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Fang L, Qiao Y, Li X, Wang C, Li C, Luan T, Wang W. A new dynamic in vitro model for evaluating antimicrobial activity against bacterial biofilms on central venous catheters. Microbiol Spectr 2024; 12:e0023724. [PMID: 39058030 PMCID: PMC11370253 DOI: 10.1128/spectrum.00237-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 06/20/2024] [Indexed: 07/28/2024] Open
Abstract
Central venous catheters (CVCs) are widely used for intravenous medication administration. However, biofilm formation along the catheter surface is the main most important cause of catheter-related bloodstream infections. Nowadays, several antimicrobial-coated catheters are available to prevent biofilm development. In this study, we introduced a new dynamic in vitro model to evaluate the antimicrobial activity against bacterial biofilms on CVCs. Rifampicin-minocycline-coated catheters and control catheters without antimicrobial component were assembled into the model to test the antimicrobial activity on external surface and internal surface. After 1 h irrigation of Staphylococcus epidermidis or Staphylococcus aureus preculture and 23 h irrigation of Trypticase Soy Broth, the viable adherent organism was collected and counted. The enumeration results showed that the number of bacteria attached to antibacterial catheter was significantly less than that of the control catheter, both on external surface (P < 0.05) and internal surface (P < 0.05). The results were further confirmed by the scanning electron microscopy. In conclusion, the dynamic in vitro model can be applied to evaluate the antimicrobial activity against bacterial biofilms grown on the external and internal surfaces of CVCs used in clinical practice.IMPORTANCEFor the first time, a new dynamic in vitro model was constructed to evaluate the antimicrobial activity against bacterial biofilms on central venous catheters (CVCs) on both external surface and internal surface. This model could be applied to evaluate the antimicrobial activity against bacterial biofilms not only on CVCs but also other types of catheters.
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Affiliation(s)
- Liangyan Fang
- Shandong Institute of Medical Device and Pharmaceutical Packaging Inspection, Jinan, Shandong, China
- NMPA Key Laboratory for Safety Evaluation of Biomaterials and Medical Devices, Jinan, Shandong, China
| | - Yunqian Qiao
- Shandong Institute of Medical Device and Pharmaceutical Packaging Inspection, Jinan, Shandong, China
- NMPA Key Laboratory for Safety Evaluation of Biomaterials and Medical Devices, Jinan, Shandong, China
| | - Xiuting Li
- Shandong Institute of Medical Device and Pharmaceutical Packaging Inspection, Jinan, Shandong, China
- NMPA Key Laboratory for Safety Evaluation of Biomaterials and Medical Devices, Jinan, Shandong, China
| | - Changbin Wang
- Shandong Institute of Medical Device and Pharmaceutical Packaging Inspection, Jinan, Shandong, China
- NMPA Key Laboratory for Safety Evaluation of Biomaterials and Medical Devices, Jinan, Shandong, China
| | - Chunqiao Li
- Shandong Institute of Medical Device and Pharmaceutical Packaging Inspection, Jinan, Shandong, China
- NMPA Key Laboratory for Safety Evaluation of Biomaterials and Medical Devices, Jinan, Shandong, China
| | - Tongqing Luan
- Shandong Institute of Medical Device and Pharmaceutical Packaging Inspection, Jinan, Shandong, China
- NMPA Key Laboratory for Safety Evaluation of Biomaterials and Medical Devices, Jinan, Shandong, China
| | - Wenqing Wang
- Shandong Institute of Medical Device and Pharmaceutical Packaging Inspection, Jinan, Shandong, China
- NMPA Key Laboratory for Safety Evaluation of Biomaterials and Medical Devices, Jinan, Shandong, China
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2
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Pandey R, Pinon V, Garren M, Maffe P, Mondal A, Brisbois EJ, Handa H. N-Acetyl Cysteine-Decorated Nitric Oxide-Releasing Interface for Biomedical Applications. ACS APPLIED MATERIALS & INTERFACES 2024; 16:24248-24260. [PMID: 38693878 PMCID: PMC11103652 DOI: 10.1021/acsami.4c02369] [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: 02/09/2024] [Revised: 04/16/2024] [Accepted: 04/19/2024] [Indexed: 05/03/2024]
Abstract
Biomedical devices are vulnerable to infections and biofilm formation, leading to extended hospital stays, high expenditure, and increased mortality. Infections are clinically treated via the administration of systemic antibiotics, leading to the development of antibiotic resistance. A multimechanistic strategy is needed to design an effective biomaterial with broad-spectrum antibacterial potential. Recent approaches have investigated the fabrication of innately antimicrobial biomedical device surfaces in the hope of making the antibiotic treatment obsolete. Herein, we report a novel fabrication strategy combining antibacterial nitric oxide (NO) with an antibiofilm agent N-acetyl cysteine (NAC) on a polyvinyl chloride surface using polycationic polyethylenimine (PEI) as a linker. The designed biomaterial could release NO for at least 7 days with minimal NO donor leaching under physiological conditions. The proposed surface technology significantly reduced the viability of Gram-negative Escherichia coli (>97%) and Gram-positive Staphylococcus aureus (>99%) bacteria in both adhered and planktonic forms in a 24 h antibacterial assay. The composites also exhibited a significant reduction in biomass and extra polymeric substance accumulation in a dynamic environment over 72 h. Overall, these results indicate that the proposed combination of the NO donor with mucolytic NAC on a polymer surface efficiently resists microbial adhesion and can be used to prevent device-associated biofilm formation.
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Affiliation(s)
- Rashmi Pandey
- School
of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Vicente Pinon
- Pharmaceutical
and Biomedical Science Department, College of Pharmacy, University of Georgia, Athens, Georgia 30602, United States
| | - Mark Garren
- School
of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Patrick Maffe
- School
of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Arnab Mondal
- School
of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Elizabeth J. Brisbois
- School
of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Hitesh Handa
- School
of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
- Pharmaceutical
and Biomedical Science Department, College of Pharmacy, University of Georgia, Athens, Georgia 30602, United States
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3
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Gu G, Erişen DE, Yang K, Zhang B, Shen M, Zou J, Qi X, Chen S, Xu X. Antibacterial and anti-inflammatory activities of chitosan/copper complex coating on medical catheters: In vitro and in vivo. J Biomed Mater Res B Appl Biomater 2022; 110:1899-1910. [PMID: 35253986 DOI: 10.1002/jbm.b.35047] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 02/11/2022] [Accepted: 02/22/2022] [Indexed: 12/21/2022]
Abstract
Copper ions (Cu) grafted chitosan coating was prepared using the pneumatic spraying method on the silicone rubber surface. Coating's surface properties, morphology, composition, Cu releasing behavior, antibacterial, and anti-inflammatory activities are investigated and discussed. Surface properties, composition, and morphology were investigated by scanning electron microscopy (SEM) and contact angle measurements. The antibacterial activity has been tested with Escherichia coli and Staphylococcus aureus suspensions in vitro. Besides, the morphology of the biofilm was inspected with a field emission SEM. To evaluate the anti-inflammatory activity and biosafety of the coating in vivo, the optimized coating samples and control groups were implanted subcutaneously into the back of mice. The bacterial environment model was established by injection of the bacterial suspension. The morphology and bacterial adhered on the surface of catheters and the surrounding tissues were analyzed after 5 days of implantation. As in vitro results, the number of adhered bacterial on the surface of the silicon rubber surface was decreased, and the anti-inflammatory rate was increased by the intensify of the Cu content in chitosan coating. As for in vivo results, after 5 days of implantation, there was no evident inflammation in the surrounding tissues of all catheters in all without the S. aureus injected group. In the injected chitosan/Cu coated group; the inflammation, the number of the adhered bacteria were observed less than other injected samples without Cu; no inflammation were noticeable. Results indicate that the Cu-modified chitosan coating can confer excellent antibacterial and anti-inflammatory activity as applied on medical catheters.
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Affiliation(s)
- Guisong Gu
- Shi-changxu Innovation Center for Advanced Materials, Institute of Metal Research, Chinese Academy of Sciences, Shenyang, Liaoning, China.,School of Materials and Metallurgy, University of Science and Technology Liaoning, Anshan, China
| | - Deniz Eren Erişen
- Shi-changxu Innovation Center for Advanced Materials, Institute of Metal Research, Chinese Academy of Sciences, Shenyang, Liaoning, China.,School of Materials Science and Engineering, University of Science and Technology of China, Hefei, Anhui, China
| | - Ke Yang
- Shi-changxu Innovation Center for Advanced Materials, Institute of Metal Research, Chinese Academy of Sciences, Shenyang, Liaoning, China
| | - Bingchun Zhang
- Shi-changxu Innovation Center for Advanced Materials, Institute of Metal Research, Chinese Academy of Sciences, Shenyang, Liaoning, China
| | - Minggang Shen
- School of Materials and Metallurgy, University of Science and Technology Liaoning, Anshan, China
| | - Jingyu Zou
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xun Qi
- Key Laboratory of Diagnostic Imaging and Interventional Radiology of Liaoning Province, Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Shanshan Chen
- Shi-changxu Innovation Center for Advanced Materials, Institute of Metal Research, Chinese Academy of Sciences, Shenyang, Liaoning, China
| | - Xiaohe Xu
- Department of Ophthalmology, Shengjing Hospital of China Medical University, Shenyang, China
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4
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Shahid A, Aslam B, Muzammil S, Aslam N, Shahid M, Almatroudi A, Allemailem KS, Saqalein M, Nisar MA, Rasool MH, Khurshid M. The prospects of antimicrobial coated medical implants. J Appl Biomater Funct Mater 2021; 19:22808000211040304. [PMID: 34409896 DOI: 10.1177/22808000211040304] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The implants are increasingly being a part of modern medicine in various surgical procedures for functional or cosmetic purposes. The progressive use of implants is associated with increased infectious complications and prevention of such infections always remains precedence in the clinical settings. The preventive approaches include the systemic administration of antimicrobial agents before and after the surgical procedures as well as the local application of antibiotics. The relevant literature and existing clinical practices have highlighted the role of antimicrobial coating approaches in the prevention of implants associated infections, although the applications of these strategies are not yet standardized, and the clinical efficacy is not much clear. The adequate data from the randomized control trials is challenging because of the unavailability of a large sample size although it is compulsory in this context to assess the clinical efficacy of preemptive practices. This review compares the efficacy of preventive approaches and the prospects of antimicrobial-coated implants in preventing implant-related infections.
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Affiliation(s)
- Aqsa Shahid
- Department of Microbiology, Government College University, Faisalabad, Pakistan
| | - Bilal Aslam
- Department of Microbiology, Government College University, Faisalabad, Pakistan
| | - Saima Muzammil
- Department of Microbiology, Government College University, Faisalabad, Pakistan
| | - Nosheen Aslam
- Department of Biochemistry, Government College University, Faisalabad, Pakistan
| | - Muhammad Shahid
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, Pakistan
| | - Ahmad Almatroudi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
| | - Khaled S Allemailem
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
| | - Muhammad Saqalein
- Department of Microbiology, Government College University, Faisalabad, Pakistan
| | - Muhammad Atif Nisar
- Department of Microbiology, Government College University, Faisalabad, Pakistan.,College of Science and Engineering, Flinders University, Bedford Park, SA, Australia
| | | | - Mohsin Khurshid
- Department of Microbiology, Government College University, Faisalabad, Pakistan
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5
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Böll B, Schalk E, Buchheidt D, Hasenkamp J, Kiehl M, Kiderlen TR, Kochanek M, Koldehoff M, Kostrewa P, Claßen AY, Mellinghoff SC, Metzner B, Penack O, Ruhnke M, Vehreschild MJGT, Weissinger F, Wolf HH, Karthaus M, Hentrich M. Central venous catheter-related infections in hematology and oncology: 2020 updated guidelines on diagnosis, management, and prevention by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). Ann Hematol 2021; 100:239-259. [PMID: 32997191 PMCID: PMC7782365 DOI: 10.1007/s00277-020-04286-x] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 09/23/2020] [Indexed: 12/31/2022]
Abstract
Cancer patients frequently require central venous catheters for therapy and parenteral nutrition and are at high risk of central venous catheter-related infections (CRIs). Moreover, CRIs prolong hospitalization, cause an excess in resource utilization and treatment cost, often delay anti-cancer treatment, and are associated with a significant increase in mortality in cancer patients. We therefore summoned a panel of experts by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO) and updated our previous guideline on CRIs in cancer patients. After conducting systematic literature searches on PubMed, Medline, and Cochrane databases, video- and meeting-based consensus discussions were held. In the presented guideline, we summarize recommendations on definition, diagnosis, management, and prevention of CRIs in cancer patients including the grading of strength of recommendations and the respective levels of evidence. This guideline supports clinicians and researchers alike in the evidence-based decision-making in the management of CRIs in cancer patients.
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Affiliation(s)
- Boris Böll
- Department I of Internal Medicine, Hematology and Oncology, Intensive Care Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
| | - Enrico Schalk
- Department of Hematology and Oncology, Otto-von-Guericke University Magdeburg, Medical Center, Magdeburg, Germany
| | - Dieter Buchheidt
- Department of Hematology and Oncology, Mannheim University Hospital, Heidelberg University, Mannheim, Germany
| | - Justin Hasenkamp
- Clinic for Hematology and Oncology, University Medicine Göttingen, Georg-August-University, Göttingen, Germany
| | - Michael Kiehl
- Department of Internal Medicine, Frankfurt (Oder) General Hospital, Frankfurt/Oder, Germany
| | - Til Ramon Kiderlen
- Department of Hematology, Oncology and Palliative Care, Vivantes Clinic Neukoelln, Berlin, Germany
| | - Matthias Kochanek
- Department I of Internal Medicine, Hematology and Oncology, Intensive Care Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Michael Koldehoff
- Department of Bone Marrow Transplantation, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Philippe Kostrewa
- Department of Hematology and Oncology, Campus Fulda, Philipps-University Marburg, Fulda, Germany
| | - Annika Y Claßen
- Department I of Internal Medicine, Hematology and Oncology, Intensive Care Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Sibylle C Mellinghoff
- Department I of Internal Medicine, Hematology and Oncology, Intensive Care Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Bernd Metzner
- Department of Hematology and Oncology, University Hospital Oldenburg, Oldenburg, Germany
| | - Olaf Penack
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Markus Ruhnke
- Department of Hematology and Oncology, Helios Klinikum Aue, Aue, Germany
| | - Maria J G T Vehreschild
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Florian Weissinger
- Department of Hematology, Oncology and Palliative Care, Department of Internal Medicine, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Hans-Heinrich Wolf
- Department III of Internal Medicine, Hematology, Oncology and Hemostaseology, Südharzklinikum, Nordhausen, Germany
| | - Meinolf Karthaus
- Department of Hematology, Oncology & Palliative Care, Klinikum Neuperlach, Munich, Germany
| | - Marcus Hentrich
- Department of Hematology and Oncology, Red Cross Hospital Munich, Munich, Germany
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6
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Ricardo SIC, Anjos IIL, Monge N, Faustino CMC, Ribeiro IAC. A Glance at Antimicrobial Strategies to Prevent Catheter-Associated Medical Infections. ACS Infect Dis 2020; 6:3109-3130. [PMID: 33245664 DOI: 10.1021/acsinfecdis.0c00526] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Urinary and intravascular catheters are two of the most used invasive medical devices; however, microbial colonization of catheter surfaces is responsible for most healthcare-associated infections (HAIs). Several antimicrobial-coated catheters are available, but recurrent antibiotic therapy can decrease their potential activity against resistant bacterial strains. The aim of this Review is to question the actual effectiveness of currently used (coated) catheters and describe the progress and promise of alternative antimicrobial coatings. Different strategies have been reviewed with the common goal of preventing biofilm formation on catheters, including release-based approaches using antibiotics, antiseptics, nitric oxide, 5-fluorouracil, and silver as well as contact-killing approaches employing quaternary ammonium compounds, chitosan, antimicrobial peptides, and enzymes. All of these strategies have given proof of antimicrobial efficacy by modifying the physiology of pathogens or disrupting their structural integrity. The aim for synergistic approaches using multitarget processes and the combination of both antifouling and bactericidal properties holds potential for the near future. Despite intensive research in biofilm preventive strategies, laboratorial studies still present some limitations since experimental conditions usually are not the same and also differ from biological conditions encountered when the catheter is inserted in the human body. Consequently, in most cases, the efficacy data obtained from in vitro studies is not properly reflected in the clinical setting. Thus, further well-designed clinical trials and additional cytotoxicity studies are needed to prove the efficacy and safety of the developed antimicrobial strategies in the prevention of biofilm formation at catheter surfaces.
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Affiliation(s)
- Susana I. C. Ricardo
- Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto, 1649-003 Lisboa, Portugal
| | - Inês I. L. Anjos
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto, 1649-003 Lisboa, Portugal
| | - Nuno Monge
- Centro Interdisciplinar de Estudos Educacionais (CIED), Escola Superior de Educação de Lisboa, Instituto Politécnico de Lisboa, Campus de Benfica do IPL, 1549-003 Lisboa, Portugal
| | - Célia M. C. Faustino
- Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto, 1649-003 Lisboa, Portugal
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto, 1649-003 Lisboa, Portugal
| | - Isabel A. C. Ribeiro
- Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto, 1649-003 Lisboa, Portugal
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto, 1649-003 Lisboa, Portugal
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7
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Fernández-Gutiérrez M, Pérez-Köhler B, Benito-Martínez S, García-Moreno F, Pascual G, García-Fernández L, Aguilar MR, Vázquez-Lasa B, Bellón JM. Development of Biocomposite Polymeric Systems Loaded with Antibacterial Nanoparticles for the Coating of Polypropylene Biomaterials. Polymers (Basel) 2020; 12:polym12081829. [PMID: 32824142 PMCID: PMC7465146 DOI: 10.3390/polym12081829] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/10/2020] [Accepted: 08/13/2020] [Indexed: 12/13/2022] Open
Abstract
The development of a biocomposite polymeric system for the antibacterial coating of polypropylene mesh materials for hernia repair is reported. Coatings were constituted by a film of chitosan containing randomly dispersed poly(d,l-lactide-co-glycolide) (PLGA) nanoparticles loaded with chlorhexidine or rifampicin. The chlorhexidine-loaded system exhibited a burst release during the first day reaching the release of the loaded drug in three or four days, whereas rifampicin was gradually released for at least 11 days. Both antibacterial coated meshes were highly active against Staphylococcus aureus and Staphylococcus epidermidis (106 CFU/mL), displaying zones of inhibition that lasted for 7 days (chlorhexidine) or 14 days (rifampicin). Apparently, both systems inhibited bacterial growth in the surrounding environment, as well as avoided bacterial adhesion to the mesh surface. These polymeric coatings loaded with biodegradable nanoparticles containing antimicrobials effectively precluded bacterial colonization of the biomaterial. Both biocomposites showed adequate performance and thus could have potential application in the design of antimicrobial coatings for the prophylactic coating of polypropylene materials for hernia repair.
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Affiliation(s)
- Mar Fernández-Gutiérrez
- Institute of Polymer Science and Technology, Spanish National Research Council (ICTP-CSIC), 28006 Madrid, Spain; (M.F.-G.); (L.G.-F.); (M.R.A.); (B.V.-L.)
- Biomedical Networking Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain; (S.B.-M.); (F.G.-M.); (J.M.B.)
| | - Bárbara Pérez-Köhler
- Biomedical Networking Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain; (S.B.-M.); (F.G.-M.); (J.M.B.)
- Department of Medicine and Medical Specialties, University of Alcalá, 28805 Madrid, Spain
- Ramón y Cajal Health Research Institute (IRYCIS), 28034 Madrid, Spain
- Correspondence: (B.P.-K.); (G.P.)
| | - Selma Benito-Martínez
- Biomedical Networking Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain; (S.B.-M.); (F.G.-M.); (J.M.B.)
- Ramón y Cajal Health Research Institute (IRYCIS), 28034 Madrid, Spain
- Department of Surgery, Medical and Social Sciences, University of Alcalá, 28805 Madrid, Spain
| | - Francisca García-Moreno
- Biomedical Networking Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain; (S.B.-M.); (F.G.-M.); (J.M.B.)
- Ramón y Cajal Health Research Institute (IRYCIS), 28034 Madrid, Spain
- Department of Surgery, Medical and Social Sciences, University of Alcalá, 28805 Madrid, Spain
| | - Gemma Pascual
- Biomedical Networking Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain; (S.B.-M.); (F.G.-M.); (J.M.B.)
- Department of Medicine and Medical Specialties, University of Alcalá, 28805 Madrid, Spain
- Ramón y Cajal Health Research Institute (IRYCIS), 28034 Madrid, Spain
- Correspondence: (B.P.-K.); (G.P.)
| | - Luis García-Fernández
- Institute of Polymer Science and Technology, Spanish National Research Council (ICTP-CSIC), 28006 Madrid, Spain; (M.F.-G.); (L.G.-F.); (M.R.A.); (B.V.-L.)
- Biomedical Networking Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain; (S.B.-M.); (F.G.-M.); (J.M.B.)
| | - María Rosa Aguilar
- Institute of Polymer Science and Technology, Spanish National Research Council (ICTP-CSIC), 28006 Madrid, Spain; (M.F.-G.); (L.G.-F.); (M.R.A.); (B.V.-L.)
- Biomedical Networking Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain; (S.B.-M.); (F.G.-M.); (J.M.B.)
| | - Blanca Vázquez-Lasa
- Institute of Polymer Science and Technology, Spanish National Research Council (ICTP-CSIC), 28006 Madrid, Spain; (M.F.-G.); (L.G.-F.); (M.R.A.); (B.V.-L.)
- Biomedical Networking Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain; (S.B.-M.); (F.G.-M.); (J.M.B.)
| | - Juan Manuel Bellón
- Biomedical Networking Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain; (S.B.-M.); (F.G.-M.); (J.M.B.)
- Ramón y Cajal Health Research Institute (IRYCIS), 28034 Madrid, Spain
- Department of Surgery, Medical and Social Sciences, University of Alcalá, 28805 Madrid, Spain
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8
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Vallieres C, Hook AL, He Y, Crucitti VC, Figueredo G, Davies CR, Burroughs L, Winkler DA, Wildman RD, Irvine DJ, Alexander MR, Avery SV. Discovery of (meth)acrylate polymers that resist colonization by fungi associated with pathogenesis and biodeterioration. SCIENCE ADVANCES 2020; 6:eaba6574. [PMID: 32548270 PMCID: PMC7274803 DOI: 10.1126/sciadv.aba6574] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 04/08/2020] [Indexed: 05/31/2023]
Abstract
Fungi have major, negative socioeconomic impacts, but control with bioactive agents is increasingly restricted, while resistance is growing. Here, we describe an alternative fungal control strategy via materials operating passively (i.e., no killing effect). We screened hundreds of (meth)acrylate polymers in high throughput, identifying several that reduce attachment of the human pathogen Candida albicans, the crop pathogen Botrytis cinerea, and other fungi. Specific polymer functional groups were associated with weak attachment. Low fungal colonization materials were not toxic, supporting their passive, anti-attachment utility. We developed a candidate monomer formulation for inkjet-based 3D printing. Printed voice prosthesis components showed up to 100% reduction in C. albicans biofilm versus commercial materials. Furthermore, spray-coated leaf surfaces resisted fungal infection, with no plant toxicity. This is the first high-throughput study of polymer chemistries resisting fungal attachment. These materials are ready for incorporation in products to counteract fungal deterioration of goods, food security, and health.
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Affiliation(s)
- Cindy Vallieres
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Andrew L. Hook
- School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Yinfeng He
- Faculty of Engineering, University of Nottingham, Nottingham, UK
| | | | | | | | | | - David A. Winkler
- School of Pharmacy, University of Nottingham, Nottingham, UK
- Monash Institute of Pharmaceutical Sciences, Monash University, Australia
- La Trobe Institute for Molecular Science, La Trobe University, Australia
- CSIRO Manufacturing, Clayton, Australia
| | - Ricky D. Wildman
- Faculty of Engineering, University of Nottingham, Nottingham, UK
| | - Derek J. Irvine
- Faculty of Engineering, University of Nottingham, Nottingham, UK
| | | | - Simon V. Avery
- School of Life Sciences, University of Nottingham, Nottingham, UK
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9
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Meddings J, Greene MT, Ratz D, Ameling J, Fowler KE, Rolle AJ, Hung L, Collier S, Saint S. Multistate programme to reduce catheter-associated infections in intensive care units with elevated infection rates. BMJ Qual Saf 2020; 29:418-429. [PMID: 31911543 PMCID: PMC7176547 DOI: 10.1136/bmjqs-2019-009330] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 10/04/2019] [Accepted: 10/13/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Preventing central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) remains challenging in intensive care units (ICUs). OBJECTIVE The Agency for Healthcare Research and Quality Safety Program for ICUs aimed to reduce CLABSI and CAUTI in units with elevated rates. METHODS Invited hospitals had at least one adult ICU with elevated CLABSI or CAUTI rates, defined by a positive cumulative attributable difference metric (CAD >0) in the Centers for Disease Control and Prevention's Targeted Assessment for Prevention strategy. This externally facilitated programme implemented by a national project team and state hospital associations included on-demand video modules and live webinars reviewing a two-tiered approach for implementing key technical and socioadaptive factors to prevent catheter infections, using principles and tools based on the Comprehensive Unit-based Safety Program. CLABSI, CAUTI and catheter use data were collected (preintervention 13 months, intervention 12 months). Multilevel negative binomial models assessed changes in catheter-associated infection rates and catheter use. RESULTS Of 366 recruited ICUs from 220 hospitals in 16 states and Puerto Rico for two cohorts, 280 ICUs completed the programme including infection outcome reporting; 274 ICUs had complete outcome data for analyses. Statistically significant reductions in adjusted infection rates were not observed (CLABSI incidence rate ratio (IRR)=0.75, 95% CI 0.52 to 1.08, p=0.13; CAUTI IRR=0.79, 95% CI 0.59 to 1.06, p=0.12). Adjusted central line utilisation (IRR=0.97, 95% CI 0.93 to 1.00, p=0.09) and adjusted urinary catheter utilisation were unchanged (IRR=0.98, 95% CI 0.95 to 1.01, p=0.14). CONCLUSION This multistate programme targeted ICUs with elevated catheter infection rates, but yielded no statistically significant reduction in CLABSI, CAUTI or catheter utilisation in the first two of six planned cohorts. Improvements in the interventions based on lessons learnt from these initial cohorts are being applied to subsequent cohorts.
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Affiliation(s)
- Jennifer Meddings
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Patient Safety Enhancement Program, University of Michigan and VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - M Todd Greene
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Patient Safety Enhancement Program, University of Michigan and VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - David Ratz
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Patient Safety Enhancement Program, University of Michigan and VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - Jessica Ameling
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Patient Safety Enhancement Program, University of Michigan and VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - Karen E Fowler
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Patient Safety Enhancement Program, University of Michigan and VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - Andrew J Rolle
- Health Research & Educational Trust, American Hospital Association, Chicago, Illinois, USA
| | - Louella Hung
- Health Research & Educational Trust, American Hospital Association, Chicago, Illinois, USA
| | - Sue Collier
- Health Research & Educational Trust, American Hospital Association, Chicago, Illinois, USA
| | - Sanjay Saint
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Patient Safety Enhancement Program, University of Michigan and VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
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Javeri Y, Jagathkar G, Dixit S, Chaudhary D, Zirpe KG, Mehta Y, Govil D, Mishra RC, Samavedam S, Pandit RA, Savio RD, Clerk AM, Srinivasan S, Juneja D, Ray S, Sahoo TK, Jakkinaboina S, Jampala N, Jain R. Indian Society of Critical Care Medicine Position Statement for Central Venous Catheterization and Management 2020. Indian J Crit Care Med 2020; 24:S6-S30. [PMID: 32205954 PMCID: PMC7085816 DOI: 10.5005/jp-journals-10071-g23183] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background and Purpose Short-term central venous catheterization (CVC) is one of the commonly used invasive interventions in ICU and other patient-care areas. Practice and management of CVC is not standardized, varies widely, and need appropriate guidance. Purpose of this document is to provide a comprehensive, evidence-based and up-to-date, one document source for practice and management of central venous catheterization. These recommendations are intended to be used by critical care physicians and allied professionals involved in care of patients with central venous lines. Methods This position statement for central venous catheterization is framed by expert committee members under the aegis of Indian Society of Critical Care Medicine (ISCCM). Experts group exchanged and reviewed the relevant literature. During the final meeting of the experts held at the ISCCM Head Office, a consensus on all the topics was made and the recommendations for final document draft were prepared. The final document was reviewed and accepted by all expert committee members and after a process of peer-review this document is finally accepted as an official ISCCM position paper. Modified grade system was utilized to classify the quality of evidence and the strength of recommendations. The draft document thus formulated was reviewed by all committee members; further comments and suggestions were incorporated after discussion, and a final document was prepared. Results This document makes recommendations about various aspects of resource preparation, infection control, prevention of mechanical complication and surveillance related to short-term central venous catheterization. This document also provides four appendices for ready reference and use at institutional level. Conclusion In this document, committee is able to make 54 different recommendations for various aspects of care, out of which 40 are strong and 14 weak recommendations. Among all of them, 42 recommendations are backed by any level of evidence, however due to paucity of data on 12 clinical questions, a consensus was reached by working committee and practice recommendations given on these topics are based on vast clinical experience of the members of this committee, which makes a useful practice point. Committee recognizes the fact that in event of new emerging evidences this document will require update, and that shall be provided in due time. Abbreviations list ABHR: Alcohol-based hand rub; AICD: Automated implantable cardioverter defibrillator; BSI: Blood stream infection; C/SS: CHG/silver sulfadiazine; Cath Lab: Catheterization laboratory (Cardiac Cath Lab); CDC: Centers for Disease Control and Prevention; CFU: Colony forming unit; CHG: Chlorhexidine gluconate; CL: Central line; COMBUX: Comparison of Bedside Ultrasound with Chest X-ray (COMBUX study); CQI: Continuous quality improvement; CRBSI: Catheter-related blood stream infection; CUS: Chest ultrasonography; CVC: Central Venous Catheter; CXR: Chest X-ray; DTTP: Differential time to positivity; DVT: Deep venous thrombosis; ECG: Electrocardiography; ELVIS: Ethanol lock and risk of hemodialysis catheter infection in critically ill patients; ER: Emergency room; FDA: Food and Drug Administration; FV: Femoral vein; GWE: Guidewire exchange; HD catheter: Hemodialysis catheter; HTS: Hypertonic saline; ICP: Intracranial pressure; ICU: Intensive Care Unit; IDSA: Infectious Disease Society of America; IJV: Internal jugular vein; IPC: Indian penal code; IRR: Incidence rate ratio; ISCCM: Indian Society of Critical Care Medicine; IV: Intravenous; LCBI: Laboratory confirmed blood stream infection; M/R: Minocycline/rifampicin; MBI-LCBI: Mucosal barrier injury laboratory-confirmed bloodstream infection; MRSA: Methicillin-resistant Staphylococcus aureus; NHS: National Health Service (UK); NHSN: National Healthcare Safety Network (USA); OT: Operation Theater; PICC: Peripherally-inserted central catheter; PIV: Peripheral intravenous line; PL: Peripheral line; PVI: Povidone-iodine; RA: Right atrium; RCT: Randomized controlled trial; RR: Relative risk; SCV/SV: Subclavian vein; ScVO2: Central venous oxygen saturation; Sn: Sensitivity; SOP: Standard operating procedure; SVC: Superior vena cava; TEE: Transesophageal echocardiography; UPP: Useful Practice Points; USG: Ultrasonography; WHO: World Health Organization How to cite this article Javeri Y, Jagathkar G, Dixit S, Chaudhary D, Zirpe KG, Mehta Y, et al. Indian Society of Critical Care Medicine Position Statement for Central Venous Catheterization and Management 2020. Indian J Crit Care Med 2020;24(Suppl 1):S6–S30.
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Affiliation(s)
- Yash Javeri
- Department of Critical Care, Anesthesia and Emergency Medicine, Regency Health, Lucknow, Uttar Pradesh, India, , e-mail:
| | - Ganshyam Jagathkar
- Department of Critical Care Medicine, Medicover Hospital, Hyderabad, Telangana, India, e-mail:
| | - Subhal Dixit
- Department of Critical Care Medicine, Sanjeevan & MJM Hospital, Pune, Maharashtra, India, e-mail:
| | - Dhruva Chaudhary
- Department of Pulmonary and Critical Care, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India, , e-mail:
| | - Kapil Gangadhar Zirpe
- Department of Neuro Trauma Unit, Grant Medical Foundation, Pune, Maharashtra, India, , e-mail:
| | - Yatin Mehta
- Department of Critical Care and Anesthesiology, Medanta The Medicity, Sector-38, Gurgaon, Haryana, India, Extn. 3335, e-mail:
| | - Deepak Govil
- Department of Critical Care, Medanta Hospital, The Medicity, Gurugram, Haryana, India, , e-mail:
| | - Rajesh C Mishra
- Department of Critical Care, Saneejivini Hospital, Vastrapur, Ahmedabad, Gujarat, India, , e-mail:
| | - Srinivas Samavedam
- Department of Critical Care, Virinchi Hospital, Hyderabad, Telangana, India, , e-mail:
| | - Rahul Anil Pandit
- Department of Intensive Care Unit, Fortis Hospital, Mumbai, Maharashtra, India, , e-mail:
| | - Raymond Dominic Savio
- Department of Critical Care Medicine, Apollo Hospital, Chennai, Tamil Nadu, India, e-mail:
| | - Anuj M Clerk
- Department of Intensive Care, Services Sunshine Global Hospital, Surat, Gujarat, India, e-mail:
| | - Shrikanth Srinivasan
- Department of Critical Care Medicine, Manipal Hospital, New Delhi, India, , e-mail:
| | - Deven Juneja
- Department of Critical Care Medicine, Max Superspecialty Hospital, New Delhi, India, , e-mail:
| | - Sumit Ray
- Department of Critical Care, Artemis Hospital, Gurugram, Haryana, India, e-mail:
| | - Tapas Kumar Sahoo
- Department of Critical Care, Medanta Hospital, Ranchi, Jharkhand, India, , e-mail:
| | - Srinivas Jakkinaboina
- Department of Critical Care Medicine, Citizens Specialty Hospital, Hyderabad, Telangana, India, , e-mail:
| | - Nandhakishore Jampala
- Department of Critical Care, Medicover Hospital, Hyderabad, Telangana, India, , e-mail:
| | - Ravi Jain
- Department of Critical Care Medicine, Nayati Medicity, Mathura, Uttar Pradesh, India, , e-mail:
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Sun RX, Song P, Walline J, Wang H, Xu YC, Zhu HD, Yu XZ, Xu J. Morbidity and mortality risk factors in emergency department patients with Acinetobacter baumannii bacteremia. World J Emerg Med 2020; 11:164-168. [PMID: 32351649 DOI: 10.5847/wjem.j.1920-8642.2020.03.006] [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] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Acinetobacter baumannii (AB) bacteremia is an increasingly common and often fatal nosocomial infection. Identification of morbidity and mortality risk factors for AB bacteremia in emergency department (ED) patients may provide ways to improve the clinical outcomes of these patients. METHODS The records for 51 patients with AB bacteremia and 51 patients without AB infection were collected and matched in a retrospective case-control study between 2013 and 2015 in a single-center ED. Risk factors were analyzed by Chi-square and multivariate logistic regression statistical models. RESULTS A significant risk factor for morbidity was the presence of a central venous catheter (CVC) (P<0.001). The mortality rate for the 51 patients with AB bacteremia was 68.6%. Risk factors for mortality were the presence of a CVC (P=0.021) and an ED stay longer than two weeks (P=0.015). CONCLUSION AB infections lead to high morbidity and mortality. The presence of a CVC was associated with higher morbidity and mortality in patients with AB bacteremia. Avoiding CVC insertions may improve outcomes in ED patients with AB bacteremia.
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Affiliation(s)
- Rui-Xue Sun
- Emergency Department, Peking Union Medical College Hospital, Beijing 100010, China
| | - Priscilla Song
- Department of Anthropology, Washington University in Saint Louis, Saint Louis 63101, USA
| | - Joseph Walline
- Division of Emergency Medicine, Saint Louis University, Saint Louis 63101, USA
| | - He Wang
- Laboratory Department, Peking Union Medical College Hospital, Beijing, China
| | - Ying-Chun Xu
- Laboratory Department, Peking Union Medical College Hospital, Beijing, China
| | - Hua-Dong Zhu
- Emergency Department, Peking Union Medical College Hospital, Beijing 100010, China
| | - Xue-Zhong Yu
- Emergency Department, Peking Union Medical College Hospital, Beijing 100010, China
| | - Jun Xu
- Emergency Department, Peking Union Medical College Hospital, Beijing 100010, China
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12
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Practical guide for safe central venous catheterization and management 2017. J Anesth 2019; 34:167-186. [PMID: 31786676 PMCID: PMC7223734 DOI: 10.1007/s00540-019-02702-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 10/15/2019] [Indexed: 12/19/2022]
Abstract
Central venous catheterization is a basic skill applicable in various medical fields. However, because it may occasionally cause lethal complications, we developed this practical guide that will help a novice operator successfully perform central venous catheterization using ultrasound guidance. The focus of this practical guide is patient safety. It details the fundamental knowledge and techniques that are indispensable for performing ultrasound-guided internal jugular vein catheterization (other choices of indwelling catheters, subclavian, axillary, and femoral venous catheter, or peripherally inserted central venous catheter are also described in alternatives).
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13
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Rosi E, Pescitelli L, Ricceri F, Di Cesare A, Novelli A, Pimpinelli N, Prignano F. Clindamycin as unique antibiotic choice in Hidradenitis Suppurativa. Dermatol Ther 2018; 32:e12792. [DOI: 10.1111/dth.12792] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 12/03/2018] [Indexed: 02/03/2023]
Affiliation(s)
- Elia Rosi
- Department of Surgery and Translational Medicine, Section of DermatologyUniversity of Florence Florence Italy
| | - Leonardo Pescitelli
- Department of Surgery and Translational Medicine, Section of DermatologyUniversity of Florence Florence Italy
| | - Federica Ricceri
- Department of Surgery and Translational Medicine, Section of DermatologyUniversity of Florence Florence Italy
| | - Antonella Di Cesare
- Department of Surgery and Translational Medicine, Section of DermatologyUniversity of Florence Florence Italy
| | - Andrea Novelli
- Department of Health Sciences, Clinical Pharmacology and Oncology SectionUniversity of Florence Florence Italy
| | - Nicola Pimpinelli
- Department of Surgery and Translational Medicine, Section of DermatologyUniversity of Florence Florence Italy
| | - Francesca Prignano
- Department of Surgery and Translational Medicine, Section of DermatologyUniversity of Florence Florence Italy
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14
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Yang Z, Gu H, Sha G, Lu W, Yu W, Zhang W, Fu Y, Wang K, Wang L. TC4/Ag Metal Matrix Nanocomposites Modified by Friction Stir Processing: Surface Characterization, Antibacterial Property, and Cytotoxicity in Vitro. ACS APPLIED MATERIALS & INTERFACES 2018; 10:41155-41166. [PMID: 30403843 DOI: 10.1021/acsami.8b16343] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Numerous antibacterial biomaterials have been developed, but a majority of them suffer from poor biocompatibility. With the purpose of reducing biomaterial-related infection and cytotoxicity, friction stir processing (FSP) was employed to embed silver nanoparticles (Ag NPs) in a Ti-6Al-4V (TC4) substrate. Characterization using scanning electron microscopy, transmission electron microscopy, and three-dimensional atom probe tomography illustrates that NPs are distributed more homogeneously on the surface of TC4 as the groove depth increases, and silver-rich NPs with a size from 10 to 20 nm exist as metallic silver diffused into the substrate, where the silver content is 4.3-5.6%. Electrochemical impedance spectroscopy shows that both FSP and the addition of silver have positive effects on corrosion resistance. The modified samples effectively inhibit both Staphylococcus aureus and Escherichia coli strains and slightly reduce their adhesion while not displaying any cytotoxicity to bone mesenchymal stem cells in vitro. The antibacterial effect is independent of Ag-ion release and is likely due to the number of embedded silver NPs on the surface, which directly contact and subsequently destroy the cell membrane. Our study shows that the TC4/Ag metal matrix nanocomposite is a potential infection-related biomaterial and that embedding Ag NPs tightly on a biomaterial surface is an effective strategy for striking a balance between the antibacterial effect and biocompatibility, providing an innovative approach for accurately controlling the cytotoxicity of infection-related biomaterials.
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Affiliation(s)
- Zhi Yang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology , Shanghai Jiao Tong University School of Medical , Shanghai 200011 , China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology , National Clinical Research Center of Stomatology , Shanghai 200011 , China
| | - Hao Gu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology , Shanghai Jiao Tong University School of Medical , Shanghai 200011 , China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology , National Clinical Research Center of Stomatology , Shanghai 200011 , China
| | - Gang Sha
- Herbert Gleiter Institute of Nanoscience , Nanjing University of Science and Technology , Nanjing 210094 , China
| | - Weijie Lu
- State Key Laboratory of Metal Matrix Composites , Shanghai Jiao Tong University , Shanghai 200240 , China
| | - Weiqiang Yu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology , Shanghai Jiao Tong University School of Medical , Shanghai 200011 , China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology , National Clinical Research Center of Stomatology , Shanghai 200011 , China
| | - Wenjie Zhang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology , Shanghai Jiao Tong University School of Medical , Shanghai 200011 , China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology , National Clinical Research Center of Stomatology , Shanghai 200011 , China
| | - Yuanfei Fu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology , Shanghai Jiao Tong University School of Medical , Shanghai 200011 , China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology , National Clinical Research Center of Stomatology , Shanghai 200011 , China
| | - Kuaishe Wang
- School of Metallurgical Engineering , Xi'an University of Architecture and Technology , Xi'an 710055 , China
| | - Liqiang Wang
- State Key Laboratory of Metal Matrix Composites , Shanghai Jiao Tong University , Shanghai 200240 , China
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15
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Chong PP, Chin VK, Wong WF, Madhavan P, Yong VC, Looi CY. Transcriptomic and Genomic Approaches for Unravelling Candida albicans Biofilm Formation and Drug Resistance-An Update. Genes (Basel) 2018; 9:genes9110540. [PMID: 30405082 PMCID: PMC6266447 DOI: 10.3390/genes9110540] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 10/29/2018] [Accepted: 10/30/2018] [Indexed: 11/17/2022] Open
Abstract
Candida albicans is an opportunistic fungal pathogen, which causes a plethora of superficial, as well as invasive, infections in humans. The ability of this fungus in switching from commensalism to active infection is attributed to its many virulence traits. Biofilm formation is a key process, which allows the fungus to adhere to and proliferate on medically implanted devices as well as host tissue and cause serious life-threatening infections. Biofilms are complex communities of filamentous and yeast cells surrounded by an extracellular matrix that confers an enhanced degree of resistance to antifungal drugs. Moreover, the extensive plasticity of the C. albicans genome has given this versatile fungus the added advantage of microevolution and adaptation to thrive within the unique environmental niches within the host. To combat these challenges in dealing with C. albicans infections, it is imperative that we target specifically the molecular pathways involved in biofilm formation as well as drug resistance. With the advent of the -omics era and whole genome sequencing platforms, novel pathways and genes involved in the pathogenesis of the fungus have been unraveled. Researchers have used a myriad of strategies including transcriptome analysis for C. albicans cells grown in different environments, whole genome sequencing of different strains, functional genomics approaches to identify critical regulatory genes, as well as comparative genomics analysis between C. albicans and its closely related, much less virulent relative, C. dubliniensis, in the quest to increase our understanding of the mechanisms underlying the success of C. albicans as a major fungal pathogen. This review attempts to summarize the most recent advancements in the field of biofilm and antifungal resistance research and offers suggestions for future directions in therapeutics development.
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Affiliation(s)
- Pei Pei Chong
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University Malaysia, Subang Jaya, 47500 Selangor, Malaysia.
| | - Voon Kin Chin
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University Malaysia, Subang Jaya, 47500 Selangor, Malaysia.
| | - Won Fen Wong
- Department of Microbiology, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Priya Madhavan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University Malaysia, Subang Jaya, 47500 Selangor, Malaysia.
| | - Voon Chen Yong
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University Malaysia, Subang Jaya, 47500 Selangor, Malaysia.
| | - Chung Yeng Looi
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University Malaysia, Subang Jaya, 47500 Selangor, Malaysia.
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16
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Cavalheiro M, Teixeira MC. Candida Biofilms: Threats, Challenges, and Promising Strategies. Front Med (Lausanne) 2018; 5:28. [PMID: 29487851 PMCID: PMC5816785 DOI: 10.3389/fmed.2018.00028] [Citation(s) in RCA: 357] [Impact Index Per Article: 59.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 01/26/2018] [Indexed: 12/19/2022] Open
Abstract
Candida species are fungal pathogens known for their ability to cause superficial and systemic infections in the human host. These pathogens are able to persist inside the host due to the development of pathogenicity and multidrug resistance traits, often leading to the failure of therapeutic strategies. One specific feature of Candida species pathogenicity is their ability to form biofilms, which protects them from external factors such as host immune system defenses and antifungal drugs. This review focuses on the current threats and challenges when dealing with biofilms formed by Candida albicans, Candida glabrata, Candida tropicalis, and Candida parapsilosis, highlighting the differences between the four species. Biofilm characteristics depend on the ability of each species to produce extracellular polymeric substances (EPS) and display dimorphic growth, but also on the biofilm substratum, carbon source availability and other factors. Additionally, the transcriptional control over processes like adhesion, biofilm formation, filamentation, and EPS production displays great complexity and diversity within pathogenic yeasts of the Candida genus. These differences not only have implications in the persistence of colonization and infections but also on antifungal resistance typically found in Candida biofilm cells, potentiated by EPS, that functions as a barrier to drug diffusion, and by the overexpression of drug resistance transporters. The ability to interact with different species in in vivo Candida biofilms is also a key factor to consider when dealing with this problem. Despite many challenges, the most promising strategies that are currently available or under development to limit biofilm formation or to eradicate mature biofilms are discussed.
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Affiliation(s)
- Mafalda Cavalheiro
- Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.,iBB - Institute for Bioengineering and Biosciences, Biological Sciences Research Group, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Miguel Cacho Teixeira
- Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.,iBB - Institute for Bioengineering and Biosciences, Biological Sciences Research Group, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
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17
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Patel PK, Gupta A, Vaughn VM, Mann JD, Ameling JM, Meddings J. Review of Strategies to Reduce Central Line-Associated Bloodstream Infection (CLABSI) and Catheter-Associated Urinary Tract Infection (CAUTI) in Adult ICUs. J Hosp Med 2018; 13:105-116. [PMID: 29154382 DOI: 10.12788/jhm.2856] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) are costly and morbid. Despite evidence-based guidelines, Some intensive care units (ICUs) continue to have elevated infection rates. In October 2015, we performed a systematic search of the peer-reviewed literature within the PubMed and Cochrane databases for interventions to reduce CLABSI and/or CAUTI in adult ICUs and synthesized findings using a narrative review process. The interventions were categorized using a conceptual model, with stages applicable to both CAUTI and CLABSI prevention: (stage 0) avoid catheter if possible, (stage 1) ensure aseptic placement, (stage 2) maintain awareness and proper care of catheters in place, and (stage 3) promptly remove unnecessary catheters. We also looked for effective components that the 5 most successful (by reduction in infection rates) studies of each infection shared. Interventions that addressed multiple stages within the conceptual model were common in these successful studies. Assuring compliance with infection prevention efforts via auditing and timely feedback were also common. Hospitalists with patient safety interests may find this review informative for formulating quality improvement interventions to reduce these infections.
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Affiliation(s)
- Payal K Patel
- Ann Arbor Veterans Affairs Medical Center, Ann Arbor, Michigan, USA.
- Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Ashwin Gupta
- Ann Arbor Veterans Affairs Medical Center, Ann Arbor, Michigan, USA
- Department of Internal Medicine, Division of General Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Valerie M Vaughn
- Department of Internal Medicine, Division of General Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Jason D Mann
- Department of Internal Medicine, Division of General Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Jessica M Ameling
- Department of Internal Medicine, Division of General Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Jennifer Meddings
- Ann Arbor Veterans Affairs Medical Center, Ann Arbor, Michigan, USA
- Department of Internal Medicine, Division of General Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Department of Pediatrics and Communicable Diseases, Division of General Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Veterans Affairs Center for Clinical Management Research, Ann Arbor Veterans Affairs Medical Center, Ann Arbor, Michigan, USA
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18
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Chong HY, Lai NM, Apisarnthanarak A, Chaiyakunapruk N. Comparative Efficacy of Antimicrobial Central Venous Catheters in Reducing Catheter-Related Bloodstream Infections in Adults: Abridged Cochrane Systematic Review and Network Meta-Analysis. Clin Infect Dis 2018; 64:S131-S140. [PMID: 28475779 DOI: 10.1093/cid/cix019] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background The efficacy of antimicrobial central venous catheters (CVCs) remains questionable. In this network meta-analysis, we aimed to assess the comparative efficacy of antimicrobial CVC impregnations in reducing catheter-related infections in adults. Methods We searched 4 electronic databases (Medline, the Cochrane Central Register of Controlled Trials, Embase, CINAHL) and internet sources for randomized controlled trials, ongoing clinical trials, and unpublished studies up to August 2016. Studies that assessed CVCs with antimicrobial impregnation with nonimpregnated catheters or catheters with another impregnation were included. Primary outcomes were clinically diagnosed sepsis, catheter-related bloodstream infection (CRBSI), and all-cause mortality. We performed a network meta-analysis to estimate risk ratio (RR) with 95% confidence interval (CI). Results Sixty studies with 17255 catheters were included. The effects of 14 impregnations were investigated. Both CRBSI and catheter colonization were the most commonly evaluated outcomes. Silver-impregnated CVCs significantly reduced clinically diagnosed sepsis compared with silver-impregnated cuffs (RR, 0.54 [95% CI, .29-.99]). When compared to no impregnation, significant CRBSI reduction was associated with minocycline-rifampicin (RR, 0.29 [95% CI, .16-.52]) and silver (RR, 0.57 [95% CI, .38-.86]) impregnations. No impregnations significantly reduced all-cause mortality. For catheter colonization, significant decreases were shown by miconazole-rifampicin (RR, 0.14 [95% CI, .05-.36]), 5-fluorouracil (RR, 0.34 [95% CI, .14-.82]), and chlorhexidine-silver sulfadiazine (RR, 0.60 [95% CI, .50-.72]) impregnations compared with no impregnation. None of the studies evaluated antibiotic/antiseptic resistance as the outcome. Conclusions Current evidence suggests that the minocycline-rifampicin-impregnated CVC appears to be the most effective in preventing CRBSI. However, its overall benefits in reducing clinical sepsis and mortality remain uncertain. Surveillance for antibiotic resistance attributed to the routine use of antimicrobial-impregnated CVCs should be emphasized in future trials.
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Affiliation(s)
| | - Nai Ming Lai
- School of Pharmacy, Monash University Malaysia.,School of Medicine, Taylor's University Lakeside Campus, Malaysia
| | - Anucha Apisarnthanarak
- Division of Infectious Diseases, Faculty of Medicine, Thammasat University Hospital, Pratumthani, Thailand
| | - Nathorn Chaiyakunapruk
- School of Pharmacy, Monash University Malaysia.,School of Population Health, University of Queensland, Brisbane, Australia.,Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand ; and.,School of Pharmacy, University of Wisconsin, Madison
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19
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Turnbull IR, Buckman SA, Horn CB, Bochicchio GV, Mazuski JE. Antibiotic-Impregnated Central Venous Catheters Do Not Change Antibiotic Resistance Patterns. Surg Infect (Larchmt) 2017; 19:40-47. [PMID: 29028461 DOI: 10.1089/sur.2017.087] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Antibiotic-impregnated central venous catheters (CVCs) decrease the incidence of infection in high-risk patients. However, use of these catheters carries the hypothetical risk of inducing antibiotic resistance. We hypothesized that routine use of minocycline and rifampin-impregnated catheters (MR-CVC) in a single intensive care unit (ICU) would change the resistance profile for Staphylococcus aureus. METHODS We reviewed antibiotic susceptibilities of S. aureus isolates obtained from blood cultures in a large urban teaching hospital from 2002-2015. Resistance patterns were compared before and after implementation of MR-CVC use in the surgical ICU (SICU) in August 2006. We also compared resistance patterns of S. aureus obtained in other ICUs and in non-ICU patients, in whom MR-CVCs were not used. RESULTS Data for rifampin, oxacillin, and clindamycin were available for 9,703 cultures; tetracycline resistance data were available for 4,627 cultures. After implementation of MR-CVC use in the SICU, rifampin resistance remained unchanged, with rates the same as in other ICU and non-ICU populations (3%). After six years of use of MR-CVCs in the SICU, the rate of tetracycline resistance was unchanged in all facilities (1%-3%). The use of MR-CVCs was not associated with any change in S. aureus oxacillin-resistance rates in the SICU (66% vs. 60%). However, there was a significant decrease in S. aureus clindamycin resistance (59% vs. 34%; p < 0.05) in SICU patients. CONCLUSIONS Routine use of rifampin-minocycline-impregnated CVCs in the SICU was not associated with increased resistance of S. aureus isolates to rifampin or tetracyclines.
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Affiliation(s)
- Isaiah R Turnbull
- Department of Surgery, Washington University School of Medicine , St. Louis, Missouri
| | - Sara A Buckman
- Department of Surgery, Washington University School of Medicine , St. Louis, Missouri
| | - Christopher B Horn
- Department of Surgery, Washington University School of Medicine , St. Louis, Missouri
| | - Grant V Bochicchio
- Department of Surgery, Washington University School of Medicine , St. Louis, Missouri
| | - John E Mazuski
- Department of Surgery, Washington University School of Medicine , St. Louis, Missouri
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20
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Francolini I, Vuotto C, Piozzi A, Donelli G. Antifouling and antimicrobial biomaterials: an overview. APMIS 2017; 125:392-417. [PMID: 28407425 DOI: 10.1111/apm.12675] [Citation(s) in RCA: 163] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 01/14/2017] [Indexed: 12/12/2022]
Abstract
The use of implantable medical devices is a common and indispensable part of medical care for both diagnostic and therapeutic purposes. However, as side effect, the implant of medical devices quite often leads to the occurrence of difficult-to-treat infections, as a consequence of the colonization of their abiotic surfaces by biofilm-growing microorganisms increasingly resistant to antimicrobial therapies. A promising strategy to combat device-related infections is based on anti-infective biomaterials that either repel microbes, so they cannot attach to the device surfaces, or kill them in the surrounding areas. In general, such biomaterials are characterized by antifouling coatings, exhibiting low adhesion or even repellent properties towards microorganisms, or antimicrobial coatings, able to kill microbes approaching the surface. In this light, the present overview will address the development in the last two decades of antifouling and antimicrobial biomaterials designed to potentially limit the initial stages of microbial adhesion, as well as the microbial growth and biofilm formation on medical device surfaces.
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Affiliation(s)
| | - Claudia Vuotto
- Microbial Biofilm Laboratory, IRCCS Fondazione Santa Lucia, Rome
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21
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Viola GM, Rosenblatt J, Raad II. Drug eluting antimicrobial vascular catheters: Progress and promise. Adv Drug Deliv Rev 2017; 112:35-47. [PMID: 27496702 DOI: 10.1016/j.addr.2016.07.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 06/14/2016] [Accepted: 07/26/2016] [Indexed: 12/13/2022]
Abstract
Vascular catheters are critical tools in modern healthcare yet present substantial risks of serious bloodstream infections that exact significant health and economic burdens. Drug-eluting antimicrobial vascular catheters have become important tools in preventing catheter-related bloodstream infections and their importance is expected to increase as significant initiatives are expanded to eliminate and make the occurrence of these infections unacceptable. Here we review clinically significant and emerging drug-eluting antimicrobial catheters within the categories of antibiotic, antiseptic, novel bioactive agents and energy-enhanced drug eluting antimicrobial catheters. Important representatives of each category are reviewed from the standpoints of mechanisms of action, physical-chemical properties, safety, in vitro and clinical effectiveness.
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Affiliation(s)
- George M Viola
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Joel Rosenblatt
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
| | - Issam I Raad
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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22
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Zinc Pyrithione Improves the Antibacterial Activity of Silver Sulfadiazine Ointment. mSphere 2016; 1:mSphere00194-16. [PMID: 27642637 PMCID: PMC5023846 DOI: 10.1128/msphere.00194-16] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 08/18/2016] [Indexed: 11/29/2022] Open
Abstract
Topical antimicrobial ointments ostensibly mitigate bacterial wound disease and reliance on systemic antibiotics. Yet studies have called into question the therapeutic benefits of several traditional topical antibacterials, accentuating the need for improved next-generation antimicrobial ointments. Yet the development of such agents consisting of a new chemical entity is a time-consuming and expensive proposition. Considering that drug combinations are a mainstay therapeutic strategy for the treatment of other therapeutic indications, one alternative approach is to improve the performance of conventional antimicrobial ointments by the addition of a well-characterized and FDA-approved agent. Here we report data that indicate that the antimicrobial properties of silver sulfadiazine ointments can be significantly improved by the addition of the antifungal zinc pyrithione, suggesting that such combinations may provide an improved therapeutic option for the topical treatment of wound infections. Pseudomonas aeruginosa, Acinetobacter baumannii, and Staphylococcus aureus are commonly associated with biofilm-associated wound infections that are recalcitrant to conventional antibiotics. As an initial means to identify agents that may have a greater propensity to improve clearance of wound-associated bacterial pathogens, we screened a Food and Drug Administration-approved drug library for members that display bactericidal activity toward 72-h-established P. aeruginosa biofilms using an adenylate kinase reporter assay for bacterial cell death. A total of 34 compounds displayed antibiofilm activity. Among these, zinc pyrithione was also shown to reduce levels of A. baumannii and S. aureus biofilm-associated bacteria and exhibited an additive effect in combination with silver sulfadiazine, a leading topical therapeutic for wound site infections. The improved antimicrobial activity of zinc pyrithione and silver sulfadiazine was maintained in an ointment formulation and led to improved clearance of P. aeruginosa, A. baumannii, and S. aureus in a murine model of wound infection. Taken together, these results suggest that topical zinc pyrithione and silver sulfadiazine combination formulations may mitigate wound-associated bacterial infections and disease progression. IMPORTANCE Topical antimicrobial ointments ostensibly mitigate bacterial wound disease and reliance on systemic antibiotics. Yet studies have called into question the therapeutic benefits of several traditional topical antibacterials, accentuating the need for improved next-generation antimicrobial ointments. Yet the development of such agents consisting of a new chemical entity is a time-consuming and expensive proposition. Considering that drug combinations are a mainstay therapeutic strategy for the treatment of other therapeutic indications, one alternative approach is to improve the performance of conventional antimicrobial ointments by the addition of a well-characterized and FDA-approved agent. Here we report data that indicate that the antimicrobial properties of silver sulfadiazine ointments can be significantly improved by the addition of the antifungal zinc pyrithione, suggesting that such combinations may provide an improved therapeutic option for the topical treatment of wound infections.
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Miquel S, Lagrafeuille R, Souweine B, Forestier C. Anti-biofilm Activity as a Health Issue. Front Microbiol 2016; 7:592. [PMID: 27199924 PMCID: PMC4845594 DOI: 10.3389/fmicb.2016.00592] [Citation(s) in RCA: 131] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 04/11/2016] [Indexed: 12/13/2022] Open
Abstract
The formation and persistence of surface-attached microbial communities, known as biofilms, are responsible for 75% of human microbial infections (National Institutes of Health). Biofilm lifestyle confers several advantages to the pathogens, notably during the colonization process of medical devices and/or patients’ organs. In addition, sessile bacteria have a high tolerance to exogenous stress including anti-infectious agents. Biofilms are highly competitive communities and some microorganisms exhibit anti-biofilm capacities such as bacterial growth inhibition, exclusion or competition, which enable them to acquire advantages and become dominant. The deciphering and control of anti-biofilm properties represent future challenges in human infection control. The aim of this review is to compare and discuss the mechanisms of natural bacterial anti-biofilm strategies/mechanisms recently identified in pathogenic, commensal and probiotic bacteria and the main synthetic strategies used in clinical practice, particularly for catheter-related infections.
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Affiliation(s)
- Sylvie Miquel
- Laboratoire Microorganismes : Génome et Environnement - UMR, CNRS 6023, Université Clermont Auvergne Clermont-Ferrand, France
| | - Rosyne Lagrafeuille
- Laboratoire Microorganismes : Génome et Environnement - UMR, CNRS 6023, Université Clermont Auvergne Clermont-Ferrand, France
| | - Bertrand Souweine
- Laboratoire Microorganismes : Génome et Environnement - UMR, CNRS 6023, Université Clermont AuvergneClermont-Ferrand, France; Service de Réanimation Médicale Polyvalente, CHU de Clermont-Ferrand, Clermont-FerrandFrance
| | - Christiane Forestier
- Laboratoire Microorganismes : Génome et Environnement - UMR, CNRS 6023, Université Clermont Auvergne Clermont-Ferrand, France
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Bujdáková H. Management of Candida biofilms: state of knowledge and new options for prevention and eradication. Future Microbiol 2016; 11:235-51. [PMID: 26849383 DOI: 10.2217/fmb.15.139] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Biofilms formed by Candida species (spp.) on medical devices represent a potential health risk. The focus of current research is searching for new options for the treatment and prevention of biofilm-associated infections using different approaches including modern nanotechnology. This review summarizes current information concerning the most relevant resistance/tolerance mechanisms to conventional drugs and a role of additional factors contributing to these phenomena in Candida spp. (mostly Candida albicans). Additionally, it provides an information update in prevention and eradication of a Candida biofilm including experiences with 'lock' therapy, potential utilization of small molecules in biomedical applications, and perspectives of using photodynamic inactivation in the control of a Candida biofilm.
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Affiliation(s)
- Helena Bujdáková
- Comenius University in Bratislava, Faculty of Natural Sciences, Department of Microbiology & Virology, Mlynská dolina, Ilkovičova 6, 842 15 Bratislava, Slovak Republic
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