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Chan RK, Nuutila K, Mathew-Steiner SS, Diaz V, Anselmo K, Batchinsky M, Carlsson A, Ghosh N, Sen CK, Roy S. A Prospective, Randomized, Controlled Study to Evaluate the Effectiveness of a Fabric-Based Wireless Electroceutical Dressing Compared to Standard-of-Care Treatment Against Acute Trauma and Burn Wound Biofilm Infection. Adv Wound Care (New Rochelle) 2024; 13:1-13. [PMID: 36855334 PMCID: PMC10654645 DOI: 10.1089/wound.2023.0007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 02/24/2023] [Indexed: 03/02/2023] Open
Abstract
Objective: Despite advances in the use of topical and parenteral antimicrobial therapy and the practice of early tangential burn wound excision to manage bacterial load, 60% of the mortality from burns is attributed to bacterial biofilm infection. A low electric field (∼1 V) generated by the novel FDA-cleared wireless electroceutical dressing (WED) was previously shown to significantly prevent and disrupt burn biofilm infection in preclinical studies. Based on this observation, the purpose of this clinical trial was to evaluate the efficacy of the WED dressing powered by a silver-zinc electrocouple in the prevention and disruption of biofilm infection. Approach: A prospective, randomized, controlled, single-center clinical trial was performed to evaluate the efficacy of the WED compared with standard-of-care (SoC) dressing to treat biofilms. Burn wounds were randomized to receive either SoC or WED. Biopsies were collected on days 0 and 7 for histology, scanning electron microscopy (SEM) examination of biofilm, and for quantitative bacteriological analyses. Results: In total, 38 subjects were enrolled in the study. In 52% of the WED-treated wounds, little to no biofilm could be detected by SEM. WED significantly lowered or prevented increase of biofilm in all wounds compared with the pair-matched SoC-treated wounds. Innovation: WED is a simple, easy, and rapid method to protect the wound while also inhibiting infection. It is activated by a moist environment and the electrical field induces transient and micromolar amounts of superoxide anion radicals that will prevent bacterial growth. Conclusion: WED decreased biofilm infection better compared with SoC. The study was registered in clinicaltrials.gov as NCT04079998.
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Affiliation(s)
- Rodney K. Chan
- United States Army Institute of Surgical Research, Ft. Sam Houston, Texas, USA
| | - Kristo Nuutila
- United States Army Institute of Surgical Research, Ft. Sam Houston, Texas, USA
| | | | | | | | - Maria Batchinsky
- United States Army Institute of Surgical Research, Ft. Sam Houston, Texas, USA
| | - Anders Carlsson
- United States Army Institute of Surgical Research, Ft. Sam Houston, Texas, USA
- Metis Foundation, San Antonio, Texas, USA
| | - Nandini Ghosh
- Comprehensive Wound Center, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Chandan K. Sen
- Comprehensive Wound Center, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Sashwati Roy
- Comprehensive Wound Center, Indiana University School of Medicine, Indianapolis, Indiana, USA
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M. Shawki M, M. Eltarahony M, E. Moustafa M. The impact of titanium oxide nanoparticles and low direct electric current on biofilm dispersal of $Bacillus~cereus$ and $Pseudomonas~aeruginosa$: A comparative study. PAPERS IN PHYSICS 2021. [DOI: 10.4279/pip.130005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Bacteria growing in biofilms cause a wide range of environmental, industrial and public health risks. Because biofilm bacteria are very resistant to antibiotics, there is an urgent need in medicine and industry to develop new approaches to eliminating bacterial biofilms. One strategy for controlling these biofilms is to generate an antibiofilm substance locally at the attachment surface. Direct electric current (DC) and nanoparticles (NPs) of metal oxides have outstanding antimicrobial properties. In this study we evaluated the effect of titanium oxide nanoparticle (TiO$_2$-NP) concentrations from 5 to 160 $\mu$g/mL on Bacillus cereus and Pseudomonas aeruginosa biofilms, and compared this with the effect of a 9 V, 6 mA DC electric field for 5, 10 and 15 min. TiO$_2$-NPs were characterized using transmission and scanning electron microscopes, X-ray diffraction and FTIR. They exhibited an average size of 22-34 nm. The TiO$_2$-NP concentrations that attained LD50 were $104 \pm 4$ $\mu$g/mL and $63 \pm 3$ $\mu$g/mL for B. cereus and P. aeruginosa, respectively. The eradication percentages obtained by DC at 5, 10, and 15 min exposure were 21%, 29%, and 33% respectively for B. cereus and 30%, 39%, and 44% respectively for P. aeruginosa. Biofilm disintegration was verified by exopolysaccharide, protein content and cell surface hydrophobicity assessment, as well as scanning electron microscopy. These data were correlated with the reactive oxygen species produced. The results indicated that both DC and TiO$_2$-NPs have a lethal effect on these bacterial biofilms, and that the DC conditions used affect the biofilms in a similar way to TiO$_2$-NPs at concentrations of 20-40 $\mu$g/mL.
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Domnin P, Arkhipova A, Petrov S, Sysolyatina E, Parfenov V, Karalkin P, Mukhachev A, Gusarov A, Moisenovich M, Khesuani Y, Ermolaeva S. An In Vitro Model of Nonattached Biofilm-Like Bacterial Aggregates Based on Magnetic Levitation. Appl Environ Microbiol 2020; 86:e01074-20. [PMID: 32680859 PMCID: PMC7480373 DOI: 10.1128/aem.01074-20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/10/2020] [Indexed: 12/27/2022] Open
Abstract
Chronic infections are associated with the formation of nonattached biofilm-like aggregates. In vitro models of surface-attached biofilms do not always accurately mimic these processes. Here, we tested a new approach to create in vitro nonattached bacterial aggregates using the principle of magnetic levitation of biological objects placed into a magnetic field gradient. Bacteria grown under magnetic levitation conditions formed nonattached aggregates that were studied with confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM) and characterized quantitatively. Nonattached aggregates consisted of bacteria submerged into an extracellular matrix and demonstrated features characteristic of biofilms, such as a polymeric matrix that binds Ruby Red and Congo red dyes, a prerequisite of bacterial growth, and increased resistance to gentamicin. Three quantitative parameters were explored to characterize strain-specific potential to form nonattached aggregates: geometric sizes, relative quantities of aggregated and free-swimming bacteria, and Congo red binding. Among three tested Escherichia coli strains, one strain formed nonattached aggregates poorly, and for this strain, all three of the considered parameters were different from those of the other two strains (P < 0.05). Further, we characterized biofilm formation on plastic and agar surfaces by these strains and found that good biofilm formation ability does not necessarily indicate good nonattached aggregate formation ability, and vice versa. The model and quantitative methods can be applied for in vitro studies of nonattached aggregates and modeling bacterial behavior in chronic infections, as it is important to increase our understanding of the role that nonattached bacterial aggregates play in the pathogenesis of chronic diseases.IMPORTANCE An increasing amount of evidence indicates that chronic infections are associated with nonattached biofilm-like aggregates formed by pathogenic bacteria. These aggregates differ from biofilms because they form under low-shear conditions within the volume of biological fluids and they do not attach to surfaces. Here, we describe an in vitro model that provides nonattached aggregate formation within the liquid volume due to magnetic levitation. Using this model, we demonstrated that despite morphological and functional similarities of nonattached aggregates and biofilms, strains that exhibit good biofilm formation might exhibit poor nonattached aggregate formation, suggesting that mechanisms underlying the formation of biofilms and nonattached aggregates are not identical. The magnetic levitation approach can be useful for in vitro studies of nonattached aggregate formation and simulation of bacterial behavior in chronic infections.
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Affiliation(s)
- Pavel Domnin
- Gamaleya Research Centre of Epidemiology and Microbiology, Moscow, Russia
- Lomonosov Moscow State University, Moscow, Russia
| | | | | | - Elena Sysolyatina
- Gamaleya Research Centre of Epidemiology and Microbiology, Moscow, Russia
| | | | | | - Andrey Mukhachev
- Gamaleya Research Centre of Epidemiology and Microbiology, Moscow, Russia
| | - Alexey Gusarov
- Gamaleya Research Centre of Epidemiology and Microbiology, Moscow, Russia
| | | | | | - Svetlana Ermolaeva
- Gamaleya Research Centre of Epidemiology and Microbiology, Moscow, Russia
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Ehrensberger MT, Clark CM, Canty MK, McDermott EP. Electrochemical methods to enhance osseointegrated prostheses. Biomed Eng Lett 2020; 10:17-41. [PMID: 32175128 PMCID: PMC7046908 DOI: 10.1007/s13534-019-00134-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 10/11/2019] [Accepted: 10/20/2019] [Indexed: 12/19/2022] Open
Abstract
Osseointegrated (OI) prosthetic limbs have been shown to provide an advantageous treatment option for amputees. In order for the OI prosthesis to be successful, the titanium implant must rapidly achieve and maintain proper integration with the bone tissue and remain free of infection. Electrochemical methods can be utilized to control and/or monitor the interfacial microenvironment where the titanium implant interacts with the biological system (host bone tissue or bacteria). This review will summarize the current understanding of how electrochemical modalities can influence bone tissue and bacteria with specific emphasis on applications where the metallic prosthesis itself can be utilized directly as a stimulating electrode for enhanced osseointegration and infection control. In addition, a summary of electrochemical impedance sensing techniques that could be used to potentially assess osseointegration and infection status of the metallic prosthesis is presented.
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Affiliation(s)
- Mark T. Ehrensberger
- Department of Biomedical Engineering, University at Buffalo, 445 Biomedical Research Building, 3435 Main Street, Buffalo, NY 14214 USA
- Department of Orthopaedics, University at Buffalo, Buffalo, NY USA
| | - Caelen M. Clark
- Department of Biomedical Engineering, University at Buffalo, 445 Biomedical Research Building, 3435 Main Street, Buffalo, NY 14214 USA
| | - Mary K. Canty
- Department of Biomedical Engineering, University at Buffalo, 445 Biomedical Research Building, 3435 Main Street, Buffalo, NY 14214 USA
- Department of Microbiology and Immunology, University at Buffalo, Buffalo, NY USA
| | - Eric P. McDermott
- Department of Biomedical Engineering, University at Buffalo, 445 Biomedical Research Building, 3435 Main Street, Buffalo, NY 14214 USA
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Antibiotics Enhance Prevention and Eradication Efficacy of Cathodic-Voltage-Controlled Electrical Stimulation against Titanium-Associated Methicillin-Resistant Staphylococcus aureus and Pseudomonas aeruginosa Biofilms. mSphere 2019; 4:4/3/e00178-19. [PMID: 31043516 PMCID: PMC6495338 DOI: 10.1128/msphere.00178-19] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Periprosthetic joint infections (PJIs) develop clinically in the presence of antibiotic therapies and are responsible for increased patient morbidity and rising health care costs. Many of these infections involve bacterial biofilm formation on orthopedic hardware, and it has been well established that these biofilms are refractory to most antibiotic treatments. Recent studies have focused on novel methods to prevent and eradicate infection. Cathodic-voltage-controlled electrical stimulation (CVCES) has previously been shown to be effective as a method for prevention and eradication of Gram-positive and Gram-negative infections. The present study revealed that the utility of CVCES for prevention and eradication of methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa is enhanced in the presence of clinically relevant antibiotics. The synergistic effects of CVCES and antibiotics are effective in a magnitude-dependent manner. The results of this study indicate a promising alternative method to current PJI mitigation techniques. Periprosthetic joint infection (PJI) develops clinically, even with antibiotic treatment, and methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa are predominant causes of these infections. Due to biofilm formation, antibiotic treatment for patients with PJI can perpetuate resistance, further complicating the use of noninvasive treatments. This study evaluated cathodic-voltage-controlled electrical stimulation (CVCES) of titanium, in combination with a clinically relevant antibiotic, to synergistically prevent MRSA and P. aeruginosa PJIs by inhibiting bacterial adherence or as a treatment for eradicating established biofilms. CVCES of −1.0 V, −1.5 V, or −1.8 V (versus Ag/AgCl), with or without vancomycin for MRSA or gentamicin for P. aeruginosa, was applied to sterile titanium incubated with cultures to evaluate prevention of attachment or eradication of preestablished biofilms. Treatments were 24 h long and included open-circuit potential controls, antibiotic alone, CVCES, and CVCES plus antibiotic. Biofilm-associated and planktonic CFU were enumerated. In general, CVCES at −1.8 V alone or with antibiotic completely eradicated biofilm-associated CFU for both strains, and these parameters were also highly effective against planktonic bacteria, resulting in a >6-log reduction in MRSA and no detectable planktonic P. aeruginosa. All CFU were reduced ∼3 to 5 logs from controls for prevention CVCES plus antibiotics at −1.0 V and −1.5 V against MRSA. Remarkably, there were no detectable P. aeruginosa CFU following prevention CVCES at −1.0 V or −1.5 V with gentamicin. Our results suggest that CVCES in combination with antibiotics may be an effective approach for prevention and treatment of PJI. IMPORTANCE Periprosthetic joint infections (PJIs) develop clinically in the presence of antibiotic therapies and are responsible for increased patient morbidity and rising health care costs. Many of these infections involve bacterial biofilm formation on orthopedic hardware, and it has been well established that these biofilms are refractory to most antibiotic treatments. Recent studies have focused on novel methods to prevent and eradicate infection. Cathodic-voltage-controlled electrical stimulation (CVCES) has previously been shown to be effective as a method for prevention and eradication of Gram-positive and Gram-negative infections. The present study revealed that the utility of CVCES for prevention and eradication of methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa is enhanced in the presence of clinically relevant antibiotics. The synergistic effects of CVCES and antibiotics are effective in a magnitude-dependent manner. The results of this study indicate a promising alternative method to current PJI mitigation techniques.
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Rubin AE, Usta OB, Schloss R, Yarmush M, Golberg A. Selective Inactivation of Pseudomonas aeruginosa and Staphylococcus epidermidis with Pulsed Electric Fields and Antibiotics. Adv Wound Care (New Rochelle) 2019; 8:136-148. [PMID: 31737412 DOI: 10.1089/wound.2018.0819] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 10/15/2018] [Indexed: 01/17/2023] Open
Abstract
Objective: Increasing numbers of multidrug-resistant bacteria make many antibiotics ineffective; therefore, new approaches to combat microbial infections are needed. In addition, antibiotics are not selective-they kill pathogenic organisms as well as organisms that could positively contribute to wound healing (bio flora). Approach: Here we report on selective inactivation of Pseudomonas aeruginosa and Staphylococcus epidermidis, potential pathogens involved in wound infections with pulsed electric fields (PEFs) and antibiotics (mix of penicillin, streptomycin, and nystatin). Results: Using a Taguchi experimental design in vitro, we found that, under similar electric field strengths, the pulse duration is the most important parameter for P. aeruginosa inactivation, followed by the number of pulses and pulse frequency. P. aeruginosa, a potential severe pathogen, is more sensitive than the less pathogenic S. epidermidis to PEF (alone or in combination with antibiotics). Applying 200 pulses with a duration of 60 μs at 2.8 Hz, the minimum electric fields of 308.8 ± 28.3 and 378.4 ± 12.9 V/mm were required to inactive P. aeruginosa and S. epidermidis, respectively. Addition of antibiotics reduced the threshold for minimum electric fields required to inactivate the bacteria. Innovation: This study provides essential information, such as critical electric field parameters for bacteria inactivation, required for developing in vivo treatment and clinical protocols for using PEF for wound healing. Conclusion: A combination of PEFs with antibiotics reduces the electric field threshold required for bacteria disinfection. Such an approach simplifies devices required to disinfect large areas of infected wounds.
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Affiliation(s)
- Andrey Ethan Rubin
- Porter School of Environment and Earth Sciences, Tel Aviv University Ramat Aviv, Tel Aviv, Israel
| | - Osman Berk Usta
- Center for Engineering in Medicine, Massachusetts General Hospital Shriners Burn Hospital for Children and Harvard Medical School, Boston, Massachusetts
| | - Rene Schloss
- Department of Biomedical Engineering, Rutgers University, Piscataway, New Jersey
| | - Martin Yarmush
- Center for Engineering in Medicine, Massachusetts General Hospital Shriners Burn Hospital for Children and Harvard Medical School, Boston, Massachusetts
- Department of Biomedical Engineering, Rutgers University, Piscataway, New Jersey
| | - Alexander Golberg
- Porter School of Environment and Earth Sciences, Tel Aviv University Ramat Aviv, Tel Aviv, Israel
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Alternating electric fields induce a period-dependent motion of Escherichia coli in three-dimension near a conductive surface. Biointerphases 2019; 14:011005. [PMID: 30786720 DOI: 10.1116/1.5078543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
It has been demonstrated that electric fields can minimize surface adhesion of bacteria, but how they affect the near-surface bacterial dynamics has remained largely overlooked. In the present study, the three-dimensional motions of Escherichia coli (E. coli) HCB1 and HCB1414 near a conductive surface under alternating-current (AC) electric fields were monitored with digital holographic microscopy. The period (T) of AC fields exhibited profound effects on near-surface bacterial behavioral patterns and thus affected the surface adhesiveness of E. coli. When T ≥ 1 s, HCB1 cells tumble frequently, and both two strain cells increasingly undergo subdiffusive motions compared to the case without electric fields. The bacterial density near the surface varies due to galvanotaxis depending on the initial polarization of the surface. For shorter periods (T ≤ 0.1 s), the electric fields reduce the near-surface bacterial density by 10%-20% with the surface as either an anode or a cathode. The AC fields directly disturb the intrinsic bacterial rotation. The bacterial body exhibits strong wobbling at T ≥ 1 s. Such wobbling was suppressed with decreasing T, which reduces the collisions between E. coli and the surface and thus leads to declining bacterial density. These results suggest that the use of low-density AC fields with tunable T may be a promising antifouling strategy and merits further investigations.
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Froughreyhani M, Salemmilani A, Mozafari A, Hosein-Soroush M. Effect of electric currents on antibacterial effect of chlorhexidine against Entrococcus faecalis biofilm: An in vitro study. J Clin Exp Dent 2018; 10:e1223-e1229. [PMID: 30697382 PMCID: PMC6343980 DOI: 10.4317/jced.55369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 11/02/2018] [Indexed: 11/08/2022] Open
Abstract
Background This in vitro study was mainly aimed to evaluate the effect of high-frequency alternating currents (AC) applied by an electronic apex locator (EAL) on the antibacterial properties of chlorhexidine (CHX) on E. faecalis biofilm. Material and Methods The root canals of 120 extracted human single-rooted teeth were prepared using Gates-Glidden drills and hand K-files. After contaminating the root canals with E. faecalis, they were incubated for 60 days. Then, the teeth were randomly divided into six experimental groups (n=20). Group 1, 2% CHX; group 2, normal saline (NS) with direct current (DC); group 3, normal saline (NS) with high-frequency alternating current (AC); group 4, 2% CHX with DC; group 5, 2% CHX with AC; group 6, control (normal saline). The samples were collected from the root canal walls of 16 teeth in each group and 1:10 serial dilutions were prepared and added to Muller-Hinton agar (MHA) plates and incubated at 37°C for 48 h. The longitudinal sections of the other 4 teeth used to observe under a scanning electron microscope (SEM). A classic colony counting technique was used for counting the vital E. faecalis bacteria in MHA. Two-way ANOVA was used for statistical analysis of the data. The level of significance was set at P<0.05. Results The electric current significantly changed the colony-forming units (CFU) values (P<0.001). According to pair-wise comparisons, the highest CFU difference was observed between the AC group and the group without electric current (P<0.001); furthermore, the difference between the DC group and the group without electric current was not significant (P=0.823). Conclusions The highest bioelectric effect occurred with the use of high-frequency alternating electric current in the form of an apex locator with CHX as a canal irrigant. Key words:Biofilm, Chlorhexidine, Direct current, Electric current, Enterococcus faecalis.
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Affiliation(s)
- Mohammad Froughreyhani
- Associate Professor. Department of Endodontics, Dental and Periodontal Research Center, Faculty of Dentistry, Tabriz University of Medical Sciences
| | - Amin Salemmilani
- Associate Professor. Department of Endodontics, Dental and Periodontal Research Center, Faculty of Dentistry, Tabriz University of Medical Sciences
| | - Aysan Mozafari
- Post-graduate Student. Department of Endodontics, Dental and Periodontal Research Center, Faculty of Dentistry, Tabriz University of Medical Sciences
| | - Mohammad Hosein-Soroush
- Associate Professor. Department of Endodontics, Dental and Periodontal Research Center, Faculty of Dentistry, Tabriz University of Medical Sciences
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Junka AF, Rakoczy R, Szymczyk P, Bartoszewicz M, Sedghizadeh PP, Fijałkowski K. Application of Rotating Magnetic Fields Increase the Activity of Antimicrobials Against Wound Biofilm Pathogens. Sci Rep 2018; 8:167. [PMID: 29317719 PMCID: PMC5760636 DOI: 10.1038/s41598-017-18557-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 11/16/2017] [Indexed: 11/11/2022] Open
Abstract
Infective complications are a major factor contributing to wound chronicity and can be associated with significant morbidity or mortality. Wound bacteria are protected in biofilm communities and are highly resistant to immune system components and to antimicrobials used in wound therapy. There is an urgent medical need to more effectively eradicate wound biofilm pathogens. In the present work, we tested the impact of such commonly used antibiotics and antiseptics as gentamycin, ciprofloxacin, octenidine, chlorhexidine, polihexanidine, and ethacridine lactate delivered to Staphylococcus aureus and Pseudomonas aeruginosa biofilms in the presence of rotating magnetic fields (RMFs) of 10–50 Hz frequency and produced by a customized RMF generator. Fifty percent greater reduction in biofilm growth and biomass was observed after exposure to RMF as compared to biofilms not exposed to RMF. Our results suggest that RMF as an adjunct to antiseptic wound care can significantly improve antibiofilm activity, which has important translational potential for clinical applications.
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Affiliation(s)
- A F Junka
- Department of Pharmaceutical Microbiology and Parasitology, Wrocław Medical University, Borowska 211A, 50-556, Wrocław, Poland
| | - R Rakoczy
- Institute of Chemical Engineering and Environmental Protection Processes, Faculty of Chemical Technology and Engineering, West Pomeranian University of Technology, Szczecin, Piastów 42, 71-065, Szczecin, Poland
| | - P Szymczyk
- Centre for Advanced Manufacturing Technologies (CAMT/FPC), Faculty of Mechanical Engineering, Wrocław University of Science and Technology, Łukasiewicza 5, 50-371, Wrocław, Poland
| | - M Bartoszewicz
- Department of Pharmaceutical Microbiology and Parasitology, Wrocław Medical University, Borowska 211A, 50-556, Wrocław, Poland
| | - P P Sedghizadeh
- Center for Biofilms, Ostrow School of Dentistry of University of Southern California, 925 West 34th, Los Angeles, California, United States of America
| | - K Fijałkowski
- Department of Immunology, Microbiology and Physiological Chemistry, Faculty of Biotechnology and Animal Husbandry, West Pomeranian University of Technology, Szczecin, Piastów 45, 70-311, Szczecin, Poland.
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Ashrafi M, Baguneid M, Alonso-Rasgado T, Rautemaa-Richardson R, Bayat A. Cutaneous wound biofilm and the potential for electrical stimulation in management of the microbiome. Future Microbiol 2017; 12:337-357. [DOI: 10.2217/fmb-2016-0204] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Infection contributes significantly to delayed cutaneous wound healing, which impacts patient care. External application of electrical stimulation (ES) has beneficial effects on wound repair and regeneration. The majority of studies to date have explored ES in relation to planktonic microorganisms, yet evidence indicates that bacteria in chronic wounds reside as antibiotic-resistant polymicrobial biofilms, which contribute to impairing wound healing. Culture-independent sequencing techniques have revolutionized our understanding of the skin microbiome and allowed a more accurate determination of microbial taxa and their relative abundance in wounds allowing a greater understanding of the host–microbial interface. Future studies combining the fields of ES, biofilm and microbiome research are necessary to fully elucidate the use of ES in the management of wound infection.
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Affiliation(s)
- Mohammed Ashrafi
- Plastic & Reconstructive Surgery Research, Centre for Dermatological Research, University of Manchester, Manchester, UK
- University Hospital of South Manchester NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
- Bioengineering Group, School of Materials, University of Manchester, Manchester, UK
| | - Mohamed Baguneid
- University Hospital of South Manchester NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | | | - Riina Rautemaa-Richardson
- University Hospital of South Manchester NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
- Manchester Academic Health Science Centre, Institute of Inflammation & Repair, University of Manchester, Manchester, UK
| | - Ardeshir Bayat
- Plastic & Reconstructive Surgery Research, Centre for Dermatological Research, University of Manchester, Manchester, UK
- University Hospital of South Manchester NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
- Bioengineering Group, School of Materials, University of Manchester, Manchester, UK
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Nakouti I, Hobbs G, Teethaisong Y, Phipps D. A demonstration of athermal effects of continuous microwave irradiation on the growth and antibiotic sensitivity ofPseudomonas aeruginosaPAO1. Biotechnol Prog 2016; 33:37-44. [DOI: 10.1002/btpr.2392] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 10/18/2016] [Indexed: 02/04/2023]
Affiliation(s)
- Ismini Nakouti
- Built Environment and Sustainable Technology Research Inst; Liverpool John Moores University; Byrom Street Liverpool L3 3AF U.K
- Pharmacy and Biomolecular Sciences; Liverpool John Moores University; Byrom Street Liverpool L3 3AF U.K
| | - Glyn Hobbs
- Pharmacy and Biomolecular Sciences; Liverpool John Moores University; Byrom Street Liverpool L3 3AF U.K
| | - Yothin Teethaisong
- Pharmacy and Biomolecular Sciences; Liverpool John Moores University; Byrom Street Liverpool L3 3AF U.K
| | - David Phipps
- Built Environment and Sustainable Technology Research Inst., Liverpool John Moores University; Byrom Street Liverpool L3 3AF U.K
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Satpathy S, Sen SK, Pattanaik S, Raut S. Review on bacterial biofilm: An universal cause of contamination. BIOCATALYSIS AND AGRICULTURAL BIOTECHNOLOGY 2016. [DOI: 10.1016/j.bcab.2016.05.002] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Effect of electrical energy on the efficacy of biofilm treatment using the bioelectric effect. NPJ Biofilms Microbiomes 2015; 1:15016. [PMID: 28721233 PMCID: PMC5515217 DOI: 10.1038/npjbiofilms.2015.16] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 06/23/2015] [Accepted: 07/31/2015] [Indexed: 01/07/2023] Open
Abstract
Background/Objectives: The use of electric fields in combination with small doses of antibiotics for enhanced treatment of biofilms is termed the ‘bioelectric effect’ (BE). Different mechanisms of action for the AC and DC fields have been reported in the literature over the last two decades. In this work, we conduct the first study on the correlation between the electrical energy and the treatment efficacy of the bioelectric effect on Escherichia coli K-12 W3110 biofilms. Methods: A thorough study was performed through the application of alternating (AC), direct (DC) and superimposed (SP) potentials of different amplitudes on mature E. coli biofilms. The electric fields were applied in combination with the antibiotic gentamicin (10 μg/ml) over a course of 24 h, after the biofilms had matured for 24 h. The biofilms were analysed using the crystal violet assay, the colony-forming unit method and fluorescence microscopy. Results: Results show that there is no statistical difference in treatment efficacy between the DC-, AC- and SP-based BE treatment of equivalent energies (analysis of variance (ANOVA) P>0.05) for voltages <1 V. We also demonstrate that the efficacy of the BE treatment as measured by the crystal violet staining method and colony-forming unit assay is proportional to the electrical energy applied (ANOVA P<0.05). We further verify that the treatment efficacy varies linearly with the energy of the BE treatment (r2=0.984). Our results thus suggest that the energy of the electrical signal is the primary factor in determining the efficacy of the BE treatment, at potentials less than the media electrolysis voltage. Conclusions: Our results demonstrate that the energy of the electrical signal, and not the type of electrical signal (AC or DC or SP), is the key to determine the efficacy of the BE treatment. We anticipate that this observation will pave the way for further understanding of the mechanism of action of the BE treatment method and may open new doors to the use of electric fields in the treatment of bacterial biofilms.
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Sadekuzzaman M, Yang S, Mizan M, Ha S. Current and Recent Advanced Strategies for Combating Biofilms. Compr Rev Food Sci Food Saf 2015. [DOI: 10.1111/1541-4337.12144] [Citation(s) in RCA: 152] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- M. Sadekuzzaman
- School of Food Science and Technology; Chung-Ang Univ; 72-1 Nae-Ri Daedeok-Myun, Anseong Gyunggido 456-756 South Korea Dept. of Livestock Services, People's Republic of Bangladesh
| | - S. Yang
- Chung-Ang Univ; 72-1 Nae-Ri Daedeok-Myun, Anseong Gyunggido 456-756 South Korea
| | - M.F.R. Mizan
- Chung-Ang Univ; 72-1 Nae-Ri Daedeok-Myun, Anseong Gyunggido 456-756 South Korea
| | - S.D. Ha
- Chung-Ang Univ; 72-1 Nae-Ri Daedeok-Myun, Anseong Gyunggido 456-756 South Korea
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16
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Abstract
The tolerance of microorganisms in biofilms to antimicrobial agents is examined through a meta-analysis of literature data. A numerical tolerance factor comparing the rates of killing in the planktonic and biofilm states is defined to provide a quantitative basis for the analysis. Tolerance factors for biocides and antibiotics range over three orders of magnitude. This variation is not explained by taking into account the molecular weight of the agent, the chemistry of the agent, the substratum material, or the speciation of the microorganisms. Tolerance factors do depend on the areal cell density of the biofilm at the time of treatment and on the age of the biofilm as grown in a particular experimental system. This suggests that there is something that happens during biofilm maturation, either physical or physiological, that is essential for full biofilm tolerance. Experimental measurements of antimicrobial penetration times in biofilms range over orders of magnitude, with slower penetration (>12 min) observed for reactive oxidants and cationic molecules. These agents are retarded through the interaction of reaction, sorption, and diffusion. The specific physiological status of microbial cells in a biofilm contributes to antimicrobial tolerance. A conceptual framework for categorizing physiological cell states is discussed in the context of antimicrobial susceptibility. It is likely that biofilms harbor cells in multiple states simultaneously (e.g., growing, stress-adapted, dormant, inactive) and that this physiological heterogeneity is an important factor in the tolerance of the biofilm state.
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Affiliation(s)
- Philip S. Stewart
- Center for Biofilm Engineering, Montana State University, Bozeman, MT 59717
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17
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Continuous drip flow system to develop biofilm of E. faecalis under anaerobic conditions. ScientificWorldJournal 2014; 2014:706189. [PMID: 25371913 PMCID: PMC4211154 DOI: 10.1155/2014/706189] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 08/28/2014] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To evaluate a structurally mature E. faecalis biofilm developed under anaerobic/dynamic conditions in an in vitro system. METHODS An experimental device was developed using a continuous drip flow system designed to develop biofilm under anaerobic conditions. The inoculum was replaced every 24 hours with a fresh growth medium for up to 10 days to feed the system. Gram staining was done every 24 hours to control the microorganism purity. Biofilms developed under the system were evaluated under the scanning electron microscope (SEM). RESULTS SEM micrographs demonstrated mushroom-shaped structures, corresponding to a mature E. faecalis biofilm. In the mature biofilm bacterial cells are totally encased in a polymeric extracellular matrix. CONCLUSIONS The proposed in vitro system model provides an additional useful tool to study the biofilm concept in endodontic microbiology, allowing for a better understanding of persistent root canal infections.
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Lappin-Scott H, Burton S, Stoodley P. Revealing a world of biofilms--the pioneering research of Bill Costerton. Nat Rev Microbiol 2014; 12:781-7. [PMID: 25157698 DOI: 10.1038/nrmicro3343] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Bill Costerton is recognized as the founding father of the field of biofilms, which is the study of microorganisms attached to surfaces. He was a true pioneer and was passionate about directly observing living complex microbial communities to learn how they function in different ecosystems. His multidisciplinary approach to the study of biofilms forged a common way of thinking about the ways in which microorganisms survive and function in the environment as well as in medical, dental, industrial, agricultural, engineering and other contexts. In this Essay, we outline some of the achievements that Bill made during his scientific journey.
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Affiliation(s)
| | - Sara Burton
- Biosciences, University of Exeter, Exeter EX4 4QD, UK
| | - Paul Stoodley
- National Centre for Advanced Tribology, Faculty of Engineering, University of Southampton, Southampton SO17 1BJ, UK, and the Department of Microbial Infection and Immunity and the Department of Orthopaedics, Center for Microbial Interface Biology, The Ohio State University, Columbus, Ohio 43210, USA
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19
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Freebairn D, Linton D, Harkin-Jones E, Jones DS, Gilmore BF, Gorman SP. Electrical methods of controlling bacterial adhesion and biofilm on device surfaces. Expert Rev Med Devices 2014; 10:85-103. [DOI: 10.1586/erd.12.70] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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20
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Sandvik EL, McLeod BR, Parker AE, Stewart PS. Direct electric current treatment under physiologic saline conditions kills Staphylococcus epidermidis biofilms via electrolytic generation of hypochlorous acid. PLoS One 2013; 8:e55118. [PMID: 23390518 PMCID: PMC3563656 DOI: 10.1371/journal.pone.0055118] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Accepted: 12/19/2012] [Indexed: 01/25/2023] Open
Abstract
The purpose of this study was to investigate the mechanism by which a direct electrical current reduced the viability of Staphylococcus epidermidis biofilms in conjunction with ciprofloxacin at physiologic saline conditions meant to approximate those in an infected artificial joint. Biofilms grown in CDC biofilm reactors were exposed to current for 24 hours in 1/10th strength tryptic soy broth containing 9 g/L total NaCl. Dose-dependent log reductions up to 6.7 log10 CFU/cm2 were observed with the application of direct current at all four levels (0.7 to 1.8 mA/cm2) both in the presence and absence of ciprofloxacin. There were no significant differences in log reductions for wells with ciprofloxacin compared to those without at the same current levels. When current exposures were repeated without biofilm or organics in the medium, significant generation of free chlorine was measured. Free chlorine doses equivalent to the 24 hour endpoint concentration for each current level were shown to mimic killing achieved by current application. Current exposure (1.8 mA/cm2) in medium lacking chloride and amended with sulfate, nitrate, or phosphate as alternative electrolytes produced diminished kills of 3, 2, and 0 log reduction, respectively. Direct current also killed Pseudomonas aeruginosa biofilms when NaCl was present. Together these results indicate that electrolysis reactions generating hypochlorous acid from chloride are likely a main contributor to the efficacy of direct current application. A physiologically relevant NaCl concentration is thus a critical parameter in experimental design if direct current is to be investigated for in vivo medical applications.
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Affiliation(s)
- Elizabeth L. Sandvik
- Center for Biofilm Engineering, Montana State University, Bozeman, Montana, United States of America
- Department of Chemical and Biological Engineering, Montana State University, Bozeman, Montana, United States of America
| | - Bruce R. McLeod
- Center for Biofilm Engineering, Montana State University, Bozeman, Montana, United States of America
- Department of Electrical and Computer Engineering, Montana State University, Bozeman, Montana, United States of America
| | - Albert E. Parker
- Center for Biofilm Engineering, Montana State University, Bozeman, Montana, United States of America
- Department of Mathematical Sciences, Montana State University, Bozeman, Montana, United States of America
| | - Philip S. Stewart
- Center for Biofilm Engineering, Montana State University, Bozeman, Montana, United States of America
- Department of Chemical and Biological Engineering, Montana State University, Bozeman, Montana, United States of America
- * E-mail:
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21
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Niepa TH, Gilbert JL, Ren D. Controlling Pseudomonas aeruginosa persister cells by weak electrochemical currents and synergistic effects with tobramycin. Biomaterials 2012; 33:7356-65. [DOI: 10.1016/j.biomaterials.2012.06.092] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2012] [Accepted: 06/29/2012] [Indexed: 11/27/2022]
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Szkotak R, Niepa THR, Jawrani N, Gilbert JL, Jones MB, Ren D. Differential Gene Expression to Investigate the Effects of Low-level Electrochemical Currents on Bacillus subtilis. AMB Express 2011; 1:39. [PMID: 22078549 PMCID: PMC3294250 DOI: 10.1186/2191-0855-1-39] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Accepted: 11/11/2011] [Indexed: 12/22/2022] Open
Abstract
With the emergence and spread of multidrug resistant bacteria, effective methods to eliminate both planktonic bacteria and those embedded in surface-attached biofilms are needed. Electric currents at μA-mA/cm2 range are known to reduce the viability of bacteria. However, the mechanism of such effects is still not well understood. In this study, Bacillus subtilis was used as the model Gram-positive species to systematically investigate the effects of electrochemical currents on bacteria including the morphology, viability, and gene expression of planktonic cells, and viability of biofilm cells. The data suggest that weak electrochemical currents can effectively eliminate B. subtilis both as planktonic cells and in biofilms. DNA microarray results indicate that the genes associated with oxidative stress response, nutrient starvation, and membrane functions were induced by electrochemical currents. These findings suggest that ions and oxidative species generated by electrochemical reactions might be important for the killing effects of these currents.
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Affiliation(s)
- Robert Szkotak
- Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, NY 13244, USA
- Syracuse Biomaterials Institute, Syracuse University, Syracuse, NY 13244, USA
| | - Tagbo H R Niepa
- Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, NY 13244, USA
- Syracuse Biomaterials Institute, Syracuse University, Syracuse, NY 13244, USA
| | - Nikhil Jawrani
- Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, NY 13244, USA
- Syracuse Biomaterials Institute, Syracuse University, Syracuse, NY 13244, USA
| | - Jeremy L Gilbert
- Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, NY 13244, USA
- Syracuse Biomaterials Institute, Syracuse University, Syracuse, NY 13244, USA
| | | | - Dacheng Ren
- Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, NY 13244, USA
- Syracuse Biomaterials Institute, Syracuse University, Syracuse, NY 13244, USA
- Department of Biology, Syracuse University, Syracuse, NY 13244, USA
- Department of Civil and Environmental Engineering, Syracuse University, Syracuse, NY 13244, USA
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23
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Urbanus J, Bisselink R, Nijkamp K, ter Horst J, Verdoes D, Roelands C. Integrated product removal of slightly water-soluble carboxylates from fermentation by electrochemically induced crystallization. J Memb Sci 2010. [DOI: 10.1016/j.memsci.2010.07.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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24
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Kim SH, Han HY, Lee YJ, Kim CW, Yang JW. Effect of electrokinetic remediation on indigenous microbial activity and community within diesel contaminated soil. THE SCIENCE OF THE TOTAL ENVIRONMENT 2010; 408:3162-3168. [PMID: 20452646 DOI: 10.1016/j.scitotenv.2010.03.038] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Revised: 03/17/2010] [Accepted: 03/23/2010] [Indexed: 05/29/2023]
Abstract
Electrokinetic remediation has been successfully used to remove organic contaminants and heavy metals within soil. The electrokinetic process changes basic soil properties, but little is known about the impact of this remediation technology on indigenous soil microbial activities. This study reports on the effects of electrokinetic remediation on indigenous microbial activity and community within diesel contaminated soil. The main removal mechanism of diesel was electroosmosis and most of the bacteria were transported by electroosmosis. After 25 days of electrokinetic remediation (0.63 mA cm(-2)), soil pH developed from pH 3.5 near the anode to pH 10.8 near the cathode. The soil pH change by electrokinetics reduced microbial cell number and microbial diversity. Especially the number of culturable bacteria decreased significantly and only Bacillus and strains in Bacillales were found as culturable bacteria. The use of EDTA as an electrolyte seemed to have detrimental effects on the soil microbial activity, particularly in the soil near the cathode. On the other hand, the soil dehydrogenase activity was enhanced close to the anode and the analysis of microbial community structure showed the increase of several microbial populations after electrokinetics. It is thought that the main causes of changes in microbial activities were soil pH and direct electric current. The results described here suggest that the application of electrokinetics can be a promising soil remediation technology if soil parameters, electric current, and electrolyte are suitably controlled based on the understanding of interaction between electrokinetics, contaminants, and indigenous microbial community.
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Affiliation(s)
- Seong-Hye Kim
- Nano Environmental Engineering Lab, Dept. of Chemical & Biomolecular Engineering, KAIST, 335 Gwahangno, 373-1 Guseong-dong, Yuseong-gu, Daejeon 305-701, Republic of Korea
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25
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Tyllianakis M, Dalas E, Christofidou M, Kallitsis JK, Chrissanthopoulos A, Koutsoukos PG, Bartzavali C, Gourdoupi N, Papadimitriou K, Oikonomou EK, Yannopoulos SN, Sevastos D. Novel composites materials from functionalized polymers and silver coated titanium oxide capable for calcium phosphate induction, control of orthopedic biofilm infections: an "in vitro" study. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2010; 21:2201-2211. [PMID: 20512404 DOI: 10.1007/s10856-010-4086-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Accepted: 04/26/2010] [Indexed: 05/28/2023]
Abstract
Three copolymers containing the functional groups P=O, S=O and C=O were prepared, and upon the introduction in calcium phosphate aqueous solutions at physiological conditions, "in vitro" were induced the precipitation of calcium phosphate crystals. The investigation of the crystal growth process was done at constant supersaturation. It is suggested that the negative end of the above functional groups acts as the active site for nucleation of the inorganic phase. In order to obtain the copolymer further antimicrobial activity, titania (TiO(2)) nanocrystals were incorporated in the polymer matrix after silver coverage by UV radiation. The antimicrobial resistance of the composite material (copolymer-titania/Ag) was tested against Staphylococcus epidermidis (SEM), Staphylococcus aureus (SAM), Candida parapsilosis (CAM) and Pseudomonas aeruginosa (PAM), microorganisms, using cut parts of "pi-plate" that covered with the above mentioned composite. The antimicrobial effect increased as the size of the nanocrystals TiO(2)/Ag decreased, the maximum achieved with the third polymer that contained also quartenary ammonium groups.
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Affiliation(s)
- M Tyllianakis
- Department of Orthopaedic, Patras University Hospital, 26504 Rio, Patras, Greece.
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26
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The electricidal effect: reduction of Staphylococcus and pseudomonas biofilms by prolonged exposure to low-intensity electrical current. Antimicrob Agents Chemother 2008; 53:41-5. [PMID: 18955534 DOI: 10.1128/aac.00680-08] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The activity of electrical current against planktonic bacteria has previously been demonstrated. The short-term exposure of the bacteria in biofilms to electrical current in the absence of antimicrobials has been shown to have no substantial effect; however, longer-term exposure has not been studied. A previously described in vitro model was used to determine the effect of prolonged exposure (i.e., up to 7 days) to low-intensity (i.e., 20-, 200-, and 2,000-microampere) electrical direct currents on Pseudomonas aeruginosa, Staphylococcus aureus, and Staphylococcus epidermidis biofilms. Dose- and time-dependent killing was observed. A maximum of a 6-log(10)-CFU/cm(2) reduction was observed when S. epidermidis biofilms were exposed to 2,000 microamperes for at least 2 days. A 4- to 5-log(10)-CFU/cm(2) reduction was observed when S. aureus biofilms were exposed to 2,000 microamperes for at least 2 days. Finally, a 3.5- to 5-log(10)-CFU/cm(2) reduction was observed when P. aeruginosa biofilms were exposed to electrical current for 7 days. A higher electrical current intensity correlated with greater decreases in viable bacteria at all time points studied. In conclusion, low-intensity electrical current substantially reduced the numbers of viable bacteria in staphylococcal or Pseudomonas biofilms, a phenomenon we have labeled the "electricidal effect."
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27
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Abstract
Bacteria growing in biofilms cause a wide range of human infections. Biofilm bacteria are resistant to antimicrobics at levels 500 to 5,000 times higher than those needed to kill non-biofilm bacteria. In vitro experiments have shown that electric current can enhance the activity of some antimicrobial agents against certain bacteria in biofilms; this has been termed the ''bioelectric effect''. Direct electrical current has already been safely used in humans for fracture healing. Application of direct electric current with antimicrobial chemotherapy in humans could theoretically abrogate the need to remove the device in device-related infections, a procedure associated with substantial morbidity and cost. In this article, we review what has been described in the literature with regards to the bioelectric effect.
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Affiliation(s)
- J L Del Pozo
- Infectious Diseases Research Laboratory, Mayo Clinic Rochester, Minnesota and Division of Infectious Diseases, Department of Medicine, Mayo Clinic Rochester, Minnesota - USA
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28
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Effect of electrical current on the activities of antimicrobial agents against Pseudomonas aeruginosa, Staphylococcus aureus, and Staphylococcus epidermidis biofilms. Antimicrob Agents Chemother 2008; 53:35-40. [PMID: 18725436 DOI: 10.1128/aac.00237-08] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Bacterial biofilms are resistant to conventional antimicrobial agents. Prior in vitro studies have shown that electrical current (EC) enhances the activities of aminoglycosides, quinolones, and oxytetracycline against Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus epidermidis, Escherichia coli, and Streptococcus gordonii. This phenomenon, known as the bioelectric effect, has been only partially defined. The purpose of this work was to study the in vitro bioelectric effect on the activities of 11 antimicrobial agents representing a variety of different classes against P. aeruginosa, methicillin-resistant Staphylococcus aureus (MRSA), and S. epidermidis. An eight-channel current generator/controller and eight chambers delivering a continuous flow of fresh medium with or without antimicrobial agents and/or EC to biofilm-coated coupons were used. No significant decreases in the numbers of log(10) CFU/cm(2) were seen after exposure to antimicrobial agents alone, with the exception of a 4.57-log-unit reduction for S. epidermidis and trimethoprim-sulfamethoxazole. We detected a statistically significant bioelectric effect when vancomycin plus 2,000 microamperes EC were used against MRSA biofilms (P = 0.04) and when daptomycin and erythromycin were used in combination with 200 or 2,000 microamperes EC against S. epidermidis biofilms (P = 0.02 and 0.0004, respectively). The results of these experiments indicate that the enhancement of the activity of antimicrobial agents against biofilm organisms by EC is not a generalizable phenomenon across microorganisms and antimicrobial agents.
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29
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Kilty SJ, Desrosiers MY. The role of bacterial biofilms and the pathophysiology of chronic rhinosinusitis. Curr Allergy Asthma Rep 2008; 8:227-33. [PMID: 18589841 DOI: 10.1007/s11882-008-0038-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The earliest description of a bacterial biofilm is likely centuries old. However, only in the past few decades has a wealth of knowledge developed pertaining to this bacterial form of existence. Biofilms have been implicated mainly in chronic disease states, and the current available treatment modalities for infection have demonstrated limited efficacy against bacteria in this form. There is evidence associating bacterial biofilm formation in chronic infections of the upper airway, and therefore we examine the possible role of a bacterial biofilm in chronic rhinosinusitis while drawing parallels with recent data from other bodily regions. Lastly, directions for contemporary biofilm research are reviewed and highlighted in terms of their application to chronic rhinosinusitis.
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Affiliation(s)
- Shaun J Kilty
- Pavilion Hôtel-Dieu, 3840, Rue St. Urbain, Montreal, Quebec, Canada
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30
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Abstract
Biofilm formation is a crucial step in the pathogenesis of many subacute and chronic bacterial infections, including foreign body-related infections. Biofilms are difficult to eradicate with conventional antimicrobial agents. Bacterial biofilms have several potential antimicrobial resistance mechanisms. Antimicrobial resistance mechanisms may act concurrently, and in some cases, synergistically. Persister cells play a major role in the tolerance of biofilm bacteria to antimicrobial agents. Understanding the mechanisms involved in biofilm-associated antimicrobial resistance is key to development of new therapeutic strategies.
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Affiliation(s)
- J L del Pozo
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA
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31
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Shirtliff ME, Bargmeyer A, Camper AK. Assessment of the ability of the bioelectric effect to eliminate mixed-species biofilms. Appl Environ Microbiol 2005; 71:6379-82. [PMID: 16204561 PMCID: PMC1265951 DOI: 10.1128/aem.71.10.6379-6382.2005] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Microbes have been able to persist in water distribution systems through the development of multicellular communities known as biofilms. This study evaluated the usefulness of the bioelectric effect for the elimination of water distribution system biofilms from annular reactors. The bioelectric effect did not have any bactericidal action either alone or when coupled with free chlorine.
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Affiliation(s)
- Mark E Shirtliff
- Department of Biomedical Sciences, Dental School, University of Maryland-Baltimore, 666 W. Baltimore Street, Baltimore, MD 21201, USA.
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32
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Abstract
The pathogenesis of many orthopaedic infections is related to the presence of microorganisms in biofilms. I examine the emerging understanding of the mechanisms of biofilm-associated antimicrobial resistance. Biofilm-associated resistance to antimicrobial agents begins at the attachment phase and increases as the biofilm ages. A variety of reasons for the increased antimicrobial resistance of microorganisms in biofilms have been postulated and investigated. Although bacteria in biofilms are surrounded by an extracellular matrix that might physically restrict the diffusion of antimicrobial agents, this does not seem to be a predominant mechanism of biofilm-associated antimicrobial resistance. Nutrient and oxygen depletion within the biofilm cause some bacteria to enter a nongrowing (ie, stationary) state, in which they are less susceptible to growth-dependent antimicrobial killing. A subpopulation of bacteria might differentiate into a phenotypically resistant state. Finally, some organisms in biofilms have been shown to express biofilm-specific antimicrobial resistance genes that are not required for biofilm formation. Overall, the mechanism of biofilm-associated antimicrobial resistance seems to be multifactorial and may vary from organism to organism. Techniques that address biofilm susceptibility testing to antimicrobial agents may be necessary before antimicrobial regimens for orthopaedic prosthetic device-associated infections can be appropriately defined in research and clinical settings. Finally, a variety of approaches are being defined to overcome biofilm-associated antimicrobial resistance.
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Affiliation(s)
- Robin Patel
- Division of Infectious Diseases, the Department of Internal Medicine, the Division of Clinical Microbiology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
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Caubet R, Pedarros-Caubet F, Chu M, Freye E, de Belém Rodrigues M, Moreau JM, Ellison WJ. A radio frequency electric current enhances antibiotic efficacy against bacterial biofilms. Antimicrob Agents Chemother 2005; 48:4662-4. [PMID: 15561841 PMCID: PMC529182 DOI: 10.1128/aac.48.12.4662-4664.2004] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Bacterial biofilms are notably resistant to antibiotic prophylaxis. The concentration of antibiotic necessary to significantly reduce the number of bacteria in the biofilm matrix can be several hundred times the MIC for the same bacteria in a planktonic phase. It has been observed that the addition of a weak continuous direct electric current to the liquid surrounding the biofilm can dramatically increase the efficacy of the antibiotic. This phenomenon, known as the bioelectric effect, has only been partially elucidated, and it is not certain that the electrical parameters are optimal. We confirm here the bioelectric effect for Escherichia coli biofilms treated with gentamicin and with oxytetracycline, and we report a new bioelectric effect with a radio frequency alternating electric current (10 MHz) instead of the usual direct current. None of the proposed explanations (transport of ions within the biofilm, production of additional biocides by electrolysis, etc.) of the direct current bioelectric effect are applicable to the radio frequency bioelectric effect. We suggest that this new phenomenon may be due to a specific action of the radio frequency electromagnetic field upon the polar parts of the molecules forming the biofilm matrix.
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Affiliation(s)
- R Caubet
- Unité Sécurité Microbiologique des Aliments, Institut des Sciences et Techniques des Aliments de Bordeaux, Université de Bordeaux 1, Talence, France.
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Trampuz A, Osmon DR, Hanssen AD, Steckelberg JM, Patel R. Molecular and antibiofilm approaches to prosthetic joint infection. Clin Orthop Relat Res 2003:69-88. [PMID: 12966280 DOI: 10.1097/01.blo.0000087324.60612.93] [Citation(s) in RCA: 202] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The majority of patients with prosthetic joint replacement (arthroplasty) experience dramatic relief of pain and restoration of satisfactory joint function. In the United States, more than.5 million people have a primary arthroplasty each year. Less than 10% of prosthesis recipients have complications develop during their lifetime, commonly as a result of aseptic biomechanical failure, followed by prosthetic joint infection. The pathogenesis of prosthetic joint infection is related to bacteria in biofilms, in which they are protected from antimicrobial killing and host responses rendering these infections difficult to eradicate. Current microbiology laboratory methods for diagnosis of prosthetic joint infection depend on isolation of a pathogen by culture. However, these methods have neither ideal sensitivity nor ideal specificity. Therefore, culture-independent molecular methods have been used to improve the diagnosis of prosthetic joint infection. In the research setting, detection of 16S ribosomal deoxyribonucleic acid by polymerase chain reaction has been used in the molecular diagnosis of prosthetic joint infection. Various antibiofilm strategies directed at disruption of adherent bacteria are the focus of intense research to improve the detection of biofilm organisms and their eradication. In this article, molecular and antibiofilm approaches to prosthetic joint infection are reviewed.
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Affiliation(s)
- Andrej Trampuz
- Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA
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35
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Wattanakaroon W, Stewart PS. Electrical enhancement of Streptococcus gordonii biofilm killing by gentamicin. Arch Oral Biol 2000; 45:167-71. [PMID: 10716621 DOI: 10.1016/s0003-9969(99)00132-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
This electrical enhancement was demonstrated in an in vitro model. Streptococcus gordonii biofilms were grown for 6 days in continuous-flow reactors on one-tenth strength trypticase peptone broth. The biofilms attained a mean areal cell density of 2.4 x 10(8) c.f.u./cm2 and a thickness of approx. 19 microm. Biofilms exhibited characteristic resistance to killing by an antibiotic. When treated with 2 microg/ml gentamicin for 24 h, they exhibited a 0.84 log reduction in viable cell numbers; a 4.7 log reduction was measured in a planktonic culture. Killing of planktonic bacteria by this treatment was reduced to 1.2 log when an oxygen-scavenging enzyme was added to the medium. When a 2-mA direct current was applied during antibiotic treatment, biofilm killing increased to a 4.3 log reduction. Electrical current alone caused a 1.9 log reduction in biofilm cell counts. It is suggested that gentamicin was less effective against Strep. gordonii under anaerobic conditions than it was under aerobic conditions and that this can explain both the reduced susceptibility of the biofilm (due to oxygen depletion) and electrical enhancement of efficacy (due to oxygen generation by electrolysis).
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Affiliation(s)
- W Wattanakaroon
- Center for Biofilm Engineering and Department of Chemical Engineering, Montana State University--Bozeman, 59717-3980, USA
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McLeod BR, Fortun S, Costerton JW, Stewart PS. Enhanced bacterial biofilm control using electromagnetic fields in combination with antibiotics. Methods Enzymol 1999; 310:656-70. [PMID: 10547827 DOI: 10.1016/s0076-6879(99)10051-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- B R McLeod
- College of Graduate Studies, Montana State University, Bozeman 59717-2580, USA
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Stewart PS, Wattanakaroon W, Goodrum L, Fortun SM, McLeod BR. Electrolytic generation of oxygen partially explains electrical enhancement of tobramycin efficacy against Pseudomonas aeruginosa biofilm. Antimicrob Agents Chemother 1999; 43:292-6. [PMID: 9925521 PMCID: PMC89066 DOI: 10.1128/aac.43.2.292] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The role of electrolysis products, including protons, hydroxyl ions, reactive oxygen intermediates, oxygen, hydrogen, and heat, in mediating electrical enhancement of killing of Pseudomonas aeruginosa biofilms by tobramycin (the bioelectric effect) was investigated. The log reduction in biofilm viable cell numbers compared to the numbers for the untreated positive control effected by antibiotic increased from 2.88 in the absence of electric current to 5.58 in the presence of electric current. No enhancement of antibiotic efficacy was observed when the buffer composition was changed to simulate the reduced pH that prevails during electrolysis. Neither did stabilization of the pH during electrical treatment by increasing the buffer strength eliminate the bioelectric effect. The temperature increase measured in our experiments, less than 0.2 degree C, was far too small to account for the greatly enhanced antibiotic efficacy. The addition of sodium thiosulfate, an agent capable of rapidly neutralizing reactive oxygen intermediates, did not abolish electrical enhancement of killing. The bioelectric effect persisted when all of the ionic constituents of the medium except the two phosphate buffer components were omitted. This renders the possibility of electrochemical generation of an inhibitory ion, such as nitrite from nitrate, an unlikely explanation for electrical enhancement. The one plausible explanation for the bioelectric effect revealed by this study was the increased delivery of oxygen to the biofilm due to electrolysis. When gaseous oxygen was bubbled into the treatment chamber during exposure to tobramycin (without electric current), a 1.8-log enhancement of killing resulted. The enhancement of antibiotic killing by oxygen was not due simply to physical disturbances caused by sparging the gas because similar delivery of gaseous hydrogen caused no enhancement whatsoever.
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Affiliation(s)
- P S Stewart
- Center for Biofilm Engineering, Montana State University-Bozeman 59717-3980, USA.
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Abstract
Biofilms have been of considerable interest in the context of food hygiene. Of special significance is the ability of microorganisms to attach and grow on food and food-contact surfaces under favourable conditions. Biofilm formation is a dynamic process and different mechanisms are involved in their attachment and growth. Extracellular polymeric substances play an important role in the attachment and colonization of microorganisms to food-contact surfaces. Various techniques have been adopted for the proper study and understanding of biofilm attachment and control. If the microorganisms from food-contact surfaces are not completely removed, they may lead to biofilm formation and also increase the biotransfer potential. Therefore, various preventive and control strategies like hygienic plant lay-out and design of equipment, choice of materials, correct use and selection of detergents and disinfectants coupled with physical methods can be suitably applied for controlling biofilm formation on food-contact surfaces. In addition, bacteriocins and enzymes are gaining importance and have an unique potential in the food industry for the effective biocontrol and removal of biofilms. These newer biocontrol strategies are considered important for the maintenance of biofilm-free systems, for quality and safety of foods.
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Affiliation(s)
- C G Kumar
- Dairy Microbiology Division, National Dairy Research Institute, Karnal, India
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39
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Stoodley P, deBeer D, Lappin-Scott HM. Influence of electric fields and pH on biofilm structure as related to the bioelectric effect. Antimicrob Agents Chemother 1997; 41:1876-9. [PMID: 9303377 PMCID: PMC164028 DOI: 10.1128/aac.41.9.1876] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Mixed species biofilms of Klebsiella pneumoniae, Pseudomonas fluorescens, and Pseudomonas aeruginosa were grown in a flow cell fitted with two platinum wire electrodes. The biofilm growing on the wires reached a thickness of approximately 50 microm after 3 days. When a voltage was applied with oscillating polarity, the biofilm attached to the wire expanded and contracted. The biofilm expanded by approximately 4% when the wire was cathodic but was reduced to 74% of the original thickness when the wire was anodic. The phenomenon was reproduced by alternately flushing the flow cell with media adjusted to pH 3 and pH 10 with no electric current. At pH 10 the biofilm was unaltered, but it became compacted to 69% of the original thickness at pH 3. We explained these phenomena in terms of the molecular interactions between charged acidic groups in the biofilm slime and the bacterial cell walls. Contraction of the biofilm under acidic conditions may be caused by (i) the elimination of electrostatic repulsion from neutralization of negatively charged carboxylate groups through protonation and (ii) subsequent hydrogen bonding between the carboxylic acids and oxygen atoms in the sugars. Electrostatic interactions between negatively charged groups in the biofilm and the charged wire may also be expected to cause biofilm expansion when the wire was cathodic and contraction when the wire was anodic. The consequences of the explanation of the increased susceptibility of biofilm cells to antibiotics in an electric field, the "bioelectric effect," are discussed.
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Affiliation(s)
- P Stoodley
- Department of Biological Sciences, University of Exeter, United Kingdom.
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Wellman N, Fortun SM, McLeod BR. Bacterial biofilms and the bioelectric effect. Antimicrob Agents Chemother 1996; 40:2012-4. [PMID: 8878572 PMCID: PMC163464 DOI: 10.1128/aac.40.9.2012] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Bacterial biofilms are acknowledged to be a major factor in problems of ineffective sterilization often encountered in clinics, hospitals, and industrial processes. There have been indications that the addition of a relatively small direct current electric field with the sterilant used to combat the biofilm greatly increases the efficacy of the sterilization process. The results of the experiments reported in this paper support the concept of the "bioelectric effect" as reported by J.W. Costerton, B. Ellis, K. Lam, F. Johnson, and A.E. Khoury (Antimicrob. Agents Chemother, 38:2803-2809, 1994). With a current of 1 mA flowing through the chamber containing the biofilm, an increase in the killing of the bacteria of about 8 log orders was observed at the end of 24 h (compared with the control with the same amount of antibacterial agent but no current). We also confirmed that the current alone does not affect the biofilm and that there appear to be optimum levels of both the current and the sterilant that are needed to obtain the maximum effect.
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Affiliation(s)
- N Wellman
- Engineering Research Center, Department of Electrical Engineering, Montana State University, Bozeman 59717-0378, USA
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