Adhesion of Staphylococcus epidermidis to biomaterials is inhibited by fibronectin and albumin

Host Soluble Factors Cause Changes in Staphylococcus epidermidis Antibiotic Susceptibility and Biofilm Formation Ability

Staphylococcus epidermidis is a major nosocomial pathogen with a remarkable ability to adhere to the surfaces of indwelling medical devices and form biofilms. Unlike other nosocomial pathogens, the interaction of S. epidermidis with host factors has not been the focus of substantial research. This study aimed to assess the alterations in the antibiotic susceptibility and biofilm formation ability of S. epidermidis in the presence of host serum factors. S. epidermidis strain RP62A was cultured in a laboratory culture medium with or without human serum/plasma, and changes in antibiotic susceptibility, biofilm formation, and gene expression were evaluated. The data obtained revealed that exposure to host serum factors increased the susceptibility of S. epidermidis to glycopeptide antibiotics and was also detrimental to biofilm formation. Gene expression analysis revealed downregulation of both dltA and fmtC genes shortly after human serum/plasma exposure. The importance of transferrin-mediated iron sequestration as a host anti-biofilm strategy against S. epidermidis was also emphasized. We have demonstrated that serum factors play a pivotal role as part of the host's anti-infective strategy against S. epidermidis infections, highlighting the importance of incorporating such factors during in vitro studies with this pathogen.

Attachment and optimization of Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa biofilms to a 3D printed lattice

A lattice was designed and fabricated using three-dimensional (3D) printing that allows for the facile transfer of biofilms formed from either Staphylococcus aureus, Staphylococcus epidermidis, or Pseudomonas aeruginosa into a fresh cell culture flask. To enhance biofilm production onto the filaments, three protein-based treatments were compared: fetal bovine serum (FBS), bovine serum albumin (BSA), and fibrinogen (Fb). Protein treatments included either supplementing the growth broths or pre-coating the lattice prior to immersion into the broth. S. aureus and P. aeruginosa biofilms were observed on all tested filaments that contained the supplement Fb. S. epidermidis required BSA to form biofilm. Ultimately, polycarbonate (PC) was chosen as the optimal material for lattice creation since it can be autoclaved without warping key design features. In addition, this 3D printed design may facilitate biofilm transfer from the bacterial culture to different cell culture platforms.

Effect of acid-alkali treatment on serum protein adsorption and bacterial adhesion to porous titanium

Modification of the titanium (Ti) surface is widely known to influence biological reactions such as protein adsorption and bacterial adhesion in vivo, ultimately controlling osseointegration. In this study, we sought to investigate the correlation of protein adsorption and bacterial adhesion with the nanoporous structure of acid-alkali-treated Ti implants, shedding light on the modification of Ti implants to promote osseointegration. We fabricated nontreated porous Ti (NTPT) by powder metallurgy and immersed it in mixed acids and NaOH to obtain acid-alkali-treated porous Ti (AAPT). Nontreated dense sample (NTDT) served as control. Our results showed that nanopores were formed after acid-alkali treatment. AAPT showed a higher specific surface area and became much more hydrophilic than NTPT and NTDT (p < 0.001). Compared to dense samples, porous samples exhibited a lower zeta potential and higher adsorbed protein level at each time point within 120 min (p < 0.001). AAPT formed a thicker protein layer by serum precoating than NTPT and NTDT (p < 0.001). The main adsorbed proteins on AAPT and NTPT were albumin, α1 antitrypsin, transferrin, apolipoprotein A1, complement C3 and haptoglobin α1 chain. The amounts of bacteria adhering to the serum-precoated samples were lower than those adhering to the nonprecoated samples (p < 0.05). Lower-molecular-weight proteins showed higher affinity to porous Ti. In conclusion, acid-alkali treatment facilitated protein adsorption by porous Ti, and the protein coating tended to prevent bacteria from adhering. These findings may be utilized for Ti implant modification aimed at reducing bacterial adhesion and enhancing osseointegration. Graphical abstract.

Endogenous nitric oxide-generating surfaces via polydopamine-copper coatings for preventing biofilm dispersal and promoting microbial killing

INTRODUCTION

Peri-implantitis is a bacterially induced inflammatory disease which affects the hard and soft tissues around a dental implant. Microbial biofilm formation is an important causative factor in peri-implantitis. The aim of this study is to develop an effective multifunctional surface coating for antimicrobial property and to counteract oral biofilm-associated infections via a single polydopamine copper coating (PDAM@Cu) on titanium implant surface to regulate endogenous nitric oxide (NO) generation.

METHODS

PDAM@Cu coatings were made with different concentrations of CuCl₂ on titanium surfaces with a simple dip coating technique. Coatings were characterised to evaluate Cu concentrations as well as NO release rates from the coatings. Further, salivary biofilms were made on the coatings using Brain Heart Infusion (BHI) media in an anaerobic chamber. Biofilms were prepared with three different mixtures, one of which was saliva only, the second had an addition of sheep's blood, and the third was prepared with NO donors S-nitrosoglutathione (GSNO) and L-glutathione (GSH) in the mixture of saliva and blood to evaluate the effects of endogenously produced NO on biofilms. The effectiveness of coated surfaces on biofilms were assessed using four different methods, namely, crystal violet assay, scanning electron microscopy imaging, 2,3-bis (2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino) carbonyl]-2H-tetrazolium hydroxide (XTT) metabolic assay, and live/dead staining.

RESULTS

NO release rates could be controlled with different Cu concentration in PDAM@Cu coatings. NO generated from the PDAM@Cu coatings effectively induced dispersal of biofilms shown by the reduction in biofilm biomass as well as reduced biofilm attachment in samples prepared with blood and NO donors. Cu ions released from the PDAM@Cu coatings resulted in killing of the dispersed bacteria, which was evidenced by the live/dead cell staining and reduced metabolic activity noted from the XTT assay. In contrast, samples prepared with saliva showed no significant reduction in biofilms, indicating the important effect of endogenously generated NO on biofilm dispersal.

CONCLUSION

In conclusion, PDAM@Cu coatings with NO generating surfaces have a dual anti-biofilm function, with a synergistic effect on biofilm dispersal from regulated NO generation and bactericidal effects from Cu ions from the coatings.

N-acetylcysteine-functionalized coating avoids bacterial adhesion and biofilm formation

N-acetyl cysteine (NAC) is an FDA-approved drug clinically applied on a broad range of pathologies. Further research has been conducted with this drug to benefit from its antimicrobial activity potential. However, NAC has a very short half-life and therefore strategies that accomplish high local concentrations would be beneficial. In this study, covalent immobilization of NAC was performed, in order to obtain long-lasting high local concentration of the drug onto a chitosan(Ch)-derived implant-related coating. For the development of NAC-functionalized Ch films, water-based carbodiimide chemistry was applied to avoid the use of toxic organic solvents. Here we report the optimization steps performed to immobilize NAC onto the surface of pre-prepared Ch coatings, to ensure full exposure of NAC. Surface characterization using ellipsometry, water contact angle measurements and X-ray photoelectron spectroscopy (XPS), demonstrated the success of NAC immobilization at 4 mg/mL. Quartz crystal microbalance with dissipation (QCM-D) demonstrated that surface immobilized NAC decreases protein adsorption to Ch coatings. Biological studies confirmed that immobilized NAC4 avoids methicillin-resistant Staphylococcus aureus adhesion to Ch coating, impairing biofilm formation, without inducing cytotoxic effects. This is particularly interesting towards further developments as a prevention coating.

Protein adsorption, platelet adhesion, and bacterial adhesion to polyethylene-glycol-textured polyurethane biomaterial surfaces

Traditional strategies for surface modification to enhance the biocompatibility of biomaterials often focus on a single route utilizing either chemical or physical approaches. This study combines the chemical and physical treatments as applied to poly(urethane urea) (PUU) biomaterials to enhance biocompatibility at the interface for inhibiting platelet-related thrombosis or bacterial adhesion-induced microbial infections. PUU films were first textured with submicron patterns by a soft lithography two-stage replication process, and then were grafted with polyethylene glycol (PEG). A series of biological response experiments including protein adsorption, platelet adhesion/activation, and bacterial adhesion/biofilm formation showed that PEG-grafted submicron textured biomaterial surfaces were resistant to protein adsorption, and greatly increased the efficiency in reducing both platelet adhesion/activation and bacterial adhesion/biofilm formation due to the additive effects of physical topography and grafted PEG. Results suggest that a combination of chemical modification and surface texturing will be more efficient in preventing biomaterial-associated thrombosis and infection of biomaterials. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 668-678, 2017.

Staphylococcus epidermidis Affinity for Fibrinogen-Coated Surfaces Correlates with the Abundance of the SdrG Adhesin on the Cell Surface

Staphylococcus epidermidis is a world-leading pathogen in healthcare facilities, mainly causing medical device-associated infections. These nosocomial diseases often result in complications such as bacteremia, fibrosis, or peritonitis. The virulence of S. epidermidis relies on its ability to colonize surfaces and develop thereupon in the form of biofilms. Bacterial adherence on biomaterials, usually covered with plasma proteins after implantation, is a critical step leading to biofilm infections. The cell surface protein SdrG mediates adhesion of S. epidermidis to fibrinogen (Fg) through a specific "dock, lock, and latch" mechanism, which results in greatly stabilized protein-ligand complexes. Here, we combine single-molecule, single-cell, and whole population assays to investigate the extent to which the surface density of SdrG determines the ability of S. epidermidis clinical strains HB, ATCC 35984, and ATCC 12228 to bind to Fg-coated surfaces. Strains that showed enhanced adhesion on Fg-coated polydimethylsiloxane (PDMS) were characterized by increased amounts of SdrG proteins on the cell surface, as observed by single-molecule analysis. Consistent with previous reports showing increased expression of SdrG following in vivo exposure, this work provides direct evidence that abundance of SdrG on the cell surface of S. epidermidis strains dramatically improves their ability to bind to Fg-coated implanted medical devices.

The role of plasma, albumin, and fibronectin in Staphylococcus epidermidis adhesion to polystyrene surface

The influence of soluble and immobilized plasma, albumin, and fibronectin (Fn) on the adhesion of three Staphylococcus epidermidis strains to polystyrene was investigated. Both soluble and immobilized plasma and albumin cause to 7-fold reduction of the amounts of adhered cells, regardless of the strain used. The soluble Fn exhibited the adhesion for one strain and did not affect the bacterial sorption for remaining strains, whereas on Fn-coated polystyrene two of the three strains showed about 1.5-fold increase in the number of adsorbed bacteria. The plasma- and albumin-coated surfaces became much more hydrophilic as the contact angle changed from 78 ± 2° for control to 18 ± 2° for plasma and 21 ± 3° for albumin. The ligand-receptor specific interactions strains S. epidermidis with Fn-coated surfaces were proved by measuring the adhesion forces between cell surface and Fn-coated AFM tip. The surface roughness measured using AFM after the plasma and proteins immobilization was changed within 10 nm and not correlate with changes in bacterial adhesion.

Proteins, platelets, and blood coagulation at biomaterial interfaces

Blood coagulation and platelet adhesion remain major impediments to the use of biomaterials in implantable medical devices. There is still significant controversy and question in the field regarding the role that surfaces play in this process. This manuscript addresses this topic area and reports on state of the art in the field. Particular emphasis is placed on the subject of surface engineering and surface measurements that allow for control and observation of surface-mediated biological responses in blood and test solutions. Appropriate use of surface texturing and chemical patterning methodologies allow for reduction of both blood coagulation and platelet adhesion, and new methods of surface interrogation at high resolution allow for measurement of the relevant biological factors.

Decreased bacteria density on nanostructured polyurethane

As is well known, medical device infections are a growing clinical problem with no clear solution due to previous failed attempts of using antibiotics to decrease bacteria functions for which bacteria quickly develop a resistance toward. Because of their altered surface energetics, the objective of the present in vitro study was to create nanoscale surface features on polyurethane (PU) by soaking PU films in HNO3 and to determine bacteria (specifically, S. epidermidis, E. coli, and P. mirabilis) colony forming units after 1 h. Such bacteria frequently infect numerous medical devices. Results provided the first evidence that without using antibiotics, S. epidermidis density decreased by 5 and 13 times, E. coli density decreased by 6 and 20 times, and P. mirabilis density decreased by 8 and 35 times compared to conventional PU and a tissue engineering control small intestine submucosa (SIS), respectively. Material characterization studies revealed significantly greater nanoscale roughness and hydrophobicity for the HNO3-treated nanostructured PU compared to conventional PU (albeit, still hydrophilic) which may provide a rationale for the observed decreased bacteria responses. In addition, significantly greater amounts of fibronectin adsorption from serum were measured on nanorough compared conventional PU which may explain the decreased bacteria growth. In summary, this study provides significant promise for the use of nanostructured PU to decrease bacteria functions without the use of antibiotics, clearly addressing the wide spread problem of increased medical device infections observed today.

Giant extracellular matrix binding protein expression in Staphylococcus epidermidis is regulated by biofilm formation and osmotic pressure

Staphylococcus epidermidis is an opportunistic bacterium that thrives as a commensal cutaneous organism and as a vascular pathogen. The S. epidermidis extracellular matrix binding protein (Embp) has been reported to be a virulence factor involved in colonization of medical device implants and subsequent biofilm formation. Here, we characterize the expression patterns of Embp in planktonic and biofilm cultures, as well as under high osmotic stresses that typify the commensal environment of the skin. Embp expression without osmotic stress was similar for planktonic and adherent cultures. Addition of osmotic stress via NaCl caused slight increases in embp expression in planktonic cultures. However, in adherent cultures a 100-fold increase in embp expression with NaCl versus controls occurred and coincided with altered biofilm morphology. Results suggest that the central role of Embp lies in commensal skin colonization, stabilizing the cell wall against osmotic stresses, rather than as a virulence factor promoting adhesion.

Effect of adsorbed fibronectin on the differential adhesion of osteoblast-like cells and Staphylococcus aureus with and without fibronectin-binding proteins

The influence of fibronectin (Fn) coated surfaces patterned with poly(ethylene glycol) microgels having inter-gel spacings between 0.5 and 3.0 μm on the adhesion of Staphylococcus aureus strains with and without Fn-binding proteins and cellular adhesion/spreading was investigated. Quantitative force measurements between a S. aureus cell and a patterned surface showed that the adhesion force between the bacterium and the patterned surface increased substantially after Fn adsorption, regardless of the strain used, but decreased with decreasing inter-gel spacing. In flow-chamber experiments, the Fn-binding strain adhered at a higher rate after Fn adsorption than the strain lacking Fn-binding proteins. In both cases, the adhesion rates decreased with decreasing inter-gel spacing. Osteoblast-like cells could bind to patterned surfaces despite the microgels, and adsorbed Fn substantially amplified this effect. Even under highly non-adhesive conditions associated with closely spaced microgels, adsorbed Fn preserves a window of inter-gel spacing around 1 μm where the adhesion of staphylococcal cells is hindered while cells can still adhere and spread.