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Dijksteel GS, Ulrich MMW, Vlig M, Sobota A, Middelkoop E, Boekema BKHL. Safety and bactericidal efficacy of cold atmospheric plasma generated by a flexible surface Dielectric Barrier Discharge device against Pseudomonas aeruginosa in vitro and in vivo. Ann Clin Microbiol Antimicrob 2020; 19:37. [PMID: 32814573 PMCID: PMC7439657 DOI: 10.1186/s12941-020-00381-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/13/2020] [Indexed: 02/07/2023] Open
Abstract
Background Cold atmospheric plasma (CAP), which is ionized gas produced at atmospheric pressure, could be a novel and potent antimicrobial therapy for the treatment of infected wounds. Previously we have shown that CAP generated with a flexible surface Dielectric Barrier Discharge (sDBD) is highly effective against bacteria in vitro and in ex vivo burn wound models. In the current paper, we determined the in vitro and in vivo safety and efficacy of CAP generated by this sDBD device. Methods The effect of CAP on DNA mutations of V79 fibroblasts was measured using a hypoxanthine–guanine-phosphoribosyltransferase (HPRT) assay. Furthermore, effects on cell proliferation, apoptosis and DNA damage in ex vivo burn wound models (BWMs) were assessed using immunohistochemistry. Next, 105 colony forming units (CFU) P. aeruginosa strain PAO1 were exposed to CAP in a 3D collagen-elastin matrix environment to determine the number of surviving bacteria in vitro. Finally, rat excision wounds were inoculated with 107 CFU PAO1 for 24 h. The wounds received a single CAP treatment, repeated treatments on 4 consecutive days with CAP, 100 µL of 1% (wt/wt) silver sulfadiazine or no treatment. Wound swabs and punch biopsies were taken to determine the number of surviving bacteria. Results Exposure of V79 fibroblasts to CAP did not increase the numbers of mutated colonies. Additionally, the number of proliferative, apoptotic and DNA damaged cells in the BWMs was comparable to that of the unexposed control. Exposure of PAO1 to CAP for 2 min resulted in the complete elimination of bacteria in vitro. Contrarily, CAP treatment for 6 min of rat wounds colonized with PAO1 did not effectively reduce the in vivo bacterial count. Conclusions CAP treatment was safe but showed limited efficacy against PAO1 in our rat wound infection model.
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Affiliation(s)
- Gabrielle S Dijksteel
- Association of Dutch Burn Centres, Zeestraat 29, 1941 AJ, Beverwijk, The Netherlands. .,Dept. of Plastic, Reconstructive & Hand Surgery, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
| | - Magda M W Ulrich
- Association of Dutch Burn Centres, Zeestraat 29, 1941 AJ, Beverwijk, The Netherlands.,Dept. of Plastic, Reconstructive & Hand Surgery, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.,Dept. of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marcel Vlig
- Association of Dutch Burn Centres, Zeestraat 29, 1941 AJ, Beverwijk, The Netherlands
| | - Ana Sobota
- Dept. of Applied Physics, Eindhoven University of Technology, PO Box 513, 5600 MB, Eindhoven, The Netherlands
| | - Esther Middelkoop
- Association of Dutch Burn Centres, Zeestraat 29, 1941 AJ, Beverwijk, The Netherlands.,Dept. of Plastic, Reconstructive & Hand Surgery, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Bouke K H L Boekema
- Association of Dutch Burn Centres, Zeestraat 29, 1941 AJ, Beverwijk, The Netherlands
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Kumar V, Chopra A, Bisht B, Bhalla V. Colorimetric and electrochemical detection of pathogens in water using silver ions as a unique probe. Sci Rep 2020; 10:11986. [PMID: 32686720 PMCID: PMC7371729 DOI: 10.1038/s41598-020-68803-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 06/11/2020] [Indexed: 12/23/2022] Open
Abstract
The manuscript highlights the efficacy of silver ions to act as a unique probe for the detection of bacterial contamination in water samples. The bacterial cell membrane adherence property of the silver ions was employed to develop two different bacterial detection assays employing colorimetric and electrochemical techniques. In one of the schemes, silver ion was used directly as a detector of bacteria in a colorimetric assay format, and in the other scheme surface-functionalized antibodies were used as a primary capture for specific detection of Salmonella enterica serovar Typhi. The colorimetric detection is based on silver-induced inhibition of urease activity and silver ion utilization by bacteria for the rapid screening of enteric pathogens in water. The specific detection of bacteria uses an antibody-based electrochemical method that employs silver as an electrochemical probe. The ability of silver to act as an electrochemical probe was investigated by employing Anodic Stripping Voltammetry (ASV) for targeted detection of Salmonella Typhi. For further insights into the developed assays, inductively coupled plasma mass spectrometry (ICP-MS) and transmission electron microscopy (TEM) studies were performed. The sensitivity of the developed assay was found to be 100 cfu mL−1 for colorimetric and 10 cfu mL−1 for electrochemical assay respectively.
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Affiliation(s)
- Virendra Kumar
- CSIR-Institute of Microbial Technology, Sector 39A, Chandigarh, 160036, India
| | - Adity Chopra
- CSIR-Institute of Microbial Technology, Sector 39A, Chandigarh, 160036, India
| | - Bhawana Bisht
- CSIR-Institute of Microbial Technology, Sector 39A, Chandigarh, 160036, India
| | - Vijayender Bhalla
- CSIR-Institute of Microbial Technology, Sector 39A, Chandigarh, 160036, India.
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Gundavda MK, Katariya A, Reddy R, Agarwal MG. Fighting Megaprosthetic Infections: What are the Chances of Winning? Indian J Orthop 2020; 54:469-476. [PMID: 32549962 PMCID: PMC7270394 DOI: 10.1007/s43465-020-00080-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 02/24/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Megaprosthetic infections continue to be a leading mode of failure after limb salvage surgery. Though challenging, amputations can be avoided with proper management in majority of the cases. This study aims to describe the spectrum of mega-endoprosthetic infections at our institute and assess the treatment efficacy in these patients. MATERIALS AND METHODS All patients treated for endoprosthetic infection at our institute between 2010 and 2018 were retrospectively analyzed for overall survival of reconstruction method, site and type of megaprosthesis, adjuvant therapy, microbial isolates, surgical and medical management and outcomes. RESULTS Thirty-five patients (22 males: 13 females) were analyzed following treatment for endoprosthetic infection. Majority were around the knee joint [most commonly with proximal tibia (n = 14) followed by distal femur (n = 12) megaprosthesis]. Ten patients had undergone primary surgical procedure at our institute, while 25 patients presented with infection after megaprosthesis implantation. In the 28 culture-positive infections, the most common micro-organism was Staphylococcus spp. (18 patients: methicillin-sensitive Staphylococcus aureus = 9, coagulase-negative Staphylococcus = 5, methicillin-resistant Staphylococcus aureus = 1, Staphylococcus epidermidis = 3) and poly-microbial infection was present in three patients. Nine patients underwent successful debridement and wound wash with insertion of antibiotic impregnated cement beads in 5/9 cases. Twenty-one patients required a two-stage revision. Of these 30 patients, all but one has completely resolved infections. One patient with resurfaced late infection after re-implantation is on chronic suppressive antimicrobial therapy and close follow-up. Amputation because of uncontrolled infection was performed in three patients (one death post-operatively due to systemic complications of septicemia), while two patients opted for amputation as opposed to stage revisions. Median antimicrobial therapy duration was 6 weeks (1-12 weeks). Reconstructive surgery for soft tissue cover was required in seven patients. CONCLUSIONS In patients with early or acute presentation without frank granulation or pus around the implant, debridement and insertion of antibiotic cement beads was adequate. Two-stage revisions with complete removal of the megaprosthesis showed best results in infections that could be controlled with antimicrobial therapy. More than one exchange of cement spacer was required for uncontrolled infections. Multidisciplinary approach in consultation with the infectious disease team is essential to determine choice of antibiotic cement for beads/spacer as well as appropriate adjuvant antimicrobial therapy to solve the challenging problem of endoprosthetic infections following bone tumor surgery. Adequate and healthy soft tissue cover of the implant should be achieved wherever indicated.
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Affiliation(s)
- Manit K. Gundavda
- Orthopedic Oncology, Department of Orthopaedics/Surgical Oncology, PD Hinduja Hospital and Medical Research Center, Veer Savarkar Marg, Mahim, Room 1417, Hinduja Clinic, Mumbai, 400016 India
| | - Ameya Katariya
- Orthopedic Oncology, Department of Orthopaedics/Surgical Oncology, PD Hinduja Hospital and Medical Research Center, Veer Savarkar Marg, Mahim, Room 1417, Hinduja Clinic, Mumbai, 400016 India
| | - Rajeev Reddy
- Orthopedic Oncology, Department of Orthopaedics/Surgical Oncology, PD Hinduja Hospital and Medical Research Center, Veer Savarkar Marg, Mahim, Room 1417, Hinduja Clinic, Mumbai, 400016 India
| | - Manish G. Agarwal
- Orthopedic Oncology, Department of Orthopaedics/Surgical Oncology, PD Hinduja Hospital and Medical Research Center, Veer Savarkar Marg, Mahim, Room 1417, Hinduja Clinic, Mumbai, 400016 India
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Manejo multimodal conservador de material de osteosíntesis ante herida quirúrgica con sobreinfección polimicrobiana, incluyendo Staphylococcus aureus resistente a meticilina. Caso clínico. Rev Esp Cir Ortop Traumatol (Engl Ed) 2020; 64:125-129. [DOI: 10.1016/j.recot.2019.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 09/27/2019] [Accepted: 11/15/2019] [Indexed: 11/22/2022] Open
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Conservative multimodal management of osteosynthesis material in surgical wounds with polymicrobial superinfection, including methicillin-resistant Staphylococcus aureus. Clinical case. Rev Esp Cir Ortop Traumatol (Engl Ed) 2020. [DOI: 10.1016/j.recote.2020.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Pimentel BNADS, de Foggi CC, Barbugli PA, de Oliveira RC, de Avila ED, Longo E, Vergani CE. Antifungal activity and biocompatibility of α-AgVO3 microcrystals: A promising material against oral Candida disease. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 108:110405. [DOI: 10.1016/j.msec.2019.110405] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 07/04/2019] [Accepted: 11/06/2019] [Indexed: 02/01/2023]
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Torre E, Giasafaki D, Steriotis T, Cassinelli C, Morra M, Fiorilli S, Vitale-Brovarone C, Charalambopoulou G, Iviglia G. Silver Decorated Mesoporous Carbons for the Treatment of Acute and Chronic Wounds, in a Tissue Regeneration Context. Int J Nanomedicine 2019; 14:10147-10164. [PMID: 32021158 PMCID: PMC6942531 DOI: 10.2147/ijn.s234393] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 12/03/2019] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Silver decorated mesoporous carbons are interesting systems that may offer effective solutions for advanced wound care products by combining the well-known anti-microbial activity of silver nanoparticles with the versatile properties of ordered mesoporous carbons. Silver is being used as a topical antimicrobial agent, especially in wound repair. However, while silver shows bactericidal properties, it is also cytotoxic at high concentrations. Therefore, the incorporation of silver into ordered mesoporous carbons allows to exploit both silver's biological effects and mesoporous carbons' biocompatibility and versatility with the purpose of conceiving silver-doped materials in light of the growing health concern in wound care. METHODS The wound healing potential of an ordered mesoporous carbon also doped with two different loadings of silver nanoparticles (2 wt% and 10 wt%), was investigated through a biological assessment study based on different assays (cell viability, inflammation, antibacterial tests, macrophage-conditioned fibroblast and human keratinocyte cell cultures). RESULTS The results show silver-doped ordered mesoporous carbons to positively condition cell viability, with a cell viability percentage >70% even for 10 wt% Ag, to modulate the expression of inflammatory cytokines and of genes involved in tissue repair (KRT6a, VEGFA, IVN) and remodeling (MMP9, TIMP3) in different cell systems. Furthermore, along with the biocompatibility and the bioactivity, the silver-doped ordered mesoporous carbons still retain an antibacterial effect, as shown by a maximum of 13.1% of inhibited area in the Halo test. The obtained results clearly showed that the silver-doped ordered mesoporous carbons exhibit both good biocompatibility and antibacterial effect with enhanced re-epithelialization, angiogenesis promotion and tissue regeneration. DISCUSSION These findings suggest that the exceptional properties of silver-doped ordered mesoporous carbons could be exploited in the treatment of acute and chronic wounds and that such carbon materials could be potential candidates for use in medical devices for wound healing purposes, in particular, the 10 wt% loading, as the results showed to be the most effective.
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Affiliation(s)
- Elisa Torre
- Nobil Bio Ricerche Srl, Portacomaro14037, AT, Italy
| | - Dimitra Giasafaki
- National Center for Scientific Research “Demokritos”, Athens15341, Greece
| | - Theodore Steriotis
- National Center for Scientific Research “Demokritos”, Athens15341, Greece
| | | | - Marco Morra
- Nobil Bio Ricerche Srl, Portacomaro14037, AT, Italy
| | - Sonia Fiorilli
- Department of Applied Science and Technology, Politecnico di Torino, Torino, Italy
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Synthesis, structures and antibacterial properties of Cu(II) and Ag(I) complexes derived from 2,6-bis(benzothiazole)-pyridine. Polyhedron 2019. [DOI: 10.1016/j.poly.2019.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Naskar A, Kim KS. Nanomaterials as Delivery Vehicles and Components of New Strategies to Combat Bacterial Infections: Advantages and Limitations. Microorganisms 2019; 7:E356. [PMID: 31527443 PMCID: PMC6780078 DOI: 10.3390/microorganisms7090356] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/11/2019] [Accepted: 09/14/2019] [Indexed: 02/07/2023] Open
Abstract
Life-threatening bacterial infections have been well-controlled by antibiotic therapies and this approach has greatly improved the health and lifespan of human beings. However, the rapid and worldwide emergence of multidrug resistant (MDR) bacteria has forced researchers to find alternative treatments for MDR infections as MDR bacteria can sometimes resist all the present day antibiotic therapies. In this respect, nanomaterials have emerged as innovative antimicrobial agents that can be a potential solution against MDR bacteria. The present review discusses the advantages of nanomaterials as potential medical means and carriers of antibacterial activity, the types of nanomaterials used for antibacterial agents, strategies to tackle toxicity of nanomaterials for clinical applications, and limitations which need extensive studies to overcome. The current progress of using different types of nanomaterials, including new emerging strategies for the single purpose of combating bacterial infections, is also discussed in detail.
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Affiliation(s)
- Atanu Naskar
- Department of Chemistry and Chemistry Institute for Functional Materials, Pusan National University, Busan 46241, Korea
| | - Kwang-Sun Kim
- Department of Chemistry and Chemistry Institute for Functional Materials, Pusan National University, Busan 46241, Korea.
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60
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Structural studies and investigation on the antifungal activity of silver(I) complexes with 5-nitrofuran-derived hydrazones. Polyhedron 2019. [DOI: 10.1016/j.poly.2019.06.033] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Chowdhry SA. Use of oxidized regenerated cellulose (ORC)/collagen/silver-ORC dressings to help manage skin graft donor site wounds. JPRAS Open 2019; 22:33-40. [PMID: 32158895 PMCID: PMC7061655 DOI: 10.1016/j.jpra.2019.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 08/08/2019] [Indexed: 11/24/2022] Open
Abstract
Harvesting donor site explants for split-thickness skin grafting creates an iatrogenic wound that presents additional challenges to clinicians due to morbidities such as persistent bleeding, pain, infection, and delayed epithelialization. Although there have been several randomized controlled trials to compare wound dressing effectiveness, there is still a lack of standardization for donor site wound dressings. A retrospective comparison of 59 patients that underwent split-thickness skin graft reconstructions between January 2017 and September 2018 was performed. Donor sites of Group 1 patients (n = 29) were treated with a transparent film dressing and transitioned to petrolatum gauze dressings if exudate management became problematic; Group 2 patients (n = 30) were treated with oxidized regenerated cellulose/collagen/silver-oxidized regenerated cellulose (ORC/C/Ag-ORC) dressings. Evaluations of time to epithelialization, number of dressings required, signs of inflammation, and objective pain were compared between groups. Group 1 was comprised of 18 female and 11 male patients, whereas Group 2 was comprised of 14 females and 16 males. There were no significant differences between groups when comparing age, sex, comorbidities, or donor site size (area or depth). Patients in Group 2 had a significantly shorter time to complete re-epithelialization (P < .0001), fewer dressing changes (P < .0001), and less objective pain as measured by the need for opioid pain mediation (P < .0001) when compared to Group 1. The percentage of patients with signs of inflammation was also lower for Group 2, although this difference was not statistically significant (P = .0797). Although prospective, controlled studies are still needed, data from this study suggest that ORC/C/Ag-ORC dressings could become a more effective alternative for the management of donor site wounds, especially in patients with known risk factors for wound healing.
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Affiliation(s)
- Saeed A Chowdhry
- Rosalind Franklin University of Medicine and Science, Chicago Medical School, 4400W 95th St, Suite 102, Oak Lawn, Chicago, IL 60453, United States
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Jain N, Mansuri A. Stopping the Unstoppable: Unconventional Methods to Prevent the Biofilm Growth. Curr Drug Discov Technol 2019; 17:515-522. [PMID: 31362660 DOI: 10.2174/1570163816666190726153441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 04/11/2019] [Accepted: 06/03/2019] [Indexed: 12/18/2022]
Abstract
Biofilms are consortia of microorganisms encased in extracellular matrix that protect cells from adverse conditions. A biofilm matrix is typically composed of extracellular DNA, cellulose and proteinaceous amyloid fibers. The matrix aids in adhesion to abiotic and biotic surface including medical devices and host tissues. The presence of biofilm makes bacteria more resilient and non-responsive to most current treatment regimes at disposal. Therefore, biofilm-associated infections are serious threat in hospital settings and pose a huge burden on economy. Inhibition of matrix components (cellulose and/or amyloid formation) has emerged as a lucrative alternative strategy to cure biofilm-related infections and combat antibiotic resistance. Here we review the current and emerging therapeutic interventions to mitigate persistent infections due to biofilms. The successful implementation of these interventions will have a huge impact on alleviating the current financial burden on healthcare services.
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Affiliation(s)
- Neha Jain
- Department of Bioscience and Bioengineering, Indian Institute of Technology (IIT) Jodhpur, NH 65, Nagaur Road, Karwar, Jodhpur (Rajasthan), India
| | - Abdulkhalik Mansuri
- Department of Bioscience and Bioengineering, Indian Institute of Technology (IIT) Jodhpur, NH 65, Nagaur Road, Karwar, Jodhpur (Rajasthan), India
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Acosta S, Quintanilla L, Alonso M, Aparicio C, Rodríguez-Cabello JC. Recombinant AMP/Polypeptide Self-Assembled Monolayers with Synergistic Antimicrobial Properties for Bacterial Strains of Medical Relevance. ACS Biomater Sci Eng 2019; 5:4708-4716. [DOI: 10.1021/acsbiomaterials.9b00247] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Sergio Acosta
- Bioforge lab, CIBER-BBN, Edificio LUCIA, University of Valladolid, Paseo Belén 19, Valladolid 47011, Spain
| | - Luis Quintanilla
- Bioforge lab, CIBER-BBN, Edificio LUCIA, University of Valladolid, Paseo Belén 19, Valladolid 47011, Spain
| | - Matilde Alonso
- Bioforge lab, CIBER-BBN, Edificio LUCIA, University of Valladolid, Paseo Belén 19, Valladolid 47011, Spain
| | - Conrado Aparicio
- MDRCBB, Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-250A Moos Tower, 515 Delaware Street Southeast, Minneapolis, Minnesota 55455, United States
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Injectable Scaffolds Enriched with Silver to Inhibit Bacterial Invasion in Tissue Regeneration. MATERIALS 2019; 12:ma12121931. [PMID: 31208032 PMCID: PMC6631215 DOI: 10.3390/ma12121931] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 06/10/2019] [Accepted: 06/11/2019] [Indexed: 01/04/2023]
Abstract
During wound healing, bacterial infections may prolong skin regeneration and tissue repair, causing delayed or incomplete healing. The therapeutic strategies currently used include general therapeutic modes, growth factors, skin substitutes, matrices and/or cell therapy. Among recent technologies, wound dressing materials comprising silver nitrate or silver sulfadiazine as the antimicrobial agent are widespread, despite their known cytotoxicity. The aim of this work was to develop and evaluate the efficacy of gelatinous injectable biomaterials composed of collagen and alginates, enriched with silver against bacterial pathogens commonly involved in wound infections. To reduce cytotoxicity, silver was used as lactate and saccharinated salts. Results show that silver-enriched beads were effective against both Gram-positive and Gram-negative strains in a concentration-dependent manner. Silver addition was more active against Staphylococcusepidermidis than against Pseudomonasaeruginosa. The antibacterial activity was localized only in the area of contact with the beads at concentrations lower than 0.3 mM, whereas at higher concentrations a larger inhibition halo was observed. No cytotoxic effect on eukaryotic cells was seen both testing the materials’ extracts or the Ag-doped beads in contact tests. These results, although preliminary, suggest that these scaffolds are a promising approach for realizing injectable or spreadable functional biomaterials with antibacterial activity for applications in wound management.
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NATURAL RUBBER - PROPOLIS MEMBRANE IMPROVES WOUND HEALING IN SECOND-DEGREE BURNING MODEL. Int J Biol Macromol 2019; 131:980-988. [DOI: 10.1016/j.ijbiomac.2019.03.147] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 03/12/2019] [Accepted: 03/21/2019] [Indexed: 11/21/2022]
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Zhang D, Liu W, Wu XD, He X, Lin X, Wang H, Li J, Jiang J, Huang W. Efficacy of novel nano-hydroxyapatite/polyurethane composite scaffolds with silver phosphate particles in chronic osteomyelitis. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2019; 30:59. [PMID: 31127361 DOI: 10.1007/s10856-019-6261-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 05/06/2019] [Indexed: 06/09/2023]
Abstract
Recently, chronic osteomyelitis is still a challenging surgical problem. Unfortunately, the traditional clinical method using bone cement loaded antibiotics is restricted due to its non-biodegradability and limited release of antibiotics. Hydroxyapatite is a good adsorbent with good biocompatibility, an ideal bone repair material, and can avert the requirement for the secondary surgical procedure of removal. In this study, nano-hydroxyapatite combined with a polyurethane containing 3% silver (Ag/n-HA/PU) was synthesized, and investigated for its efficacy of treating chronic bone infection with bone defects. To clarify its silver ions release characteristics, the concentration of the Ag+ in the elution was analyzed every day after in vitro deionized water immersion. A chronic osteomyelitis of tibia in rabbit model was established, and 70 New Zealand rabbits were divided into 4 groups, including the blank control group, nano-hydroxyapatite combined with polyurethane (n-HA/PU) implant group, 3% Ag/n-HA/PU group and 10% Ag/n-HA/PU group after debridement. Routine blood tests, radiography, Micro-CT, and histological staining were conducted at 4 days, 3, 6 and 12 weeks post-treatment. The results showed that the released silver from the 3% Ag/n-HA/PU and 10% Ag/n-HA/PU exhibited an initial burst release and followed by a slow controlled release up to 39 days and 42 days respectively. A good repair of bone defects, an appropriate rate of degradation of scaffolds and no significant toxicity were observed in the 3% Ag/n-HA/PU group, indicating the advantages of this novel synthetic scaffold to be a potential option for the treatment of chronic osteomyelitis. A novel nano-composite, nano-hydroxyapatite combined with a polyurethane containing 3% silver (Ag/n-HA/PU) provide controlled release of Ag+, illustrated by its abilities of biodegradation, antimicrobial activity, and favorable repair of bone defects in the treatment of chronic osteomyelitis.
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Affiliation(s)
- Dongli Zhang
- Department of orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Wen Liu
- Department of orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Xiang-Dong Wu
- Department of orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Xiaoqiang He
- Department of orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Xiao Lin
- Department of orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Han Wang
- Department of orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Jidong Li
- Research Center for Nano-Biomaterials, Analytical & Testing Center, Sichuan University, Chengdu, 610064, China
| | - Jiaxing Jiang
- Research Center for Nano-Biomaterials, Analytical & Testing Center, Sichuan University, Chengdu, 610064, China
| | - Wei Huang
- Department of orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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Gugala N, Vu D, Parkins MD, Turner RJ. Specificity in the Susceptibilities of Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus Clinical Isolates to Six Metal Antimicrobials. Antibiotics (Basel) 2019; 8:antibiotics8020051. [PMID: 31052359 PMCID: PMC6627307 DOI: 10.3390/antibiotics8020051] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 04/18/2019] [Accepted: 04/30/2019] [Indexed: 02/06/2023] Open
Abstract
In response to the occurrence of antibiotic resistance, there has been rapid developments in the field of metal-based antimicrobials. Although it is largely assumed that metals provide broad-spectrum microbial efficacy, studies have shown that this is not always the case. Therefore, in this study, we compared the susceptibilities of 93 clinical isolates belonging to the species Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus against six metals, namely aluminum, copper, gallium, nickel, silver and zinc. To provide qualitative comparative information, the resulting zones of growth inhibition were compared to the minimal inhibitory concentrations of three indicator strains E. coli ATCC 25922, P. aeruginosa ATCC 27853 and S. aureus ATCC 25923. Here, we demonstrate that the metal efficacies were species- and isolate-specific. Only several isolates were either resistant or sensitive to all of the six metals, with great variability found between isolates. However, the greatest degree of similarity was found with the E. coli isolates. In contrast, the susceptibilities of the remaining two collections, S. aureus and P. aeruginosa, were more highly dispersed. Using this information, we have shown that metals are not equal in their efficacies. Hence, their use should be tailored against a particular microorganism and care should be taken to ensure the use of the correct concentration.
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Affiliation(s)
- Natalie Gugala
- Department of Biological Sciences, University of Calgary, Calgary T2N 1N4, Canada.
| | - Dennis Vu
- Department of Biological Sciences, University of Calgary, Calgary T2N 1N4, Canada.
| | - Michael D Parkins
- Cumming School of Medicine, University of Calgary, Calgary T2N 1N4, Canada.
| | - Raymond J Turner
- Department of Biological Sciences, University of Calgary, Calgary T2N 1N4, Canada.
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Antibacterial effect and wound healing ability of silver nanoparticles incorporation into chitosan-based nanofibrous membranes. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 98:1053-1063. [DOI: 10.1016/j.msec.2019.01.073] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 12/16/2018] [Accepted: 01/16/2019] [Indexed: 11/18/2022]
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Trieu A, Mohamed A, Lynch E. Silver diamine fluoride versus sodium fluoride for arresting dentine caries in children: a systematic review and meta-analysis. Sci Rep 2019; 9:2115. [PMID: 30765785 PMCID: PMC6376061 DOI: 10.1038/s41598-019-38569-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 12/07/2018] [Indexed: 11/08/2022] Open
Abstract
Dental caries can compromise quality of life and is associated with demineralization of tooth structure by organic acids produced by microorganisms. This study systematically reviewed the dentine caries arrest capabilities of silver diamine fluoride (SDF) and sodium fluoride (NaF). A comprehensive search strategy was developed to identify the relevant publications in electronic databases and hand searched journals and reviews (to March 2018). By applying strict inclusion and exclusion criteria, only six papers (two randomized controlled trials, two follow-up articles and two secondary statistical analysis studies) were considered for full text qualitative and quantitative assessment. The included studies were critically appraised and statistically evaluated. Only four articles were considered for meta-analysis, as the other two were secondary analyses of included studies. When comparing the caries arrest lesions of SDF and NaF, SDF was found to be statistically more effective in dentine caries arrest of primary teeth during the 18 and 30 month clinical examinations. The weighted total effect size of the differences between SDF and NaF regarding arrested caries surfaces was calculated and showed nearly double the effectiveness of SDF to NaF at 30 months. Therefore, SDF is a more effective caries management reagent than NaF. Further clinical research is needed to consolidate the findings of this systematic review.
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Affiliation(s)
- Alice Trieu
- Pediatric Dental Resident, Pediatric Dentistry Department, University of Nevada, Las Vegas (UNLV), 89106, USA
| | - Ahmed Mohamed
- Visiting Faculty, Biomedical and Clinical Research, University of Nevada, Las Vegas (UNLV), 89106, USA
| | - Edward Lynch
- Professor and Principal Director of Biomedical and Clinical Research, University of Nevada, Las Vegas (UNLV), 89106, USA.
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Iwalokun BA, Akinloye O, Udoh BE, Akinyemi KO. Efficacy of silver nanoparticles against multidrug resistant clinical Staphylococcus aureus isolates from Nigeria. J Immunoassay Immunochem 2019; 40:214-236. [PMID: 30696349 DOI: 10.1080/15321819.2018.1555765] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Multidrug resistant (MDR) S. aureus infections continue to account for excess mortality in hospital and community settings and constitute a rising global health problem. However, data on the efficacy and mechanism of actions of alternative solutions like silver nanoparticles in developing countries are lacking. This study investigated anti-staphylococcal activity of silver nanoparticles (AgNP) against local strains from Nigeria. A total 119 clinical isolates of S. aureus from five Nigerian laboratories categorized as MRSA (n = 52) and MSSA (n = 67) by PCR were studied. The MIC of AgNP produced by chemical reduction method and characterized by surface plasmon resonance absorbance and size equivalence by scanning electron microscopy was determined by microbroth dilution method. Its effect on protease activity and plasmids were also investigated. Baseline characteristics of the isolates revealed MDR phenotype of the isolates, carriage of diverse plasmids (15-32 kb) among the MDR MSSA, and mean extracellular protease activity of 24.8-55.7 U/mL. The chemically synthesized AgNP had a peak absorbance at 400 nm with a size equivalence of 4.58 nm. The MICs of AgNP against the isolates were 4.7 μg/mL and 4.9 μg/mL, respectively, for MRSA and MSSA (P > 0.05). The bactericidal effect of AgNP at 2.5-5 μg/mL on the MSSA and MRSA isolates was observed at 2.7-5.5 h post exposure in vitro. Further analysis revealed plasmid eviction in the MDR MSSA isolates exposed to 5 μg/mL AgNP and dose-dependent reduction in extracellular protease activity by 84.6-93.1%. Hemolysis of human erythrocytes by AgNP was not observed at the MIC range. Conclusion: This study revealed safety and efficacy of AgNP against clinical MDR S. aureus isolates from Nigeria, using plasmid eviction and protease inhibition as mechanisms of action.
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Affiliation(s)
- B A Iwalokun
- a Molecular Biology & Biotechnology Department , Nigerian Institute of Medical Research , Lagos , Nigeria
| | - O Akinloye
- a Molecular Biology & Biotechnology Department , Nigerian Institute of Medical Research , Lagos , Nigeria.,b Clinical Chemistry and Molecular Diagnostic Research Laboratory, Department of Medical Laboratory Science, College of Medicine , University of Lagos , Lagos , Nigeria
| | - B E Udoh
- c Department of Medical Microbiology and Parasitology , Olabisi Onabanjo University , Sagamu , Nigeria
| | - K O Akinyemi
- d Department of Microbiology , Lagos State University , Lagos , Nigeria
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A Precautionary Approach to Guide the Use of Transition Metal-Based Nanotechnology to Prevent Orthopedic Infections. MATERIALS 2019; 12:ma12020314. [PMID: 30669523 PMCID: PMC6356474 DOI: 10.3390/ma12020314] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 01/15/2019] [Accepted: 01/18/2019] [Indexed: 12/11/2022]
Abstract
The increase of multidrug-resistant bacteria remains a global concern. Among the proposed strategies, the use of nanoparticles (NPs) alone or associated with orthopedic implants represents a promising solution. NPs are well-known for their antimicrobial effects, induced by their size, shape, charge, concentration and reactive oxygen species (ROS) generation. However, this non-specific cytotoxic potential is a powerful weapon effective against almost all microorganisms, but also against eukaryotic cells, raising concerns related to their safe use. Among the analyzed transition metals, silver is the most investigated element due to its antimicrobial properties per se or as NPs; however, its toxicity raises questions about its biosafety. Even though it has milder antimicrobial and cytotoxic activity, TiO2 needs to be exposed to UV light to be activated, thus limiting its use conjugated to orthopedic devices. By contrast, gold has a good balance between antimicrobial activity as an NP and cytocompatibility because of its inability to generate ROS. Nevertheless, although the toxicity and persistence of NPs within filter organs are not well verified, nowadays, several basic research on NP development and potential uses as antimicrobial weapons is reported, overemphasizing NPs potentialities, but without any existing potential of translation in clinics. This analysis cautions readers with respect to regulation in advancing the development and use of NPs. Hopefully, future works in vivo and clinical trials will support and regulate the use of nano-coatings to guarantee safer use of this promising approach against antibiotic-resistant microorganisms.
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Kandel S, Stenger-Smith J, Chakraborty I, Raptis RG. Syntheses and X-ray crystal structures of a family of dinuclear silver(I)pyrazolates: Assessment of their antibacterial efficacy against P. aeruginosa with a soft tissue and skin infection model. Polyhedron 2018. [DOI: 10.1016/j.poly.2018.08.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Silver-Impregnated Dressing Does Not Decrease Incidence of Surgical Site Infection After Adult Cardiac Surgery. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2018; 13:296-299. [PMID: 30124586 DOI: 10.1097/imi.0000000000000538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Sternal wound infections complicate 1% to 8% of cardiac surgeries and carry significant morbidity. We investigated the utility of silver-impregnated dressing in decreasing sternal wound infections after sternotomy cases. METHODS A single-institution cohort study was performed as part of a quality improvement trial of a new sternal dressing. Five hundred fifty-seven sternotomy cases were performed in 2015 with application of a traditional gauze dressing. In 2016, 682 sternotomy cases were performed with the use of a commercially available silver-impregnated dressing. Prospectively identified metrics were analyzed for each patient population along with nursing assessments and structured questionnaires. RESULTS Baseline characteristics of patients in traditional gauze and silver-impregnated dressing groups were similar. Morbidity and mortality were similar. Nine (1.6%) and 12 (1.8%) sternal wound infections were reported in traditional gauze and silver-impregnated dressing groups, respectively. There was no difference in the rate of sternal wound infections (P = 0.80). The number of organ space infections (3) and deep sternal wound infections (3) was the same; however, the number of superficial infections was greater in the silver-impregnated dressing cohort (3 vs. 6). Among patients in either group with sternal wound infection, there were no differences in the proportion of superficial infections (44% vs. 50%, P = 0.8) or the organism cultured (67% vs. 50% staphylococcus, P = 0.45). A total of 22% of patients reported "not satisfied" with silver-impregnated dressing. CONCLUSIONS Silver dressings did not reduce sternal wound infection after sternotomy for cardiac surgery in a large-cohort study. We discontinued the routine use of silver dressings for adult cardiac surgery based on these results because traditional gauze likely represents an equally effective and less costly alternative.
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Hashemi MM, Rovig J, Bateman J, Holden BS, Modelzelewski T, Gueorguieva I, von Dyck M, Bracken R, Genberg C, Deng S, Savage PB. Preclinical testing of a broad-spectrum antimicrobial endotracheal tube coated with an innate immune synthetic mimic. J Antimicrob Chemother 2018; 73:143-150. [PMID: 29029265 DOI: 10.1093/jac/dkx347] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 08/25/2017] [Indexed: 12/17/2022] Open
Abstract
Background Endotracheal tubes provide an abiotic surface on which bacteria and fungi form biofilms, and the release of endotoxins and planktonic organisms can cause damaging inflammation and infections. Objectives Ceragenins are small molecule mimics of antimicrobial peptides with broad-spectrum antibacterial and antifungal activity, and a ceragenin may be used to provide antimicrobial protection to the abiotic surface of an endotracheal tube. Methods A hydrogel film, containing CSA-131, was generated on endotracheal tubes. Elution of CSA-131 was quantified in drip-flow and static systems, antifungal and antibacterial activity was measured with repeated inoculation in growth media, biofilm formation was observed through electron microscopy, safety was determined by intubation of pigs with coated and uncoated endotracheal tubes. Results Optimized coatings containing CSA-131 provided controlled elution of CSA-131, with concentrations released of less than 1 μg/mL. The eluting ceragenin prevented fungal and bacterial colonization of coated endotracheal tubes for extended periods, while uncoated tubes were colonized by bacteria and fungi. Coated tubes were well tolerated in intubated pigs. Conclusions Thin films containing CSA-131 provide protection against microbial colonization of endotracheal tubes. This protection prevents fungal and bacterial biofilm formation on the tubes and reduces endotoxin associated with tubes. This coating is well suited for decreasing the adverse effects of intubation associated with infection and inflammation.
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Affiliation(s)
- Marjan M Hashemi
- Department of Chemistry and Biochemistry, Brigham Young University, Provo, UT, USA
| | - John Rovig
- Department of Chemistry and Biochemistry, Brigham Young University, Provo, UT, USA
| | - Jordan Bateman
- Department of Chemistry and Biochemistry, Brigham Young University, Provo, UT, USA
| | - Brett S Holden
- Department of Chemistry and Biochemistry, Brigham Young University, Provo, UT, USA
| | | | | | | | | | | | - Shenglou Deng
- Department of Chemistry and Biochemistry, Brigham Young University, Provo, UT, USA
| | - Paul B Savage
- Department of Chemistry and Biochemistry, Brigham Young University, Provo, UT, USA
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Gugala N, Lemire J, Chatfield-Reed K, Yan Y, Chua G, Turner RJ. Using a Chemical Genetic Screen to Enhance Our Understanding of the Antibacterial Properties of Silver. Genes (Basel) 2018; 9:E344. [PMID: 29986482 PMCID: PMC6071238 DOI: 10.3390/genes9070344] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 06/30/2018] [Accepted: 07/03/2018] [Indexed: 12/26/2022] Open
Abstract
It is essential to understand the mechanisms by which a toxicant is capable of poisoning the bacterial cell. The mechanism of action of many biocides and toxins, including numerous ubiquitous compounds, is not fully understood. For example, despite the widespread clinical and commercial use of silver (Ag), the mechanisms describing how this metal poisons bacterial cells remains incomplete. To advance our understanding surrounding the antimicrobial action of Ag, we performed a chemical genetic screen of a mutant library of Escherichia coli—the Keio collection, in order to identify Ag sensitive or resistant deletion strains. Indeed, our findings corroborate many previously established mechanisms that describe the antibacterial effects of Ag, such as the disruption of iron-sulfur clusters containing proteins and certain cellular redox enzymes. However, the data presented here demonstrates that the activity of Ag within the bacterial cell is more extensive, encompassing genes involved in cell wall maintenance, quinone metabolism and sulfur assimilation. Altogether, this study provides further insight into the antimicrobial mechanism of Ag and the physiological adaption of E. coli to this metal.
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Affiliation(s)
- Natalie Gugala
- Department of Biological Sciences, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada.
| | - Joe Lemire
- Department of Biological Sciences, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada.
| | - Kate Chatfield-Reed
- Department of Biological Sciences, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada.
| | - Ying Yan
- Department of Mathematics and Statistics, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada.
| | - Gordon Chua
- Department of Biological Sciences, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada.
| | - Raymond J Turner
- Department of Biological Sciences, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada.
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Abstract
With the advent of the global antimicrobial resistance (AMR) crisis, our arsenal of effective antibiotics is diminishing. The widespread use and misuse of antibiotics in human and veterinary medicine, compounded by the lack of novel classes of antibiotic in the pharmaceutical pipeline, has left a hole in our antibiotic armamentarium. Thus, alternatives to traditional antibiotics are being investigated, including two major groups of antibacterial agents, which have been extensively studied, phytochemicals and metals. Within these groups, there are several subclasses of compound/elements, including polyphenols and metal nanoparticles, which could be used to complement traditional antibiotics, either to increase their potency or extend their spectrum of activity. Alone or in combination, these antibacterial agents have been shown to be effective against a vast array of human and animal bacterial pathogens, including those resistant to licensed antibacterials. These alternative antibacterial agents could be a key element in our fight against AMR and provide desperately needed options, to veterinary and medical clinicians alike.
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Efficacy of different revision procedures for infected megaprostheses in musculoskeletal tumour surgery of the lower limb. PLoS One 2018; 13:e0200304. [PMID: 29975769 PMCID: PMC6033467 DOI: 10.1371/journal.pone.0200304] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 06/22/2018] [Indexed: 11/20/2022] Open
Abstract
Purpose The incidence of recurrent infections in patients following one or two stage revision for infected megaprostheses after resection of bone tumours was investigated. The difference between retaining at least one well fixed stem and a complete removal of the megaprosthesis during a two stage revision was also analysed. Methods 627 patients who experienced a replacement of a musculoskeletal tumour by megaprostheses were recorded. An infection occurred in 83 of 621 patients available for follow-up. 61 patients underwent one stage revision, and 16 patients two stage revision for the first revision surgery. In the entire study period, two stage revision was performed 32 times (first, second, and third revision). Results The cumulative incidence analysis showed a reinfection probability after one stage revision of 18% at one year, 30% at two years, 39% at five years, 46% at ten years, and 56% at 15 years. After two stage revision, a reinfection probability of 28% at two years, and 48% at five years was calculated. Cumulative incidence curves did not differ significantly (Gray’s test; p = 0.51) between one and two stage revision (with and without complete removal of the stems). In two stage revision (n = 32), a statistically significant difference in infection rates between patients treated with complete removal of the megaprosthesis (n = 18) including anchorage stems and patients with at least one retained stem (n = 14) was shown (Fisher’s exact test, p = 0.029). Conclusion Two stage revisions with complete removal of the megaprosthesis showed the best results among limb salvage procedures for the treatment of infected megaprosthesis.
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Silver-coated megaprostheses in the proximal femur in patients with sarcoma. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2018; 29:79-85. [DOI: 10.1007/s00590-018-2270-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 06/14/2018] [Indexed: 10/28/2022]
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Milo S, Nzakizwanayo J, Hathaway HJ, Jones BV, Jenkins ATA. Emerging medical and engineering strategies for the prevention of long-term indwelling catheter blockage. Proc Inst Mech Eng H 2018; 233:68-83. [PMID: 29807465 DOI: 10.1177/0954411918776691] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Urinary catheters have been used on an intermittent or indwelling basis for centuries, in order to relieve urinary retention and incontinence. Nevertheless, the use of urinary catheters in the clinical setting is fraught with complication, the most common of which is the development of nosocomial urinary tract infections, known as catheter-associated urinary tract infections. Infections of this nature are not only significant owing to their high incidence rate and subsequent economic burden but also to the severe medical consecutions that result. A range of techniques have been employed in recent years, utilising various technologies in attempts to counteract the perilous medical cascade following catheter blockage. This review will focus on the current advancement (within the last 10 years) in prevention of encrustation and blockage of long-term indwelling catheters both from engineering and medical perspectives, with particular emphasis on the importance of stimuli-responsive systems.
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Affiliation(s)
- Scarlet Milo
- 1 Department of Chemistry, University of Bath, Bath, UK
| | - Jonathan Nzakizwanayo
- 2 School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton, UK
| | | | - Brian V Jones
- 4 Department of Biology and Biochemistry, University of Bath, UK
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Liang S, Dang Q, Liu C, Zhang Y, Wang Y, Zhu W, Chang G, Sun H, Cha D, Fan B. Characterization and antibacterial mechanism of poly(aminoethyl) modified chitin synthesized via a facile one-step pathway. Carbohydr Polym 2018; 195:275-287. [PMID: 29804977 DOI: 10.1016/j.carbpol.2018.04.109] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 04/24/2018] [Accepted: 04/27/2018] [Indexed: 01/22/2023]
Abstract
This work aims to synthesize poly(aminoethyl) modified chitin (PAEMC) and ascertain its antibacterial activity and mechanism. FTIR and 1H NMR results proved aminoethyl moieties were grafted to C6OH and C3OH on chitin backbone in the form of polymerization. XRD and TG/DTG analyses manifested its well-defined crystallinity and thermostability. PAEMC, with average molecular weight (MW) of 851.0 kDa, degree of deacetylation (DD) of 27.95%, and degree of substitution (DS) of 1.77, had good solubility in aqueous solutions over the pH range of 3-12, and also possessed high antimicrobial activity against Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Bacillus proteus, and Klebsiella pneumoniae, commonly causing chronic wound infections. Nucleic acid release, protein leakage, increased inner membrane permeability, and decreased cell surface hydrophobicity implied bacterial cytomembranes were substantially compromised in the presence of PAEMC. Microscopically, PAEMC visually perturbed bacteria, illustrating deformed and even collapsed morphologies. Overall, PAEMC possessed good solubility, effectively destroyed bacteria via a membrane damage mechanism, and might serve as an antibacterial agent for treatments of chronic wound infections.
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Affiliation(s)
- Shengnan Liang
- College of Marine Life Sciences, Ocean University of China, 5 Yushan Road, Qingdao 266003, PR China
| | - Qifeng Dang
- College of Marine Life Sciences, Ocean University of China, 5 Yushan Road, Qingdao 266003, PR China
| | - Chengsheng Liu
- College of Marine Life Sciences, Ocean University of China, 5 Yushan Road, Qingdao 266003, PR China.
| | - Yubei Zhang
- College of Marine Life Sciences, Ocean University of China, 5 Yushan Road, Qingdao 266003, PR China
| | - Yan Wang
- College of Marine Life Sciences, Ocean University of China, 5 Yushan Road, Qingdao 266003, PR China
| | - Wenjing Zhu
- College of Marine Life Sciences, Ocean University of China, 5 Yushan Road, Qingdao 266003, PR China
| | - Guozhu Chang
- College of Marine Life Sciences, Ocean University of China, 5 Yushan Road, Qingdao 266003, PR China
| | - Hantian Sun
- College of Marine Life Sciences, Ocean University of China, 5 Yushan Road, Qingdao 266003, PR China
| | - Dongsu Cha
- The Graduate School of Biotechnology, Korea University, Seoul 136-701, South Korea
| | - Bing Fan
- Qingdao Aorun Biotechnology Co., Ltd., Room 602, Century Mansion, 39 Donghaixi Road, Qingdao 266071, PR China
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Silver Sulfadiazine Retards Wound Healing and Increases Hypertrophic Scarring in a Rabbit Ear Excisional Wound Model. J Burn Care Res 2018; 38:e418-e422. [PMID: 28009700 DOI: 10.1097/bcr.0000000000000406] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This study evaluated the effects of topical use of silver sulfadiazine cream (SSD) on wound healing and subsequent scarring in a rabbit ear wound model. Seven millimeter full-thickness excisional wounds were created in rabbit ears. Twenty-four rabbits were randomized into four groups in which each group received base cream, 0.01% SSD, 0.1% SSD, or 1% SSD, respectively. Each treatment was applied at 2-day intervals from postoperative days (PODs) 2 to 14. At POD 7, half of the rabbits from each group were killed and tissues were harvested to measure wound healing parameters that included epithelial gap and granulation area. At POD 28, the remaining rabbits from each group were assessed for hypertrophic scarring. Epithelial gaps in SSD-treated groups at concentrations of 0.1 and 1% were significantly larger than those of base cream-treated controls. In contrast, analysis of granulation areas that represent volume of granulation tissue formed during healing did not show any statistical differences between the base cream-treated group and all three SSD-treated groups. At POD 28, when compared to the base cream-treated group (1.44 ± 0.03), SSD-treated-groups (0.1 and 1%) had more (P < .05) hypertrophic scar formation (scar elevation index = 1.65 ± 0.04, 0.1%; 1.63 ± 0.06, 1%). The results of this study demonstrate that SSD treatment contributes not only to impaired reepithelialization but also to a greater hypertrophic scar formation. These results also indicate that caution should be exercised when using SSD clinically to prevent or treat wound infections.
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Abstract
Over half of the nearly two million healthcare-associated infections can be attributed to indwelling medical devices. In this review, we highlight the difficulty in diagnosing implantable device-related infection and how this leads to a likely underestimate of the prevalence. We then provide a length-scale conceptualization of device-related infection pathogenesis. Within this conceptualization we focus specifically on biofilm formation and the role of host immune and coagulation systems. Using this framework, we describe how current and developing preventative strategies target specific processes along the entire length-scale. In light of the significant time horizon for the development and translation of new preventative technologies, we also emphasize the need for parallel development of in situ treatment strategies. Specific examples of both preventative and treatment strategies and how they align with the length-scale conceptualization are described.
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Cambiaso-Daniel J, Boukovalas S, Bitz GH, Branski LK, Herndon DN, Culnan DM. Topical Antimicrobials in Burn Care: Part 1-Topical Antiseptics. Ann Plast Surg 2018; Publish Ahead of Print:10.1097/SAP.0000000000001297. [PMID: 29319571 PMCID: PMC6037606 DOI: 10.1097/sap.0000000000001297] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Burn wounds disrupt the body's primary defense against invasion and colonization by microorganisms. Topical antimicrobials are one component in burn wound care. These agents suppress microbial growth to advantage skin cells and wound healing. Topical antimicrobials can be divided into 2 superclasses: antiseptics and antibiotics. We review the 4 main classes of topical antiseptics (emulsifiers, acids, oxidizers, and heavy metals) and antiseptic-impregnated dressings in current clinical use and address the mechanisms, as well as the advantages and disadvantages of each antiseptic for burn wound management.
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Affiliation(s)
- Janos Cambiaso-Daniel
- Department of Surgery, University of Texas Medical Branch, and Shriners Hospitals for Children, Galveston, Texas, USA
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Austria
| | - Stafanos Boukovalas
- Division of Plastic Surgery, University of Texas Medical Branch, Galveston, Texas, USA
| | - Genevieve H. Bitz
- JMS Burn and Reconstructive Center, Merit Health Central Hospital, Jackson, Mississippi, USA
| | - Ludwik K. Branski
- Department of Surgery, University of Texas Medical Branch, and Shriners Hospitals for Children, Galveston, Texas, USA
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Austria
| | - David N. Herndon
- Department of Surgery, University of Texas Medical Branch, and Shriners Hospitals for Children, Galveston, Texas, USA
- Division of Plastic Surgery, University of Texas Medical Branch, Galveston, Texas, USA
| | - Derek M. Culnan
- JMS Burn and Reconstructive Center, Merit Health Central Hospital, Jackson, Mississippi, USA
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Seo SB, Dananjaya SHS, Nikapitiya C, Park BK, Gooneratne R, Kim TY, Lee J, Kim CH, De Zoysa M. Silver nanoparticles enhance wound healing in zebrafish (Danio rerio). FISH & SHELLFISH IMMUNOLOGY 2017; 68:536-545. [PMID: 28757200 DOI: 10.1016/j.fsi.2017.07.057] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 07/17/2017] [Accepted: 07/26/2017] [Indexed: 06/07/2023]
Abstract
Silver nanoparticles (AgNPs) were successfully synthesized by a chemical reduction method, physico-chemically characterized and their effect on wound-healing activity in zebrafish was investigated. The prepared AgNPs were circular-shaped, water soluble with average diameter and zeta potential of 72.66 nm and -0.45 mv, respectively. Following the creation of a laser skin wound on zebrafish, the effect of AgNPs on wound-healing activity was tested by two methods, direct skin application (2 μg/wound) and immersion in a solution of AgNPs and water (50 μg/L). The zebrafish were followed for 20 days post-wounding (dpw) by visual observation of wound size, calculating wound healing percentage (WHP), and histological examination. Visually, both direct skin application and immersion AgNPs treatments displayed clear and faster wound closure at 5, 10 and 20 dpw compared to the controls, which was confirmed by 5 dpw histology data. At 5 dpw, WHP was highest in the AgNPs immersion group (36.6%) > AgNPs direct application group (23.7%) > controls (18.2%), showing that WHP was most effective in fish immersed in AgNPs solution. In general, exposure to AgNPs induced gene expression of selected wound-healing-related genes, namely, transforming growth factor (TGF-β), matrix metalloproteinase (MMP) -9 and -13, pro-inflammatory cytokines (IL-1β and TNF-α) and antioxidant enzymes (superoxide dismutase and catalase), which observed differentiation at 12 and 24 h against the control; but the results were not consistently significant, and many either reached basal levels or were down regulated at 5 dpw in the wounded muscle. These results suggest that AgNPs are effective in acceleration of wound healing and altered the expression of some wound-healing-related genes. However, the detailed mechanism of enhanced wound healing remains to be investigated in fish.
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Affiliation(s)
- Seung Beom Seo
- College of Veterinary Medicine and Research Institute of Veterinary Medicine, Chungnam National University, Yuseong-gu, Daejeon, 34134, Republic of Korea
| | - S H S Dananjaya
- College of Veterinary Medicine and Research Institute of Veterinary Medicine, Chungnam National University, Yuseong-gu, Daejeon, 34134, Republic of Korea
| | - Chamilani Nikapitiya
- Department of Marine Life Sciences, School of Marine Biomedical Sciences, Jeju National University, Jeju Self-Governing Province, 63243, Republic of Korea; Fish Vaccine Research Center, Jeju National University, Jeju Self-Governing Province, 63243, Republic of Korea
| | - Bae Keun Park
- College of Veterinary Medicine and Research Institute of Veterinary Medicine, Chungnam National University, Yuseong-gu, Daejeon, 34134, Republic of Korea
| | - Ravi Gooneratne
- Department of Wine, Food and Molecular Biosciences, Faculty of Agriculture & Life Sciences, Lincoln University, New Zealand
| | - Tae-Yoon Kim
- Department of Biology, Chungnam National University, Yuseong-gu, Daejeon, 34134, Republic of Korea
| | - Jehee Lee
- Department of Marine Life Sciences, School of Marine Biomedical Sciences, Jeju National University, Jeju Self-Governing Province, 63243, Republic of Korea; Fish Vaccine Research Center, Jeju National University, Jeju Self-Governing Province, 63243, Republic of Korea
| | - Cheol-Hee Kim
- Department of Biology, Chungnam National University, Yuseong-gu, Daejeon, 34134, Republic of Korea.
| | - Mahanama De Zoysa
- College of Veterinary Medicine and Research Institute of Veterinary Medicine, Chungnam National University, Yuseong-gu, Daejeon, 34134, Republic of Korea; Fish Vaccine Research Center, Jeju National University, Jeju Self-Governing Province, 63243, Republic of Korea.
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85
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Hardes J, Henrichs MP, Hauschild G, Nottrott M, Guder W, Streitbuerger A. Silver-Coated Megaprosthesis of the Proximal Tibia in Patients With Sarcoma. J Arthroplasty 2017; 32:2208-2213. [PMID: 28343825 DOI: 10.1016/j.arth.2017.02.054] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 02/02/2017] [Accepted: 02/20/2017] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Proximal tibia arthroplasty is associated with high rates of infection. This study is the largest one that has compared the infection rates with titanium vs silver-coated megaprostheses in patients treated for sarcomas. METHODS The infection rate in 98 patients with sarcoma or giant-cell tumor in the proximal tibia who underwent placement of a titanium (n = 42) or silver-coated (n = 56) megaprosthesis (MUTARS) was assessed, along with the treatments administered for any infection. RESULTS As the primary end point of the study, the rates of infection were 16.7% in the titanium group and 8.9% in the silver group, resulting in 5-year prosthesis survival rates of 90% in the silver and 84% in the titanium group. Whereas in the titanium group 37.5% of patients ultimately had to undergo amputation in the present study, these mutilating surgical procedures were only necessary in the silver group in one patient (14.3%). CONCLUSION The use of silver-coated prosthesis reduced the infection rate in a relatively large and homogeneous group of patients. In addition, less-aggressive treatment of infection was possible in the group with silver-coated prosthesis.
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Affiliation(s)
- Jendrik Hardes
- Department of Orthopaedics and Tumour Orthopaedics, Münster University Hospital, Münster, Germany
| | - Marcel P Henrichs
- Department of Orthopaedics and Tumour Orthopaedics, Münster University Hospital, Münster, Germany
| | - Gregor Hauschild
- Department of Orthopaedics and Tumour Orthopaedics, Münster University Hospital, Münster, Germany
| | - Markus Nottrott
- Department of Orthopaedics and Tumour Orthopaedics, Münster University Hospital, Münster, Germany
| | - Wiebke Guder
- Department of Orthopaedics and Tumour Orthopaedics, Münster University Hospital, Münster, Germany
| | - Arne Streitbuerger
- Department of Orthopaedics and Tumour Orthopaedics, Münster University Hospital, Münster, Germany
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86
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Pelaz B, Alexiou C, Alvarez-Puebla RA, Alves F, Andrews AM, Ashraf S, Balogh LP, Ballerini L, Bestetti A, Brendel C, Bosi S, Carril M, Chan WCW, Chen C, Chen X, Chen X, Cheng Z, Cui D, Du J, Dullin C, Escudero A, Feliu N, Gao M, George M, Gogotsi Y, Grünweller A, Gu Z, Halas NJ, Hampp N, Hartmann RK, Hersam MC, Hunziker P, Jian J, Jiang X, Jungebluth P, Kadhiresan P, Kataoka K, Khademhosseini A, Kopeček J, Kotov NA, Krug HF, Lee DS, Lehr CM, Leong KW, Liang XJ, Ling Lim M, Liz-Marzán LM, Ma X, Macchiarini P, Meng H, Möhwald H, Mulvaney P, Nel AE, Nie S, Nordlander P, Okano T, Oliveira J, Park TH, Penner RM, Prato M, Puntes V, Rotello VM, Samarakoon A, Schaak RE, Shen Y, Sjöqvist S, Skirtach AG, Soliman MG, Stevens MM, Sung HW, Tang BZ, Tietze R, Udugama BN, VanEpps JS, Weil T, Weiss PS, Willner I, Wu Y, Yang L, Yue Z, Zhang Q, Zhang Q, Zhang XE, Zhao Y, Zhou X, Parak WJ. Diverse Applications of Nanomedicine. ACS NANO 2017; 11:2313-2381. [PMID: 28290206 PMCID: PMC5371978 DOI: 10.1021/acsnano.6b06040] [Citation(s) in RCA: 756] [Impact Index Per Article: 108.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Indexed: 04/14/2023]
Abstract
The design and use of materials in the nanoscale size range for addressing medical and health-related issues continues to receive increasing interest. Research in nanomedicine spans a multitude of areas, including drug delivery, vaccine development, antibacterial, diagnosis and imaging tools, wearable devices, implants, high-throughput screening platforms, etc. using biological, nonbiological, biomimetic, or hybrid materials. Many of these developments are starting to be translated into viable clinical products. Here, we provide an overview of recent developments in nanomedicine and highlight the current challenges and upcoming opportunities for the field and translation to the clinic.
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Affiliation(s)
- Beatriz Pelaz
- Fachbereich Physik, Fachbereich Medizin, Fachbereich Pharmazie, and Department of Chemistry, Philipps Universität Marburg, 35037 Marburg, Germany
| | - Christoph Alexiou
- ENT-Department, Section of Experimental Oncology & Nanomedicine
(SEON), Else Kröner-Fresenius-Stiftung-Professorship for Nanomedicine, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Ramon A. Alvarez-Puebla
- Department of Physical Chemistry, Universitat Rovira I Virgili, 43007 Tarragona, Spain
- ICREA, Pg. Lluís Companys 23, 08010 Barcelona, Spain
| | - Frauke Alves
- Department of Haematology and Medical Oncology, Department of Diagnostic
and Interventional Radiology, University
Medical Center Göttingen, 37075 Göttingen Germany
- Department of Molecular Biology of Neuronal Signals, Max-Planck-Institute for Experimental Medicine, 37075 Göttingen, Germany
| | - Anne M. Andrews
- California NanoSystems Institute, Department of Chemistry
and Biochemistry and Department of Psychiatry and Semel Institute
for Neuroscience and Human Behavior, Division of NanoMedicine and Center
for the Environmental Impact of Nanotechnology, and Department of Materials Science
and Engineering, University of California,
Los Angeles, Los Angeles, California 90095, United States
| | - Sumaira Ashraf
- Fachbereich Physik, Fachbereich Medizin, Fachbereich Pharmazie, and Department of Chemistry, Philipps Universität Marburg, 35037 Marburg, Germany
| | - Lajos P. Balogh
- AA Nanomedicine & Nanotechnology Consultants, North Andover, Massachusetts 01845, United States
| | - Laura Ballerini
- International School for Advanced Studies (SISSA/ISAS), 34136 Trieste, Italy
| | - Alessandra Bestetti
- School of Chemistry & Bio21 Institute, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Cornelia Brendel
- Fachbereich Physik, Fachbereich Medizin, Fachbereich Pharmazie, and Department of Chemistry, Philipps Universität Marburg, 35037 Marburg, Germany
| | - Susanna Bosi
- Department of Chemical
and Pharmaceutical Sciences, University
of Trieste, 34127 Trieste, Italy
| | - Monica Carril
- CIC biomaGUNE, Paseo de Miramón 182, 20014, Donostia - San Sebastián, Spain
- Ikerbasque, Basque Foundation
for Science, 48013 Bilbao, Spain
| | - Warren C. W. Chan
- Institute of Biomaterials
and Biomedical Engineering, University of
Toronto, Toronto, Ontario M5S 3G9, Canada
| | - Chunying Chen
- CAS Center for Excellence in Nanoscience and CAS Key
Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology of
China, Beijing 100190, China
| | - Xiaodong Chen
- School of Materials
Science and Engineering, Nanyang Technological
University, Singapore 639798
| | - Xiaoyuan Chen
- Laboratory of Molecular Imaging and Nanomedicine,
National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, Maryland 20892, United States
| | - Zhen Cheng
- Molecular
Imaging Program at Stanford and Bio-X Program, Canary Center at Stanford
for Cancer Early Detection, Stanford University, Stanford, California 94305, United States
| | - Daxiang Cui
- Institute of Nano Biomedicine and Engineering, Department of Instrument
Science and Engineering, School of Electronic Information and Electronical
Engineering, National Center for Translational Medicine, Shanghai Jiao Tong University, 200240 Shanghai, China
| | - Jianzhong Du
- Department of Polymeric Materials, School of Materials
Science and Engineering, Tongji University, Shanghai, China
| | - Christian Dullin
- Department of Haematology and Medical Oncology, Department of Diagnostic
and Interventional Radiology, University
Medical Center Göttingen, 37075 Göttingen Germany
| | - Alberto Escudero
- Fachbereich Physik, Fachbereich Medizin, Fachbereich Pharmazie, and Department of Chemistry, Philipps Universität Marburg, 35037 Marburg, Germany
- Instituto
de Ciencia de Materiales de Sevilla. CSIC, Universidad de Sevilla, 41092 Seville, Spain
| | - Neus Feliu
- Department of Clinical Science, Intervention, and Technology (CLINTEC), Karolinska Institutet, 141 86 Stockholm, Sweden
| | - Mingyuan Gao
- Institute of Chemistry, Chinese
Academy of Sciences, 100190 Beijing, China
| | | | - Yury Gogotsi
- Department of Materials Science and Engineering and A.J. Drexel Nanomaterials
Institute, Drexel University, Philadelphia, Pennsylvania 19104, United States
| | - Arnold Grünweller
- Fachbereich Physik, Fachbereich Medizin, Fachbereich Pharmazie, and Department of Chemistry, Philipps Universität Marburg, 35037 Marburg, Germany
| | - Zhongwei Gu
- College of Polymer Science and Engineering, Sichuan University, 610000 Chengdu, China
| | - Naomi J. Halas
- Departments of Physics and Astronomy, Rice
University, Houston, Texas 77005, United
States
| | - Norbert Hampp
- Fachbereich Physik, Fachbereich Medizin, Fachbereich Pharmazie, and Department of Chemistry, Philipps Universität Marburg, 35037 Marburg, Germany
| | - Roland K. Hartmann
- Fachbereich Physik, Fachbereich Medizin, Fachbereich Pharmazie, and Department of Chemistry, Philipps Universität Marburg, 35037 Marburg, Germany
| | - Mark C. Hersam
- Departments of Materials Science and Engineering, Chemistry,
and Medicine, Northwestern University, Evanston, Illinois 60208, United States
| | - Patrick Hunziker
- University Hospital, 4056 Basel, Switzerland
- CLINAM,
European Foundation for Clinical Nanomedicine, 4058 Basel, Switzerland
| | - Ji Jian
- Department of Polymer Science and Engineering and Center for
Bionanoengineering and Department of Chemical and Biological Engineering, Zhejiang University, 310027 Hangzhou, China
| | - Xingyu Jiang
- CAS Center for Excellence in Nanoscience and CAS Key
Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology of
China, Beijing 100190, China
| | - Philipp Jungebluth
- Thoraxklinik Heidelberg, Universitätsklinikum
Heidelberg, 69120 Heidelberg, Germany
| | - Pranav Kadhiresan
- Institute of Biomaterials
and Biomedical Engineering, University of
Toronto, Toronto, Ontario M5S 3G9, Canada
| | | | | | - Jindřich Kopeček
- Biomedical Polymers Laboratory, University of Utah, Salt Lake City, Utah 84112, United States
| | - Nicholas A. Kotov
- Emergency Medicine, University of Michigan, Ann Arbor, Michigan 48019, United States
| | - Harald F. Krug
- EMPA, Federal Institute for Materials
Science and Technology, CH-9014 St. Gallen, Switzerland
| | - Dong Soo Lee
- Department of Molecular Medicine and Biopharmaceutical
Sciences and School of Chemical and Biological Engineering, Seoul National University, Seoul, South Korea
| | - Claus-Michael Lehr
- Department of Pharmacy, Saarland University, 66123 Saarbrücken, Germany
- HIPS - Helmhotz Institute for Pharmaceutical Research Saarland, Helmholtz-Center for Infection Research, 66123 Saarbrücken, Germany
| | - Kam W. Leong
- Department of Biomedical Engineering, Columbia University, New York City, New York 10027, United States
| | - Xing-Jie Liang
- CAS Center for Excellence in Nanoscience and CAS Key
Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology of
China, Beijing 100190, China
- Laboratory of Controllable Nanopharmaceuticals, Chinese Academy of Sciences (CAS), 100190 Beijing, China
| | - Mei Ling Lim
- Department of Clinical Science, Intervention, and Technology (CLINTEC), Karolinska Institutet, 141 86 Stockholm, Sweden
| | - Luis M. Liz-Marzán
- CIC biomaGUNE, Paseo de Miramón 182, 20014, Donostia - San Sebastián, Spain
- Ikerbasque, Basque Foundation
for Science, 48013 Bilbao, Spain
- Biomedical Research Networking Center in Bioengineering Biomaterials and Nanomedicine, Ciber-BBN, 20014 Donostia - San Sebastián, Spain
| | - Xiaowei Ma
- Laboratory of Controllable Nanopharmaceuticals, Chinese Academy of Sciences (CAS), 100190 Beijing, China
| | - Paolo Macchiarini
- Laboratory of Bioengineering Regenerative Medicine (BioReM), Kazan Federal University, 420008 Kazan, Russia
| | - Huan Meng
- California NanoSystems Institute, Department of Chemistry
and Biochemistry and Department of Psychiatry and Semel Institute
for Neuroscience and Human Behavior, Division of NanoMedicine and Center
for the Environmental Impact of Nanotechnology, and Department of Materials Science
and Engineering, University of California,
Los Angeles, Los Angeles, California 90095, United States
| | - Helmuth Möhwald
- Department of Interfaces, Max-Planck
Institute of Colloids and Interfaces, 14476 Potsdam, Germany
| | - Paul Mulvaney
- School of Chemistry & Bio21 Institute, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Andre E. Nel
- California NanoSystems Institute, Department of Chemistry
and Biochemistry and Department of Psychiatry and Semel Institute
for Neuroscience and Human Behavior, Division of NanoMedicine and Center
for the Environmental Impact of Nanotechnology, and Department of Materials Science
and Engineering, University of California,
Los Angeles, Los Angeles, California 90095, United States
| | - Shuming Nie
- Emory University, Atlanta, Georgia 30322, United States
| | - Peter Nordlander
- Departments of Physics and Astronomy, Rice
University, Houston, Texas 77005, United
States
| | - Teruo Okano
- Tokyo Women’s Medical University, Tokyo 162-8666, Japan
| | | | - Tai Hyun Park
- Department of Molecular Medicine and Biopharmaceutical
Sciences and School of Chemical and Biological Engineering, Seoul National University, Seoul, South Korea
- Advanced Institutes of Convergence Technology, Suwon, South Korea
| | - Reginald M. Penner
- Department of Chemistry, University of
California, Irvine, California 92697, United States
| | - Maurizio Prato
- Department of Chemical
and Pharmaceutical Sciences, University
of Trieste, 34127 Trieste, Italy
- CIC biomaGUNE, Paseo de Miramón 182, 20014, Donostia - San Sebastián, Spain
- Ikerbasque, Basque Foundation
for Science, 48013 Bilbao, Spain
| | - Victor Puntes
- ICREA, Pg. Lluís Companys 23, 08010 Barcelona, Spain
- Institut Català de Nanotecnologia, UAB, 08193 Barcelona, Spain
- Vall d’Hebron University Hospital
Institute of Research, 08035 Barcelona, Spain
| | - Vincent M. Rotello
- Department
of Chemistry, University of Massachusetts, Amherst, Massachusetts 01003, United States
| | - Amila Samarakoon
- Institute of Biomaterials
and Biomedical Engineering, University of
Toronto, Toronto, Ontario M5S 3G9, Canada
| | - Raymond E. Schaak
- Department of Chemistry, The
Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Youqing Shen
- Department of Polymer Science and Engineering and Center for
Bionanoengineering and Department of Chemical and Biological Engineering, Zhejiang University, 310027 Hangzhou, China
| | - Sebastian Sjöqvist
- Department of Clinical Science, Intervention, and Technology (CLINTEC), Karolinska Institutet, 141 86 Stockholm, Sweden
| | - Andre G. Skirtach
- Department of Interfaces, Max-Planck
Institute of Colloids and Interfaces, 14476 Potsdam, Germany
- Department of Molecular Biotechnology, University of Ghent, B-9000 Ghent, Belgium
| | - Mahmoud G. Soliman
- Fachbereich Physik, Fachbereich Medizin, Fachbereich Pharmazie, and Department of Chemistry, Philipps Universität Marburg, 35037 Marburg, Germany
| | - Molly M. Stevens
- Department of Materials,
Department of Bioengineering, Institute for Biomedical Engineering, Imperial College London, London SW7 2AZ, United Kingdom
| | - Hsing-Wen Sung
- Department of Chemical Engineering and Institute of Biomedical
Engineering, National Tsing Hua University, Hsinchu City, Taiwan,
ROC 300
| | - Ben Zhong Tang
- Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and Reconstruction, Hong Kong, China
| | - Rainer Tietze
- ENT-Department, Section of Experimental Oncology & Nanomedicine
(SEON), Else Kröner-Fresenius-Stiftung-Professorship for Nanomedicine, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Buddhisha N. Udugama
- Institute of Biomaterials
and Biomedical Engineering, University of
Toronto, Toronto, Ontario M5S 3G9, Canada
| | - J. Scott VanEpps
- Emergency Medicine, University of Michigan, Ann Arbor, Michigan 48019, United States
| | - Tanja Weil
- Institut für
Organische Chemie, Universität Ulm, 89081 Ulm, Germany
- Max-Planck-Institute for Polymer Research, 55128 Mainz, Germany
| | - Paul S. Weiss
- California NanoSystems Institute, Department of Chemistry
and Biochemistry and Department of Psychiatry and Semel Institute
for Neuroscience and Human Behavior, Division of NanoMedicine and Center
for the Environmental Impact of Nanotechnology, and Department of Materials Science
and Engineering, University of California,
Los Angeles, Los Angeles, California 90095, United States
| | - Itamar Willner
- Institute of Chemistry, The Center for
Nanoscience and Nanotechnology, The Hebrew
University of Jerusalem, Jerusalem 91904, Israel
| | - Yuzhou Wu
- Max-Planck-Institute for Polymer Research, 55128 Mainz, Germany
- School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology, 430074 Wuhan, China
| | | | - Zhao Yue
- Fachbereich Physik, Fachbereich Medizin, Fachbereich Pharmazie, and Department of Chemistry, Philipps Universität Marburg, 35037 Marburg, Germany
| | - Qian Zhang
- Fachbereich Physik, Fachbereich Medizin, Fachbereich Pharmazie, and Department of Chemistry, Philipps Universität Marburg, 35037 Marburg, Germany
| | - Qiang Zhang
- School of Pharmaceutical Science, Peking University, 100191 Beijing, China
| | - Xian-En Zhang
- National Laboratory of Biomacromolecules,
CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, 15 Datun Road, Chaoyang District, Beijing, 100101, China
| | - Yuliang Zhao
- CAS Center for Excellence in Nanoscience and CAS Key
Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology of
China, Beijing 100190, China
| | - Xin Zhou
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences, Wuhan 430071, China
| | - Wolfgang J. Parak
- Fachbereich Physik, Fachbereich Medizin, Fachbereich Pharmazie, and Department of Chemistry, Philipps Universität Marburg, 35037 Marburg, Germany
- CIC biomaGUNE, Paseo de Miramón 182, 20014, Donostia - San Sebastián, Spain
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87
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Schmidt-Braekling T, Streitbuerger A, Gosheger G, Boettner F, Nottrott M, Ahrens H, Dieckmann R, Guder W, Andreou D, Hauschild G, Moellenbeck B, Waldstein W, Hardes J. Silver-coated megaprostheses: review of the literature. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2017; 27:483-489. [PMID: 28265758 DOI: 10.1007/s00590-017-1933-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 02/26/2017] [Indexed: 01/06/2023]
Abstract
Periprosthetic infection remains one of the most serious complications following megaendoprostheses. Despite a large number of preventive measures that have been introduced in recent years, it has not been possible to further reduce the rate of periprosthetic infection. With regard to metallic modification of implants, silver in particular has been regarded as highly promising, since silver particles combine a high degree of antimicrobial activity with a low level of human toxicity. This review provides an overview of the history of the use of silver as an antimicrobial agent, its mechanism of action, and its clinical application in the field of megaendoprosthetics. The benefits of silver-coated prostheses could not be confirmed until now. However, a large number of retrospective studies suggest that the rate of periprosthetic infections could be reduced by using silver-coated megaprostheses.
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Affiliation(s)
- Tom Schmidt-Braekling
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany.
| | - Arne Streitbuerger
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany
| | - Georg Gosheger
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany
| | - Friedrich Boettner
- Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY, USA
| | - Markus Nottrott
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany
| | - Helmut Ahrens
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany
| | - Ralf Dieckmann
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany
| | - Wiebke Guder
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany
| | - Dimosthenis Andreou
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany
| | - Gregor Hauschild
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany
| | - Burkhard Moellenbeck
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany
| | - Wenzel Waldstein
- Department of Orthopedics, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Jendrik Hardes
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany
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88
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Viola GM, Rosenblatt J, Raad II. Drug eluting antimicrobial vascular catheters: Progress and promise. Adv Drug Deliv Rev 2017; 112:35-47. [PMID: 27496702 DOI: 10.1016/j.addr.2016.07.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 06/14/2016] [Accepted: 07/26/2016] [Indexed: 12/13/2022]
Abstract
Vascular catheters are critical tools in modern healthcare yet present substantial risks of serious bloodstream infections that exact significant health and economic burdens. Drug-eluting antimicrobial vascular catheters have become important tools in preventing catheter-related bloodstream infections and their importance is expected to increase as significant initiatives are expanded to eliminate and make the occurrence of these infections unacceptable. Here we review clinically significant and emerging drug-eluting antimicrobial catheters within the categories of antibiotic, antiseptic, novel bioactive agents and energy-enhanced drug eluting antimicrobial catheters. Important representatives of each category are reviewed from the standpoints of mechanisms of action, physical-chemical properties, safety, in vitro and clinical effectiveness.
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Affiliation(s)
- George M Viola
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Joel Rosenblatt
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
| | - Issam I Raad
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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89
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Abdelhadi RA, Rahe K, Lyman B. Pediatric Enteral Access Device Management. Nutr Clin Pract 2016; 31:748-761. [DOI: 10.1177/0884533616670640] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Ruba A. Abdelhadi
- Enteral Access Team, Children’s Mercy Kansas City, Kansas City, Missouri, USA
| | - Katina Rahe
- Enteral Access Team, Children’s Mercy Kansas City, Kansas City, Missouri, USA
| | - Beth Lyman
- Nutrition Support Team, Children’s Mercy Kansas City, Kansas City, Missouri, USA
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90
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Scoccianti G, Frenos F, Beltrami G, Campanacci DA, Capanna R. Levels of silver ions in body fluids and clinical results in silver-coated megaprostheses after tumour, trauma or failed arthroplasty. Injury 2016; 47 Suppl 4:S11-S16. [PMID: 27523624 DOI: 10.1016/j.injury.2016.07.042] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Infection in megaprostheses remains an unsolved problem, with a rate of occurrence ranging from 5% to 12%. Silver coating of medical devices has recently been proposed to reduce infection rate because of the antibacterial effect of silver. This innovation could be particularly interesting for megaprostheses, but few data have been reported in the literature. MATERIALS AND METHODS From June 2010 to August 2014 a modified MegaC System megaprosthesis with an innovative peripheral silver-added layer of titanium alloy ('Porag') was implanted in 33 patients after previous infection (21 patients) or at high risk for infection because of local or general conditions (12 patients). Previous infection followed megaprosthesis or standard arthroplasty procedures in 14 patients and trauma surgery in seven patients. A proximal femur replacement was performed in 13 patients, distal femur replacement in 13, total femur in one, and knee arthrodesis in six. Clinical results and levels of silver in blood, urine and wound drains were examined. RESULTS Minimum follow-up of the patients was one year (average 25.9 months). There was no infection during the first two years after surgery in the 12 patients who received a silver-coated megaprosthesis and had no previous history of infection. An infection developed in one patient at 25 months after surgery following two further surgical procedures. Infection recurred at seven months and 24 months in two out of the 21 patients (9.5%) who had received the implant because of previous septic complications. There was no clinical evidence of argyria, and no local or systemic side effects related to silver were detected. Mean levels of silver ranging from 0.41 to 5.33μg/L in blood and from 0.28 to 0.86μg/L in urine were detected at 24h to 36 months after surgery. CONCLUSIONS Silver-coated megaprostheses showed promising results in this series in terms of prevention of infection in a high-risk group of patients, many of whom had a history of infection. No side-effects were detected. The circulating silver levels confirm both the persistence of silver-coating activity after three years and the safety of silver-coated implants. Longer follow-up and larger series are needed.
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Affiliation(s)
- Guido Scoccianti
- Orthopaedic Oncology Unit, Careggi University-Hospital, Firenze, Italy.
| | - Filippo Frenos
- Orthopaedic Oncology Unit, Careggi University-Hospital, Firenze, Italy
| | - Giovanni Beltrami
- Orthopaedic Oncology Unit, Careggi University-Hospital, Firenze, Italy
| | | | - Rodolfo Capanna
- Orthopaedic Oncology Unit, Careggi University-Hospital, Firenze, Italy
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91
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Zinc Pyrithione Improves the Antibacterial Activity of Silver Sulfadiazine Ointment. mSphere 2016; 1:mSphere00194-16. [PMID: 27642637 PMCID: PMC5023846 DOI: 10.1128/msphere.00194-16] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 08/18/2016] [Indexed: 11/29/2022] Open
Abstract
Topical antimicrobial ointments ostensibly mitigate bacterial wound disease and reliance on systemic antibiotics. Yet studies have called into question the therapeutic benefits of several traditional topical antibacterials, accentuating the need for improved next-generation antimicrobial ointments. Yet the development of such agents consisting of a new chemical entity is a time-consuming and expensive proposition. Considering that drug combinations are a mainstay therapeutic strategy for the treatment of other therapeutic indications, one alternative approach is to improve the performance of conventional antimicrobial ointments by the addition of a well-characterized and FDA-approved agent. Here we report data that indicate that the antimicrobial properties of silver sulfadiazine ointments can be significantly improved by the addition of the antifungal zinc pyrithione, suggesting that such combinations may provide an improved therapeutic option for the topical treatment of wound infections. Pseudomonas aeruginosa, Acinetobacter baumannii, and Staphylococcus aureus are commonly associated with biofilm-associated wound infections that are recalcitrant to conventional antibiotics. As an initial means to identify agents that may have a greater propensity to improve clearance of wound-associated bacterial pathogens, we screened a Food and Drug Administration-approved drug library for members that display bactericidal activity toward 72-h-established P. aeruginosa biofilms using an adenylate kinase reporter assay for bacterial cell death. A total of 34 compounds displayed antibiofilm activity. Among these, zinc pyrithione was also shown to reduce levels of A. baumannii and S. aureus biofilm-associated bacteria and exhibited an additive effect in combination with silver sulfadiazine, a leading topical therapeutic for wound site infections. The improved antimicrobial activity of zinc pyrithione and silver sulfadiazine was maintained in an ointment formulation and led to improved clearance of P. aeruginosa, A. baumannii, and S. aureus in a murine model of wound infection. Taken together, these results suggest that topical zinc pyrithione and silver sulfadiazine combination formulations may mitigate wound-associated bacterial infections and disease progression. IMPORTANCE Topical antimicrobial ointments ostensibly mitigate bacterial wound disease and reliance on systemic antibiotics. Yet studies have called into question the therapeutic benefits of several traditional topical antibacterials, accentuating the need for improved next-generation antimicrobial ointments. Yet the development of such agents consisting of a new chemical entity is a time-consuming and expensive proposition. Considering that drug combinations are a mainstay therapeutic strategy for the treatment of other therapeutic indications, one alternative approach is to improve the performance of conventional antimicrobial ointments by the addition of a well-characterized and FDA-approved agent. Here we report data that indicate that the antimicrobial properties of silver sulfadiazine ointments can be significantly improved by the addition of the antifungal zinc pyrithione, suggesting that such combinations may provide an improved therapeutic option for the topical treatment of wound infections.
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92
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Kuehl R, Brunetto PS, Woischnig AK, Varisco M, Rajacic Z, Vosbeck J, Terracciano L, Fromm KM, Khanna N. Preventing Implant-Associated Infections by Silver Coating. Antimicrob Agents Chemother 2016; 60:2467-75. [PMID: 26883700 PMCID: PMC4808148 DOI: 10.1128/aac.02934-15] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 02/04/2016] [Indexed: 01/22/2023] Open
Abstract
Implant-associated infections (IAIs) are a dreaded complication mainly caused by biofilm-forming staphylococci. Implant surfaces preventing microbial colonization would be desirable. We examined the preventive effect of a silver-coated titanium-aluminum-niobium (TiAlNb) alloy. The surface elicited a strong, inoculum-dependent activity againstStaphylococcus epidermidisandStaphylococcus aureusin an agar inhibition assay. Gamma sterilization and alcohol disinfection did not alter the effect. In a tissue cage mouse model, silver coating of TiAlNb cages prevented perioperative infections in an inoculum-dependent manner and led to a 100% prevention rate after challenge with 2 × 10(6)CFU ofS. epidermidisper cage. InS. aureusinfections, silver coating had only limited effect. Similarly, daptomycin or vancomycin prophylaxis alone did not preventS. aureusinfections. However, silver coating combined with daptomycin or vancomycin prophylaxis thwarted methicillin-resistantS. aureusinfections at a prevention rate of 100% or 33%, respectively. Moreover, silver release from the surface was independent of infection and occurred rapidly after implantation. On day 2, a peak of 82 μg Ag/ml was reached in the cage fluid, corresponding to almost 6× the MIC of the staphylococci. Cytotoxicity toward leukocytes in the cage was low and temporary. Surrounding tissue did not reveal histological signs of silver toxicity.In vitro, no emergence of silver resistance was observed in several clinical strains of staphylococci upon serial subinhibitory silver exposures. In conclusion, our data demonstrate that silver-coated TiAlNb is potent for prevention of IAIs and thus can be considered for clinical application.
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Affiliation(s)
- Richard Kuehl
- Infection Biology Laboratory, Department of Biomedicine, University and University Hospital of Basel, Basel, Switzerland Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland
| | | | - Anne-Kathrin Woischnig
- Infection Biology Laboratory, Department of Biomedicine, University and University Hospital of Basel, Basel, Switzerland
| | - Massimo Varisco
- Department of Chemistry, University of Fribourg, Fribourg, Switzerland
| | - Zarko Rajacic
- Infection Biology Laboratory, Department of Biomedicine, University and University Hospital of Basel, Basel, Switzerland
| | - Juerg Vosbeck
- Institute of Pathology, University Hospital of Basel, Basel, Switzerland
| | - Luigi Terracciano
- Institute of Pathology, University Hospital of Basel, Basel, Switzerland
| | - Katharina M Fromm
- Department of Chemistry, University of Fribourg, Fribourg, Switzerland
| | - Nina Khanna
- Infection Biology Laboratory, Department of Biomedicine, University and University Hospital of Basel, Basel, Switzerland Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland
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93
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Bujdáková H. Management of Candida biofilms: state of knowledge and new options for prevention and eradication. Future Microbiol 2016; 11:235-51. [PMID: 26849383 DOI: 10.2217/fmb.15.139] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Biofilms formed by Candida species (spp.) on medical devices represent a potential health risk. The focus of current research is searching for new options for the treatment and prevention of biofilm-associated infections using different approaches including modern nanotechnology. This review summarizes current information concerning the most relevant resistance/tolerance mechanisms to conventional drugs and a role of additional factors contributing to these phenomena in Candida spp. (mostly Candida albicans). Additionally, it provides an information update in prevention and eradication of a Candida biofilm including experiences with 'lock' therapy, potential utilization of small molecules in biomedical applications, and perspectives of using photodynamic inactivation in the control of a Candida biofilm.
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Affiliation(s)
- Helena Bujdáková
- Comenius University in Bratislava, Faculty of Natural Sciences, Department of Microbiology & Virology, Mlynská dolina, Ilkovičova 6, 842 15 Bratislava, Slovak Republic
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94
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Wu K, Yang Y, Zhang Y, Deng J, Lin C. Antimicrobial activity and cytocompatibility of silver nanoparticles coated catheters via a biomimetic surface functionalization strategy. Int J Nanomedicine 2015; 10:7241-52. [PMID: 26664115 PMCID: PMC4671771 DOI: 10.2147/ijn.s92307] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Catheter-related bloodstream infections are a significant problem in the clinic and may result in a serious infection. Here, we developed a facile and green procedure for buildup of silver nanoparticles (AgNPs) on the central venous catheters (CVCs) surface. Inspired by mussel adhesive proteins, dopamine was used to form a thin polydopamine layer and induce AgNPs formation without additional reductants or stabilizers. The chemical and physicochemical properties of AgNPs coated CVCs were characterized by scanning electron microscopy, X-ray photoelectron spectroscopy, Raman spectroscopy, and water contact angle. The Staphylococcus aureus culture experiment was used to study the antibacterial properties. The cytocompatibility was assessed by water soluble tetrazolium salts (WST-1) assay, fluorescence staining, and scanning electron microscopy analysis. The results indicated that the CVCs surface was successfully coated with compact AgNPs. AgNPs were significantly well separated and spherical with a size of 30–50 nm. The density of AgNPs could be modulated by the concentration of silver nitrate solution. The antibacterial activity was dependent on the AgNPs dose. The high dose of AgNPs showed excellent antibacterial activity while associated with increased cytotoxicity. The appropriate density of AgNPs coated CVCs could exhibit improved biocompatibility and maintained evident sterilization effect. It is promising to design mussel-inspired silver releasing CVCs with both significant antimicrobial efficacy and appropriate biological safety.
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Affiliation(s)
- Ke Wu
- Department of Cardiology, The Affiliated Dongnan Hospital of Xiamen University, Zhangzhou, People's Republic of China
| | - Yun Yang
- Department of Medical Materials, Beijing Medical Implant Engineering Research Center, Beijing Naton Technology Group, Beijing, People's Republic of China ; State Key Laboratory of Physical Chemistry of Solid Surfaces, Department of Chemistry, College of Chemistry and Chemical Engineering, Xiamen University, Xiamen, People's Republic of China
| | - Yanmei Zhang
- Department of Medical Materials, Beijing Medical Implant Engineering Research Center, Beijing Naton Technology Group, Beijing, People's Republic of China ; State Key Laboratory of Physical Chemistry of Solid Surfaces, Department of Chemistry, College of Chemistry and Chemical Engineering, Xiamen University, Xiamen, People's Republic of China
| | - Jiexi Deng
- Department of Cardiology, The Affiliated Dongnan Hospital of Xiamen University, Zhangzhou, People's Republic of China
| | - Changjian Lin
- Department of Medical Materials, Beijing Medical Implant Engineering Research Center, Beijing Naton Technology Group, Beijing, People's Republic of China ; State Key Laboratory of Physical Chemistry of Solid Surfaces, Department of Chemistry, College of Chemistry and Chemical Engineering, Xiamen University, Xiamen, People's Republic of China
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95
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Salvarci A, Koroglu M, Erayman B. Investigation of Antibacterial Activity and Biofilm Formation of Silicones Coated With Minocycline-Rifampicin, Silver Nitrate, and Nitrofurantoin for Short-term Utilization in In Vitro Urinary System Models. Urology 2015; 88:66-75. [PMID: 26522971 DOI: 10.1016/j.urology.2015.10.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 09/29/2015] [Accepted: 10/20/2015] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To analyze antimicrobial activity and biofilm formation on silicones coated with antimicrobial substances in in vivo short-term catheterization simulation using our newly developed in vitro urinary system model and to compare minocycline-rifampin (MR)-, silver nitrate-, and nitrofurantoin (NF)-coated silicone discs. MATERIALS AND METHODS Silicone discs were exposed to bacterial urine suspension for 168 hours. The antimicrobial activities were assessed in the medium, and the inhibition zone diameters were measured. The weight of the silicones was measured for biofilm growth assessment before and after the experiment, and confocal microscopy images were taken. RESULTS Although the inhibition zone diameters of silver nitrate silicones were larger than those of pure silicone (PS), MR, and NF silicones, biofilm formation could not be prevented (P < .05). MR and NF silicones were superior to PS in terms of antimicrobial efficacy and prevention of biofilm formation (P < .05). In terms of biofilm prevention, no differences were detected between NF and MR silicones apart from a slightly superior ability of MR silicones to inhibit Escherichia coli (P > .05). Biofilm formation occurred on all silicone discs. CONCLUSION In short-term urinary catheter utilization, antimicrobial efficacy and biofilm formation prevention were superior in coated silicones, regardless of the type of antibiotic used, compared with the control group (PS). As the study was conducted in an in vitro setting, the findings should be substantiated with in vivo studies on the grounds that different results may be obtained in these settings.
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Affiliation(s)
- Ahmet Salvarci
- Department of Urology, Konya Hospital, Karatay, Konya, Turkey.
| | - Mehmet Koroglu
- Department of Medical Microbiology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Berna Erayman
- Department of Medical Microbiology, Konya System Laboratory, Selcuklu, Konya, Turkey
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96
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McGuffie MJ, Hong J, Bahng JH, Glynos E, Green PF, Kotov NA, Younger JG, VanEpps JS. Zinc oxide nanoparticle suspensions and layer-by-layer coatings inhibit staphylococcal growth. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2015; 12:33-42. [PMID: 26515755 DOI: 10.1016/j.nano.2015.10.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 10/01/2015] [Accepted: 10/07/2015] [Indexed: 11/18/2022]
Abstract
Despite a decade of engineering and process improvements, bacterial infection remains the primary threat to implanted medical devices. Zinc oxide nanoparticles (ZnO-NPs) have demonstrated antimicrobial properties. Their microbial selectivity, stability, ease of production, and low cost make them attractive alternatives to silver NPs or antimicrobial peptides. Here we sought to (1) determine the relative efficacy of ZnO-NPs on planktonic growth of medically relevant pathogens; (2) establish the role of bacterial surface chemistry on ZnO-NP effectiveness; (3) evaluate NP shape as a factor in the dose-response; and (4) evaluate layer-by-layer (LBL) ZnO-NP surface coatings on biofilm growth. ZnO-NPs inhibited bacterial growth in a shape-dependent manner not previously seen or predicted. Pyramid shaped particles were the most effective and contrary to previous work, larger particles were more effective than smaller particles. Differential susceptibility of pathogens may be related to their surface hydrophobicity. LBL ZnO-NO coatings reduced staphylococcal biofilm burden by >95%. From the Clinical Editor: The use of medical implants is widespread. However, bacterial colonization remains a major concern. In this article, the authors investigated the use of zinc oxide nanoparticles (ZnO-NPs) to prevent bacterial infection. They showed in their experiments that ZnO-NPs significantly inhibited bacterial growth. This work may present a new alternative in using ZnO-NPs in medical devices.
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Affiliation(s)
- Matthew J McGuffie
- Department of Emergency Medicine, Ann Arbor, MI, USA; Michigan Center for Integrative Research in Critical Care, Ann Arbor, MI, USA; Biointerfaces Institute University of Michigan, Ann Arbor, MI, USA
| | - Jin Hong
- Key Laboratory of Biomedical Functional Materials, School of Sciences, China Pharmaceutical University, Nanjing, China
| | | | - Emmanouil Glynos
- Department of Materials Science and Engineering, Ann Arbor, MI, USA; Biointerfaces Institute University of Michigan, Ann Arbor, MI, USA
| | - Peter F Green
- Department of Chemical Engineering, Ann Arbor, MI, USA; Department of Materials Science and Engineering, Ann Arbor, MI, USA; Department of Applied Physics, Ann Arbor, MI, USA
| | - Nicholas A Kotov
- Department of Chemical Engineering, Ann Arbor, MI, USA; Department of Biomedical Engineering, Ann Arbor, MI, USA; Department of Materials Science and Engineering, Ann Arbor, MI, USA; Department of Macromolecular Science and Engineering, Ann Arbor, MI, USA; Biointerfaces Institute University of Michigan, Ann Arbor, MI, USA
| | - John G Younger
- Department of Emergency Medicine, Ann Arbor, MI, USA; Michigan Center for Integrative Research in Critical Care, Ann Arbor, MI, USA; Biointerfaces Institute University of Michigan, Ann Arbor, MI, USA
| | - J Scott VanEpps
- Department of Emergency Medicine, Ann Arbor, MI, USA; Michigan Center for Integrative Research in Critical Care, Ann Arbor, MI, USA; Biointerfaces Institute University of Michigan, Ann Arbor, MI, USA.
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97
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Jiang X, Lv B, Shen Q, Wang X. Preparation of silicon‐modified antimicrobial polyethylene endotracheal tubes. J Biomed Mater Res B Appl Biomater 2015; 105:91-98. [PMID: 26426543 DOI: 10.1002/jbm.b.33530] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Revised: 08/12/2015] [Accepted: 09/05/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Xuhong Jiang
- The First Clinical Medical College of Zhejiang Chinese Medical UniversityHangzhou China
- Emergency DepartmentThe First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhou China
| | - Bin Lv
- The First Clinical Medical College of Zhejiang Chinese Medical UniversityHangzhou China
- Emergency DepartmentThe First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhou China
| | - Qianhong Shen
- Zhejiang‐California International NanoSystems Institute, Zhejiang UniversityHangzhou China
| | - Xinmin Wang
- Zhejiang‐California International NanoSystems Institute, Zhejiang UniversityHangzhou China
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98
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Cavanaugh DL, Tan ZG, Norris JP, Hardee A, Weinhold PS, Dahners LE, Orndorff PE, Shirwaiker RA. Evaluation of silver-titanium implants activated by low intensity direct current for orthopedic infection control: Anin vitroandin vivostudy. J Biomed Mater Res B Appl Biomater 2015; 104:1023-31. [DOI: 10.1002/jbm.b.33451] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 03/15/2015] [Accepted: 04/24/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Daniel L. Cavanaugh
- Department of Orthopaedics; University of North Carolina; Chapel-Hill North Carolina
| | - Zhuo George Tan
- Department of Industrial and Systems Engineering; North Carolina State University; Raleigh North Carolina
| | - James P. Norris
- Department of Orthopaedics; University of North Carolina; Chapel-Hill North Carolina
| | - Amelia Hardee
- Department of Industrial and Systems Engineering; North Carolina State University; Raleigh North Carolina
| | - Paul S. Weinhold
- Department of Orthopaedics; University of North Carolina; Chapel-Hill North Carolina
- Joint Department of Biomedical Engineering; University of North Carolina and North Carolina State University; Raleigh North Carolina
| | - Laurence E. Dahners
- Department of Orthopaedics; University of North Carolina; Chapel-Hill North Carolina
| | - Paul E. Orndorff
- Department of Population Health and Pathobiology; North Carolina State University; Raleigh North Carolina
| | - Rohan A. Shirwaiker
- Department of Industrial and Systems Engineering; North Carolina State University; Raleigh North Carolina
- Joint Department of Biomedical Engineering; University of North Carolina and North Carolina State University; Raleigh North Carolina
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99
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Morrison S, Singh A, Rousseau J, Walker M, Nazarali A, Crawford E, Brisson B, Sears WC, Weese JS. Impact of polymethylmethacrylate additives on methicillin-resistant Staphylococcus pseudintermedius biofilm formation in vitro. Am J Vet Res 2015; 76:395-401. [PMID: 25909371 DOI: 10.2460/ajvr.76.5.395] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the impact of gentamicin, silver, or both additives in polymethylmethacrylate (PMMA) beads on methicillin-resistant Staphylococcus pseudintermedius (MRSP) biofilm formation in vitro. SAMPLE 4 preparations of PMMA beads (formed with no additive [control], gentamicin, silver, and gentamicin and silver). PROCEDURES Beads from each group were exposed to 10 MRSP isolates known to be strong biofilm formers. Following incubation, the beads were rinsed to remove planktonic bacteria, then sonicated to dislodge biofilm-associated bacteria. Resulting suspensions were serially diluted, plated on blood agar, and incubated overnight; CFUs were counted. Variance of mean CFU counts following log10 transformation was analyzed among PMMA groups. RESULTS None of the PMMA additives tested completely inhibited MRSP biofilm formation. There was a significant effect of gentamicin and gentamicin plus silver on this variable, compared with controls, but not of silver alone. There was no difference between gentamicin and gentamicin plus silver. When only isolates not susceptible to gentamicin were evaluated, there were no significant differences among PMMA additive groups. Within gentamicin-susceptible isolates, there was an impact of gentamicin and gentamicin plus silver, but no impact of silver alone and no difference between gentamicin and gentamicin plus silver. CONCLUSIONS AND CLINICAL RELEVANCE Gentamicin-impregnated PMMA was effective at reducing biofilm formation of gentamicin-susceptible MRSP isolates but had no effect on isolates not susceptible to gentamicin. Silver-impregnated PMMA had no effect on MRSP biofilm formation. Results suggested that gentamicin-impregnated PMMA may not be effective in vivo against MRSP isolates not susceptible to gentamicin. Antibacterial efficacy of silver should not be assumed without proper testing of the target bacteria and specific silver compound.
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Affiliation(s)
- Shauna Morrison
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada
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100
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Ellenrieder M, Redanz S, Bader R, Mittelmeier W, Podbielski A. Influence of Antimicrobial Coatings of Vacuum-Assisted Closure Dressings on Methicillin-Resistant Staphylococcus aureus Growth Kinetics: An In Vitro Study. Surg Infect (Larchmt) 2015; 16:139-45. [DOI: 10.1089/sur.2013.268] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Affiliation(s)
- Martin Ellenrieder
- Department of Orthopedics, University Medicine Rostock, Rostock, Germany
| | - Sylvio Redanz
- Institute of Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Rostock, Germany
| | - Rainer Bader
- Department of Orthopedics, University Medicine Rostock, Rostock, Germany
| | | | - Andreas Podbielski
- Institute of Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Rostock, Germany
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