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Alves D, Pereira MO, Lopes SP. Co-immobilization of Ciprofloxacin and Chlorhexidine as a Broad-Spectrum Antimicrobial Dual-Drug Coating for Poly(vinyl chloride) (PVC)-Based Endotracheal Tubes. ACS APPLIED MATERIALS & INTERFACES 2024; 16:16861-16879. [PMID: 38507790 PMCID: PMC10995906 DOI: 10.1021/acsami.4c01334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/23/2024] [Accepted: 03/05/2024] [Indexed: 03/22/2024]
Abstract
The endotracheal tube (ETT) affords support for intubated patients, but the increasing incidence of ventilator-associated pneumonia (VAP) is jeopardizing its application. ETT surfaces promote (poly)microbial colonization and biofilm formation, with a heavy burden for VAP. Devising safe, broad-spectrum antimicrobial materials to tackle the ETT bioburden is needful. Herein, we immobilized ciprofloxacin (CIP) and/or chlorhexidine (CHX), through polydopamine (pDA)-based functionalization, onto poly(vinyl chloride) (PVC) surfaces. These surfaces were characterized regarding physicochemical properties and challenged with single and polymicrobial cultures of VAP-relevant bacteria (Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus, Staphylococcus epidermidis) and fungi (Candida albicans). The coatings imparted PVC surfaces with a homogeneous morphology, varied wettability, and low roughness. The antimicrobial immobilization via pDA chemistry was still evidenced by infrared spectroscopy. Coated surfaces exhibited sustained CIP/CHX release, retaining prolonged (10 days) activity. CIP/CHX-coated surfaces evidencing no A549 lung cell toxicity displayed better antibiofilm outcomes than CIP or CHX coatings, preventing bacterial attachment by 4.1-7.2 Log10 CFU/mL and modestly distressingC. albicans. Their antibiofilm effectiveness was endured toward polymicrobial consortia, substantially inhibiting the adhesion of the bacterial populations (up to 8 Log10 CFU/mL) within the consortia in dual- and even inP. aeruginosa/S. aureus/C. albicans triple-species biofilms while affecting fungal adhesion by 2.7 Log10 CFU/mL (dual consortia) and 1 Log10 CFU/mL (triple consortia). The potential of the dual-drug coating strategy in preventing triple-species adhesion and impairing bacterial viability was still strengthened by live/dead microscopy. The pDA-assisted CIP/CHX co-immobilization holds a safe and robust broad-spectrum antimicrobial coating strategy for PVC-ETTs, with the promise laying in reducing VAP incidence.
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Affiliation(s)
- Diana
Filipa Alves
- CEB
- Centre of Biological Engineering, University
of Minho, 4710-057 Braga, Portugal
- LABBELS—Associate
Laboratory, 4710-057 Braga/Guimarães, Portugal
| | - Maria Olívia Pereira
- CEB
- Centre of Biological Engineering, University
of Minho, 4710-057 Braga, Portugal
- LABBELS—Associate
Laboratory, 4710-057 Braga/Guimarães, Portugal
| | - Susana Patrícia Lopes
- CEB
- Centre of Biological Engineering, University
of Minho, 4710-057 Braga, Portugal
- LABBELS—Associate
Laboratory, 4710-057 Braga/Guimarães, Portugal
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Marcut L, Manescu Paltanea V, Antoniac A, Paltanea G, Robu A, Mohan AG, Grosu E, Corneschi I, Bodog AD. Antimicrobial Solutions for Endotracheal Tubes in Prevention of Ventilator-Associated Pneumonia. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5034. [PMID: 37512308 PMCID: PMC10386556 DOI: 10.3390/ma16145034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/14/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023]
Abstract
Ventilator-associated pneumonia is one of the most frequently encountered hospital infections and is an essential issue in the healthcare field. It is usually linked to a high mortality rate and prolonged hospitalization time. There is a lack of treatment, so alternative solutions must be continuously sought. The endotracheal tube is an indwelling device that is a significant culprit for ventilator-associated pneumonia because its surface can be colonized by different types of pathogens, which generate a multispecies biofilm. In the paper, we discuss the definition of ventilator-associated pneumonia, the economic burdens, and its outcomes. Then, we present the latest technological solutions for endotracheal tube surfaces, such as active antimicrobial coatings, passive coatings, and combinatorial methods, with examples from the literature. We end our analysis by identifying the gaps existing in the present research and investigating future possibilities that can decrease ventilator-associated pneumonia cases and improve patient comfort during treatment.
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Affiliation(s)
- Lavinia Marcut
- Faculty of Medicine and Pharmacy, University of Oradea, 10 P-ta 1 December Street, RO-410073 Oradea, Romania
- Intensive Care Unit, Clinical Emergency Hospital Oradea, 65 Gheorghe Doja Street, RO-410169 Oradea, Romania
| | - Veronica Manescu Paltanea
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, RO-060042 Bucharest, Romania
- Faculty of Electrical Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, RO-060042 Bucharest, Romania
| | - Aurora Antoniac
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, RO-060042 Bucharest, Romania
| | - Gheorghe Paltanea
- Faculty of Electrical Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, RO-060042 Bucharest, Romania
| | - Alina Robu
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, RO-060042 Bucharest, Romania
| | - Aurel George Mohan
- Faculty of Medicine and Pharmacy, University of Oradea, 10 P-ta 1 December Street, RO-410073 Oradea, Romania
- Department of Neurosurgery, Clinical Emergency Hospital Oradea, 65 Gheorghe Doja Street, RO-410169 Oradea, Romania
| | - Elena Grosu
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, RO-060042 Bucharest, Romania
| | - Iuliana Corneschi
- Romfire Protect Solutions SRL, 39 Drumul Taberei, RO-061359 Bucharest, Romania
| | - Alin Danut Bodog
- Faculty of Medicine and Pharmacy, University of Oradea, 10 P-ta 1 December Street, RO-410073 Oradea, Romania
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Contreas L, Hook AL, Winkler DA, Figueredo G, Williams P, Laughton CA, Alexander MR, Williams PM. Linear Binary Classifier to Predict Bacterial Biofilm Formation on Polyacrylates. ACS APPLIED MATERIALS & INTERFACES 2023; 15. [PMID: 36881023 PMCID: PMC10037238 DOI: 10.1021/acsami.2c23182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
Bacterial infections are increasingly problematic due to the rise of antimicrobial resistance. Consequently, the rational design of materials naturally resistant to biofilm formation is an important strategy for preventing medical device-associated infections. Machine learning (ML) is a powerful method to find useful patterns in complex data from a wide range of fields. Recent reports showed how ML can reveal strong relationships between bacterial adhesion and the physicochemical properties of polyacrylate libraries. These studies used robust and predictive nonlinear regression methods that had better quantitative prediction power than linear models. However, as nonlinear models' feature importance is a local rather than global property, these models were hard to interpret and provided limited insight into the molecular details of material-bacteria interactions. Here, we show that the use of interpretable mass spectral molecular ions and chemoinformatic descriptors and a linear binary classification model of attachment of three common nosocomial pathogens to a library of polyacrylates can provide improved guidance for the design of more effective pathogen-resistant coatings. Relevant features from each model were analyzed and correlated with easily interpretable chemoinformatic descriptors to derive a small set of rules that give model features tangible meaning that elucidate relationships between the structure and function. The results show that the attachment of Pseudomonas aeruginosa and Staphylococcus aureus can be robustly predicted by chemoinformatic descriptors, suggesting that the obtained models can predict the attachment response to polyacrylates to identify anti-attachment materials to synthesize and test in the future.
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Affiliation(s)
- Leonardo Contreas
- School
of Pharmacy, University of Nottingham, Nottingham NG7 2RD, United Kingdom
| | - Andrew L. Hook
- School
of Pharmacy, University of Nottingham, Nottingham NG7 2RD, United Kingdom
| | - David A. Winkler
- School
of Pharmacy, University of Nottingham, Nottingham NG7 2RD, United Kingdom
- Monash
Institute of Pharmaceutical Sciences, Monash
University, Parkville, Victoria 3052, Australia
- Department
of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, Victoria 3086, Australia
| | - Grazziela Figueredo
- School
of Computer Science, University of Nottingham, Nottingham NG8 1BB, United Kingdom
| | - Paul Williams
- National
Biofilms Innovation Centre and Biodiscovery Institute, School of Life
Sciences, University of Nottingham, Nottingham NG7 2RD, United Kingdom
| | - Charles A. Laughton
- School
of Pharmacy, University of Nottingham, Nottingham NG7 2RD, United Kingdom
| | - Morgan R. Alexander
- School
of Pharmacy, University of Nottingham, Nottingham NG7 2RD, United Kingdom
| | - Philip M. Williams
- School
of Pharmacy, University of Nottingham, Nottingham NG7 2RD, United Kingdom
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Alves D, Grainha T, Pereira MO, Lopes SP. Antimicrobial materials for endotracheal tubes: A review on the last two decades of technological progress. Acta Biomater 2023; 158:32-55. [PMID: 36632877 DOI: 10.1016/j.actbio.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/21/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023]
Abstract
Ventilator-associated pneumonia (VAP) is an unresolved problem in nosocomial settings, remaining consistently associated with a lack of treatment, high mortality, and prolonged hospital stay. The endotracheal tube (ETT) is the major culprit for VAP development owing to its early surface microbial colonization and biofilm formation by multiple pathogens, both critical events for VAP pathogenesis and relapses. To combat this matter, gradual research on antimicrobial ETT surface coating/modification approaches has been made. This review provides an overview of the relevance and implications of the ETT bioburden for VAP pathogenesis and how technological research on antimicrobial materials for ETTs has evolved. Firstly, certain main VAP attributes (definition/categorization; outcomes; economic impact) were outlined, highlighting the issues in defining/diagnosing VAP that often difficult VAP early- and late-onset differentiation, and that generate misinterpretations in VAP surveillance and discrepant outcomes. The central role of the ETT microbial colonization and subsequent biofilm formation as fundamental contributors to VAP pathogenesis was then underscored, in parallel with the uncovering of the polymicrobial ecosystem of VAP-related infections. Secondly, the latest technological developments (reported since 2002) on materials able to endow the ETT surface with active antimicrobial and/or passive antifouling properties were annotated, being further subject to critical scrutiny concerning their potentialities and/or constraints in reducing ETT bioburden and the risk of VAP while retaining/improving the safety of use. Taking those gaps/challenges into consideration, we discussed potential avenues that may assist upcoming advances in the field to tackle VAP rampant rates and improve patient care. STATEMENT OF SIGNIFICANCE: The use of the endotracheal tube (ETT) in patients requiring mechanical ventilation is associated with the development of ventilator-associated pneumonia (VAP). Its rapid surface colonization and biofilm formation are critical events for VAP pathogenesis and relapses. This review provides a comprehensive overview on the relevance/implications of the ETT biofilm in VAP, and on how research on antimicrobial ETT surface coating/modification technology has evolved over the last two decades. Despite significant technological advances, the limited number of gathered reports (46), highlights difficulty in overcoming certain hurdles associated with VAP (e.g., persistent colonization/biofilm formation; mechanical ventilation duration; hospital length of stay; VAP occurrence), which makes this an evolving, complex, and challenging matter. Challenges and opportunities in the field are discussed.
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Affiliation(s)
- Diana Alves
- CEB - Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal; LABBELS - Associate Laboratory, Braga/Guimarães, Portugal.
| | - Tânia Grainha
- CEB - Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal; LABBELS - Associate Laboratory, Braga/Guimarães, Portugal.
| | - Maria Olívia Pereira
- CEB - Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal; LABBELS - Associate Laboratory, Braga/Guimarães, Portugal.
| | - Susana Patrícia Lopes
- CEB - Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal; LABBELS - Associate Laboratory, Braga/Guimarães, Portugal.
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Bergamini G, Perico ME, Di Palma S, Sabatini D, Andreetta F, Defazio R, Felici A, Ferrari L. Mouse pneumonia model by Acinetobacter baumannii multidrug resistant strains: Comparison between intranasal inoculation, intratracheal instillation and oropharyngeal aspiration techniques. PLoS One 2021; 16:e0260627. [PMID: 34855837 PMCID: PMC8638993 DOI: 10.1371/journal.pone.0260627] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/12/2021] [Indexed: 11/18/2022] Open
Abstract
Infectious pneumonia induced by multidrug resistant (MDR) Acinetobacter baumannii strains is among the most common and deadly forms of healthcare acquired infections. Over the years, different strategies have been put in place to increase host susceptibility to MDR A. baumannii, since only a self-limiting pneumonia with no or limited local bacterial replication was frequently obtained in mouse models. Direct instillation into the trachea or intranasal inoculation of the bacterial suspension are the techniques used to induce the infection in most of the preclinical models of pneumonia developed to date. More recently, the oropharyngeal aspiration procedure has been widely described in the literature for a variety of purposes including pathogens administration. Aim of this study was to compare the oropharyngeal aspiration technique to the intranasal inoculation and intratracheal instillation in the ability of inducing a consistent lung infection with two MDR A. baumannii clinical isolates in immunocompromised mice. Moreover, pneumonia obtained by bacteria administration with two out of three techniques, intratracheal and oropharyngeal, was characterised in terms of histopathology of pulmonary lesions, biomarkers of inflammation level and leukocytes cells infiltration extent after mice treatment with either vehicle or the antibiotic tigecycline. The data generated clearly showed that both strains were not able to colonize the lungs when inoculated by intranasal route. By contrast, the bacterial load in lungs of mice intratracheally or oropharyngeally infected significantly increased during 26 hours of monitoring, thus highlighting the ability of these strains to generate the infection when directly instilled into the lower respiratory airways. Furthermore, the intragroup variability of mice was significantly reduced with respect to those intranasally administered. Tigecycline was efficacious in lung bacterial load and cytokines release reduction. Findings were supported by semi-quantitative histopathological evaluation of the pulmonary lesions and by inflammatory biomarkers analysis. To conclude, both intratracheal instillation and oropharyngeal aspiration techniques showed to be suitable methods for inducing a robust and consistent pneumonia infection in mice when difficult MDR A. baumannii clinical isolates were used. Noteworthy, oropharyngeal aspiration not requiring specific technical skills and dedicated equipment, was proven to be a safer, easier and faster technique in comparison to the intratracheal instillation.
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Affiliation(s)
- Gabriella Bergamini
- Translational Microbiology, Antibacterial Discovery, Aptuit (Verona) S.r.l., an Evotec Company DD&D Research Centre, Verona, Italy
- * E-mail:
| | - Maria Elisa Perico
- In vitro Pharmacology, Aptuit (Verona) S.r.l., an Evotec Company DD&D Research Centre, Verona, Italy
| | - Stefano Di Palma
- Pathology, Preclinical Development, Aptuit (Verona) S.r.l., an Evotec Company, DD&D Research Centre, Verona, Italy
| | - Daniela Sabatini
- In vitro Pharmacology, Microbiology Discovery, Aptuit (Verona) S.r.l., an Evotec Company, DD&D Research Centre, Verona, Italy
| | - Filippo Andreetta
- In vitro Pharmacology, Aptuit (Verona) S.r.l., an Evotec Company DD&D Research Centre, Verona, Italy
| | - Rossella Defazio
- Pathology, Preclinical Development, Aptuit (Verona) S.r.l., an Evotec Company, DD&D Research Centre, Verona, Italy
| | - Antonio Felici
- In vitro Pharmacology, Microbiology Discovery, Aptuit (Verona) S.r.l., an Evotec Company, DD&D Research Centre, Verona, Italy
| | - Livia Ferrari
- Translational Microbiology, Antibacterial Discovery, Aptuit (Verona) S.r.l., an Evotec Company DD&D Research Centre, Verona, Italy
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6
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Biofilm Matrix Formation in Human: Clinical Significance, Diagnostic Techniques, and Therapeutic Drugs. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2021. [DOI: 10.5812/archcid.107919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Context: Some recent reports have indicated that almost 80% of clinical infections in humans have biofilm origin and impose additional healthcare costs. This study was an updated review of extracellular polymeric substance matrix (Biofilm) formation in humans and elaborated on its clinical significance, diagnosis, and therapeutic approaches. Evidence Acquisition: This narrative study reviewed the most recent information on the significance of microbial biofilm formation in clinical settings, common biofilm-producing bacterial species, its diagnosis, antibiotic drug resistance, and new approaches to the treatment of infections associated with biofilm formation. Results: Evidence indicated a permanent increase in the frequency of microbial biofilm in the central venous catheter, mechanical heart valve, and urinary catheter, as well as persistent infections. However, antimicrobial resistance induced by biofilms formation and the antimicrobial treatment of biofilms were problematic. Moreover, several assays and lab devices were described to evaluate biofilm formation. Furthermore, new attitudes towards anti-biofilm treatments were introduced in this paper. Conclusions: The number of different mechanisms were in accordance with the recent knowledge on how biofilms play a critical role in the disease pathogenesis. Biofilm strikes the treatment and surveillance of patients bearing infectious diseases under different conditions. The use of new methods in anti-biofilm treatments is effective for the recovery of infected patients.
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7
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Mannix-Fisher E, McLean S. The antimicrobial activity of silver acetate against Acinetobacter baumannii in a Galleria mellonella infection model. PeerJ 2021; 9:e11196. [PMID: 33981496 PMCID: PMC8071075 DOI: 10.7717/peerj.11196] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/09/2021] [Indexed: 11/24/2022] Open
Abstract
Background The increasing prevalence of bacterial infections that are resistant to antibiotic treatment has caused the scientific and medical communities to look for alternate remedies aimed at prevention and treatment. In addition to researching novel antimicrobials, there has also been much interest in revisiting some of the earliest therapies used by man. One such antimicrobial is silver; its use stretches back to the ancient Greeks but interest in its medicinal properties has increased in recent years due to the rise in antibiotic resistance. Currently antimicrobial silver is found in everything from lunch boxes to medical device implants. Though much is claimed about the antimicrobial efficacy of silver salts the research in this area is mixed. Methods Herein we investigated the efficacy of silver acetate against a carbapenem resistant strain of Acinetobacter baumannii to determine the in vitro activity of this silver salt against a World Health Organisation designated category I critical pathogen. Furthermore, we use the Galleria mellonella larvae model to assess toxicity of the compound and its efficacy in treating infections in a live host. Results We found that silver acetate can be delivered safely to Galleria at medically relevant and antimicrobial levels without detriment to the larvae and that administration of silver acetate to an infection model significantly improved survival. This demonstrates the selective toxicity of silver acetate for bacterial pathogens but also highlights the need for administration of well-defined doses of the antimicrobial to provide an efficacious treatment.
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Affiliation(s)
- Eden Mannix-Fisher
- School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Samantha McLean
- School of Science and Technology, Nottingham Trent University, Nottingham, UK
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Bagińska N, Cieślik M, Górski A, Jończyk-Matysiak E. The Role of Antibiotic Resistant A. baumannii in the Pathogenesis of Urinary Tract Infection and the Potential of Its Treatment with the Use of Bacteriophage Therapy. Antibiotics (Basel) 2021; 10:281. [PMID: 33803438 PMCID: PMC8001842 DOI: 10.3390/antibiotics10030281] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/01/2021] [Accepted: 03/05/2021] [Indexed: 12/20/2022] Open
Abstract
Acinetobacter baumannii are bacteria that belong to the critical priority group due to their carbapenems and third generation cephalosporins resistance, which are last-chance antibiotics. The growing multi-drug resistance and the ability of these bacteria to form biofilms makes it difficult to treat infections caused by this species, which often affects people with immunodeficiency or intensive care unit patients. In addition, most of the infections are associated with catheterization of patients. These bacteria are causative agents, inter alia, of urinary tract infections (UTI) which can cause serious medical and social problems, because of treatment difficulties as well as the possibility of recurrence and thus severely decrease patients' quality of life. Therefore, a promising alternative to standard antibiotic therapy can be bacteriophage therapy, which will generate lower costs and will be safer for the treated patients and has real potential to be much more effective. The aim of the review is to outline the important role of drug-resistant A. baumannii in the pathogenesis of UTI and highlight the potential for fighting these infections with bacteriophage therapy. Further studies on the use of bacteriophages in the treatment of UTIs in animal models may lead to the use of bacteriophage therapy in human urinary tract infections caused by A. baumannii in the future.
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Affiliation(s)
- Natalia Bagińska
- Bacteriophage Laboratory, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland; (N.B.); (M.C.); (A.G.)
| | - Martyna Cieślik
- Bacteriophage Laboratory, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland; (N.B.); (M.C.); (A.G.)
| | - Andrzej Górski
- Bacteriophage Laboratory, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland; (N.B.); (M.C.); (A.G.)
- Phage Therapy Unit, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland
- Infant Jesus Hospital, The Medical University of Warsaw, 02-006 Warsaw, Poland
| | - Ewa Jończyk-Matysiak
- Bacteriophage Laboratory, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland; (N.B.); (M.C.); (A.G.)
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9
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Srivastava P, Lakshmi GBVS, Sri S, Chauhan D, Chakraborty A, Singh S, Solanki PR. Potential of electrospun cellulose acetate nanofiber mat integrated with silver nanoparticles from Azadirachta indica as antimicrobial agent. JOURNAL OF POLYMER RESEARCH 2020. [DOI: 10.1007/s10965-020-02308-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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10
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Chu L, Zhou X, Shen Y, Yu Y. Inhibitory effect of trisodium citrate on biofilms formed by Klebsiella pneumoniae. J Glob Antimicrob Resist 2020; 22:452-456. [PMID: 32387258 DOI: 10.1016/j.jgar.2020.04.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 04/02/2020] [Accepted: 04/03/2020] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES Klebsiella pneumoniae is a significant nosocomial pathogen related to ventilator-associated pneumonia owing to biofilm formation. Trisodium citrate (TSC) has antibacterial activity, but there is little research on the effect of TSC on biofilm formed by K. pneumoniae. The aims of this study were to evaluate the inhibitory effect of 4% TSC on K. pneumoniae biofilm formation and to determine the best time of TSC addition for biofilm inhibition. METHODS A total of 45 K. pneumoniae strains isolated from tracheal tip and sputum specimens were included. Modified Congo red agar was used to screen for biofilm production. Biofilm-positive strains were cultured for 4 days. TSC (4%) was added either initially or 3 days later. Crystal violet staining was used to quantify biofilm mass by measuring the optical density at 570 nm (OD570). Scanning electron microscopy (SEM) was used to observe biofilm morphology. RESULTS The OD570 was significantly lower in the 4% TSC group than that in the no-TSC group during the 4-day experiment. Compared with addition of TSC after 3 days, initial TSC addition resulted in a significant absorbance decrease (Day 4, 0.63 ± 0.11 later-TSC group vs. 0.41 ± 0.16 initial-TSC group). As observed by SEM, bacteria were stacked most densely in the no-TSC group on Day 4. In contrast, few bacteria were observed when TSC was added initially, whilst bacteria were obviously dispersed when TSC was added after 3 days. CONCLUSION TSC can inhibit K. pneumoniae biofilm formation and has the best effect when added initially.
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Affiliation(s)
- Lijuan Chu
- Department of Clinical Laboratory Center, Chongqing Health Center for Women and Children, Chongqing 401147, China.
| | - Xingyan Zhou
- Department of Clinical Laboratory Center, Chongqing Health Center for Women and Children, Chongqing 401147, China
| | - Yan Shen
- Department of Clinical Laboratory Center, Chongqing Health Center for Women and Children, Chongqing 401147, China
| | - Yu Yu
- Department of Clinical Laboratory Center, Chongqing Health Center for Women and Children, Chongqing 401147, China
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11
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Homeyer KH, Singha P, Goudie MJ, Handa H. S-Nitroso-N-acetylpenicillamine impregnated endotracheal tubes for prevention of ventilator-associated pneumonia. Biotechnol Bioeng 2020; 117:2237-2246. [PMID: 32215917 DOI: 10.1002/bit.27341] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/28/2020] [Accepted: 03/19/2020] [Indexed: 12/14/2022]
Abstract
The chances of ventilator-associated pneumonia (VAP) increases 6-20 folds when an endotracheal tube (ETT) is placed in a patient. VAP is one of the most common hospital-acquired infections and comprises 86% of the nosocomial pneumonia cases. This study introduces the idea of nitric oxide-releasing ETTs (NORel-ETTs) fabricated by the incorporation of the nitric oxide (NO) donor S-nitroso-N-acetylpenicillamine (SNAP) into commercially available ETTs via solvent swelling. The impregnation of SNAP provides NO release over a 7-day period without altering the mechanical properties of the ETT. The NORel-ETTs successfully reduced the bacterial infection from a commonly found pathogen in VAP, Pseudomonas aeruginosa, by 92.72 ± 0.97% when compared with the control ETTs. Overall, this study presents the incorporation of the active release of a bactericidal agent in ETTs as an efficient strategy to prevent the risk of VAP.
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Affiliation(s)
- Katie H Homeyer
- School of Chemical, Materials, and Biomedical Engineering, University of Georgia, Athens, Georgia
| | - Priyadarshini Singha
- School of Chemical, Materials, and Biomedical Engineering, University of Georgia, Athens, Georgia
| | - Marcus J Goudie
- School of Chemical, Materials, and Biomedical Engineering, University of Georgia, Athens, Georgia
| | - Hitesh Handa
- School of Chemical, Materials, and Biomedical Engineering, University of Georgia, Athens, Georgia
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12
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Lethongkam S, Daengngam C, Tansakul C, Siri R, Chumpraman A, Phengmak M, Voravuthikunchai SP. Prolonged inhibitory effects against planktonic growth, adherence, and biofilm formation of pathogens causing ventilator-associated pneumonia using a novel polyamide/silver nanoparticle composite-coated endotracheal tube. BIOFOULING 2020; 36:292-307. [PMID: 32367731 DOI: 10.1080/08927014.2020.1759041] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 04/15/2020] [Accepted: 04/19/2020] [Indexed: 06/11/2023]
Abstract
Microbial cells can rapidly form biofilm on endotracheal tubes (ETT) causing ventilator-associated pneumonia, a serious complication in patients receiving mechanical ventilation. A novel polyamide with a good balance of hydrophilic/hydrophobic moieties was used for the embedment of green-reduction silver nanoparticles (AgNPs) for the composite-coated ETT. The films were conformal with a thickness of ∼ 17 ± 3 µm accommodating high loading of 60 ± 35 nm spherical-shaped AgNPs. The coated ETT resulted in a significant difference in reducing both planktonic growth and microbial adhesion of single and mixed-species cultures, compared with uncoated ETT (p < 0.05). A time-kill assay demonstrated rapid bactericidal effects of the coating on bacterial growth and cell adhesion to ETT surface. Biofilm formation by Pseudomonas aeruginosa and Staphylococcus aureus, commonly encountered pathogens, was inhibited by > 96% after incubation for 72 h. Polyamide/AgNP composite-coated ETT provided a broad-spectrum activity against both Gram-positive and Gram-negative bacteria as well as Candida albicans and prolonged antimicrobial activity.
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Affiliation(s)
- Sakkarin Lethongkam
- Department of Microbiology, Faculty of Science and Natural Product Research Center of Excellence, Excellence Research Laboratory on Natural Products, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Chalongrat Daengngam
- Department of Physics, Faculty of Science, Prince of Songkla University, Songkhla, Thailand
| | - Chittreeya Tansakul
- Department of Chemistry and Center of Excellence for Innovation in Chemistry, Faculty of Science, Prince of Songkla University, Songkhla, Thailand
| | - Ratchaneewan Siri
- Department of Physics, Faculty of Science, Prince of Songkla University, Songkhla, Thailand
| | - Apisit Chumpraman
- Department of Microbiology, Faculty of Science and Natural Product Research Center of Excellence, Excellence Research Laboratory on Natural Products, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Manthana Phengmak
- Department of Pathology, Faculty of Medicine, Clinical Microbiology Unit, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Supayang P Voravuthikunchai
- Department of Microbiology, Faculty of Science and Natural Product Research Center of Excellence, Excellence Research Laboratory on Natural Products, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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13
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Seitz AP, Schumacher F, Baker J, Soddemann M, Wilker B, Caldwell CC, Gobble RM, Kamler M, Becker KA, Beck S, Kleuser B, Edwards MJ, Gulbins E. Sphingosine-coating of plastic surfaces prevents ventilator-associated pneumonia. J Mol Med (Berl) 2019; 97:1195-1211. [PMID: 31222488 PMCID: PMC6647234 DOI: 10.1007/s00109-019-01800-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/01/2019] [Accepted: 05/20/2019] [Indexed: 12/12/2022]
Abstract
Ventilator-associated pneumonia (VAP) is a major cause of morbidity and mortality in critically ill patients. Here, we employed the broad antibacterial effects of sphingosine to prevent VAP by developing a novel method of coating surfaces of endotracheal tubes with sphingosine and sphingosine analogs. Sphingosine and phytosphingosine coatings of endotracheal tubes prevent adherence and mediate killing of Pseudomonas aeruginosa, Acinetobacter baumannii, and Staphylococcus aureus, even in biofilms. Most importantly, sphingosine-coating of endotracheal tubes also prevented P. aeruginosa and S. aureus pneumonia in vivo. Coating of the tubes with sphingosine was stable, without obvious side effects on tracheal epithelial cells and did not induce inflammation. In summary, we describe a novel method to coat plastic surfaces and provide evidence for the application of sphingosine and phytosphingosine as novel antimicrobial coatings to prevent bacterial adherence and induce killing of pathogens on the surface of endotracheal tubes with potential to prevent biofilm formation and VAP. KEY MESSAGES: Novel dip-coating method to coat plastic surfaces with lipids. Sphingosine and phytosphingosine as novel antimicrobial coatings on plastic surface. Sphingosine coatings of endotracheal tubes prevent bacterial adherence and biofilms. Sphingosine coatings of endotracheal tubes induce killing of pathogens. Sphingosine coatings of endotracheal tubes ventilator-associated pneumonia.
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Affiliation(s)
- Aaron P Seitz
- Department of Surgery, College of Medicine, University of Cincinnati, 231 Albert Sabin Way ML 0558, Cincinnati, OH, 45267, USA.
| | - Fabian Schumacher
- Institute of Nutritional Science, Department of Toxicology, University of Potsdam, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.,Department of Molecular Biology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany
| | - Jennifer Baker
- Department of Surgery, College of Medicine, University of Cincinnati, 231 Albert Sabin Way ML 0558, Cincinnati, OH, 45267, USA
| | - Matthias Soddemann
- Department of Molecular Biology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany
| | - Barbara Wilker
- Department of Molecular Biology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany
| | - Charles C Caldwell
- Department of Surgery, College of Medicine, University of Cincinnati, 231 Albert Sabin Way ML 0558, Cincinnati, OH, 45267, USA.,Division of Research, Shriners Hospital for Children, Cincinnati, OH, 45229, USA
| | - Ryan M Gobble
- Department of Surgery, College of Medicine, University of Cincinnati, 231 Albert Sabin Way ML 0558, Cincinnati, OH, 45267, USA
| | - Markus Kamler
- Thoracic Transplantation, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany
| | - Katrin Anne Becker
- Department of Molecular Biology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany
| | - Sascha Beck
- Orthopedic Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany
| | - Burkhard Kleuser
- Institute of Nutritional Science, Department of Toxicology, University of Potsdam, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany
| | - Michael J Edwards
- Department of Surgery, College of Medicine, University of Cincinnati, 231 Albert Sabin Way ML 0558, Cincinnati, OH, 45267, USA
| | - Erich Gulbins
- Department of Surgery, College of Medicine, University of Cincinnati, 231 Albert Sabin Way ML 0558, Cincinnati, OH, 45267, USA. .,Department of Molecular Biology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany.
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14
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Pereira TDSF, Travassos DV, Silva RCC, Nunes LFM, Santos ME, Lanza CR, Goebel GA, Kakehasi FM, Silva TA. Acinetobacter baumannii orofacial cellulitis: report of 2 cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 127:e118-e122. [PMID: 30954493 DOI: 10.1016/j.oooo.2019.02.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 01/18/2019] [Accepted: 02/12/2019] [Indexed: 02/02/2023]
Abstract
Acinetobacter baumannii infection of skin and soft tissues is uncommon and usually associated with trauma. The present report describes 2 pediatric cases of cellulitis in the orofacial region, caused by A. baumannii infection with a fatal outcome. A 12-year-old male patient, diagnosed with acute promyelocytic leukemia, presented with an ulcerated lesion on the lip suggestive of local trauma. The condition progressed to cellulitis, epithelial necrosis, and nonspecific vesicles and blisters. The second case occurred in a 10-year-old male patient with a diagnosis of Burkitt lymphoma. The patient's condition progressed to World Health Organization Grade IV mucositis and cellulitis. In both cases, hemoculture was positive for multidrug-resistant A. baumannii. In conclusion, A. baumannii should be considered a potentially multidrug-resistant pathogen in the presence of skin and soft tissue cellulitis. Ulcerated oral lesions may place hospitalized pediatric patients at risk for A. baumannii infection.
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Affiliation(s)
| | - Denise Vieira Travassos
- Department of Social and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Raissa Cristina Costa Silva
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Laiz Fernandes Mendes Nunes
- Multiprofessional Integrated Residency in Health, Hospital das Clínicas, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Maria Edileusa Santos
- Multiprofessional Integrated Residency in Health, Hospital das Clínicas, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Célia Regina Lanza
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Gabriela Assunção Goebel
- Residence in Pediatrics, Hospital das Clínicas, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Fabiana Maria Kakehasi
- Department of Pediatrics, School of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Tarcília Aparecida Silva
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
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15
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Tang J, Zhu H, Cai L, Tang T, Tang J, Sun Y, Liu M, Dai K, Qiao Z, Yu C. Postoperative infection caused by Acinetobacter baumannii misdiagnosed as a free-living amoeba species in a humeral head hemiarthroplasty patient: a case report. Infect Dis Poverty 2018; 7:33. [PMID: 29631621 PMCID: PMC5890356 DOI: 10.1186/s40249-018-0408-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 03/19/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Acinetobacter baumannii is ubiquitous, facultative intracellular, and opportunistic bacterial pathogen. Its unique abilities allow it to survive in a diverse range of environments, including health care settings, leading to nosocomial infections. And its exceptional ability to develop resistance to multiple antibiotics leaves few drug options for treatment. It has been recognized as a leading cause of nosocomial pneumonia and bacteremia over the world. CASE PRESENTATION In this case, a 73-year-old woman presented with a Neer Group VI proximal humeral fracture. Six hours after a successfully performed hemiarthroplasty, she developed continuous fever. Clinical examination revealed that the vitals were regular. Laboratory and radiographic examinations revealed only elevated procalcitonin levels. Blood culture revealed no bacterial or fungal growth. Cooling treatment and empirical broad-spectrum antibiotic therapy showed no apparent effect. CONCLUSIONS We report a postoperative infection caused by Acinetobacter baumannii. The infectious pathogen was identified via molecular DNA sequencing and was initially misidentified as a free-living amoeba species upon microscopic examinations. The patient was mistreated with antiamebic combination therapy. Her symptoms persisted for over 4 months and were eventually followed by her death.
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Affiliation(s)
- Jiaxin Tang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Huaimin Zhu
- Department of Microbiology and Parasitology, Second Military Medical University, Shanghai, 200433, China
| | - Li Cai
- Shanghai Municipal Center for Disease Control & Prevention, Shanghai, 200336, China
| | - Tingting Tang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Jian Tang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yuehua Sun
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Ming Liu
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Kerong Dai
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Zhiguang Qiao
- Medical 3D Printing Innovation Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200125, China. .,Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai, 200030, China.
| | - Chao Yu
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
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16
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Abstract
Microbial biofilms can colonize medical devices and human tissues, and their role in microbial pathogenesis is now well established. Not only are biofilms ubiquitous in natural and human-made environments, but they are also estimated to be associated with approximately two-thirds of nosocomial infections. This multicellular aggregated form of microbial growth confers a remarkable resistance to killing by antimicrobials and host defenses, leading biofilms to cause a wide range of subacute or chronic infections that are difficult to eradicate. We have gained tremendous knowledge on the molecular, genetic, microbiological, and biophysical processes involved in biofilm formation. These insights now shape our understanding, diagnosis, and management of many infectious diseases and direct the development of novel antimicrobial therapies that target biofilms. Bacterial and fungal biofilms play an important role in a range of diseases in pulmonary and critical care medicine, most importantly catheter-associated infections, ventilator-associated pneumonia, chronic Pseudomonas aeruginosa infections in cystic fibrosis lung disease, and Aspergillus fumigatus pulmonary infections.
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17
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Future Directions and Molecular Basis of Ventilator Associated Pneumonia. Can Respir J 2017; 2017:2614602. [PMID: 29162982 PMCID: PMC5661065 DOI: 10.1155/2017/2614602] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 09/14/2017] [Indexed: 12/26/2022] Open
Abstract
Mechanical ventilation is a lifesaving treatment and has complications such as ventilator associated pneumonia (VAP) that lead to high morbidity and mortality. Moreover VAP is the second most common hospital-acquired infection in pediatric intensive care units. Although it is still not well understood, understanding molecular pathogenesis is essential for preventing and treating pneumonia. A lot of microbes are detected as a causative agent of VAP. The most common isolated VAP pathogens in pediatric patients are Staphylococcus aureus, Pseudomonas aeruginosa, and other gram negative bacteria. All of the bacteria have different pathogenesis due to their different virulence factors and host reactions. This review article focused on mechanisms of VAP with molecular pathogenesis of the causative bacteria one by one from the literature. We hope that we know more about molecular pathogenesis of VAP and we can investigate and focus on the management of the disease in near future.
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18
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Clinical and Pathophysiological Overview of Acinetobacter Infections: a Century of Challenges. Clin Microbiol Rev 2017; 30:409-447. [PMID: 27974412 DOI: 10.1128/cmr.00058-16] [Citation(s) in RCA: 608] [Impact Index Per Article: 86.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Acinetobacter is a complex genus, and historically, there has been confusion about the existence of multiple species. The species commonly cause nosocomial infections, predominantly aspiration pneumonia and catheter-associated bacteremia, but can also cause soft tissue and urinary tract infections. Community-acquired infections by Acinetobacter spp. are increasingly reported. Transmission of Acinetobacter and subsequent disease is facilitated by the organism's environmental tenacity, resistance to desiccation, and evasion of host immunity. The virulence properties demonstrated by Acinetobacter spp. primarily stem from evasion of rapid clearance by the innate immune system, effectively enabling high bacterial density that triggers lipopolysaccharide (LPS)-Toll-like receptor 4 (TLR4)-mediated sepsis. Capsular polysaccharide is a critical virulence factor that enables immune evasion, while LPS triggers septic shock. However, the primary driver of clinical outcome is antibiotic resistance. Administration of initially effective therapy is key to improving survival, reducing 30-day mortality threefold. Regrettably, due to the high frequency of this organism having an extreme drug resistance (XDR) phenotype, early initiation of effective therapy is a major clinical challenge. Given its high rate of antibiotic resistance and abysmal outcomes (up to 70% mortality rate from infections caused by XDR strains in some case series), new preventative and therapeutic options for Acinetobacter spp. are desperately needed.
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19
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Álvarez-Fraga L, Rumbo-Feal S, Pérez A, Gómez MJ, Gayoso C, Vallejo JA, Ohneck EJ, Valle J, Actis LA, Beceiro A, Bou G, Poza M. Global assessment of small RNAs reveals a non-coding transcript involved in biofilm formation and attachment in Acinetobacter baumannii ATCC 17978. PLoS One 2017; 12:e0182084. [PMID: 28763494 PMCID: PMC5538643 DOI: 10.1371/journal.pone.0182084] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 07/12/2017] [Indexed: 12/30/2022] Open
Abstract
Many strains of Acinetobacter baumannii have been described as being able to form biofilm. Small non-coding RNAs (sRNAs) control gene expression in many regulatory circuits in bacteria. The aim of the present work was to provide a global description of the sRNAs produced both by planktonic and biofilm-associated (sessile) cells of A. baumannii ATCC 17978, and to compare the corresponding gene expression profiles to identify sRNAs molecules associated to biofilm formation and virulence. sRNA was extracted from both planktonic and sessile cells and reverse transcribed. cDNA was subjected to 454-pyrosequencing using the GS-FLX Titanium chemistry. The global analysis of the small RNA transcriptome revealed different sRNA expression patterns in planktonic and biofilm associated cells, with some of the transcripts only expressed or repressed in sessile bacteria. A total of 255 sRNAs were detected, with 185 of them differentially expressed in the different types of cells. A total of 9 sRNAs were expressed only in biofilm cells, while the expression of other 21 coding regions were repressed only in biofilm cells. Strikingly, the expression level of the sRNA 13573 was 120 times higher in biofilms than in planktonic cells, an observation that prompted us to further investigate the biological role of this non-coding transcript. Analyses of an isogenic mutant and over-expressing strains revealed that the sRNA 13573 gene is involved in biofilm formation and attachment to A549 human alveolar epithelial cells. The present work serves as a basis for future studies examining the complex regulatory network that regulate biofilm biogenesis and attachment to eukaryotic cells in A. baumannii ATCC 17978.
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Affiliation(s)
- Laura Álvarez-Fraga
- Departamento de Microbiología, Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario (CHUAC), A Coruña, Spain
| | - Soraya Rumbo-Feal
- Departamento de Microbiología, Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario (CHUAC), A Coruña, Spain
| | - Astrid Pérez
- Departamento de Microbiología, Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario (CHUAC), A Coruña, Spain
- Department of Microbiology, Miami University, Oxford, Ohio, United States of America
| | - Manuel J. Gómez
- Department of Molecular Evolution, Center for Astrobiology, INTA-CSIC, Torrejón de Ardoz, Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain
| | - Carmen Gayoso
- Departamento de Microbiología, Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario (CHUAC), A Coruña, Spain
| | - Juan A. Vallejo
- Departamento de Microbiología, Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario (CHUAC), A Coruña, Spain
| | - Emily J. Ohneck
- Department of Microbiology, Miami University, Oxford, Ohio, United States of America
| | - Jaione Valle
- Departamento de Biofilms Microbianos, Instituto de Agrobiotecnología, Navarra, Spain
| | - Luis A. Actis
- Department of Microbiology, Miami University, Oxford, Ohio, United States of America
| | - Alejandro Beceiro
- Departamento de Microbiología, Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario (CHUAC), A Coruña, Spain
| | - Germán Bou
- Departamento de Microbiología, Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario (CHUAC), A Coruña, Spain
- * E-mail: (GB); (MP)
| | - Margarita Poza
- Departamento de Microbiología, Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario (CHUAC), A Coruña, Spain
- * E-mail: (GB); (MP)
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20
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Li S, Li H, Qi T, Yan X, Wang B, Guan J, Li Y. Comparative transcriptomics analyses of the different growth states of multidrug-resistant Acinetobacter baumannii. Biomed Pharmacother 2016; 85:564-574. [PMID: 27916419 DOI: 10.1016/j.biopha.2016.11.065] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 11/03/2016] [Accepted: 11/14/2016] [Indexed: 11/30/2022] Open
Abstract
Multidrug-resistant (MDR) Acinetobacter baumannii is an important bacterial pathogen commonly associated with hospital acquired infections. A. baumannii can remain viable and hence virulent in the environment for a long period of time due primarily to its ability to form biofilms. A total of 459 cases of MDR A. baumannii our hospital collected from March 2014 to March 2015 were examined in this study, and a representative isolate selected for high-throughput mRNA sequencing and comparison of gene expression profiles under the biofilm and exponential growth conditions. Our study found that the same bacteria indeed exhibited differential mRNA expression under different conditions. Compared to the rapidly growing bacteria, biofilm bacteria had 106 genes upregulated and 92 genes downregulated. Bioinformatics analyses suggested that many of these genes are involved in the formation and maintenance of biofilms, whose expression also depends on the environment and specific signaling pathways and transcription factors that are absent in the log phase bacteria. These differentially expressed mRNAs might contribute to A. baumannii's unique pathogenicity and ability to inflict chronic and recurrent infections.
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Affiliation(s)
- Shuai Li
- Department of Respiratory Medicine, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Xinhua, Shijiazhuang, Hebei Province 050000, China
| | - Haitao Li
- Department of Respiratory Medicine, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Xinhua, Shijiazhuang, Hebei Province 050000, China
| | - Tianjie Qi
- Department of Respiratory Medicine, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Xinhua, Shijiazhuang, Hebei Province 050000, China
| | - Xixin Yan
- Department of Respiratory Medicine, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Xinhua, Shijiazhuang, Hebei Province 050000, China.
| | - Boli Wang
- Department of Respiratory Medicine, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Xinhua, Shijiazhuang, Hebei Province 050000, China
| | - Jitao Guan
- Department of Respiratory Medicine, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Xinhua, Shijiazhuang, Hebei Province 050000, China
| | - Yu Li
- Hebei Medical University, No. 48 Donggang Road, Yuhua, Shijiazhuang, Hebei 050000, China
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21
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Álvarez-Fraga L, Pérez A, Rumbo-Feal S, Merino M, Vallejo JA, Ohneck EJ, Edelmann RE, Beceiro A, Vázquez-Ucha JC, Valle J, Actis LA, Bou G, Poza M. Analysis of the role of the LH92_11085 gene of a biofilm hyper-producing Acinetobacter baumannii strain on biofilm formation and attachment to eukaryotic cells. Virulence 2016; 7:443-55. [PMID: 26854744 PMCID: PMC4871663 DOI: 10.1080/21505594.2016.1145335] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Acinetobacter baumannii is a nosocomial pathogen that has a considerable ability to survive in the hospital environment partly due to its capacity to form biofilms. The first step in the process of establishing an infection is adherence of the bacteria to target cells. Chaperone-usher pili assembly systems are involved in pilus biogenesis pathways that play an important role in adhesion to host cells and tissues as well as medically relevant surfaces. After screening a collection of strains, a biofilm hyper-producing A. baumannii strain (MAR002) was selected to describe potential targets involved in pathogenicity. MAR002 showed a remarkable ability to form biofilm and attach to A549 human alveolar epithelial cells. Analysis of MAR002 using transmission electron microscopy (TEM) showed a significant presence of pili on the bacterial surface. Putative protein-coding genes involved in pili formation were identified based on the newly sequenced genome of MAR002 strain (JRHB01000001/2 or NZ_JRHB01000001/2). As assessed by qRT-PCR, the gene LH92_11085, belonging to the operon LH92_11070-11085, is overexpressed (ca. 25-fold more) in biofilm-associated cells compared to exponential planktonic cells. In the present work we investigate the role of this gene on the MAR002 biofilm phenotype. Scanning electron microscopy (SEM) and biofilm assays showed that inactivation of LH92_11085 gene significantly reduced bacterial attachment to A549 cells and biofilm formation on plastic, respectively. TEM analysis of the LH92_11085 mutant showed the absence of long pili formations normally present in the wild-type. These observations indicate the potential role this LH92_11085 gene could play in the pathobiology of A baumannii.
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Affiliation(s)
- Laura Álvarez-Fraga
- a Departamento de Microbiología , Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario (CHUAC), Universidad de A Coruña (UDC) , A Coruña , Spain
| | - Astrid Pérez
- a Departamento de Microbiología , Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario (CHUAC), Universidad de A Coruña (UDC) , A Coruña , Spain.,b Departamento de Microbiología y Parasitología , Universidad de Santiago de Compostela (USC) , Santiago de Compostela , Spain.,c Department of Microbiology , Miami University , Oxford , OH , USA
| | - Soraya Rumbo-Feal
- a Departamento de Microbiología , Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario (CHUAC), Universidad de A Coruña (UDC) , A Coruña , Spain
| | - María Merino
- a Departamento de Microbiología , Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario (CHUAC), Universidad de A Coruña (UDC) , A Coruña , Spain
| | - Juan Andrés Vallejo
- a Departamento de Microbiología , Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario (CHUAC), Universidad de A Coruña (UDC) , A Coruña , Spain
| | - Emily J Ohneck
- c Department of Microbiology , Miami University , Oxford , OH , USA
| | - Richard E Edelmann
- d Center for Advanced Microscopy and Imaging, Miami University , Oxford , OH , USA
| | - Alejandro Beceiro
- a Departamento de Microbiología , Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario (CHUAC), Universidad de A Coruña (UDC) , A Coruña , Spain
| | - Juan C Vázquez-Ucha
- a Departamento de Microbiología , Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario (CHUAC), Universidad de A Coruña (UDC) , A Coruña , Spain
| | - Jaione Valle
- e Departamento de Biofilms Microbianos , Instituto de Agrobiotecnología , Navarra , Spain
| | - Luis A Actis
- b Departamento de Microbiología y Parasitología , Universidad de Santiago de Compostela (USC) , Santiago de Compostela , Spain.,c Department of Microbiology , Miami University , Oxford , OH , USA
| | - Germán Bou
- a Departamento de Microbiología , Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario (CHUAC), Universidad de A Coruña (UDC) , A Coruña , Spain
| | - Margarita Poza
- a Departamento de Microbiología , Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario (CHUAC), Universidad de A Coruña (UDC) , A Coruña , Spain
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22
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Sands KM, Twigg JA, Lewis MAO, Wise MP, Marchesi JR, Smith A, Wilson MJ, Williams DW. Microbial profiling of dental plaque from mechanically ventilated patients. J Med Microbiol 2015; 65:147-159. [PMID: 26690690 PMCID: PMC5115166 DOI: 10.1099/jmm.0.000212] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Micro-organisms isolated from the oral cavity may translocate to the lower airways during mechanical ventilation (MV) leading to ventilator-associated pneumonia (VAP). Changes within the dental plaque microbiome during MV have been documented previously, primarily using culture-based techniques. The aim of this study was to use community profiling by high throughput sequencing to comprehensively analyse suggested microbial changes within dental plaque during MV. Bacterial 16S rDNA gene sequences were obtained from 38 samples of dental plaque sampled from 13 mechanically ventilated patients and sequenced using the Illumina platform. Sequences were processed using Mothur, applying a 97 % gene similarity cut-off for bacterial species level identifications. A significant ‘microbial shift’ occurred in the microbial community of dental plaque during MV for nine out of 13 patients. Following extubation, or removal of the endotracheal tube that facilitates ventilation, sampling revealed a decrease in the relative abundance of potential respiratory pathogens and a compositional change towards a more predominantly (in terms of abundance) oral microbiota including Prevotella spp., and streptococci. The results highlight the need to better understand microbial shifts in the oral microbiome in the development of strategies to reduce VAP, and may have implications for the development of other forms of pneumonia such as community-acquired infection.
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Affiliation(s)
- Kirsty M Sands
- Oral and Biomedical Sciences, School of Dentistry, Cardiff University, UK
| | - Joshua A Twigg
- Oral and Biomedical Sciences, School of Dentistry, Cardiff University, UK
| | - Michael A O Lewis
- Oral and Biomedical Sciences, School of Dentistry, Cardiff University, UK
| | - Matt P Wise
- Adult Critical Care, University Hospital of Wales, Heath Park, Cardiff, UK
| | - Julian R Marchesi
- School of Biosciences, Main Building, Park Place, Cardiff University, Cardiff, Wales, UK.,Centre for Digestive and Gut Health, Imperial College London, London, UK
| | - Ann Smith
- School of Biosciences, Main Building, Park Place, Cardiff University, Cardiff, Wales, UK
| | - Melanie J Wilson
- Oral and Biomedical Sciences, School of Dentistry, Cardiff University, UK
| | - David W Williams
- Oral and Biomedical Sciences, School of Dentistry, Cardiff University, UK
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23
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In vivo biocompatibility and in vitro efficacy of antimicrobial gendine-coated central catheters. Antimicrob Agents Chemother 2015; 59:5611-8. [PMID: 26124171 DOI: 10.1128/aac.00834-15] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 06/23/2015] [Indexed: 11/20/2022] Open
Abstract
Antimicrobial peripherally inserted central catheters (PICCs) might reduce the incidence of central line-associated bloodstream infections (CLABSI). We tested the biocompatibility of a novel gendine-coated (combination of chlorhexidine [CHX] and gentian violet [GV]) PICC in a rabbit intravascular model and tested antimicrobial efficacy in comparison with commercially available minocycline/rifampin (M/R)- and CHX-treated PICCs in an in vitro biofilm colonization model. Gendine-coated and uncoated control PICCs were inserted in the jugular veins of rabbits for 4 days. Histopathological analysis was performed at the end of the 4-day period, and circulating levels of CHX and GV in the blood were measured at different time points using liquid chromatography-mass spectrometry. The antimicrobial efficacy of the PICCs was tested following simulated intravascular indwells of 24 h and 1 week against clinical isolates of methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Pseudomonas aeruginosa, Escherichia coli, Acinetobacter baumannii, Enterobacter cloacae, Candida albicans, and Candida glabrata. Rabbits implanted with gendine-coated PICCs exhibited reduced levels of thrombosis and inflammation compared to those of the rabbits with uncoated controls. No GV was detected in blood samples over the entire study period, and trace concentrations of CHX were detected. The gendine-coated PICCs completely prevented the adherence of all pathogens from 24 h to 1 week (P ≤ 0.001), while M/R-treated, CHX-treated, and control PICCs did not. Gendine-coated PICCs were highly effective in preventing biofilm formation of multidrug-resistant pathogenic bacteria and fungi. Gendine-coated PICCs were biocompatible in an intravascular setting. Further, the pharmacokinetic testing established that acute systemic exposures of CHX and GV from the gendine-coated catheters were well within safe levels.
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24
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Percival SL, Suleman L, Vuotto C, Donelli G. Healthcare-associated infections, medical devices and biofilms: risk, tolerance and control. J Med Microbiol 2015; 64:323-334. [PMID: 25670813 DOI: 10.1099/jmm.0.000032] [Citation(s) in RCA: 427] [Impact Index Per Article: 47.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 01/23/2015] [Indexed: 01/30/2023] Open
Abstract
Biofilms are of great importance in infection control and healthcare-associated infections owing to their inherent tolerance and 'resistance' to antimicrobial therapies. Biofilms have been shown to develop on medical device surfaces, and dispersal of single and clustered cells implies a significant risk of microbial dissemination within the host and increased risk of infection. Although routine microbiological testing assists with the diagnosis of a clinical infection, there is no 'gold standard' available to reveal the presence of microbial biofilm from samples collected within clinical settings. Furthermore, such limiting factors as viable but non-culturable micro-organisms and small-colony variants often prevent successful detection. In order to increase the chances of detection and provide a more accurate diagnosis, a combination of microbiological culture techniques and molecular methods should be employed. Measures such as antimicrobial coating and surface alterations of medical devices provide promising opportunities in the prevention of biofilm formation on medical devices.
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Affiliation(s)
- Steven L Percival
- Scapa Healthcare, Manchester, UK.,Surface Science Research Centre, University of Liverpool, Liverpool, UK.,Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Louise Suleman
- Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Claudia Vuotto
- Microbial Biofilm Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy
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25
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Insights on the role of antimicrobial cuffed endotracheal tubes in preventing transtracheal transmission of VAP pathogens from an in vitro model of microaspiration and microbial proliferation. BIOMED RESEARCH INTERNATIONAL 2014; 2014:120468. [PMID: 24818125 PMCID: PMC4003835 DOI: 10.1155/2014/120468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 12/12/2013] [Accepted: 03/18/2014] [Indexed: 11/17/2022]
Abstract
We developed an in vitro model to evaluate the effect of different cuffed endotracheal tubes (ETTs) on transtracheal transmission of ventilator-associated pneumonia (VAP) pathogens along external surfaces of ETTs. The model independently assessed the relative contributions of microbial proliferation to the distal tip and microaspiration of contaminated secretions past the cuff by testing in three modes: microaspiration only, microbial proliferation only, and simultaneous microaspiration and microbial proliferation. We evaluated transmission of methicillin resistant Staphylococcus aureus (MRSA) or Pseudomonas aeruginosa (PA) in the presence of a standard ETT; a soft, tapered cuff ETT with subglottic suctioning; and a novel antimicrobial gendine (combination of gentian violet and chlorhexidine) ETT in the model. In the microaspiration only mode, when leakage past the cuff occurred quickly, no ETT prevented transmission. When microaspiration was delayed, the gendine ETT was able to completely disinfect the fluid above the cuff and thereby prevent transmission of pathogens. In microbial proliferation only mode, the gendine ETT was the sole ETT that prevented transmission. With both mechanisms simultaneously available, transmission was dependent on how long microaspiration was delayed. Potent antimicrobial ETTs, such as a gendine ETT, can make unique contributions to prevent VAP when microaspiration is gradual.
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26
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Loo CY, Young PM, Lee WH, Cavaliere R, Whitchurch CB, Rohanizadeh R. Non-cytotoxic silver nanoparticle-polyvinyl alcohol hydrogels with anti-biofilm activity: designed as coatings for endotracheal tube materials. BIOFOULING 2014; 30:773-788. [PMID: 24963686 DOI: 10.1080/08927014.2014.926475] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Endotracheal intubation is commonly associated with hospital-acquired infections as the intubation device acts as reservoir for bacterial colonization in the lungs. To reduce the incidence of bacterial colonization on the tubes, hydrogel coatings loaded with antimicrobial agents are gaining popularity. The aim of this study was to incorporate silver nanoparticles (AgNPs) into polyvinyl alcohol (PVA) to form stable hydrogels. Embedding AgNPs into PVA resulted in a decreased elongation at break and an increased tensile strength compared to PVA alone. The Ag release profile varied as a function of the degree of hydrolysis of PVA: the higher degree of hydrolysis demonstrated a lower release rate. Fourier infrared transform spectroscopy demonstrated that AgNPs interacted exclusively with the -OH groups of PVA. AgNP-loaded PVA was non-toxic against human normal bronchial epithelial cells while effective against the attachment of Pseudomonas aeruginosa and Staphylococcus aureus with a greater effect on P. aeruginosa.
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Affiliation(s)
- Ching-Yee Loo
- a Advanced Drug Delivery Group, Faculty of Pharmacy , University of Sydney , Sydney , NSW 2006 , Australia
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27
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Rumbo-Feal S, Gómez MJ, Gayoso C, Álvarez-Fraga L, Cabral MP, Aransay AM, Rodríguez-Ezpeleta N, Fullaondo A, Valle J, Tomás M, Bou G, Poza M. Whole transcriptome analysis of Acinetobacter baumannii assessed by RNA-sequencing reveals different mRNA expression profiles in biofilm compared to planktonic cells. PLoS One 2013; 8:e72968. [PMID: 24023660 PMCID: PMC3758355 DOI: 10.1371/journal.pone.0072968] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 07/15/2013] [Indexed: 11/18/2022] Open
Abstract
Acinetobacterbaumannii has emerged as a dangerous opportunistic pathogen, with many strains able to form biofilms and thus cause persistent infections. The aim of the present study was to use high-throughput sequencing techniques to establish complete transcriptome profiles of planktonic (free-living) and sessile (biofilm) forms of A. baumannii ATCC 17978 and thereby identify differences in their gene expression patterns. Collections of mRNA from planktonic (both exponential and stationary phase cultures) and sessile (biofilm) cells were sequenced. Six mRNA libraries were prepared following the mRNA-Seq protocols from Illumina. Reads were obtained in a HiScanSQ platform and mapped against the complete genome to describe the complete mRNA transcriptomes of planktonic and sessile cells. The results showed that the gene expression pattern of A. baumannii biofilm cells was distinct from that of planktonic cells, including 1621 genes over-expressed in biofilms relative to stationary phase cells and 55 genes expressed only in biofilms. These differences suggested important changes in amino acid and fatty acid metabolism, motility, active transport, DNA-methylation, iron acquisition, transcriptional regulation, and quorum sensing, among other processes. Disruption or deletion of five of these genes caused a significant decrease in biofilm formation ability in the corresponding mutant strains. Among the genes over-expressed in biofilm cells were those in an operon involved in quorum sensing. One of them, encoding an acyl carrier protein, was shown to be involved in biofilm formation as demonstrated by the significant decrease in biofilm formation by the corresponding knockout strain. The present work serves as a basis for future studies examining the complex network systems that regulate bacterial biofilm formation and maintenance.
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Affiliation(s)
- Soraya Rumbo-Feal
- Department of Microbiology, Biomedical Research Institute, University Hospital, A Coruña, Spain
| | - Manuel J. Gómez
- Department of Molecular Evolution, Center for Astrobiology, INTA-CSIC, Madrid, Spain
| | - Carmen Gayoso
- Department of Microbiology, Biomedical Research Institute, University Hospital, A Coruña, Spain
| | - Laura Álvarez-Fraga
- Department of Microbiology, Biomedical Research Institute, University Hospital, A Coruña, Spain
| | - María P. Cabral
- Department of Microbiology, Biomedical Research Institute, University Hospital, A Coruña, Spain
| | - Ana M. Aransay
- Genome Analysis Platform, CIC bioGUNE & CIBERehd, Derio, Spain
| | - Naiara Rodríguez-Ezpeleta
- Genome Analysis Platform, CIC bioGUNE & CIBERehd, Derio, Spain
- Marine Research Division, AZTI, Tecnalia, Sukarrieta, Spain
| | - Ane Fullaondo
- Genome Analysis Platform, CIC bioGUNE & CIBERehd, Derio, Spain
| | - Jaione Valle
- Department of Microbial biofilms, Agrobiotechnology Institute, Navarra, Spain
| | - María Tomás
- Department of Microbiology, Biomedical Research Institute, University Hospital, A Coruña, Spain
| | - Germán Bou
- Department of Microbiology, Biomedical Research Institute, University Hospital, A Coruña, Spain
- * E-mail: (MP); (GB)
| | - Margarita Poza
- Department of Microbiology, Biomedical Research Institute, University Hospital, A Coruña, Spain
- * E-mail: (MP); (GB)
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28
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Campoccia D, Montanaro L, Arciola CR. A review of the clinical implications of anti-infective biomaterials and infection-resistant surfaces. Biomaterials 2013; 34:8018-29. [PMID: 23932292 DOI: 10.1016/j.biomaterials.2013.07.048] [Citation(s) in RCA: 215] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2013] [Accepted: 07/15/2013] [Indexed: 12/28/2022]
Abstract
Infection is currently regarded as the most severe and devastating complication associated to the use of biomaterials. The important social, clinical and economic impacts of implant-related infections are promoting the efforts to obviate these severe diseases. In this context, the development of anti-infective biomaterials and of infection-resistant surfaces is being regarded as the main strategy to prevent the establishment of implant colonisation and biofilm formation by bacteria. In this review, the attention is focused on the biomaterial-associated infections, from which the need for anti-infective biomaterials originates. Biomaterial-associated infections differ markedly for epidemiology, aetiology and severity, depending mainly on the anatomic site, on the time of biomaterial application, and on the depth of the tissues harbouring the prosthesis. Here, the diversity and complexity of the different scenarios where medical devices are currently utilised are explored, providing an overview of the emblematic applicative fields and of the requirements for anti-infective biomaterials.
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Affiliation(s)
- Davide Campoccia
- Research Unit on Implant Infections, Rizzoli Orthopaedic Institute, Bologna, Via di Barbiano 1/10, 40136 Bologna, Italy
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29
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Shining light on materials--a self-sterilising revolution. Adv Drug Deliv Rev 2013; 65:570-80. [PMID: 22819684 DOI: 10.1016/j.addr.2012.07.003] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 06/15/2012] [Accepted: 07/06/2012] [Indexed: 12/20/2022]
Abstract
This review focuses on the development of light activated antimicrobial surfaces. These surfaces kill microbes by the action of light and have potential applications in domestic and healthcare settings. The inspiration for the new self-cleaning surfaces originates from photodynamic therapy where light is used to locate and destroy tumours. The first generation photosensitiser molecules, based on a porphyrin ring structure, could be considered as bioinspired and chemically related to chlorophyll. The review looks at developments of both soft polymeric surfaces with either surface bound or impregnated photosensitiser molecules; and hard inorganic surfaces such as modified titanium dioxide. The bacterial kill mechanisms are looked into with both surface types showing primary microbial kill through a radical induced pathway. The hard inorganic surfaces also show low bacterial adherence by means of a light activated photo-wetting of the surfaces meaning that they are "Easy Clean" and wash off microbes uniformly.
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30
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31
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Linezolid limits burden of methicillin-resistant Staphylococcus aureus in biofilm of tracheal tubes. Crit Care Med 2012; 40:2385-9. [DOI: 10.1097/ccm.0b013e31825332fc] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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32
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Durmus NG, Taylor EN, Inci F, Kummer KM, Tarquinio KM, Webster TJ. Fructose-enhanced reduction of bacterial growth on nanorough surfaces. Int J Nanomedicine 2012; 7:537-45. [PMID: 22334783 PMCID: PMC3273985 DOI: 10.2147/ijn.s27957] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Patients on mechanical ventilators for extended periods of time often face the risk of developing ventilator-associated pneumonia. During the ventilation process, patients incapable of breathing are intubated with polyvinyl chloride (PVC) endotracheal tubes (ETTs). PVC ETTs provide surfaces where bacteria can attach and proliferate from the contaminated oropharyngeal space to the sterile bronchoalveolar area. To overcome this problem, ETTs can be coated with antimicrobial agents. However, such coatings may easily delaminate during use. Recently, it has been shown that changes in material topography at the nanometer level can provide antibacterial properties. In addition, some metabolites, such as fructose, have been found to increase the efficiency of antibiotics used to treat Staphylococcus aureus (S. aureus) infections. In this study, we combined the antibacterial effect of nanorough ETT topographies with sugar metabolites to decrease bacterial growth and biofilm formation on ETTs. We present for the first time that the presence of fructose on the nanorough surfaces decreases the number of planktonic S. aureus bacteria in the solution and biofilm formation on the surface after 24 hours. We thus envision that this method has the potential to impact the future of surface engineering of biomaterials leading to more successful clinical outcomes in terms of longer ETT lifetimes, minimized infections, and decreased antibiotic usage; all of which can decrease the presence of antibiotic resistant bacteria in the clinical setting.
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33
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Francolini I, Crisante F, Martinelli A, D’Ilario L, Piozzi A. Synthesis of biomimetic segmented polyurethanes as antifouling biomaterials. Acta Biomater 2012; 8:549-58. [PMID: 22051237 DOI: 10.1016/j.actbio.2011.10.024] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Revised: 09/22/2011] [Accepted: 10/17/2011] [Indexed: 10/16/2022]
Abstract
Controlling the non-specific adsorption of proteins, cells and bacteria onto biomaterial surfaces is of crucial importance for the development of medical devices with specific levels of performance. Among the strategies pursued to control the interactions between material surfaces and biological tissues, the immobilization of non-fouling polymers on biomaterial surfaces as well as the synthesis of the so-called biomimetic polymers are considered promising approaches to elicit specific cellular responses. In this study, in order to obtain materials able to prevent infectious and thrombotic complications related to the use of blood-contacting medical devices, heparin-mimetic segmented polyurethanes were synthesized and fully characterized. Specifically, sulfate or sulfamate groups, known to be responsible for the biological activity of heparin, were introduced into the side chain of a carboxylated polyurethane. Due to the introduction of these groups, the obtained polymers possessed a higher hard/soft phase segregation (lower glass transition temperatures) and a greater hydrophilicity than the pristine polymer. In addition, the synthesized polymers were able to significantly delay the activated partial thromboplastin time, this increased hemocompatibility being related both to polymer hydrophilicity and to the presence of the -SO3H groups. This last feature was also responsible for the ability of these biomimetic polymers to prevent the adhesion of a strain of Staphylococcus epidermidis.
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34
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Dwidar M, Hong S, Cha M, Jang J, Mitchell RJ. Combined application of bacterial predation and carbon dioxide aerosols to effectively remove biofilms. BIOFOULING 2012; 28:671-680. [PMID: 22783977 DOI: 10.1080/08927014.2012.701286] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This study evaluated predation with Bdellovibrio bacteriovorous and CO(2) aerosol spraying to remove fluorescent Escherichia coli biofilms from silicon chips. Initial tests found that 7.5×10(5) viable E. coli cells were dispersed into the surrounding environment during aerosol treatment. The total number dispersed per test decreased to only 16 for predated biofilms. This is nearly 50,000-fold lower compared to untreated chips and 1000-fold lower compared to chips soaked in HEPES buffer only. Both scanning electron microscopy (SEM) and fluorescent microscopy analyses confirmed that predation alone did not completely eradicate the biofilm population. When used in conjunction with CO(2) aerosols, however, no fluorescent signals remained and the SEM pictures showed a pristine surface devoid of bacteria. Consequently, this study demonstrates these two methods can be used with each other to significantly remove biofilms from surfaces while also significantly reducing the likelihood of human exposure to potential pathogens during their removal.
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Affiliation(s)
- Mohammed Dwidar
- School of Nano-Bioscience and Chemical Engineering, Ulsan National Institute of Science and Technology (UNIST), 100 Banyeon-ri, Eonyang-eup, Ulsan, 689-798, Republic of Korea
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35
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Abu-Salah T, Dhand R. Inhaled antibiotic therapy for ventilator-associated tracheobronchitis and ventilator-associated pneumonia: an update. Adv Ther 2011; 28:728-47. [PMID: 21833701 DOI: 10.1007/s12325-011-0051-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Indexed: 02/06/2023]
Abstract
Ventilator-associated pneumonia (VAP) remains a leading cause of morbidity and mortality in mechanically-ventilated patients in the Intensive Care Unit (ICU). Ventilator-associated tracheobronchitis (VAT) was previously believed to be an intermediate stage between colonization of the lower respiratory tract and VAP. More recent data, however, suggest that VAT may be a separate entity that increases morbidity and mortality, independently of the occurrence of VAP. Some, but not all, patients with VAT progress to develop VAP. Although inhaled antibiotics alone could be effective for the treatment of VAP, the current consensus of opinion favors their role as adjuncts to systemic antimicrobial therapy for VAP. Inhaled antibiotics are increasingly employed for salvage therapy in patients with VAP due to multi-drug resistant Gram-negative bacteria. In contrast to VAP, VAT could be effectively treated with inhaled antibiotic therapy alone or in combination with systemic antimicrobials.
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Affiliation(s)
- Tareq Abu-Salah
- Division of Pulmonary, Critical Care, and Environmental Medicine, Department of Internal Medicine, University of Missouri, Columbia, MO 65212, USA
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36
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Bordi C, de Bentzmann S. Hacking into bacterial biofilms: a new therapeutic challenge. Ann Intensive Care 2011; 1:19. [PMID: 21906350 PMCID: PMC3224501 DOI: 10.1186/2110-5820-1-19] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Accepted: 06/13/2011] [Indexed: 02/07/2023] Open
Abstract
Microbiologists have extensively worked during the past decade on a particular phase of the bacterial cell cycle known as biofilm, in which single-celled individuals gather together to form a sedentary but dynamic community within a complex structure, displaying spatial and functional heterogeneity. In response to the perception of environmental signals by sensing systems, appropriate responses are triggered, leading to biofilm formation. This process involves various molecular systems that enable bacteria to identify appropriate surfaces on which to anchor themselves, to stick to those surfaces and to each other, to construct multicellular communities several hundreds of micrometers thick, and to detach from the community. The biofilm microbial community is a unique, highly competitive, and crowded environment facilitating microevolutionary processes and horizontal gene transfer between distantly related microorganisms. It is governed by social rules, based on the production and use of "public" goods, with actors and recipients. Biofilms constitute a unique shield against external aggressions, including drug treatment and immune reactions. Biofilm-associated infections in humans have therefore generated major problems for the diagnosis and treatment of diseases. Improvements in our understanding of biofilms have led to innovative research designed to interfere with this process.
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Affiliation(s)
- Christophe Bordi
- Laboratoire d'Ingénierie des Systèmes Macromoléculaires, UPR9027 CNRS - Aix Marseille Université, Institut de Microbiologie de la Méditerranée, 31 Chemin Joseph Aiguier, 13402 Marseille, France.
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