Field emission scanning electron microscopy of biofilm-growing bacteria involved in nosocomial infections

Evaluation of antibiofilm activity of cefiderocol alone and in combination with imipenem against Pseudomonas aeruginosa

OBJECTIVES

The main aim of this study was to evaluate the antibiofilm activity of cefiderocol alone and in combination with imipenem vs. sessile cells of Pseudomonas aeruginosa, assessing a potential synergistic bactericidal effect.

METHODS

Ten P. aeruginosa clinical isolates from infected implants and bloodstream were included in the study. Cefiderocol was tested alone and in combination with imipenem on 24-h-old P. aeruginosa biofilm formed on porous glass beads. For each antibiotic formulation, minimum bactericidal biofilm concentration (MBBC), defined as the lowest concentration that determined a reduction of at least 3 log10 CFU/mL compared with the untreated control, was evaluated. Scanning electron microscopy (SEM) was used to investigate the biofilm of P. aeruginosa treated with cefiderocol, imipenem, or their combination.

RESULTS

Cefiderocol and imipenem were tested alone on P. aeruginosa biofilm and a reasonable reduction in the number of viable cells was observed, especially at high drug concentrations tested. The synergistic effect of cefiderocol in combination with imipenem was evaluated for five selected isolates. Cotreatment with the two drugs led to a remarkable reduction of cell viability by resulting in synergistic bactericidal activity in all tested strains and in synergistic eradicating activity in only one isolate. SEM analysis revealed that, in cefiderocol-treated biofilm, bacterial cells became more elongated than in the untreated control, forming filaments in which bacterial division seems to be inhibited.

CONCLUSIONS

Cefiderocol exhibited an encouraging antibiofilm activity against tested strains, representing a valid option for the treatment of P. aeruginosa biofilm-associated infections, especially when administered in combination with imipenem.

In vitro and in vivo antibacterial studies of volatile oil from Atractylodis Rhizoma against Staphylococcus pseudintermedius and multidrug resistant Staphylococcus pseudintermedius strains from canine pyoderma

ETHNOPHARMACOLOGICAL RELEVANCE

Atractylodis Rhizoma is extensively employed in Traditional Chinese Medicine for the treatment of skin and gastrointestinal ailments. Its active components have been proven to demonstrate numerous beneficial properties, including antibacterial, antiviral, anti-inflammatory, anti-tumor, and anti-ulcer activities. Furthermore, the volatile oil from Atractylodis Rhizoma (VOAR) has been reported to effectively inhibit and eradicate pathogens such as Staphylococcus aureus, Escherichia coli and Candida albicans. Of particular concern is Staphylococcus pseudintermedius, the predominant pathogen responsible for canine pyoderma, whose increasing antimicrobial resistance poses a serious public health threat. VOAR merits further investigation regarding its antibacterial potential against Staphylococcus pseudintermedius.

AIM OF THE STUDY

The study aims to verify the in vitro antibacterial activity of VOAR against Staphylococcus pseudintermedius. And a superficial skin infection model in mice was established to assess the in vivo therapeutic effect of VOAR.

MATERIALS AND METHODS

Thirty strains of S. pseudintermedius were isolated from dogs with pyoderma, and the drug resistance was analyzed by disc diffusion method. The Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) of VOAR were determined through the broth dilution method. The growth curve of bacteria in a culture medium containing VOAR was monitored using a UV spectrophotometer. Scanning electron microscopy was employed to observe the effects of VOAR on the microstructure of S. pseudintermedius. The impact of VOAR on the antibiotic resistance of S. pseudintermedius was assessed using the disc diffusion method. Twenty mice were randomly divided into four groups: the control group, the physiological saline group, the VOAR group, and the amikacin group. With the exception of the control group, the skin barrier of mice was disrupted by tap stripping, and the mice were subsequently inoculated with S. pseudintermedius to establish a superficial skin infection model. The modeled mice were treated with normal saline, VOAR, and amikacin for 5 days. Following the treatment period, the therapeutic effect of each group was evaluated based on the measures of body weight, skin symptoms, tissue bacterial load, tissue IL-6 content, and histopathological changes.

RESULTS

The MIC and MBC of VOAR against 30 clinical isolates of S. pseudintermedius were found to be 0.005425% and 0.016875%, respectively. VOAR could exhibit the ability to delay the entry of bacteria into the logarithmic growth phase, disrupt the bacterial structure, and enhance the antibacterial zone in conjunction with antibiotic drugs. In the superficial skin infection model mice, VOAR significantly reduced the scores for skin redness (P < 0.0001), scab formation (P < 0.0001), and wrinkles (P < 0.0001). Moreover, VOAR markedly reduced the bacterial load (P < 0.001) and IL-6 content (P < 0.0001) in the skin tissues of mice. Histopathological observations revealed that the full-layer skin structure in the VOAR group was more complete, with clearer skin layers, and showed significant improvement in inflammatory cell infiltration and fibroblast proliferation compared to other groups.

CONCLUSION

The results demonstrate that VOAR effectively inhibits and eradicates Staphylococcus pseudintermedius in vitro while also enhancing the pathogen's sensitivity to antibiotics. Moreover, VOAR exhibits a pronounced therapeutic effect in the superficial skin infection model mice.

Dual-action gallium-flavonoid compounds for combating Pseudomonas aeruginosa infection

The opportunistic pathogen Pseudomonas aeruginosa (P. aeruginosa) causes infections that are difficult to treat, which is due to the bacterial natural resistance to antibiotics. The bacterium is also able to form a biofilm that protects the bacterium from clearance by the human immune system and leads to chronic infection. Herein, we synthesized and characterized a novel gallium compound that interferes with both the iron metabolism and quorum sensing system of P. aeruginosa to achieve a significant bactericidal activity. The compound could substantially reduce the secretion of bacterial virulence factors as well as eliminate biofilm formation. Integrative omics analysis indicates that this compound can significantly disturb the gene transcription and metabolism of P. aeruginosa. The effectiveness of the gallium compound was further validated in mammalian cell and murine skin infection models. Our study offers a new strategy to design new gallium-based antimicrobials to combat P. aeruginosa infection.

Scanning Electron Microscope Examination as an Alternative to Classical Microbiology in the Diagnostics of Catheter-Related Sepsis?

Central venous catheters are essential elements enabling the treatment of intensive care unit patients. However, these catheters are sometimes colonised by both bacteria and fungi, and thus, they may become a potential source of systemic infections-catheter-related bloodstream infections (CRBSI). The identification of the pathogen responsible for CRBSI is a time-consuming process. At the same time, the relationship between the quick identification of the pathogen and the implementation of targeted antibiotic therapy is of key importance for controlling the clinical symptoms of sepsis and septic shock in the patient. Quick diagnosis is of key importance to reduce morbidity and mortality in this group of patients. In our study, we attempted to create a catalogue of images of the most commonly cultured pathogens responsible for CRBSI. An FEI Quanta 250 FEG Scanning Electron Microscope (SEM) was used for measurements. SEM images obtained during the analysis were included in this study. Images of SEM are three-dimensional and comparable to the images seen with the human eye and are a tool used for research and measurement whenever it is necessary to analyse the state of the surface and assess its morphology. The method described in our study will not replace the current procedures recognised as the gold standard, i.e., pathogen culturing, determination of the count of microorganisms (CFU -colony forming units), and assessment of drug sensitivity. However, in some cases, the solution proposed in our study may aid the diagnosis of patients with suspected catheter-related bloodstream infections leading to sepsis and septic shock.

Atomic force microscopy and scanning electron microscopy as alternative methods of early identification of pathogens causing catheter-related bloodstream infections of patients in ICU

Introduction

Vascular catheters are an indispensable element of the therapy of patients in intensive care. Their use is associated with the possibility of complications, including infectious. According to various sources, the incidence of catheter-related bloodstream infections (CRBSIs) ranges from 0.1 to 22.7 per 1,000 catheter days.

Materials and Methods

The central venous catheter tip culture samples were collected from 24 patients with suspected catheter-related bloodstream infection, from three intensive care units (ICUs). The results of microscopic examinations: atomic force microscope (AFM) and scanning electron microscope (SEM) were compared with the results of microbiological analysis of the central venous catheter tip and blood collected from the catheter.

Results

The microscopic examination and microbiological analysis of both the blood and central venous catheter samples confirmed the presence of microorganisms in 16 cases (double positive result). Our study was conducted in a short period of time (up to 6 hours) and it gave an initial answer to the question about the type of microorganisms colonising the central venous catheter. In one patient the infection was not caused by removal of the central venous catheter. However, not all results were fully consistent within the two diagnostic methods. The colonisation of the central venous catheter with Pseudomonas aeruginosa and Staphylococcus epidermidis was microbiologically confirmed, but it was not confirmed by the microscopic examination of the sample collected from patient No. 20. However, the examination enabled preliminary assessment of the microorganism colonising the catheter, which may have caused the blood infection. It cannot be ruled out that Pseudomonas aeruginosa bacilli were grown on the catheter that came into contact with blood from another source of infection, e.g. the respiratory, nervous or urinary systems. Information on the presence of cocci-shaped bacteria forming characteristic clusters or rods may enable initial diagnosis of catheter-related bloodstream infection if it is accompanied by typical clinical symptoms. Alternative diagnostics also provides valuable information on the presence of biofilm, which is a factor hindering the body’s response to infection and penetration of antibiotics.

Conclusions

Our pilot study presents new diagnostic possibilities of microscopic imaging with the atomic force microscope (AFM) and scanning electron microscope (SEM) to identify pathogens on routinely used disposable medical devices, such as the central venous catheter. On the other hand, this range of diagnostics reveals the potential to constantly improve medical materials which come into direct contact with patients’ tissues. It is important to create a database of microscopic images, which would be a repeatable diagnostic pattern and fully correlated with the results of microbiological analysis, because it would facilitate initial quick diagnosis of a potential CRBSI.

Antimicrobial resistance and virulence characteristics in ERIC-PCR typed biofilm forming isolates of P. aeruginosa

Pseudomonas aeruginosa is a serious pathogen particularly in immunocompromised patients. In this work, 103 clinical isolates of P. aeruginosa were collected and classified into weak, moderate, and strong biofilm producers according to their biofilm forming abilities via tissue culture plate method. The antimicrobial resistance and the presence of different virulence genes were investigated via disc diffusion method and polymerase chain reaction respectively. Moreover, ERIC-PCR typing was performed to investigate the genetic diversity among the clinical isolates. No significant correlation was observed between biofilm formation and resistance to each antimicrobial agent. Similar observation was detected concerning the multidrug resistance and biofilm formation. Regarding virulence genes, algD gene was harbored by all isolates (100%). Only pelA and phzM were significantly prevalent in strong biofilm producers. Additionally, the mean virulence score was higher in strong biofilm producers (9.33) than moderate (8.62) and weak (7) biofilm producers. Moreover, there was a significant correlation between the overall virulence score of the isolates and its ability to form biofilm. ERIC-PCR genotyping revealed the presence of 99 different ERIC patterns based on 70% similarity, and the different ERIC patterns were categorized into 8 clusters. 100% similarity indicates the possibility of cross-colonization in P. aeruginosa infections.

Microbial Biofilms in the Food Industry-A Comprehensive Review

Biofilms, present as microorganisms and surviving on surfaces, can increase food cross-contamination, leading to changes in the food industry’s cleaning and disinfection dynamics. Biofilm is an association of microorganisms that is irreversibly linked with a surface, contained in an extracellular polymeric substance matrix, which poses a formidable challenge for food industries. To avoid biofilms from forming, and to eliminate them from reversible attachment and irreversible stages, where attached microorganisms improve surface adhesion, a strong disinfectant is required to eliminate bacterial attachments. This review paper tackles biofilm problems from all perspectives, including biofilm-forming pathogens in the food industry, disinfectant resistance of biofilm, and identification methods. As biofilms are largely responsible for food spoilage and outbreaks, they are also considered responsible for damage to food processing equipment. Hence the need to gain good knowledge about all of the factors favouring their development or growth, such as the attachment surface, food matrix components, environmental conditions, the bacterial cells involved, and electrostatic charging of surfaces. Overall, this review study shows the real threat of biofilms in the food industry due to the resistance of disinfectants and the mechanisms developed for their survival, including the intercellular signalling system, the cyclic nucleotide second messenger, and biofilm-associated proteins.

Nonclassical Biofilms Induced by DNA Breaks in Klebsiella pneumoniae

Many pathogenic bacteria can form biofilm matrices that consist of complex molecules such as polysaccharides, proteins, and DNA. These biofilms help the bacteria to infect and colonize a host. Such biofilms may attach and develop on the surfaces of indwelling medical devices or other supportive environments. This study found that following double-strand breaks in their DNA, Klebsiella pneumoniae cells can form a novel type of biofilm with ring-like or discoid morphology. This biofilm structure, named the “R-biofilm,” helps protect the bacteria against adverse conditions such as exposure to ethanol, hydrogen peroxide, and UV radiation.

Biofilms usually form when the density of bacteria increases during the middle to late periods of growth in culture, commonly induced by quorum-sensing systems. Biofilms attach to the surfaces of either living or nonliving objects and protect bacteria against antibiotics and a host’s immune system. Here, a novel type of biofilm (the “R-biofilm”) is reported. These biofilms were formed by clinically isolated Klebsiella pneumoniae strains following double-stranded-DNA breaks (DSBs), while undamaged bacteria did not form classic biofilms even in the later stages of growth. R-biofilms had a fixed ring-like or discoid shape with good ductility and could protect many living bacterial cells within. We show that extracellular proteins and DNAs released, probably by dead bacteria, were the core structural materials of R-biofilms. We anticipate that novel signaling pathways besides the bacterial SOS response are involved in R-biofilm formation. The observations in this study suggest a limitation to the use of the currently popular Cas9-mediated bactericidal tools to eliminate certain bacteria because the resulting DSBs may lead to the formation of these protective R-biofilms.

IMPORTANCE Many pathogenic bacteria can form biofilm matrices that consist of complex molecules such as polysaccharides, proteins, and DNA. These biofilms help the bacteria to infect and colonize a host. Such biofilms may attach and develop on the surfaces of indwelling medical devices or other supportive environments. This study found that following double-strand breaks in their DNA, Klebsiella pneumoniae cells can form a novel type of biofilm with ring-like or discoid morphology. This biofilm structure, named the “R-biofilm,” helps protect the bacteria against adverse conditions such as exposure to ethanol, hydrogen peroxide, and UV radiation.

Novel electrospun fibers with incorporated commensal bacteria for potential preventive treatment of the diabetic foot

AIM

A novel electrospun biocompatible nanofibrous material loaded with commensal bacteria for potential preventive treatment of the diabetic foot was developed.

MATERIALS & METHODS

Two biocompatible polymers (carboxymethylcellulose and polyethylene oxide) were combined with a bacterium isolate from the skin located between the toes of a healthy adult (identified using a matrix-assisted laser desorption/ionization mass spectrometry-based method as a strain of Staphylococcus epidermidis). Higher bacteria loads in the material were assured through their encapsulation in polyethylenimine. The nanofibrous material was characterized using scanning electron microscopy, zeta-potential measurements and through evaluation of cell growth and viability.

RESULTS & DISCUSSION

nanometer formation was confirmed using scanning electron microscopy, while the zeta-potential measurements revealed successful bacteria encapsulation. Viable and sufficiently growing cells were confirmed prior and after their incorporation.

CONCLUSION

The prepared materials were proven suitable to deliver viable commensal bacteria in a comparable share to the Staphylococcaceae in the foot microbiome making this approach promising for preventive diabetic foot treatment.

Biofilm-Forming Ability and Clonality in Acinetobacter baumannii Strains Isolated from Urine Samples and Urinary Catheters in Different European Hospitals

OBJECTIVE

Biofilm formation has been associated with the persistence of Acinetobacter baumannii in hospital settings and its propensity to cause infection. We investigated the adhesion ability and clonality of 128 A. baumannii isolates recovered from urine and urinary catheters of patients admitted to 5 European hospitals during 1991-2013.

METHODS

Isolates identification was confirmed by rpoB sequencing and by the presence of blaOXA-51. The presence of carbapenemases was detected by PCR. Clonality was determined by Sequence Group (SG) identification, Pulsed field gel electrophoresis (PFGE) and Multilocus sequence typing. Adhesion ability was defined by quantitative biofilm production assay and biofilms were characterized by Confocal Laser Microscopy and Scanning Electron Microscopy.

RESULTS

The 128 isolates, either resistant (85.9%) or susceptible (14.1%) to carbapenems, and belonging to 50 different PFGE types and 24 different STs, were distributed among SG1 (67.2%), SG2 (10.2%) and other allelic profiles (22.7%). ST218 was the most frequent ST, corresponding to 54,5% of the isolates collected between 2011 and 2013. Among the 109 isolates showing resistance to at least 1 carbapenem, 55% revealed the presence of an acquired carbapenem-hydrolyzing class D - lactamases (CHDL): blaOXA-23 were the most frequent gene detected from 2008 onwards (75%). Among all the clinical isolates, 42.2% were strong biofilm producers, with the older isolates having the highest adhesion ability. Most isolates recovered later, belonging to ST218 and harbouring blaOXA-23, were homogeneously less adhesive.

CONCLUSIONS

An evolution towards a decrease in adhesion ability and a CHDL content change was observed along the years in several European countries.

The efficacy of photodynamic and photothermal therapy on biofilm formation of Streptococcus mutans: An in vitro study

BACKGROUND

The alternative antibacterial treatments of photodynamic therapy (PDT) and photothermal therapy (PTT) significantly affect microbiota inactivation. The aim of the present research was the assessment of the antimicrobial and anti-biofilm effects of PDT with toluidine blue O (TBO) and PTT with indocyanine green (ICG) on Streptococcus mutans as a cariogenic bacterium.

MATERIALS AND METHODS

The S. mutans ATCC 35668 strain was treated with final concentrations of 0.1mg/mL TBO and 1mg/mL ICG with energy densities of 17.18 and 15.62J/cm², respectively. Cell viability was evaluated after culturing and anti-biofilm potential was analyzed using crystal violet assay and scanning electron microscopy.

RESULTS

The number of S. mutans colony forming unit (CFU)/mL was significantly lower in the groups submitted to PDT (12.5-100μg/mL TBO) and PTT (62.5-1000μg/mL) compared to the control (untreated group). 0.1mg/mL TBO-PDT and 1mg/mL ICG-PTT showed stronger inhibitory effects on biofilm formation in S. mutans than other concentration levels, with a reduction of 63.87% and 67.3%, respectively.

CONCLUSION

Photo-elimination by high concentrations of TBO-PDT and ICG-PTT exhibited significantly stronger inhibitory effects on biofilm formation and cell viability in S. mutans.