of Dispersin B, an enzyme with antibiofilm properties, shows the bioconjugation potential of the novel plasma polymer layers. The excellent antibiofilm activity against Staphylococcus epidermidis is comparable to the PDA-based layers prepared by wet chemical methods with slow deposition rates. A study of preosteoblastic MG-63 human cell line viability and adhesion properties on plasma polymer layers demonstrates early interaction required for biomedical applications.
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Affiliation(s)
- Urszula Czuba
- Materials Research and Technology Department; Luxembourg Institute of Science and Technology (LIST); L-4422 Belvaux Luxembourg
- Chemistry Department, Center for Education and Research on Macromolecules (CERM); CESAM Research Unit; University of Liege; 4000 Liège Belgium
| | - Robert Quintana
- Materials Research and Technology Department; Luxembourg Institute of Science and Technology (LIST); L-4422 Belvaux Luxembourg
| | | | - Maxime Bourguignon
- Chemistry Department, Center for Education and Research on Macromolecules (CERM); CESAM Research Unit; University of Liege; 4000 Liège Belgium
- Symbiose Biomaterials s.a.; 4000 Liège Belgium
| | - Maryline Moreno-Couranjou
- Materials Research and Technology Department; Luxembourg Institute of Science and Technology (LIST); L-4422 Belvaux Luxembourg
| | | | - Christophe Detrembleur
- Chemistry Department, Center for Education and Research on Macromolecules (CERM); CESAM Research Unit; University of Liege; 4000 Liège Belgium
| | - Patrick Choquet
- Materials Research and Technology Department; Luxembourg Institute of Science and Technology (LIST); L-4422 Belvaux Luxembourg
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36
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Campoccia D, Montanaro L, Ravaioli S, Cangini I, Testoni F, Visai L, Arciola CR. New Parameters to Quantitatively Express the Invasiveness of Bacterial Strains from Implant-Related Orthopaedic Infections into Osteoblast Cells. MATERIALS 2018; 11:ma11040550. [PMID: 29614037 PMCID: PMC5951434 DOI: 10.3390/ma11040550] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 03/23/2018] [Accepted: 03/27/2018] [Indexed: 12/31/2022]
Abstract
Complete eradication of bacterial infections is often a challenging task, especially in presence of prosthetic devices. Invasion of non-phagocytic host cells appears to be a critical mechanism of microbial persistence in host tissues. Hidden within host cells, bacteria elude host defences and antibiotic treatments that are intracellularly inactive. The intracellular invasiveness of bacteria is generally measured by conventional gentamicin protection assays. The efficiency of invasion, however, markedly differs across bacterial species and adjustments to the titre of the microbial inocula used in the assays are often needed to enumerate intracellular bacteria. Such changes affect the standardisation of the method and hamper a direct comparison of bacteria on a same scale. This study aims at investigating the precise relation between inoculum, in terms of multiplicity of infection (MOI), and internalised bacteria. The investigation included nine Staphylococcus aureus, seven Staphylococcus epidermidis, five Staphylococcus lugdunensis and two Enterococcus faecalis clinical strains, which are co-cultured with MG63 human osteoblasts. Unprecedented insights are offered on the relations existing between MOI, number of internalised bacteria and per cent of internalised bacteria. New parameters are identified that are of potential use for qualifying the efficiency of internalization and compare the behaviour of bacterial strains.
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Affiliation(s)
- Davide Campoccia
- Research Unit on Implant Infections, Rizzoli Orthopaedic Institute, 40136 Bologna, Italy.
| | - Lucio Montanaro
- Research Unit on Implant Infections, Rizzoli Orthopaedic Institute, 40136 Bologna, Italy.
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40126 Bologna, Italy.
| | - Stefano Ravaioli
- Research Unit on Implant Infections, Rizzoli Orthopaedic Institute, 40136 Bologna, Italy.
| | - Ilaria Cangini
- Research Unit on Implant Infections, Rizzoli Orthopaedic Institute, 40136 Bologna, Italy.
| | - Francesca Testoni
- Research Unit on Implant Infections, Rizzoli Orthopaedic Institute, 40136 Bologna, Italy.
| | - Livia Visai
- Department of Molecular Medicine, Center for Tissue Engineering (CIT), INSTM UdR of Pavia, University of Pavia, 27100 Pavia, Italy.
- Department of Occupational Medicine, Ergonomy and Disability, Nanotechnology Laboratory, Salvatore Maugeri Foundation, 27100 Pavia, Italy.
| | - Carla Renata Arciola
- Research Unit on Implant Infections, Rizzoli Orthopaedic Institute, 40136 Bologna, Italy.
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40126 Bologna, Italy.
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37
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Panico A, Paladini F, Pollini M. Development of regenerative and flexible fibroin‐based wound dressings. J Biomed Mater Res B Appl Biomater 2018; 107:7-18. [DOI: 10.1002/jbm.b.34090] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 12/12/2017] [Accepted: 01/28/2018] [Indexed: 12/16/2022]
Affiliation(s)
- Angelica Panico
- Department of Engineering for InnovationUniversity of SalentoLecce Italy
| | - Federica Paladini
- Department of Engineering for InnovationUniversity of SalentoLecce Italy
- Caresilk S.r.l.s., Via Monteroni c/o Technological District DHITECHLecce, Italy
- CNR NANOTEC‐Institute of Nanotechnology c/o Campus EcotekneLecce Italy
| | - Mauro Pollini
- Department of Engineering for InnovationUniversity of SalentoLecce Italy
- Caresilk S.r.l.s., Via Monteroni c/o Technological District DHITECHLecce, Italy
- CNR NANOTEC‐Institute of Nanotechnology c/o Campus EcotekneLecce Italy
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38
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Staphylococcal Osteomyelitis: Disease Progression, Treatment Challenges, and Future Directions. Clin Microbiol Rev 2018; 31:31/2/e00084-17. [PMID: 29444953 DOI: 10.1128/cmr.00084-17] [Citation(s) in RCA: 231] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Osteomyelitis is an inflammatory bone disease that is caused by an infecting microorganism and leads to progressive bone destruction and loss. The most common causative species are the usually commensal staphylococci, with Staphylococcus aureus and Staphylococcus epidermidis responsible for the majority of cases. Staphylococcal infections are becoming an increasing global concern, partially due to the resistance mechanisms developed by staphylococci to evade the host immune system and antibiotic treatment. In addition to the ability of staphylococci to withstand treatment, surgical intervention in an effort to remove necrotic and infected bone further exacerbates patient impairment. Despite the advances in current health care, osteomyelitis is now a major clinical challenge, with recurrent and persistent infections occurring in approximately 40% of patients. This review aims to provide information about staphylococcus-induced bone infection, covering the clinical presentation and diagnosis of osteomyelitis, pathophysiology and complications of osteomyelitis, and future avenues that are being explored to treat osteomyelitis.
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39
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Su EP, Justin DF, Pratt CR, Sarin VK, Nguyen VS, Oh S, Jin S. Effects of titanium nanotubes on the osseointegration, cell differentiation, mineralisation and antibacterial properties of orthopaedic implant surfaces. Bone Joint J 2018; 100-B:9-16. [PMID: 29292334 PMCID: PMC6424438 DOI: 10.1302/0301-620x.100b1.bjj-2017-0551.r1] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 06/16/2017] [Indexed: 11/21/2022]
Abstract
The development and pre-clinical evaluation of
nano-texturised, biomimetic, surfaces of titanium (Ti) implants treated
with titanium dioxide (TiO2) nanotube arrays is reviewed. In
vitro and in vivo evaluations show that
TiO2 nanotubes on Ti surfaces positively affect the osseointegration,
cell differentiation, mineralisation, and anti-microbial properties.
This surface treatment can be superimposed onto existing macro and
micro porous Ti implants creating a surface texture that also interacts
with cells at the nano level. Histology and mechanical pull-out testing
of specimens in rabbits indicate that TiO2 nanotubes
improves bone bonding nine-fold (p = 0.008). The rate of mineralisation
associated with TiO2 nanotube surfaces is about three
times that of non-treated Ti surfaces. In addition to improved osseointegration
properties, TiO2 nanotubes reduce the initial adhesion
and colonisation of Staphylococcus epidermidis.
Collectively, the properties of Ti implant surfaces enhanced with
TiO2 nanotubes show great promise. Cite this article: Bone Joint J 2018;100-B(1
Supple A):9–16.
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Affiliation(s)
- E P Su
- Hospital for Special Surgery, New York, USA
| | - D F Justin
- Nanovation Partners, LLC, Camarillo, California, USA
| | - C R Pratt
- Nanovation Partners, LLC, Camarillo, California, USA
| | - V K Sarin
- Kinamed Incorporated, Camarillo, California, USA
| | - V S Nguyen
- Optimotion Implants, LLC, Orlando, Florida, USA
| | - S Oh
- Department of Dental Biomaterials, College of Dentistry, Wonkwang University, Iksan, Jeonbuk, Republic of Korea
| | - S Jin
- Nanovation Partners, LLC, Camarillo, California, USA
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40
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Josse J, Laurent F, Diot A. Staphylococcal Adhesion and Host Cell Invasion: Fibronectin-Binding and Other Mechanisms. Front Microbiol 2017; 8:2433. [PMID: 29259603 PMCID: PMC5723312 DOI: 10.3389/fmicb.2017.02433] [Citation(s) in RCA: 135] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 11/23/2017] [Indexed: 02/02/2023] Open
Abstract
Opportunistic bacteria from the genus Staphylococcus can cause life-threatening infections such as pneumonia, endocarditis, bone and joint infections, and sepsis. This pathogenicity is closely related to their capacity to bind directly to the extracellular matrix or to host cells. Adhesion is indeed the first step in the formation of biofilm or the invasion of host cells, which protect the bacteria from the host immune system and facilitate chronic infection. Adhesion relies on the expression of a repertoire of surface proteins called adhesins, notably microbial surface components recognizing adhesive matrix molecules. In this short review, we discuss the main pathway (FnBP-Fn-α5β1 integrin), as well as alternatives, through which Staphylococcus aureus adheres to and then invades non-professional phagocytic cells. We then examine the corresponding mechanisms for coagulase negative staphylococci. There is currently a little understanding of the molecular mechanisms that lead to internalization. Filling this gap in the literature would therefore be an important step toward limiting the duration of staphylococci infections in clinical practice.
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Affiliation(s)
- Jérôme Josse
- International Center for Infectiology Research, INSERM U1111, CNRS UMR5308, ENS Lyon, Lyon 1 University, Lyon, France
| | - Frédéric Laurent
- International Center for Infectiology Research, INSERM U1111, CNRS UMR5308, ENS Lyon, Lyon 1 University, Lyon, France.,Institute for Infectious Agents, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,French National Reference Centre for Staphylococci, Lyon, France.,Microbiology-Mycology Department, Institut des Sciences Pharmaceutiques et Biologiques de Lyon, Lyon, France
| | - Alan Diot
- International Center for Infectiology Research, INSERM U1111, CNRS UMR5308, ENS Lyon, Lyon 1 University, Lyon, France
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41
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Sabaté Brescó M, Harris LG, Thompson K, Stanic B, Morgenstern M, O'Mahony L, Richards RG, Moriarty TF. Pathogenic Mechanisms and Host Interactions in Staphylococcus epidermidis Device-Related Infection. Front Microbiol 2017; 8:1401. [PMID: 28824556 PMCID: PMC5539136 DOI: 10.3389/fmicb.2017.01401] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 07/11/2017] [Indexed: 12/25/2022] Open
Abstract
Staphylococcus epidermidis is a permanent member of the normal human microbiota, commonly found on skin and mucous membranes. By adhering to tissue surface moieties of the host via specific adhesins, S. epidermidis is capable of establishing a lifelong commensal relationship with humans that begins early in life. In its role as a commensal organism, S. epidermidis is thought to provide benefits to human host, including out-competing more virulent pathogens. However, largely due to its capacity to form biofilm on implanted foreign bodies, S. epidermidis has emerged as an important opportunistic pathogen in patients receiving medical devices. S. epidermidis causes approximately 20% of all orthopedic device-related infections (ODRIs), increasing up to 50% in late-developing infections. Despite this prevalence, it remains underrepresented in the scientific literature, in particular lagging behind the study of the S. aureus. This review aims to provide an overview of the interactions of S. epidermidis with the human host, both as a commensal and as a pathogen. The mechanisms retained by S. epidermidis that enable colonization of human skin as well as invasive infection, will be described, with a particular focus upon biofilm formation. The host immune responses to these infections are also described, including how S. epidermidis seems to trigger low levels of pro-inflammatory cytokines and high levels of interleukin-10, which may contribute to the sub-acute and persistent nature often associated with these infections. The adaptive immune response to S. epidermidis remains poorly described, and represents an area which may provide significant new discoveries in the coming years.
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Affiliation(s)
- Marina Sabaté Brescó
- Musculoskeletal Infection, AO Research Institute DavosDavos, Switzerland.,Molecular Immunology, Swiss Institute of Allergy and Asthma Research, University of ZurichDavos, Switzerland
| | - Llinos G Harris
- Microbiology and Infectious Diseases, Institute of Life Science, Swansea University Medical SchoolSwansea, United Kingdom
| | - Keith Thompson
- Musculoskeletal Infection, AO Research Institute DavosDavos, Switzerland
| | - Barbara Stanic
- Musculoskeletal Infection, AO Research Institute DavosDavos, Switzerland
| | - Mario Morgenstern
- Department of Orthopedic and Trauma Surgery, University Hospital BaselBasel, Switzerland
| | - Liam O'Mahony
- Molecular Immunology, Swiss Institute of Allergy and Asthma Research, University of ZurichDavos, Switzerland
| | - R Geoff Richards
- Musculoskeletal Infection, AO Research Institute DavosDavos, Switzerland
| | - T Fintan Moriarty
- Musculoskeletal Infection, AO Research Institute DavosDavos, Switzerland
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42
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Induced membrane technique: Advances in the management of bone defects. Int J Surg 2017; 42:110-116. [DOI: 10.1016/j.ijsu.2017.04.064] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 04/19/2017] [Accepted: 04/30/2017] [Indexed: 12/31/2022]
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43
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Dibartola AC, Swearingen MC, Granger JF, Stoodley P, Dusane DH. Biofilms in orthopedic infections: a review of laboratory methods. APMIS 2017; 125:418-428. [DOI: 10.1111/apm.12671] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 01/06/2016] [Indexed: 12/18/2022]
Affiliation(s)
| | - Matthew C. Swearingen
- Department of Microbial Infection and Immunity; The Ohio State University; Columbus OH USA
| | | | - Paul Stoodley
- Department of Microbial Infection and Immunity; The Ohio State University; Columbus OH USA
- Department of Orthopaedics; The Ohio State University; Columbus OH USA
- National Centre for Advanced Tribology; Faculty of Engineering and the Environment; University of Southampton; Southampton UK
| | - Devendra H. Dusane
- Department of Microbial Infection and Immunity; The Ohio State University; Columbus OH USA
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44
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Szczuka E, Jabłońska L, Kaznowski A. Coagulase-negative staphylococci: pathogenesis, occurrence of antibiotic resistance genes and in vitro effects of antimicrobial agents on biofilm-growing bacteria. J Med Microbiol 2016; 65:1405-1413. [PMID: 27902368 DOI: 10.1099/jmm.0.000372] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Coagulase-negative staphylococci (CoNS) are opportunistic pathogens that particularly cause infections in patients with implanted medical devices. The present research was performed to study the virulence potential of 53 clinical isolates of Staphylococcus capitis, Staphylococcus auricularis, Staphylococcus lugdunensis, Staphylococcus simulans, Staphylococcus cohnii and Staphylococcus caprae. All clinical strains were clonally unrelated. Isolates carried genes encoding resistance to β-lactam (mecA) (15 %), aminoglycoside [aac(6')/aph(2″)(11 %), aph (3')-IIIa (15 %), ant(4')-Ia (19 %)] and macrolide, lincosamide and streptogramin B (MLSB) [erm(A) (4 %), erm(B) (13 %), erm(C) (41 %), msr(A) (11 %)] antibiotics. CoNS isolates (64 %) were able to form biofilms. Confocal laser scanning microscopy revealed that these biofilms formed a three-dimensional structure composed mainly of living cells. All biofilm-positive strains carried the ica operon. In vitro studies demonstrated that a combination treatment with tigecycline and rifampicin was more effective against biofilms than one with ciprofloxacin and rifampicin. The minimum biofilm eradication concentration values were 0.062-0.5 µg ml-1 for tigecycline/rifampicin and 0.250-2 µg ml-1 for ciprofloxacin/rifampicin. All CoNS strains adhered to the human epithelial cell line HeLa, and more than half of the isolates were able to invade the HeLa cells, although most invaded relatively poorly. The virulence of CoNS is also attributed to their cytotoxic effects on HeLa cells. Incubation of HeLa cells with culture supernatant of the CoNS isolates resulted in cell death. The results indicate that the pathogenicity of S. capitis, S. auricularis, S. lugdunensis, S. cohnii and S. caprae is multi-factorial, involving the ability of these bacteria to adhere to human epithelial cells, form biofilms and invade and destroy human cells.
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Affiliation(s)
- Ewa Szczuka
- Department of Microbiology, Institute of Experimental Biology, Faculty of Biology, Adam Mickiewicz University, ul. Umultowska 89, 61-614 Poznań, Poland
| | - Lucyna Jabłońska
- Department of Microbiology, Institute of Experimental Biology, Faculty of Biology, Adam Mickiewicz University, ul. Umultowska 89, 61-614 Poznań, Poland
| | - Adam Kaznowski
- Department of Microbiology, Institute of Experimental Biology, Faculty of Biology, Adam Mickiewicz University, ul. Umultowska 89, 61-614 Poznań, Poland
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45
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Clonality, virulence and the occurrence of genes encoding antibiotic resistance among Staphylococcus warneri isolates from bloodstream infections. J Med Microbiol 2016; 65:828-836. [DOI: 10.1099/jmm.0.000287] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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46
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Maali Y, Martins-Simões P, Valour F, Bouvard D, Rasigade JP, Bes M, Haenni M, Ferry T, Laurent F, Trouillet-Assant S. Pathophysiological Mechanisms of Staphylococcus Non-aureus Bone and Joint Infection: Interspecies Homogeneity and Specific Behavior of S. pseudintermedius. Front Microbiol 2016; 7:1063. [PMID: 27462303 PMCID: PMC4940379 DOI: 10.3389/fmicb.2016.01063] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 06/24/2016] [Indexed: 01/10/2023] Open
Abstract
Implicated in more than 60% of bone and joint infections (BJIs), Staphylococci have a particular tropism for osteoarticular tissue and lead to difficult-to-treat clinical infections. To date, Staphylococcus aureus internalization in non-professional phagocytic cells (NPPCs) is a well-explored virulence mechanism involved in BJI chronicity. Conversely, the pathophysiological pathways associated with Staphylococcus non-aureus (SNA) BJIs have scarcely been studied despite their high prevalence. In this study, 15 reference strains from 15 different SNA species were compared in terms of (i) adhesion to human fibronectin based on adhesion microplate assays and (ii) internalization ability, intracellular persistence and cytotoxicity based on an in vitro infection model using human osteoblasts. Compared to S. aureus, S. pseudintermedius was the only species that significantly adhered to human fibronectin. This species was also associated with high (even superior to S. aureus) internalization ability, intracellular persistence and cytotoxicity. These findings were confirmed using a panel of 17 different S. pseudintermedius isolates. Additionally, S. pseudintermedius internalization by osteoblasts was completely abolished in β1 integrin-deficient murine osteoblasts. These results suggest the involvement of β1 integrin in the invasion process, although this mechanism was previously restricted to S. aureus. In summary, our results suggest that internalization into NPPCs is not a classical pathophysiologic mechanism of SNA BJIs. S. pseudintermedius appears to be an exception, and its ability to invade and subsequently induce cytotoxicity in NPPCs could explain its severe and necrotic forms of infection, notably in dogs, which exhibit a high prevalence of S. pseudintermedius infection.
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Affiliation(s)
- Yousef Maali
- Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, Université de Lyon 1, ENS de Lyon, Team "Pathogenesis of staphylococcal infections"Lyon, France; Department of Clinical Microbiology, Northern Hospital Group, Hospices Civils de LyonLyon, France
| | - Patrícia Martins-Simões
- Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, Université de Lyon 1, ENS de Lyon, Team "Pathogenesis of staphylococcal infections"Lyon, France; Department of Clinical Microbiology, Northern Hospital Group, Hospices Civils de LyonLyon, France
| | - Florent Valour
- Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, Université de Lyon 1, ENS de Lyon, Team "Pathogenesis of staphylococcal infections"Lyon, France; Infectious Diseases Department, Northern Hospital Group, Hospices Civils de LyonLyon, France
| | - Daniel Bouvard
- INSERM U1209, Albert Bonniot InstituteGrenoble, France; Université Grenoble AlpesGrenoble, France
| | - Jean-Philippe Rasigade
- Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, Université de Lyon 1, ENS de Lyon, Team "Pathogenesis of staphylococcal infections"Lyon, France; National Reference Center of Staphylococci, Hospices Civils de LyonLyon, France
| | - Michele Bes
- National Reference Center of Staphylococci, Hospices Civils de Lyon Lyon, France
| | - Marisa Haenni
- ANSES - French Agency for Food, Environmental and Occupational Health & Safety Lyon, France
| | - Tristan Ferry
- Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, Université de Lyon 1, ENS de Lyon, Team "Pathogenesis of staphylococcal infections"Lyon, France; Infectious Diseases Department, Northern Hospital Group, Hospices Civils de LyonLyon, France
| | - Frédéric Laurent
- Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, Université de Lyon 1, ENS de Lyon, Team "Pathogenesis of staphylococcal infections"Lyon, France; Department of Clinical Microbiology, Northern Hospital Group, Hospices Civils de LyonLyon, France; National Reference Center of Staphylococci, Hospices Civils de LyonLyon, France
| | - Sophie Trouillet-Assant
- Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, Université de Lyon 1, ENS de Lyon, Team "Pathogenesis of staphylococcal infections"Lyon, France; Department of Clinical Microbiology, Northern Hospital Group, Hospices Civils de LyonLyon, France
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Dapunt U, Giese T, Stegmaier S, Moghaddam A, Hänsch GM. The osteoblast as an inflammatory cell: production of cytokines in response to bacteria and components of bacterial biofilms. BMC Musculoskelet Disord 2016; 17:243. [PMID: 27250617 PMCID: PMC4890488 DOI: 10.1186/s12891-016-1091-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 05/19/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Implant infections are a major complication in the field of orthopaedics. Bacteria attach to the implant-surface and form biofilm-colonies which makes them difficult to treat. Not only immune cells exclusively respond to bacterial challenges, but also local tissue cells are capable of participating in defense mechanisms. The aim of this study was to evaluate the role of osteoblasts in the context of implant infections. METHODS Primary osteoblasts were cultivated and stimulated with free-swimming bacteria at 4 °C and 37 °C. Supernatants were harvested for ELISA and expression of pro-inflammatory cytokines evaluated by RT-PCR. Bacterial binding to osteoblasts was evaluated using cytofluorometry and uptake was investigated by (3)H thymidine-labelling of bacteria. Osteoblasts were additionally stimulated with the extracellular polymeric substance (EPS) of Staphylococcus epidermidis biofilms, as well as components of the EPS; the bacterial heat shock protein GroEL in particular. RESULTS We demonstrated that binding of bacteria to the osteoblast cell surface leads to an increased production of pro-inflammatory cytokines. Bacteria are capable of surviving intracellular. Furthermore, osteoblasts do not only respond to free-swimming, planktonic bacteria, but also to components of the EPS, including lipoteichoic acid and the heat shock protein GroEL. CONCLUSION In conclusion, local tissue cells, specifically osteoblasts, might contribute to the persistence of the inflammatory response associated with implant-infections.
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Affiliation(s)
- Ulrike Dapunt
- Center for Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, Heidelberg, 69118, Germany.
| | - Thomas Giese
- Institute for Immunology, Heidelberg University, Im Neuenheimer Feld 305, Heidelberg, 69120, Germany
| | - Sabine Stegmaier
- Institute for Immunology, Heidelberg University, Im Neuenheimer Feld 305, Heidelberg, 69120, Germany
| | - Arash Moghaddam
- HTRG Heidelberg Trauma Research Group, Center for Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, Heidelberg, 69118, Germany
| | - Gertrud Maria Hänsch
- Institute for Immunology, Heidelberg University, Im Neuenheimer Feld 305, Heidelberg, 69120, Germany
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Trouillet-Assant S, Lelièvre L, Martins-Simões P, Gonzaga L, Tasse J, Valour F, Rasigade JP, Vandenesch F, Muniz Guedes RL, Ribeiro de Vasconcelos AT, Caillon J, Lustig S, Ferry T, Jacqueline C, Loss de Morais G, Laurent F. Adaptive processes of Staphylococcus aureus isolates during the progression from acute to chronic bone and joint infections in patients. Cell Microbiol 2016; 18:1405-14. [PMID: 26918656 DOI: 10.1111/cmi.12582] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 02/20/2016] [Indexed: 11/28/2022]
Abstract
Staphylococcus aureus bone and joint infection (BJI) is associated with significant rates of chronicity and relapse. In this study, we investigated how S. aureus is able to adapt to the human environment by comparing isolates from single patients with persisting or relapsing BJIs that were recovered during the initial and recurrent BJI episodes. In vitro and in vivo assays and whole-genome sequencing analyses revealed that the recurrent isolates induced a reduced inflammatory response, formed more biofilms, persisted longer in the intracellular compartments of host bone cells, were less cytotoxic and induced less mortality in a mouse infection model compared with the initial isolates despite the lack of significant changes at the genomic level. These findings suggest that S. aureus BJI chronicization is associated with an in vivo bacterial phenotypical adaptation that leads to decreased virulence and host immune escape, which is linked to increased intraosteoblastic persistence and biofilm formation.
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Affiliation(s)
- Sophie Trouillet-Assant
- Centre International de Recherche en Infectiologie, INSERM U1111, Pathogenesis of staphylococcal infections, University of Lyon 1, Lyon, France. .,Department of Clinical Microbiology, Northern Hospital Group, Hospices Civils de Lyon, Lyon, France.
| | - Lucie Lelièvre
- Centre International de Recherche en Infectiologie, INSERM U1111, Pathogenesis of staphylococcal infections, University of Lyon 1, Lyon, France
| | - Patrícia Martins-Simões
- Centre International de Recherche en Infectiologie, INSERM U1111, Pathogenesis of staphylococcal infections, University of Lyon 1, Lyon, France.,Department of Clinical Microbiology, Northern Hospital Group, Hospices Civils de Lyon, Lyon, France
| | - Luiz Gonzaga
- Bioinformatics Laboratory - LABINFO, National Laboratory of Scientific Computation - LNCC/MCTI, Petrópolis, Brazil
| | - Jason Tasse
- Centre International de Recherche en Infectiologie, INSERM U1111, Pathogenesis of staphylococcal infections, University of Lyon 1, Lyon, France.,Department of Clinical Microbiology, Northern Hospital Group, Hospices Civils de Lyon, Lyon, France
| | - Florent Valour
- Centre International de Recherche en Infectiologie, INSERM U1111, Pathogenesis of staphylococcal infections, University of Lyon 1, Lyon, France.,Infectious Diseases Department, Northern Hospital Group, Hospices Civils de Lyon, Lyon, France
| | - Jean-Philippe Rasigade
- Centre International de Recherche en Infectiologie, INSERM U1111, Pathogenesis of staphylococcal infections, University of Lyon 1, Lyon, France.,Department of Clinical Microbiology, Northern Hospital Group, Hospices Civils de Lyon, Lyon, France.,National Reference Center for Staphylococci, Hospices Civils de Lyon, Lyon, France
| | - François Vandenesch
- Centre International de Recherche en Infectiologie, INSERM U1111, Pathogenesis of staphylococcal infections, University of Lyon 1, Lyon, France.,Department of Clinical Microbiology, Northern Hospital Group, Hospices Civils de Lyon, Lyon, France.,National Reference Center for Staphylococci, Hospices Civils de Lyon, Lyon, France
| | - Rafael Lucas Muniz Guedes
- Bioinformatics Laboratory - LABINFO, National Laboratory of Scientific Computation - LNCC/MCTI, Petrópolis, Brazil
| | | | - Jocelyne Caillon
- University of Nantes, Medical School, UPRES EA, 3826, Nantes, France
| | - Sebastien Lustig
- Orthopedic Surgery Department, Northern Hospital Group, Hospices Civils de Lyon, Lyon, France
| | - Tristan Ferry
- Centre International de Recherche en Infectiologie, INSERM U1111, Pathogenesis of staphylococcal infections, University of Lyon 1, Lyon, France.,Infectious Diseases Department, Northern Hospital Group, Hospices Civils de Lyon, Lyon, France
| | - Cédric Jacqueline
- University of Nantes, Medical School, UPRES EA, 3826, Nantes, France
| | - Guilherme Loss de Morais
- Bioinformatics Laboratory - LABINFO, National Laboratory of Scientific Computation - LNCC/MCTI, Petrópolis, Brazil
| | - Frédéric Laurent
- Centre International de Recherche en Infectiologie, INSERM U1111, Pathogenesis of staphylococcal infections, University of Lyon 1, Lyon, France.,Department of Clinical Microbiology, Northern Hospital Group, Hospices Civils de Lyon, Lyon, France.,National Reference Center for Staphylococci, Hospices Civils de Lyon, Lyon, France
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Molina-Manso D, Del-Prado G, Gómez-Barrena E, Cordero-Ampuero J, Fernandez-Roblas R, Esteban J. Effect of different agents with potential antibiofilm activity on antimicrobial susceptibility of biofilms formed by Staphylococcus spp. isolated from implant-related infections. J Antibiot (Tokyo) 2016; 69:686-8. [DOI: 10.1038/ja.2016.9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 12/14/2015] [Accepted: 01/11/2016] [Indexed: 02/06/2023]
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Campoccia D, Testoni F, Ravaioli S, Cangini I, Maso A, Speziale P, Montanaro L, Visai L, Arciola CR. Orthopedic implant infections: Incompetence of Staphylococcus epidermidis, Staphylococcus lugdunensis, and Enterococcus faecalis to invade osteoblasts. J Biomed Mater Res A 2015; 104:788-801. [PMID: 26378773 DOI: 10.1002/jbm.a.35564] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 09/15/2015] [Indexed: 11/11/2022]
Abstract
Septic failure is still the major complication of prosthetic implants. Entering host cells, bacteria hide from host immune defenses, shelter from extracellular antibiotics, and cause chronic infection. Staphylococcus aureus, the leading etiologic agent of orthopedic implant infections, is able to enter bone cells and induce osteoblast apoptosis, osteoclast recruitment, and highly destructive osteomyelitis. Staphylococcus epidermidis, Staphylococcus lugdunensis, and Enterococcus faecalis are opportunistic pathogens causative of implant-related infections. This study investigated the ability to internalize into osteoblastic MG63 cells of 22 S. epidermidis, 9 S. lugdunensis, and 21 E. faecalis clinical isolates from orthopedic implant infections. Isolates were categorized in clusters by ribotyping. Internalization assay was carried out by means of a microtiter plate-based method. S. epidermidis, S. lugdunensis, and E. faecalis strains turned out incompetent to enter osteoblasts, exhibiting negligible internalization into MG63 cells, nearly three orders of magnitude lower than that of S. aureus. Osteoblast invasion does not appear as a pathogenetic mechanism utilized by S. epidermidis, S. lugdunensis, or E. faecalis for infecting orthopedic implants. Moreover, it can be inferred that intracellularly active antimicrobials should not be necessary against implant infections caused by the three bacterial species. Finally, implications with the uptake of biomaterial microparticles by nonphagocytic cells are enlightened. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 788-801, 2016.
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Affiliation(s)
- Davide Campoccia
- Research Unit on Implant Infections, Rizzoli Orthopedic Institute, Bologna, Italy
| | - Francesca Testoni
- Research Unit on Implant Infections, Rizzoli Orthopedic Institute, Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Stefano Ravaioli
- Research Unit on Implant Infections, Rizzoli Orthopedic Institute, Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Ilaria Cangini
- Research Unit on Implant Infections, Rizzoli Orthopedic Institute, Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Alessandra Maso
- Microbiology Analysis Section of the Musculoskeletal Tissue Bank, Rizzoli Orthopedic Institute, Bologna, Italy
| | - Pietro Speziale
- Department of Molecular Medicine, Unit of Biochemistry, University of Pavia, Pavia, Italy
| | - Lucio Montanaro
- Research Unit on Implant Infections, Rizzoli Orthopedic Institute, Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Livia Visai
- Department of Molecular Medicine, Center for Tissue Engineering (CIT), INSTM UdR of Pavia, University of Pavia, Pavia, Italy.,Department of Occupational Medicine, Ergonomy and Disability, Nanotechnology Laboratory, Salvatore Maugeri Foundation, Pavia, Italy
| | - Carla Renata Arciola
- Research Unit on Implant Infections, Rizzoli Orthopedic Institute, Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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