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Jonblat S, As-Sadi F, Zibara K, Sabban ME, Dermesrobian V, Khoury AE, Kallassy M, Chokr A. Staphylococcus epidermidis biofilm assembly and self-dispersion: bacteria and matrix dynamics. Int Microbiol 2024; 27:831-844. [PMID: 37824024 DOI: 10.1007/s10123-023-00433-2] [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: 08/08/2023] [Revised: 09/17/2023] [Accepted: 09/25/2023] [Indexed: 10/13/2023]
Abstract
Staphylococcus epidermidis, despite being a commensal of human skin and mucosa, is a major nosocomial pathogen implicated in device-associated infections. The dissemination of infection to other body sites is related to biofilm dispersal. This study focused on the dispersion stage of S. epidermidis CIP 444 biofilm, with the assessment of biofilm matrix composition in a time-dependent experiment (7 days extended) with 3 independent repetitions, using confocal laser scanning microcopy (CLSM) in association with ZEN 3.4 blue edition, COMSTAT, and ImageJ software. SYTO-9, propidium iodide (PI), DID'OIL, FITC, and calcofluor white M2R (CFW) were used to stain biofilm components. The results indicated that the biomass of dead cells increased from 15.18 ± 1.81 µm3/µm2 (day 3) to 23.15 ± 6.075 µm3/µm2 (day 4), along with a decrease in alive cells' biomass from 22.75 ± 2.968 µm3/µm2 (day 3) to 18.95 ± 5.713 µm3/µm2 (day 4). When the intensities were measured after marking the biofilm components, in a 24-h-old biofilm, polysaccharide made up the majority of the investigated components (52%), followed by protein (18.9%). Lipids make up just 11.6% of the mature biofilm. Protein makes up the largest portion (48%) of a 4-day-old biofilm, followed by polysaccharides (37.8%) and lipids (7.27%). According to our findings, S. epidermidis CIP 444 dispersion occurred on day 4 of incubation, and new establishment of the biofilm occurred on day 7. Remarkable changes in biofilm composition will pave the way for a new approach to understanding bacterial strategies inside biofilms and finding solutions to their impacts in the medical field.
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Affiliation(s)
- Suzanne Jonblat
- Research Laboratory of Microbiology (RLM), Department of Life and Earth Sciences, Faculty of Sciences I, Lebanese University, Hadat Campus, Beirut, Lebanon
- Platform of Research and Analysis in Environmental Sciences (PRASE), Doctoral School of Sciences and Technologies, Lebanese University, Hadat Campus, Beirut, Lebanon
- Functional Genomics and Proteomic Laboratory, Faculté Des Sciences, Université Saint-Joseph de Beyrouth, Campus Des Sciences Et Technologies, Mar Roukos, Matn, Lebanon
- Centre d'Analyses Et de Recherche (CAR), Unité de Recherche Technologies Et Valorisation Agro-Alimentaire (UR-TVA), Faculté Des Sciences, Université Saint-Joseph de Beyrouth, Campus Des Sciences Et Technologies, Mar Roukos, Matn, Lebanon
| | - Falah As-Sadi
- Research Laboratory of Microbiology (RLM), Department of Life and Earth Sciences, Faculty of Sciences I, Lebanese University, Hadat Campus, Beirut, Lebanon
- Department of Plant Production, Faculty of Agriculture and Veterinary Medicine, Lebanese University, Beirut, 999095, Lebanon
| | - Kazem Zibara
- ER045, Laboratory of Stem Cells, DSST, Biology Department, Faculty of Sciences-I, Lebanese University, Beirut, Lebanon
| | - Marwan El Sabban
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Bliss Street, Beirut, 1107, Lebanon
| | - Vera Dermesrobian
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Bliss Street, Beirut, 1107, Lebanon
- Department of Microbiology, Immunology and Transplantation, Laboratory of Adaptive Immunity, KU Leuven, Louvain, Belgium
| | - André El Khoury
- Centre d'Analyses Et de Recherche (CAR), Unité de Recherche Technologies Et Valorisation Agro-Alimentaire (UR-TVA), Faculté Des Sciences, Université Saint-Joseph de Beyrouth, Campus Des Sciences Et Technologies, Mar Roukos, Matn, Lebanon
| | - Mireille Kallassy
- Functional Genomics and Proteomic Laboratory, Faculté Des Sciences, Université Saint-Joseph de Beyrouth, Campus Des Sciences Et Technologies, Mar Roukos, Matn, Lebanon
| | - Ali Chokr
- Research Laboratory of Microbiology (RLM), Department of Life and Earth Sciences, Faculty of Sciences I, Lebanese University, Hadat Campus, Beirut, Lebanon.
- Platform of Research and Analysis in Environmental Sciences (PRASE), Doctoral School of Sciences and Technologies, Lebanese University, Hadat Campus, Beirut, Lebanon.
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2
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Arora A, Singh M, Saini V, Mehta D, Safwan SM, Pandey N, Verma V, Bajaj A. Cholic Acid-Derived Gemini Amphiphile Can Eradicate Interkingdom Polymicrobial Biofilms and Wound Infections. ACS Infect Dis 2024; 10:138-154. [PMID: 38146853 DOI: 10.1021/acsinfecdis.3c00369] [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] [Indexed: 12/27/2023]
Abstract
Biofilm infections are mainly caused by Gram-positive bacteria (GPB) like Staphylococcus aureus, Gram-negative bacteria (GNB) like Pseudomonas aeruginosa, and fungi like Candida albicans. These infections are responsible for antimicrobial tolerance, and commensal interactions of these microbes pose a severe threat to chronic infections. Treatment therapies against biofilm infections are limited to eradicating only 20-30% of infections. Here, we present the synthesis of a series of bile acid-derived molecules using lithocholic acid, deoxycholic acid, and cholic acid where two bile acid molecules are tethered through 3'-hydroxyl or 24'-carboxyl terminals with varying spacer length (trimethylene, pentamethylene, octamethylene, and dodecamethylene). Our structure-activity relationship investigations revealed that G21, a cholic acid-derived gemini amphiphile having trimethylene spacer tethered through the C24 position, is a broad-spectrum antimicrobial agent. Biochemical studies witnessed that G21 interacts with negatively charged lipoteichoic acid, lipopolysaccharide, and phosphatidylcholine moieties of GPB, GNB, and fungi and disrupts the microbial cell membranes. We further demonstrated that G21 can eradicate polymicrobial biofilms and wound infections and prevent bacteria and fungi from developing drug resistance. Therefore, our findings revealed the potential of G21 as a versatile antimicrobial agent capable of effectively targeting polymicrobial biofilms and wound infections, suggesting that it is a promising antimicrobial agent for future applications.
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Affiliation(s)
- Amit Arora
- Department of Chemistry, Guru Jambheshwar University of Science & Technology, Hisar 125001, Haryana, India
| | - Mohit Singh
- Laboratory of Nanotechnology and Chemical Biology, Regional Centre for Biotechnology, 3rd Milestone Faridabad-Gurgaon Expressway, NCR Biotech Cluster, Faridabad 121001, Haryana, India
| | - Varsha Saini
- Laboratory of Nanotechnology and Chemical Biology, Regional Centre for Biotechnology, 3rd Milestone Faridabad-Gurgaon Expressway, NCR Biotech Cluster, Faridabad 121001, Haryana, India
| | - Devashish Mehta
- Laboratory of Nanotechnology and Chemical Biology, Regional Centre for Biotechnology, 3rd Milestone Faridabad-Gurgaon Expressway, NCR Biotech Cluster, Faridabad 121001, Haryana, India
| | - Sayed M Safwan
- Laboratory of Nanotechnology and Chemical Biology, Regional Centre for Biotechnology, 3rd Milestone Faridabad-Gurgaon Expressway, NCR Biotech Cluster, Faridabad 121001, Haryana, India
| | - Nishant Pandey
- Laboratory of Nanotechnology and Chemical Biology, Regional Centre for Biotechnology, 3rd Milestone Faridabad-Gurgaon Expressway, NCR Biotech Cluster, Faridabad 121001, Haryana, India
| | - Vikas Verma
- Department of Chemistry, Guru Jambheshwar University of Science & Technology, Hisar 125001, Haryana, India
| | - Avinash Bajaj
- Laboratory of Nanotechnology and Chemical Biology, Regional Centre for Biotechnology, 3rd Milestone Faridabad-Gurgaon Expressway, NCR Biotech Cluster, Faridabad 121001, Haryana, India
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Farfour E, Roux A, Sage E, Revillet H, Vasse M, Vallée A. Rarely Encountered Gram-Negative Rods and Lung Transplant Recipients: A Narrative Review. Microorganisms 2023; 11:1468. [PMID: 37374970 DOI: 10.3390/microorganisms11061468] [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: 04/25/2023] [Revised: 05/18/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
The respiratory tract of lung transplant recipients (LTR) is likely to be colonized with non-fermentative Gram-negative rods. As a consequence of the improvements in molecular sequencing and taxonomy, an increasing number of bacterial species have been described. We performed a review of the literature of bacterial infections in LTR involving non-fermentative Gram-negative rods with exclusion of Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Achromobacter spp. and Burkholderia spp. Overall, non-fermenting GNR were recovered from 17 LTR involving the following genera: Acetobacter, Bordetella, Chryseobacterium, Elizabethkinga, Inquilinus, and Pandoraea. We then discuss the issues raised by these bacteria, including detection and identification, antimicrobial resistance, pathogenesis, and cross-transmission.
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Affiliation(s)
- Eric Farfour
- Service de Biologie Clinique, Hôpital Foch, 92150 Suresnes, France
| | - Antoine Roux
- Service de Pneumologie et Transplantation Pulmonaire, Hôpital Foch, 92150 Suresnes, France
| | - Edouard Sage
- Service de Chirurgie Thoracique et Transplantation Pulmonaire, Hôpital Foch, 92150 Suresnes, France
| | - Hélène Revillet
- Service de Bactériologie-Hygiène Hospitalière, CHU de Toulouse, 31300 Toulouse, France
- Observatoire National Burkholderia cepacia, 31403 Toulouse, France
| | - Marc Vasse
- Service de Biologie Clinique, Hôpital Foch, 92150 Suresnes, France
- INSERM Hémostase Inflammation Thrombose HITH U1176, Université Paris-Saclay, 94276 Le Kremlin-Bicêtre, France
| | - Alexandre Vallée
- Service d'Epidémiologie-Data-Biostatistiques, Délégation à la Recherche Clinique et à l'Innovation, Hôpital Foch, 92150 Suresnes, France
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O'Brien TJ, Figueroa W, Welch M. Decreased efficacy of antimicrobial agents in a polymicrobial environment. THE ISME JOURNAL 2022; 16:1694-1704. [PMID: 35304578 PMCID: PMC9213441 DOI: 10.1038/s41396-022-01218-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 02/14/2022] [Accepted: 02/21/2022] [Indexed: 12/20/2022]
Abstract
The airways of people with cystic fibrosis (CF) often harbour diverse polymicrobial communities. These airway infections can be impossible to resolve through antibiotic intervention, even though isolates of the individual species present are susceptible to the treatment when tested in vitro. In this work, we investigate how polymicrobial cultures comprised of key CF-associated pathogens respond to challenge with species-specific antimicrobial agents; colistin (targets Pseudomonas aeruginosa), fusidic acid (targets Staphylococcus aureus), and fluconazole (targets Candida albicans). We found that growth in a polymicrobial environment protects the target microorganism (sometimes by several orders of magnitude) from the effect(s) of the antimicrobial agent. This decreased antimicrobial efficacy was found to have both non-heritable (physiological) and heritable (genetic) components. Whole-genome sequencing of the colistin-resistant P. aeruginosa isolates revealed single nucleotide polymorphisms and indels in genes encoding lipopolysaccharide (LPS) biosynthesis and/or pilus biogenesis, indicating that a previously undescribed colistin resistance mechanism was in operation. This was subsequently confirmed through further genetic analyses. Our findings indicate that the polymicrobial nature of the CF airways is likely to have a significant impact on the clinical response to antimicrobial therapy.
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Affiliation(s)
| | - Wendy Figueroa
- Department of Biochemistry, University of Cambridge, Cambridge, United Kingdom
| | - Martin Welch
- Department of Biochemistry, University of Cambridge, Cambridge, United Kingdom.
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Pseudomonas Synergizes with Fluconazole against Candida during Treatment of Polymicrobial Infection. Infect Immun 2022; 90:e0062621. [PMID: 35289633 PMCID: PMC9022521 DOI: 10.1128/iai.00626-21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Polymicrobial infections are challenging to treat because we don’t fully understand how pathogens interact during infection and how these interactions affect drug efficacy. Candida albicans and Pseudomonas aeruginosa are opportunistic pathogens that can be found in similar sites of infection such as in burn wounds and most importantly in the lungs of CF and mechanically ventilated patients. C. albicans is particularly difficult to treat because of the paucity of antifungal agents, some of which lack fungicidal activity. In this study, we investigated the efficacy of anti-fungal treatment during C. albicans-P. aeruginosa coculture in vitro and co-infection in the mucosal zebrafish infection model analogous to the lung. We find that P. aeruginosa enhances the activity of fluconazole (FLC), an anti-fungal drug that is fungistatic in vitro, to promote both clearance of C. albicans during co-infection in vivo and fungal killing in vitro. This synergy between FLC treatment and bacterial antagonism is partly due to iron piracy, as it is reduced upon iron supplementation and knockout of bacterial siderophores. Our work demonstrates that FLC has enhanced activity in clinically relevant contexts and highlights the need to understand antimicrobial effectiveness in the complex environment of the host with its associated microbial communities.
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Bacterial Morphotypes as Important Trait for Uropathogenic E. coli Diagnostic; a Virulence-Phenotype-Phylogeny Study. Microorganisms 2021; 9:microorganisms9112381. [PMID: 34835506 PMCID: PMC8621242 DOI: 10.3390/microorganisms9112381] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/11/2021] [Accepted: 11/13/2021] [Indexed: 11/21/2022] Open
Abstract
Urinary tract infections (UTIs) belong to the most common pathologies in Mexico and are mainly caused by Uropathogenic Escherichia coli (UPEC). UPEC possesses a wide diversity of virulence factors that allow it to carry out its pathogenesis mechanism in the urinary tract (UT). The development of morphotypes in UT represents an important feature of UPEC because it is associated with complications in diagnosis of UTI. The aim of this study was to determine the presence of bacterial morphotypes, virulence genes, virulence phenotypes, antibiotic resistant, and phylogenetic groups in clinical isolates of UPEC obtained from women in Sonora, Mexico. Forty UPEC isolates were obtained, and urine morphotypes were observed in 65% of the urine samples from where E. coli was isolated. Phylogenetic group B2 was the most prevalent. The most frequent virulence genes were fimH (100%), fliCD (90%), and sfaD/focC (72%). Biofilm formation (100%) and motility (98%) were the most prevalent phenotypes. Clinical isolates showed high resistance to aminoglycosides and β-lactams antibiotics. These data suggest that the search for morphotypes in urine sediment must be incorporated in the urinalysis procedure and also that clinical isolates of UPEC in this study can cause upper, lower, and recurrent UTI.
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Lauman P, Dennis JJ. Advances in Phage Therapy: Targeting the Burkholderia cepacia Complex. Viruses 2021; 13:1331. [PMID: 34372537 PMCID: PMC8310193 DOI: 10.3390/v13071331] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/29/2021] [Accepted: 07/06/2021] [Indexed: 01/16/2023] Open
Abstract
The increasing prevalence and worldwide distribution of multidrug-resistant bacterial pathogens is an imminent danger to public health and threatens virtually all aspects of modern medicine. Particularly concerning, yet insufficiently addressed, are the members of the Burkholderia cepacia complex (Bcc), a group of at least twenty opportunistic, hospital-transmitted, and notoriously drug-resistant species, which infect and cause morbidity in patients who are immunocompromised and those afflicted with chronic illnesses, including cystic fibrosis (CF) and chronic granulomatous disease (CGD). One potential solution to the antimicrobial resistance crisis is phage therapy-the use of phages for the treatment of bacterial infections. Although phage therapy has a long and somewhat checkered history, an impressive volume of modern research has been amassed in the past decades to show that when applied through specific, scientifically supported treatment strategies, phage therapy is highly efficacious and is a promising avenue against drug-resistant and difficult-to-treat pathogens, such as the Bcc. In this review, we discuss the clinical significance of the Bcc, the advantages of phage therapy, and the theoretical and clinical advancements made in phage therapy in general over the past decades, and apply these concepts specifically to the nascent, but growing and rapidly developing, field of Bcc phage therapy.
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Affiliation(s)
| | - Jonathan J. Dennis
- Department of Biological Sciences, University of Alberta, Edmonton, AB T6G 2E9, Canada;
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Vollstedt A, Baunoch D, Wolfe A, Luke N, Wojno KJ, Cline K, Belkoff L, Milbank A, Sherman N, Haverkorn R, Gaines N, Yore L, Shore N, Opel M, Korman H, Kelly C, Jafri M, Campbell M, Keating P, Hazelton D, Makhlouf B, Wenzler D, Sabry M, Burks F, Penaranda M, Smith DE, Cacdac P, Sirls L. Bacterial Interactions as Detected by Pooled Antibiotic Susceptibility Testing (P-AST) in Polymicrobial Urine Specimens. JOURNAL OF SURGICAL UROLOGY 2020; 1:101. [PMID: 36416755 PMCID: PMC9678350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Antimicrobial susceptibility is well characterized in monomicrobial infections, but bacterial species often coexist with other bacterial species. Antimicrobial susceptibility is often tested against single bacterial isolates; this approach ignores interactions between cohabiting bacteria that could impact susceptibility. Here, we use Pooled Antibiotic Susceptibility Testing to compare antimicrobial susceptibility patterns exhibited by polymicrobial and monomicrobial urine specimens obtained from patients with urinary tract infection symptoms. METHODS Urine samples were collected from patients who had symptoms consistent with a urinary tract infection. Multiplex polymerase chain reaction testing was performed to identify and quantify 31 bacterial species. Antibiotic susceptibility was determined using a novel Pooled Antibiotic Susceptibility Testing method. Antibiotic resistance rates in polymicrobial specimens were compared with those in monomicrobial infections. Using a logistic model, resistance rates were estimated when specific bacterial species were present. To assess interactions between pairs of bacteria, the predicted resistance rates were compared when a pair of bacterial species were present versus when just one bacterial species was present. RESULTS Urine specimens were collected from 3,124 patients with symptoms of urinary tract infection. Of these, multiplex polymerase chain reaction testing detected bacteria in 61.1% (1910) of specimens. Pooled Antibiotic Susceptibility Testing results were available for 70.8% (1352) of these positive specimens. Of these positive specimens, 43.9% (594) were monomicrobial, while 56.1% (758) were polymicrobial. The odds of resistance to ampicillin (p = 0.005), amoxicillin/clavulanate (p = 0.008), five different cephalosporins, vancomycin (p = <0.0001), and tetracycline (p = 0.010) increased with each additional species present in a polymicrobial specimen. In contrast, the odds of resistance to piperacillin/tazobactam decreased by 75% for each additional species present (95% CI 0.61, 0.94, p = 0.010). For one or more antibiotics tested, thirteen pairs of bacterial species exhibited statistically significant interactions compared with the expected resistance rate obtained with the Highest Single Agent Principle and Union Principle. CONCLUSION Bacterial interactions in polymicrobial specimens can result in antimicrobial susceptibility patterns that are not detected when bacterial isolates are tested by themselves. Optimizing an effective treatment regimen for patients with polymicrobial infections may depend on accurate identification of the constituent species, as well as results obtained by Pooled Antibiotic Susceptibility Testing.
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Affiliation(s)
- Annah Vollstedt
- Beaumont Hospital, 3601 W. Thirteen Mile Rd, Royal Oak, MI 48073, USA
| | | | - Alan Wolfe
- Department of Microbiology and Immunology, Loyola University Chicago, Maywood, IL, USA
| | | | - Kirk J Wojno
- Comprehensive Urology-A Division of Michigan Healthcare Professionals, 31157 Woodward Ave, Royal Oak, MI 48073, USA
| | - Kevin Cline
- Regional Urology, LLC, 255 Bert Kouns, Shreveport, LA 71106, USA
| | - Laurence Belkoff
- Urologic Consultants of SE PA, 1 Presidential Blvd, Suite 115, Bala Cynwyd, PA 19004, USA
| | - Aaron Milbank
- Minnesota Urology, 11850 Blackfoot Street NW, Suite #470, Coon Rapids, MN 55125, USA
| | - Neil Sherman
- Premier Urology, 10 Parsonage Road, Suite # 118, Edison, NJ, 08837, USA
| | - Rashel Haverkorn
- Urology San Antonio, 7909 Fredericksburg Rd, Suite 150, San Antonio, TX, 78229, USA
| | - Natalie Gaines
- Urology San Antonio, 7909 Fredericksburg Rd, Suite 150, San Antonio, TX, 78229, USA
| | - Laurence Yore
- Advanced Urology of SO FL, LLC, 5350 W Atlantic Blvd, #102, Delray Beach, FL 33484, USA
| | - Neal Shore
- Carolina Urologic Research Center, 823 82nd Parkway, Suite B, Myrtle Beach, SC 29572, USA
| | | | - Howard Korman
- Comprehensive Urology-A Division of Michigan Healthcare Professionals, 31157 Woodward Ave, Royal Oak, MI 48073, USA
| | - Colleen Kelly
- Kelly Statistical Consulting, Palomar Airport Rd, Carlsbad, CA 92011, USA
| | - Mohammad Jafri
- Comprehensive Urology-A Division of Michigan Healthcare Professionals, 31157 Woodward Ave, Royal Oak, MI 48073, USA
| | - Meghan Campbell
- Pathnostics, 17661 Cowan, Irvine, CA 92614, USA
- University of Kentucky College of Medicine, 800 Rose Street MN 150, Lexington, KY 40506, USA
| | - Patrick Keating
- Comprehensive Urology-A Division of Michigan Healthcare Professionals, 31157 Woodward Ave, Royal Oak, MI 48073, USA
| | - Dylan Hazelton
- Comprehensive Urology-A Division of Michigan Healthcare Professionals, 31157 Woodward Ave, Royal Oak, MI 48073, USA
| | - Bridget Makhlouf
- Comprehensive Urology-A Division of Michigan Healthcare Professionals, 31157 Woodward Ave, Royal Oak, MI 48073, USA
| | - David Wenzler
- Comprehensive Urology-A Division of Michigan Healthcare Professionals, 31157 Woodward Ave, Royal Oak, MI 48073, USA
| | - Mansour Sabry
- Comprehensive Urology-A Division of Michigan Healthcare Professionals, 31157 Woodward Ave, Royal Oak, MI 48073, USA
| | - Frank Burks
- Comprehensive Urology-A Division of Michigan Healthcare Professionals, 31157 Woodward Ave, Royal Oak, MI 48073, USA
| | | | | | - Patrick Cacdac
- Beaumont Hospital, 3601 W. Thirteen Mile Rd, Royal Oak, MI 48073, USA
- Pathnostics, 17661 Cowan, Irvine, CA 92614, USA
- Department of Microbiology and Immunology, Loyola University Chicago, Maywood, IL, USA
- Comprehensive Urology-A Division of Michigan Healthcare Professionals, 31157 Woodward Ave, Royal Oak, MI 48073, USA
- Regional Urology, LLC, 255 Bert Kouns, Shreveport, LA 71106, USA
- Urologic Consultants of SE PA, 1 Presidential Blvd, Suite 115, Bala Cynwyd, PA 19004, USA
- Minnesota Urology, 11850 Blackfoot Street NW, Suite #470, Coon Rapids, MN 55125, USA
- Premier Urology, 10 Parsonage Road, Suite # 118, Edison, NJ, 08837, USA
- Urology San Antonio, 7909 Fredericksburg Rd, Suite 150, San Antonio, TX, 78229, USA
- Advanced Urology of SO FL, LLC, 5350 W Atlantic Blvd, #102, Delray Beach, FL 33484, USA
- Carolina Urologic Research Center, 823 82nd Parkway, Suite B, Myrtle Beach, SC 29572, USA
- Kelly Statistical Consulting, Palomar Airport Rd, Carlsbad, CA 92011, USA
- University of Kentucky College of Medicine, 800 Rose Street MN 150, Lexington, KY 40506, USA
| | - Larry Sirls
- Comprehensive Urology-A Division of Michigan Healthcare Professionals, 31157 Woodward Ave, Royal Oak, MI 48073, USA
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Nelson MT, Pope CE, Marsh RL, Wolter DJ, Weiss EJ, Hager KR, Vo AT, Brittnacher MJ, Radey MC, Hayden HS, Eng A, Miller SI, Borenstein E, Hoffman LR. Human and Extracellular DNA Depletion for Metagenomic Analysis of Complex Clinical Infection Samples Yields Optimized Viable Microbiome Profiles. Cell Rep 2020; 26:2227-2240.e5. [PMID: 30784601 PMCID: PMC6435281 DOI: 10.1016/j.celrep.2019.01.091] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 11/20/2018] [Accepted: 01/25/2019] [Indexed: 01/27/2023] Open
Abstract
Metagenomic sequencing is a promising approach for identifying and characterizing organisms and their functional characteristics in complex, polymicrobial infections, such as airway infections in people with cystic fibrosis. These analyses are often hampered, however, by overwhelming quantities of human DNA, yielding only a small proportion of microbial reads for analysis. In addition, many abundant microbes in respiratory samples can produce large quantities of extracellular bacterial DNA originating either from biofilms or dead cells. We describe a method for simultaneously depleting DNA from intact human cells and extracellular DNA (human and bacterial) in sputum, using selective lysis of eukaryotic cells and endonuclease digestion. We show that this method increases microbial sequencing depth and, consequently, both the number of taxa detected and coverage of individual genes such as those involved in antibiotic resistance. This finding underscores the substantial impact of DNA from sources other than live bacteria in micro-biological analyses of complex, chronic infection specimens. Nelson et al. describe a method for reducing both human cellular DNA and extracellular DNA (human and bacterial) in a complex respiratory sample using hypotonic lysis and endonuclease digestion. This method increases effective microbial sequencing depth and minimizes bias introduced into subsequent phylogenetic analysis by bacterial extracellular DNA.
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Affiliation(s)
- Maria T Nelson
- Department of Microbiology, University of Washington School of Medicine, Seattle, WA 98105, USA; Department of Pediatrics, University of Washington School of Medicine, Seattle, WA 98105, USA; Medical Scientist Training Program, University of Washington School of Medicine, Seattle, WA 98105, USA
| | - Christopher E Pope
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA 98105, USA
| | - Robyn L Marsh
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0811, Australia
| | - Daniel J Wolter
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA 98105, USA; Pulmonary and Sleep Medicine, Seattle Children's Hospital, Seattle, WA 98105, USA
| | - Eli J Weiss
- Department of Microbiology, University of Washington School of Medicine, Seattle, WA 98105, USA
| | - Kyle R Hager
- Department of Microbiology, University of Washington School of Medicine, Seattle, WA 98105, USA
| | - Anh T Vo
- Department of Microbiology, University of Washington School of Medicine, Seattle, WA 98105, USA
| | - Mitchell J Brittnacher
- Department of Microbiology, University of Washington School of Medicine, Seattle, WA 98105, USA
| | - Matthew C Radey
- Department of Microbiology, University of Washington School of Medicine, Seattle, WA 98105, USA
| | - Hillary S Hayden
- Department of Microbiology, University of Washington School of Medicine, Seattle, WA 98105, USA
| | - Alexander Eng
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA 98105, USA
| | - Samuel I Miller
- Department of Microbiology, University of Washington School of Medicine, Seattle, WA 98105, USA; Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA 98105, USA; Department of Medicine, University of Washington School of Medicine, Seattle, WA 98105, USA
| | - Elhanan Borenstein
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA 98105, USA; Department of Computer Science and Engineering, University of Washington School of Medicine, Seattle, WA 98105, USA; Blavatnik School of Computer Science, Tel Aviv University, Tel Aviv 6997801, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; Santa Fe Institute, Santa Fe, NM 87501, USA
| | - Lucas R Hoffman
- Department of Microbiology, University of Washington School of Medicine, Seattle, WA 98105, USA; Department of Pediatrics, University of Washington School of Medicine, Seattle, WA 98105, USA; Pulmonary and Sleep Medicine, Seattle Children's Hospital, Seattle, WA 98105, USA.
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10
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Cigana C, Ranucci S, Rossi A, De Fino I, Melessike M, Bragonzi A. Antibiotic efficacy varies based on the infection model and treatment regimen for Pseudomonas aeruginosa. Eur Respir J 2020; 55:13993003.02456-2018. [PMID: 31624114 PMCID: PMC7057181 DOI: 10.1183/13993003.02456-2018] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 10/10/2019] [Indexed: 12/14/2022]
Abstract
Antibiotic discovery and preclinical testing are needed to combat the Pseudomonas aeruginosa health threat. Most frequently, antibiotic efficacy is tested in models of acute respiratory infection, with chronic pneumonia remaining largely unexplored. This approach generates serious concerns about the evaluation of treatment for chronically infected patients, and highlights the need for animal models that mimic the course of human disease. In this study, the efficacy of the marketed antibacterial drugs tobramycin (TOB) and colistin (COL) was tested in murine models of acute and chronic P. aeruginosa pulmonary infection. Different administration routes (intranasal, aerosol or subcutaneous) and treatment schedules (soon or 7 days post-infection) were tested. In the acute infection model, aerosol and subcutaneous administration of TOB reduced the bacterial burden and inflammatory response, while intranasal treatment showed modest efficacy. COL reduced the bacterial burden less effectively but dampened inflammation. Mice treated soon after chronic infection for 7 days with daily aerosol or subcutaneous administration of TOB showed higher and more rapid body weight recovery and reduced bacterial burden and inflammation than vehicle-treated mice. COL-treated mice showed no improvement in body weight or change in inflammation. Modest bacterial burden reduction was recorded only with aerosol COL administration. When treatment for chronic infection was commenced 7 days after infection, both TOB and COL failed to reduce P. aeruginosa burden and inflammation, or aid in recovery of body weight. Our findings suggest that the animal model and treatment regimen should be carefully chosen based on the type of infection to assess antibiotic efficacy. Disease-specific animal models and treatment regimens are essential in order to optimise anti-Pseudomonas drug testinghttp://bit.ly/2ISfBiB
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Affiliation(s)
- Cristina Cigana
- Infections and Cystic Fibrosis Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milano, Italy.,Both authors contributed equally and share senior authorship
| | - Serena Ranucci
- Infections and Cystic Fibrosis Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Alice Rossi
- Infections and Cystic Fibrosis Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Ida De Fino
- Infections and Cystic Fibrosis Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Medede Melessike
- Infections and Cystic Fibrosis Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Alessandra Bragonzi
- Infections and Cystic Fibrosis Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milano, Italy .,Both authors contributed equally and share senior authorship
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11
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Magalhães AP, Jorge P, Pereira MO. Pseudomonas aeruginosa and Staphylococcus aureus communication in biofilm infections: insights through network and database construction. Crit Rev Microbiol 2019; 45:712-728. [DOI: 10.1080/1040841x.2019.1700209] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Andreia Patrícia Magalhães
- CEB - Centre of Biological Engineering, LIBRO - Laboratory of Research in Biofilms Rosário Oliveira, University of Minho, Braga, Portugal
| | - Paula Jorge
- CEB - Centre of Biological Engineering, LIBRO - Laboratory of Research in Biofilms Rosário Oliveira, University of Minho, Braga, Portugal
| | - Maria Olívia Pereira
- CEB - Centre of Biological Engineering, LIBRO - Laboratory of Research in Biofilms Rosário Oliveira, University of Minho, Braga, Portugal
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12
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O'Brien TJ, Welch M. Recapitulation of polymicrobial communities associated with cystic fibrosis airway infections: a perspective. Future Microbiol 2019; 14:1437-1450. [PMID: 31778075 DOI: 10.2217/fmb-2019-0200] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The airways of persons with cystic fibrosis are prone to infection by a diverse and dynamic polymicrobial consortium. Currently, no models exist that permit recapitulation of this consortium within the laboratory. Such microbial ecosystems likely have a network of interspecies interactions, serving to modulate metabolic pathways and impact upon disease severity. The contribution of less abundant/fastidious microbial species on this cross-talk has often been neglected due to lack of experimental tractability. Here, we critically assess the existing models for studying polymicrobial infections. Particular attention is paid to 3Rs-compliant in vitro and in silico infection models, offering significant advantages over mammalian infection models. We outline why these models will likely become the 'go to' approaches when recapitulating polymicrobial cystic fibrosis infection.
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Affiliation(s)
- Thomas J O'Brien
- Department of Biochemistry, University of Cambridge, Cambridge, CB2 1QW, UK
| | - Martin Welch
- Department of Biochemistry, University of Cambridge, Cambridge, CB2 1QW, UK
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13
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O’Brien TJ, Welch M. A Continuous-Flow Model for in vitro Cultivation of Mixed Microbial Populations Associated With Cystic Fibrosis Airway Infections. Front Microbiol 2019; 10:2713. [PMID: 31824471 PMCID: PMC6883238 DOI: 10.3389/fmicb.2019.02713] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 11/08/2019] [Indexed: 12/13/2022] Open
Abstract
The airways of people with cystic fibrosis (CF) provide a nutrient-rich environment which favours colonisation by a variety of bacteria and fungi. Although the dominant pathogen associated with CF airway infections is Pseudomonas aeruginosa, it is becoming increasingly clear that inter-species interactions between P. aeruginosa and other colonists in the airways may have a large impact on microbial physiology and virulence. However, there are currently no suitable experimental models that permit long-term co-culture of P. aeruginosa with other CF-associated pathogens. Here, we redress this problem by describing a "3R's-compliant" continuous-flow in vitro culture model which enables long-term co-culture of three representative CF-associated microbes: P. aeruginosa, Staphylococcus aureus and Candida albicans. Although these species rapidly out-compete one another when grown together or in pairs in batch culture, we show that in a continuously-fed setup, they can be maintained in a very stable, steady-state community. We use our system to show that even numerically (0.1%) minor species can have a major impact on intercellular signalling by P. aeruginosa. Importantly, we also show that co-culturing does not appear to influence species mutation rates, further reinforcing the notion that the system favours stability rather than divergence. The model is experimentally tractable and offers an inexpensive yet robust means of investigating inter-species interactions between CF pathogens.
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Affiliation(s)
| | - Martin Welch
- Department of Biochemistry, University of Cambridge, Cambridge, United Kingdom
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14
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Apjok G, Boross G, Nyerges Á, Fekete G, Lázár V, Papp B, Pál C, Csörgő B. Limited Evolutionary Conservation of the Phenotypic Effects of Antibiotic Resistance Mutations. Mol Biol Evol 2019; 36:1601-1611. [PMID: 31058961 PMCID: PMC6657729 DOI: 10.1093/molbev/msz109] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Multidrug-resistant clinical isolates are common in certain pathogens, but rare in others. This pattern may be due to the fact that mutations shaping resistance have species-specific effects. To investigate this issue, we transferred a range of resistance-conferring mutations and a full resistance gene into Escherichia coli and closely related bacteria. We found that resistance mutations in one bacterial species frequently provide no resistance, in fact even yielding drug hypersensitivity in close relatives. In depth analysis of a key gene involved in aminoglycoside resistance (trkH) indicated that preexisting mutations in other genes-intergenic epistasis-underlie such extreme differences in mutational effects between species. Finally, reconstruction of adaptive landscapes under multiple antibiotic stresses revealed that mutations frequently provide multidrug resistance or elevated drug susceptibility (i.e., collateral sensitivity) only with certain combinations of other resistance mutations. We conclude that resistance and collateral sensitivity are contingent upon the genetic makeup of the bacterial population, and such contingency could shape the long-term fate of resistant bacteria. These results underlie the importance of species-specific treatment strategies.
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Affiliation(s)
- Gábor Apjok
- Synthetic and Systems Biology Unit, Institute of Biochemistry, Biological Research Centre of the Hungarian Academy of Sciences, Szeged, Hungary
| | - Gábor Boross
- Synthetic and Systems Biology Unit, Institute of Biochemistry, Biological Research Centre of the Hungarian Academy of Sciences, Szeged, Hungary
- Department of Biology, Stanford University, Stanford, CA
| | - Ákos Nyerges
- Synthetic and Systems Biology Unit, Institute of Biochemistry, Biological Research Centre of the Hungarian Academy of Sciences, Szeged, Hungary
| | - Gergely Fekete
- Synthetic and Systems Biology Unit, Institute of Biochemistry, Biological Research Centre of the Hungarian Academy of Sciences, Szeged, Hungary
| | - Viktória Lázár
- Synthetic and Systems Biology Unit, Institute of Biochemistry, Biological Research Centre of the Hungarian Academy of Sciences, Szeged, Hungary
- Technion – Israel Institute of Technology, Faculty of Biology, Haifa, Israel
| | - Balázs Papp
- Synthetic and Systems Biology Unit, Institute of Biochemistry, Biological Research Centre of the Hungarian Academy of Sciences, Szeged, Hungary
| | - Csaba Pál
- Synthetic and Systems Biology Unit, Institute of Biochemistry, Biological Research Centre of the Hungarian Academy of Sciences, Szeged, Hungary
| | - Bálint Csörgő
- Synthetic and Systems Biology Unit, Institute of Biochemistry, Biological Research Centre of the Hungarian Academy of Sciences, Szeged, Hungary
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA
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15
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Woods PW, Haynes ZM, Mina EG, Marques CNH. Maintenance of S. aureus in Co-culture With P. aeruginosa While Growing as Biofilms. Front Microbiol 2019; 9:3291. [PMID: 30687276 PMCID: PMC6333908 DOI: 10.3389/fmicb.2018.03291] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 12/18/2018] [Indexed: 12/11/2022] Open
Abstract
Bacterial biofilms are found in various environmental niches and are mostly comprised by two or more bacterial species. One such example, are the mixed species bacterial biofilms found in chronic lung infections of cystic fibrosis (CF) patients, which include the Staphylococcus aureus and Pseudomonas aeruginosa bacterial species. S. aureus is one of the CF lung initial colonizers and is assumed to be abrogated when P. aeruginosa becomes established, eliminating its involvement as the infection evolves. Common models used in research do not mimic the actual progression of the mixed species biofilms thus, in this work we developed an in vitro model, where S. aureus biofilms establish prior to the introduction of P. aeruginosa, simulating a state that is phenotypically more similar to the one found in CF lungs. Overall our results demonstrate that S. aureus is not outcompeted, and that timing of inoculation and bacterial concentration affect the final bacterial ratio and quorum sensing related gene expression during the dual species biofilm development.
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Affiliation(s)
- Paul W Woods
- Department of Biological Sciences, Binghamton University, Binghamton, NY, United States.,Binghamton Biofilm Research Center, Binghamton University, Binghamton, NY, United States
| | - Zane M Haynes
- Department of Biological Sciences, Binghamton University, Binghamton, NY, United States.,Binghamton Biofilm Research Center, Binghamton University, Binghamton, NY, United States
| | - Elin G Mina
- Department of Biological Sciences, Binghamton University, Binghamton, NY, United States.,Binghamton Biofilm Research Center, Binghamton University, Binghamton, NY, United States
| | - Cláudia N H Marques
- Department of Biological Sciences, Binghamton University, Binghamton, NY, United States.,Binghamton Biofilm Research Center, Binghamton University, Binghamton, NY, United States
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16
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Estrela S, Brown SP. Community interactions and spatial structure shape selection on antibiotic resistant lineages. PLoS Comput Biol 2018; 14:e1006179. [PMID: 29927925 PMCID: PMC6013025 DOI: 10.1371/journal.pcbi.1006179] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 05/06/2018] [Indexed: 01/21/2023] Open
Abstract
Polymicrobial interactions play an important role in shaping the outcome of antibiotic treatment, yet how multispecies communities respond to antibiotic assault is still little understood. Here we use an individual-based simulation model of microbial biofilms to investigate how competitive and mutualistic interactions between an antibiotic-resistant and a susceptible strain (or species) influence the two-lineage community response to antibiotic exposure. Our model predicts that while increasing competition and antibiotics leads to increasing competitive release of the antibiotic-resistant strain, hitting a mutualistic community of cross-feeding species with antibiotics leads to a mutualistic suppression effect where both susceptible and resistant species are harmed. We next show that the impact of antibiotics is further governed by emergent spatial feedbacks within communities. Mutualistic cross-feeding communities can rescue susceptible members by subsidizing their growth inside the biofilm despite lack of access to the nutrient-rich and high-antibiotic growing front. Moreover, we show that antibiotic detoxification by resistant cells can protect nearby susceptible cells, but such cross-protection is more effective in mutualistic communities because mutualism drives mixing of resistant and susceptible cells. In contrast, competition leads to segregation, which ultimately prevents susceptible cells to profit from detoxification. Understanding how the interplay between microbial metabolic interactions and community spatial structuring shapes the outcome of antibiotic treatment can be key to effectively leverage the power of antibiotics and promote microbiome health. Pathogens -microorganisms that make us sick- often live within dynamic and complex multispecies communities, where they may not only compete for limiting resources but also exchange beneficial resources or services with other resident species. While antibiotics are commonly used to get rid of such harmful microbes, the community-wide effects of antibiotic treatment and its consequences for antibiotic resistance are still not well understood. How do competitive or mutually beneficial interactions between antibiotic resistant and susceptible species influence community resistance to antibiotics? Here we investigate this question using a computational model. We find that antibiotic exposure favours the resistant lineage when resistant and susceptible strains are competitors but harms both types when they are mutualists. With antibiotic-detoxifying resistant cells, cross-protection of susceptible cells is more effective in mutualistic communities because mutualism drives mixing of susceptible and resistant cells. In contrast, competition leads to their segregation, precluding susceptible cells to profit from their competitor’s local detoxification. Our findings highlight that knowing not only what species are present but also how they interact with each other and arrange themselves in space is central to understanding antibiotic resistance and to informing the development of strategies that promote microbiome health.
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Affiliation(s)
- Sylvie Estrela
- Department of Ecology and Evolutionary Biology, Yale University, New Haven, Connecticut, United States of America
- Microbial Sciences Institute, Yale University, West Haven, Connecticut, United States of America
- * E-mail:
| | - Sam P. Brown
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia, United States of America
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17
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Im H, Choi SY, Son S, Mitchell RJ. Combined Application of Bacterial Predation and Violacein to Kill Polymicrobial Pathogenic Communities. Sci Rep 2017; 7:14415. [PMID: 29089523 PMCID: PMC5663959 DOI: 10.1038/s41598-017-14567-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 10/11/2017] [Indexed: 12/02/2022] Open
Abstract
Violacein is a bisindole antibiotic that is effective against Gram-positive bacteria while the bacterial predator, Bdellovibrio bacteriovorus HD100, predates on Gram-negative strains. In this study, we evaluated the use of both together against multidrug resistant pathogens. The two antibacterial agents did not antagonize the activity of the other. For example, treatment of Staphylococcus aureus with violacein reduced its viability by more than 2,000-fold with or without B. bacteriovorus addition. Likewise, predation of Acinetobacter baumannii reduced the viability of this pathogen by more than 13,000-fold, regardless if violacein was present or not. When used individually against mixed bacterial cultures containing both Gram-positive and Gram-negative strains, violacein and B. bacteriovorus HD100 were effective against only their respective strains. The combined application of both violacein and B. bacteriovorus HD100, however, reduced the total pathogen numbers by as much as 84,500-fold. Their combined effectiveness was also demonstrated using a 4-species culture containing S. aureus, A. baumannii, Bacillus cereus and Klebsiella pneumoniae. When used alone, violacein and bacterial predation reduced the total population by only 19% and 68%, respectively. In conjunction with each other, the pathogen viability was reduced by 2,965-fold (99.98%), illustrating the prospective use of these two antimicrobials together against mixed species populations.
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Affiliation(s)
- Hansol Im
- Division of Biological Sciences, School of Life Sciences Ulsan National Institute of Science and Technology (UNIST), Ulsan, 44919, South Korea
| | - Seong Yeol Choi
- Division of Biological Sciences, School of Life Sciences Ulsan National Institute of Science and Technology (UNIST), Ulsan, 44919, South Korea
| | - Sangmo Son
- Division of Biological Sciences, School of Life Sciences Ulsan National Institute of Science and Technology (UNIST), Ulsan, 44919, South Korea
| | - Robert J Mitchell
- Division of Biological Sciences, School of Life Sciences Ulsan National Institute of Science and Technology (UNIST), Ulsan, 44919, South Korea.
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18
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nBioChip, a Lab-on-a-Chip Platform of Mono- and Polymicrobial Biofilms for High-Throughput Downstream Applications. mSphere 2017; 2:mSphere00247-17. [PMID: 28680970 PMCID: PMC5489659 DOI: 10.1128/msphere.00247-17] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 06/08/2017] [Indexed: 12/13/2022] Open
Abstract
With an estimated 80% of infections being associated with a biofilm mode of growth and the ensuing recalcitrance of these biofilms with respect to conventional antibiotic treatment leading to high mortality rates, there is a dire and unmet need for the development of novel approaches to prevent, treat, and control these infections. Both bacteria and fungi are capable of forming biofilms that are inherently fragile and often polymicrobial in nature, which further complicates treatment. In this work, we showcase a nanobiofilm chip as a convenient platform for culturing several hundreds of mono- or polymicrobial biofilms and for susceptibility testing. This platform enables true ultra-high-throughput screening for antimicrobial drug discovery or diagnostics or for addressing fundamental issues in microbiology. Current in vitro techniques for the culture of microorganisms, and particularly of delicate microbial biofilms, are still mostly limited to low-density plates and manual labor and are not amenable to automation and true high-throughput (HT) applications. We have developed a novel fully automated platform for the formation of mono- and polymicrobial biofilms of Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans at the nanoscale level. The nBioChip is robotically printed, robustly handled, and scanned using a standard microarray reader. Using this technique, hundreds to thousands of identical nanobiofilms encapsulated in hydrogel spots were cultured on microscope slides. The spots can withstand the washing steps involved in screening assays. The miniaturized biofilms demonstrated characteristics similar to those displayed by conventionally formed macroscopic biofilms, including (i) three-dimensional architectural features, (ii) synthesis of exopolymeric matrix material, and (iii) elevated resistance to antibiotic treatment. On the basis of our results, the nBioChip can generate reliable high-throughput antimicrobial susceptibility testing (HT-AST) in 12 to 18 h. The chip serves as a proof-of-concept universal platform for high-throughput drug screening and other downstream applications and furthers understanding of microbial interactions in mixed-species communities at the nanoscale level. IMPORTANCE With an estimated 80% of infections being associated with a biofilm mode of growth and the ensuing recalcitrance of these biofilms with respect to conventional antibiotic treatment leading to high mortality rates, there is a dire and unmet need for the development of novel approaches to prevent, treat, and control these infections. Both bacteria and fungi are capable of forming biofilms that are inherently fragile and often polymicrobial in nature, which further complicates treatment. In this work, we showcase a nanobiofilm chip as a convenient platform for culturing several hundreds of mono- or polymicrobial biofilms and for susceptibility testing. This platform enables true ultra-high-throughput screening for antimicrobial drug discovery or diagnostics or for addressing fundamental issues in microbiology.
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19
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Magalhães AP, Lopes SP, Pereira MO. Insights into Cystic Fibrosis Polymicrobial Consortia: The Role of Species Interactions in Biofilm Development, Phenotype, and Response to In-Use Antibiotics. Front Microbiol 2017; 7:2146. [PMID: 28133457 PMCID: PMC5233685 DOI: 10.3389/fmicb.2016.02146] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 12/20/2016] [Indexed: 12/30/2022] Open
Abstract
Cystic Fibrosis (CF) airways disease involves complex polymicrobial infections where different bacterial species can interact and influence each other and/or even interfere with the whole community. To gain insights into the role that interactions between Pseudomonas aeruginosa in co-culture with Staphylococcus aureus, Inquilinus limosus, and Stenotrophomonas maltophilia may play in infection, the reciprocal effect during biofilm formation and the response of dual biofilms toward ciprofloxacin under in vitro atmospheres with different oxygen availabilities were evaluated. Biofilm formation kinetics showed that the growth of S. aureus, I. limosus, and S. maltophilia was disturbed in the presence of P. aeruginosa, under both aerobic and anaerobic environments. On the other hand, under aerobic conditions, I. limosus led to a decrease in biofilm mass production by P. aeruginosa, although biofilm-cells viability remains unaltered. The interaction between S. maltophilia and P. aeruginosa positively influenced dual biofilm development by increasing its biomass. Compared with monocultures, biomass of P. aeruginosa+ S. aureus biofilms was significantly reduced by reciprocal interference. When grown in dual biofilms with P. aeruginosa, ciprofloxacin was less effective against S. aureus, I. limosus, and S. maltophilia, with increasing antibiotic doses leading to drastic inhibitions of P. aeruginosa cultivability. Therefore, P. aeruginosa might be responsible for the protection of the whole dual consortia against ciprofloxacin activity. Based on the overall data, it can be speculated that reciprocal interferences occur between the different bacterial species in CF lung, regardless the level of oxygen. The findings also suggest that alterations of bacterial behavior due to species interplay may be important for disease progression in CF infection.
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Affiliation(s)
- Andreia P Magalhães
- Centre of Biological Engineering (CEB), Laboratório de Investigação em Biofilmes Rosário Oliveira (LIBRO), University of Minho, Braga Portugal
| | - Susana P Lopes
- Centre of Biological Engineering (CEB), Laboratório de Investigação em Biofilmes Rosário Oliveira (LIBRO), University of Minho, Braga Portugal
| | - Maria O Pereira
- Centre of Biological Engineering (CEB), Laboratório de Investigação em Biofilmes Rosário Oliveira (LIBRO), University of Minho, Braga Portugal
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20
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21
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Li YH, Huang X, Tian XL. Recent advances in dental biofilm: impacts of microbial interactions
on the biofilm ecology and pathogenesis. AIMS BIOENGINEERING 2017. [DOI: 10.3934/bioeng.2017.3.335] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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22
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Wasko MK, Goodman SB. Emperor's new clothes: Is particle disease really infected particle disease? J Orthop Res 2016; 34:1497-504. [PMID: 27175824 PMCID: PMC5529039 DOI: 10.1002/jor.23292] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 05/10/2016] [Indexed: 02/04/2023]
Abstract
Aseptic loosening remains the most significant long-term complication of total hip replacement. The current paradigm points to an inflammatory response to wear particles as its main trigger. Recently, there have been increasing numbers of positive bacterial isolates reported among patients with clinically absent infection. This paper reviews existing evidence on possible involvement of bacteria and microbial-associated molecular patterns in the pathology of so-called "aseptic loosening." © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1497-1504, 2016.
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Affiliation(s)
- Marcin K. Wasko
- Department of Orthopaedic and Rheumoorthopaedic Surgery, The Medical Centre of Postgraduate Education, Warsaw, Poland,Foundation for the Development of Medicine, Slupsk, Poland,SPSK im. Prof. A. Grucy, Konarskiego 13, Otwock 05-400, Poland
| | - Stuart B. Goodman
- Department of Orthopaedic Surgery, Orthopaedic Surgery Laboratories, Stanford University, Stanford, California,Department of Bioengineering, Stanford University, Stanford, California
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23
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Prevaes SMPJ, de Winter-de Groot KM, Janssens HM, de Steenhuijsen Piters WAA, Tramper-Stranders GA, Wyllie AL, Hasrat R, Tiddens HA, van Westreenen M, van der Ent CK, Sanders EAM, Bogaert D. Development of the Nasopharyngeal Microbiota in Infants with Cystic Fibrosis. Am J Respir Crit Care Med 2016; 193:504-15. [PMID: 26492486 DOI: 10.1164/rccm.201509-1759oc] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
RATIONALE Cystic fibrosis (CF) is characterized by early structural lung disease caused by pulmonary infections. The nasopharynx of infants is a major ecological reservoir of potential respiratory pathogens. OBJECTIVES To investigate the development of nasopharyngeal microbiota profiles in infants with CF compared with those of healthy control subjects during the first 6 months of life. METHODS We conducted a prospective cohort study, from the time of diagnosis onward, in which we collected questionnaires and 324 nasopharynx samples from 20 infants with CF and 45 age-matched healthy control subjects. Microbiota profiles were characterized by 16S ribosomal RNA-based sequencing. MEASUREMENTS AND MAIN RESULTS We observed significant differences in microbial community composition (P < 0.0002 by permutational multivariate analysis of variance) and development between groups. In infants with CF, early Staphylococcus aureus and, to a lesser extent, Corynebacterium spp. and Moraxella spp. dominance were followed by a switch to Streptococcus mitis predominance after 3 months of age. In control subjects, Moraxella spp. enrichment occurred throughout the first 6 months of life. In a multivariate analysis, S. aureus, S. mitis, Corynebacterium accolens, and bacilli were significantly more abundant in infants with CF, whereas Moraxella spp., Corynebacterium pseudodiphtericum and Corynebacterium propinquum and Haemophilus influenzae were significantly more abundant in control subjects, after correction for age, antibiotic use, and respiratory symptoms. Antibiotic use was independently associated with increased colonization of gram-negative bacteria such as Burkholderia spp. and members of the Enterobacteriaceae bacteria family and reduced colonization of potential beneficial commensals. CONCLUSIONS From diagnosis onward, we observed distinct patterns of nasopharyngeal microbiota development in infants with CF under 6 months of age compared with control subjects and a marked effect of antibiotic therapy leading toward a gram-negative microbial composition.
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Affiliation(s)
- Sabine M P J Prevaes
- 1 Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Karin M de Winter-de Groot
- 1 Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Hettie M Janssens
- 2 Department of Pediatric Pulmonology and Allergology, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, the Netherlands; and
| | | | - Gerdien A Tramper-Stranders
- 1 Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Anne L Wyllie
- 1 Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Raiza Hasrat
- 1 Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Harm A Tiddens
- 2 Department of Pediatric Pulmonology and Allergology, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, the Netherlands; and
| | - Mireille van Westreenen
- 3 Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Cornelis K van der Ent
- 1 Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Elisabeth A M Sanders
- 1 Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Debby Bogaert
- 1 Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
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Nguyen AT, Oglesby-Sherrouse AG. Interactions between Pseudomonas aeruginosa and Staphylococcus aureus during co-cultivations and polymicrobial infections. Appl Microbiol Biotechnol 2016; 100:6141-6148. [PMID: 27236810 DOI: 10.1007/s00253-016-7596-3] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 04/26/2016] [Accepted: 04/28/2016] [Indexed: 02/06/2023]
Abstract
Pseudomonas aeruginosa and Staphylococcus aureus are versatile bacterial pathogens and common etiological agents in polymicrobial infections. Microbial communities containing both of these pathogens are shaped by interactions ranging from parasitic to mutualistic, with the net impact of these interactions in many cases resulting in enhanced virulence. Polymicrobial communities of these organisms are further defined by multiple aspects of the host environment, with important implications for disease progression and therapeutic outcomes. This mini-review highlights the impact of these interactions on the host and individual pathogens, the molecular mechanisms that underlie these interactions, and host-specific factors that drive interactions between these two important pathogens.
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Affiliation(s)
- Angela T Nguyen
- School of Pharmacy, Department of Pharmaceutical Sciences, University of Maryland, Baltimore, MD, 21201, USA
| | - Amanda G Oglesby-Sherrouse
- School of Pharmacy, Department of Pharmaceutical Sciences, University of Maryland, Baltimore, MD, 21201, USA. .,School of Medicine, Department of Microbiology and Immunology, University of Maryland, Baltimore, MD, 21201, USA.
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25
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Cheng Y, Shen PS, Zhang Z, Lai HJ. Nonparametric association analysis of bivariate left-truncated competing risks data. Biom J 2016; 58:635-51. [DOI: 10.1002/bimj.201400126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 06/08/2015] [Accepted: 07/09/2015] [Indexed: 12/29/2022]
Affiliation(s)
- Yu Cheng
- Department of Statistics and Department of Psychiatry; University of Pittsburgh; Pittsburgh PA 15260 USA
| | - Pao-sheng Shen
- Department of Statistics; Tunghai University; Taichung 40704 Taiwan
| | - Zhumin Zhang
- Department of Nutritional Sciences; University of Wisconsin-Madison; Madison WI 53706 USA
| | - HuiChuan J. Lai
- Departments of Nutritional Science; Pediatrics, and Biostatistics and Medical Informatics, University of Wisconsin-Madison; Madison WI 53706 USA
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26
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Wang Z, Xiang Q, Yang T, Li L, Yang J, Li H, He Y, Zhang Y, Lu Q, Yu J. Autoinducer-2 of Streptococcus mitis as a Target Molecule to Inhibit Pathogenic Multi-Species Biofilm Formation In Vitro and in an Endotracheal Intubation Rat Model. Front Microbiol 2016; 7:88. [PMID: 26903968 PMCID: PMC4744849 DOI: 10.3389/fmicb.2016.00088] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 01/18/2016] [Indexed: 11/13/2022] Open
Abstract
Streptococcus mitis (S. mitis) and Pseudomonas aeruginosa (P. aeruginosa) are typically found in the upper respiratory tract of infants. We previously found that P. aeruginosa and S. mitis were two of the most common bacteria in biofilms on newborns' endotracheal tubes (ETTs) and in their sputa and that S. mitis was able to produce autoinducer-2 (AI-2), whereas P. aeruginosa was not. Recently, we also found that exogenous AI-2 and S. mitis could influence the behaviors of P. aeruginosa. We hypothesized that S. mitis contributes to this interspecies interaction and that inhibition of AI-2 could result in inhibition of these effects. To test this hypothesis, we selected PAO1 as a representative model strain of P. aeruginosa and evaluated the effect of S. mitis as well as an AI-2 analog (D-ribose) on mono- and co-culture biofilms in both in vitro and in vivo models. In this context, S. mitis promoted PAO1 biofilm formation and pathogenicity. Dual-species (PAO1 and S. mitis) biofilms exhibited higher expression of quorum sensing genes than single-species (PAO1) biofilms did. Additionally, ETTs covered in dual-species biofilms increased the mortality rate and aggravated lung infection compared with ETTs covered in mono-species biofilms in an endotracheal intubation rat model, all of which was inhibited by D-ribose. Our results demonstrated that S. mitis AI-2 plays an important role in interspecies interactions with PAO1 and may be a target for inhibition of biofilm formation and infection in ventilator-associated pneumonia.
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Affiliation(s)
- Zhengli Wang
- Department of Neonatology, Children's Hospital of Chongqing Medical UniversityChongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders - Chongqing Key Laboratory of Pediatrics - China International Science and Technology Cooperation Base of Child Development and Critical DisordersChongqing, China
| | - Qingqing Xiang
- Department of Neonatology, Children's Hospital of Chongqing Medical UniversityChongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders - Chongqing Key Laboratory of Pediatrics - China International Science and Technology Cooperation Base of Child Development and Critical DisordersChongqing, China
| | - Ting Yang
- Ministry of Education Key Laboratory of Child Development and Disorders - Chongqing Key Laboratory of Pediatrics - China International Science and Technology Cooperation Base of Child Development and Critical Disorders Chongqing, China
| | - Luquan Li
- Department of Neonatology, Children's Hospital of Chongqing Medical UniversityChongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders - Chongqing Key Laboratory of Pediatrics - China International Science and Technology Cooperation Base of Child Development and Critical DisordersChongqing, China
| | - Jingli Yang
- Department of Neonatology, Children's Hospital of Chongqing Medical UniversityChongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders - Chongqing Key Laboratory of Pediatrics - China International Science and Technology Cooperation Base of Child Development and Critical DisordersChongqing, China
| | - Hongong Li
- Department of Neonatology, Children's Hospital of Chongqing Medical UniversityChongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders - Chongqing Key Laboratory of Pediatrics - China International Science and Technology Cooperation Base of Child Development and Critical DisordersChongqing, China
| | - Yu He
- Department of Neonatology, Children's Hospital of Chongqing Medical UniversityChongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders - Chongqing Key Laboratory of Pediatrics - China International Science and Technology Cooperation Base of Child Development and Critical DisordersChongqing, China
| | - Yunhui Zhang
- Department of Neonatology, Children's Hospital of Chongqing Medical UniversityChongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders - Chongqing Key Laboratory of Pediatrics - China International Science and Technology Cooperation Base of Child Development and Critical DisordersChongqing, China
| | - Qi Lu
- Department of Neonatology, Children's Hospital of Chongqing Medical UniversityChongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders - Chongqing Key Laboratory of Pediatrics - China International Science and Technology Cooperation Base of Child Development and Critical DisordersChongqing, China
| | - Jialin Yu
- Department of Neonatology, Children's Hospital of Chongqing Medical UniversityChongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders - Chongqing Key Laboratory of Pediatrics - China International Science and Technology Cooperation Base of Child Development and Critical DisordersChongqing, China
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27
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Stanley CE, Grossmann G, i Solvas XC, deMello AJ. Soil-on-a-Chip: microfluidic platforms for environmental organismal studies. LAB ON A CHIP 2016; 16:228-41. [PMID: 26645910 DOI: 10.1039/c5lc01285f] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Soil is the habitat of countless organisms and encompasses an enormous variety of dynamic environmental conditions. While it is evident that a thorough understanding of how organisms interact with the soil environment may have substantial ecological and economical impact, current laboratory-based methods depend on reductionist approaches that are incapable of simulating natural diversity. The application of Lab-on-a-Chip or microfluidic technologies to organismal studies is an emerging field, where the unique benefits afforded by system miniaturisation offer new opportunities for the experimentalist. Indeed, precise spatiotemporal control over the microenvironments of soil organisms in combination with high-resolution imaging has the potential to provide an unprecedented view of biological events at the single-organism or single-cell level, which in turn opens up new avenues for environmental and organismal studies. Herein we review some of the most recent and interesting developments in microfluidic technologies for the study of soil organisms and their interactions with the environment. We discuss how so-called "Soil-on-a-Chip" technology has already contributed significantly to the study of bacteria, nematodes, fungi and plants, as well as inter-organismal interactions, by advancing experimental access and environmental control. Most crucially, we highlight where distinct advantages over traditional approaches exist and where novel biological insights will ensue.
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Affiliation(s)
- Claire E Stanley
- Institute of Chemical and Bioengineering, ETH Zürich, Vladimir-Prelog-Weg 1, 8093 Zürich, Switzerland.
| | - Guido Grossmann
- Cell Networks-Cluster of Excellence and Centre for Organismal Studies (COS) Heidelberg, Universität Heidelberg, 69120 Heidelberg, Germany
| | | | - Andrew J deMello
- Institute of Chemical and Bioengineering, ETH Zürich, Vladimir-Prelog-Weg 1, 8093 Zürich, Switzerland.
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28
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Rogers GB, Wesselingh S. Precision respiratory medicine and the microbiome. THE LANCET RESPIRATORY MEDICINE 2015; 4:73-82. [PMID: 26700443 DOI: 10.1016/s2213-2600(15)00476-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Revised: 11/04/2015] [Accepted: 11/04/2015] [Indexed: 02/06/2023]
Abstract
A decade of rapid technological advances has provided an exciting opportunity to incorporate information relating to a range of potentially important disease determinants in the clinical decision-making process. Access to highly detailed data will enable respiratory medicine to evolve from one-size-fits-all models of care, which are associated with variable clinical effectiveness and high rates of side-effects, to precision approaches, where treatment is tailored to individual patients. The human microbiome has increasingly been recognised as playing an important part in determining disease course and response to treatment. Its inclusion in precision models of respiratory medicine, therefore, is essential. Analysis of the microbiome provides an opportunity to develop novel prognostic markers for airways disease, improve definition of clinical phenotypes, develop additional guidance to aid treatment selection, and increase the accuracy of indicators of treatment effect. In this Review we propose that collaboration between researchers and clinicians is needed if respiratory medicine is to replicate the successes of precision medicine seen in other clinical specialties.
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Affiliation(s)
- Geraint B Rogers
- South Australian Health and Medical Research Institute, Adelaide, SA, Australia; SAHMRI Microbiome Research Laboratory Flinders University School of Medicine, Adelaide, SA, Australia.
| | - Steve Wesselingh
- South Australian Health and Medical Research Institute, Adelaide, SA, Australia; SAHMRI Microbiome Research Laboratory Flinders University School of Medicine, Adelaide, SA, Australia
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Pompilio A, Crocetta V, De Nicola S, Verginelli F, Fiscarelli E, Di Bonaventura G. Cooperative pathogenicity in cystic fibrosis: Stenotrophomonas maltophilia modulates Pseudomonas aeruginosa virulence in mixed biofilm. Front Microbiol 2015; 6:951. [PMID: 26441885 PMCID: PMC4584994 DOI: 10.3389/fmicb.2015.00951] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 08/27/2015] [Indexed: 12/23/2022] Open
Abstract
The present study was undertaken in order to understand more about the interaction occurring between S. maltophilia and P. aeruginosa, which are frequently co-isolated from CF airways. For this purpose, S. maltophilia RR7 and P. aeruginosa RR8 strains, co-isolated from the lung of a chronically infected CF patient during a pulmonary exacerbation episode, were evaluated for reciprocal effect during planktonic growth, adhesion and biofilm formation onto both polystyrene and CF bronchial cell monolayer, motility, as well as for gene expression in mixed biofilms. P. aeruginosa significantly affected S. maltophilia growth in both planktonic and biofilm cultures, due to an inhibitory activity probably requiring direct contact. Conversely, no effect was observed on P. aeruginosa by S. maltophilia. Compared with monocultures, the adhesiveness of P. aeruginosa on CFBE41o- cells was significantly reduced by S. maltophilia, which probably acts by reducing P. aeruginosa's swimming motility. An opposite trend was observed for biofilm formation, confirming the findings obtained using polystyrene. When grown in mixed biofilm with S. maltophilia, P. aeruginosa significantly over-expressed aprA, and algD-codifying for protease and alginate, respectively-while the quorum sensing related rhlR and lasI genes were down-regulated. The induced alginate expression by P. aeruginosa might be responsible for the protection of S. maltophilia against tobramycin activity we observed in mixed biofilms. Taken together, our results suggest that the existence of reciprocal interference of S. maltophilia and P. aeruginosa in CF lung is plausible. In particular, S. maltophilia might confer some selective "fitness advantage" to P. aeruginosa under the specific conditions of chronic infection or, alternatively, increase the virulence of P. aeruginosa thus leading to pulmonary exacerbation.
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Affiliation(s)
- Arianna Pompilio
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University of Chieti-Pescara Chieti, Italy ; Aging Research Center (Ce.S.I.), "G. d'Annunzio" University Foundation Chieti, Italy
| | - Valentina Crocetta
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University of Chieti-Pescara Chieti, Italy ; Aging Research Center (Ce.S.I.), "G. d'Annunzio" University Foundation Chieti, Italy
| | - Serena De Nicola
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University of Chieti-Pescara Chieti, Italy ; Aging Research Center (Ce.S.I.), "G. d'Annunzio" University Foundation Chieti, Italy
| | - Fabio Verginelli
- Aging Research Center (Ce.S.I.), "G. d'Annunzio" University Foundation Chieti, Italy ; Department of Pharmacy, "G. d'Annunzio" University of Chieti-Pescara Chieti, Italy
| | | | - Giovanni Di Bonaventura
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University of Chieti-Pescara Chieti, Italy ; Aging Research Center (Ce.S.I.), "G. d'Annunzio" University Foundation Chieti, Italy
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30
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Rapid Detection of Emerging Pathogens and Loss of Microbial Diversity Associated with Severe Lung Disease in Cystic Fibrosis. J Clin Microbiol 2015; 53:2022-9. [PMID: 25878338 DOI: 10.1128/jcm.00432-15] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 04/07/2015] [Indexed: 12/31/2022] Open
Abstract
Respiratory infection in cystic fibrosis (CF) is polymicrobial, but standard sputum microbiology does not account for the lung microbiome or detect changes in microbial diversity associated with disease. As a clinically applicable CF microbiome surveillance scheme, total sputum nucleic acids isolated by a standard high-throughput robotic method for accredited viral diagnosis were profiled for bacterial diversity using ribosomal intergenic spacer analysis (RISA) PCR. Conventional culture and RISA were performed on 200 paired sputum samples from 93 CF adults; pyrosequencing of the 16S rRNA gene was applied to 59 patients to systematically determine bacterial diversity. Compared to the microbiology data, RISA profiles clustered into two groups: the emerging nonfermenting Gram-negative organisms (eNFGN) and Pseudomonas groups. Patients who were culture positive for Burkholderia, Achromobacter, Stenotrophomonas, and Ralstonia clustered within the eNFGN group. Pseudomonas group RISA profiles were associated with Pseudomonas aeruginosa culture-positive patients. Sequence analysis confirmed the abundance of eNFGN genera and Pseudomonas within these respective groups. Low bacterial diversity was associated with severe lung disease (P < 0.001) and the presence of Burkholderia (P < 0.001). An absence of Streptococcus (P < 0.05) occurred in individuals with lung function in the lowest quartile. In summary, nucleic acids isolated from CF sputum can serve as a single template for both molecular virology and bacteriology, with a RISA PCR rapidly detecting the presence of dominant eNFGN pathogens or P. aeruginosa missed by culture (11% of cases). We provide guidance for how this straightforward CF microbiota profiling scheme may be adopted by clinical laboratories.
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31
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Mohan R, Sanpitakseree C, Desai AV, Sevgen SE, Schroeder CM, Kenis PJA. A microfluidic approach to study the effect of bacterial interactions on antimicrobial susceptibility in polymicrobial cultures. RSC Adv 2015. [DOI: 10.1039/c5ra04092b] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
An easy-to-use, lab-on-a-chip platform to rapidly quantify the efficacy of antibiotics to treat polymicrobial infections.
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Affiliation(s)
- Ritika Mohan
- Department of Chemical & Biomolecular Engineering
- University of Illinois
- Urbana-Champaign
- Urbana
- USA 61801
| | - Chotitath Sanpitakseree
- Department of Chemical & Biomolecular Engineering
- University of Illinois
- Urbana-Champaign
- Urbana
- USA 61801
| | - Amit V. Desai
- Department of Chemical & Biomolecular Engineering
- University of Illinois
- Urbana-Champaign
- Urbana
- USA 61801
| | - Selami E. Sevgen
- Department of Chemical & Biomolecular Engineering
- University of Illinois
- Urbana-Champaign
- Urbana
- USA 61801
| | - Charles M. Schroeder
- Department of Chemical & Biomolecular Engineering
- University of Illinois
- Urbana-Champaign
- Urbana
- USA 61801
| | - Paul J. A. Kenis
- Department of Chemical & Biomolecular Engineering
- University of Illinois
- Urbana-Champaign
- Urbana
- USA 61801
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32
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Simón-Soro A, Mira A. Solving the etiology of dental caries. Trends Microbiol 2014; 23:76-82. [PMID: 25435135 DOI: 10.1016/j.tim.2014.10.010] [Citation(s) in RCA: 272] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 10/28/2014] [Accepted: 10/30/2014] [Indexed: 01/22/2023]
Abstract
For decades, the sugar-fermenting, acidogenic species Streptococcus mutans has been considered the main causative agent of dental caries and most diagnostic and therapeutic strategies have been targeted toward this microorganism. However, recent DNA- and RNA-based studies from carious lesions have uncovered an extraordinarily diverse ecosystem where S. mutans accounts only a tiny fraction of the bacterial community. This supports the concept that consortia formed by multiple microorganisms act collectively, probably synergistically, to initiate and expand the cavity. Thus, antimicrobial therapies are not expected to be effective in the treatment of caries and other polymicrobial diseases that do not follow classical Koch's postulates.
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Affiliation(s)
- Aurea Simón-Soro
- FISABIO Foundation, Center for Advanced Research in Public Health, Avda Cataluña 21, 46020 Valencia, Spain
| | - Alex Mira
- FISABIO Foundation, Center for Advanced Research in Public Health, Avda Cataluña 21, 46020 Valencia, Spain.
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Dalhoff A. Pharmacokinetics and pharmacodynamics of aerosolized antibacterial agents in chronically infected cystic fibrosis patients. Clin Microbiol Rev 2014; 27:753-82. [PMID: 25278574 PMCID: PMC4187638 DOI: 10.1128/cmr.00022-14] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Bacteria adapt to growth in lungs of patients with cystic fibrosis (CF) by selection of heterogeneously resistant variants that are not detected by conventional susceptibility testing but are selected for rapidly during antibacterial treatment. Therefore, total bacterial counts and antibiotic susceptibilities are misleading indicators of infection and are not helpful as guides for therapy decisions or efficacy endpoints. High drug concentrations delivered by aerosol may maximize efficacy, as decreased drug susceptibilities of the pathogens are compensated for by high target site concentrations. However, reductions of the bacterial load in sputum and improvements in lung function were within the same ranges following aerosolized and conventional therapies. Furthermore, the use of conventional pharmacokinetic/pharmacodynamic (PK/PD) surrogates correlating pharmacokinetics in serum with clinical cure and presumed or proven eradication of the pathogen as a basis for PK/PD investigations in CF patients is irrelevant, as minimization of systemic exposure is one of the main objectives of aerosolized therapy; in addition, bacterial pathogens cannot be eradicated, and chronic infection cannot be cured. Consequently, conventional PK/PD surrogates are not applicable to CF patients. It is nonetheless obvious that systemic exposure of patients, with all its sequelae, is minimized and that the burden of oral treatment for CF patients suffering from chronic infections is reduced.
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Affiliation(s)
- Axel Dalhoff
- University Medical Center Schleswig-Holstein, Institute for Infection Medicine, Kiel, Germany
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34
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Emergent bacteria in cystic fibrosis: in vitro biofilm formation and resilience under variable oxygen conditions. BIOMED RESEARCH INTERNATIONAL 2014; 2014:678301. [PMID: 24868541 PMCID: PMC4020565 DOI: 10.1155/2014/678301] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Accepted: 04/15/2014] [Indexed: 12/14/2022]
Abstract
Concurrent to conventional bacterial pathogens, unusual microbes are emerging from cystic fibrosis (CF) airways. Nonetheless, little is known about the contribution of these newly microbes to the resilience of CF-associated biofilms, particularly under variable-oxygen concentrations that are known to occur in vivo in the mucus of CF patients. Two CF-emergent bacterial species, Inquilinus limosus and Dolosigranulum pigrum, and the major pathogen Pseudomonas aeruginosa were studied in terms of biofilm development and antibiotic susceptibilities under in vitro atmospheres with different oxygen availabilities. All species were able to develop in vitro biofilms under different oxygen-available environments, with D. pigrum accumulating high amounts of biomass and respiratory activities. When established, biofilms were of difficult eradication, with antibiotics losing their effectiveness in comparison with the corresponding planktonic populations. Surprisingly, biofilms of each emergent organism displayed multidrug resistance under aerobic environments, enduring even in low-oxygen atmospheres. This study suggests a potential prospect on the impact of nonconventional organisms I. limosus and D. pigrum on CF lung infections, demonstrating capacity to adapt to biofilm mode of life under restricted-oxygen atmospheres resembling CF airways, which may ultimately endanger the efficacy of currently used antibiotic regimens.
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35
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Lopes SP, Azevedo NF, Pereira MO. Microbiome in cystic fibrosis: Shaping polymicrobial interactions for advances in antibiotic therapy. Crit Rev Microbiol 2014; 41:353-65. [PMID: 24645634 DOI: 10.3109/1040841x.2013.847898] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Recent molecular methodologies have demonstrated a complex microbial ecosystem in cystic fibrosis (CF) airways, with a wide array of uncommon microorganisms co-existing with the traditional pathogens. Although there are lines of evidence supporting the contribution of some of those emergent species for lung disease chronicity, clinical significance remains uncertain for most cases. A possible contribution for disease is likely to be related with the dynamic interactions established between microorganisms within the microbial community and with the host. If this is the case, management of CF will only be successful upon suitable and exhaustive modulation of such mixed ecological processes, which will also be useful to predict the effects of new therapeutic interventions.
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Affiliation(s)
- Susana P Lopes
- IBB-CEB, Institute for Biotechnology and Bioengineering, Centre of Biological Engineering, University of Minho, Campus de Gualtar , Braga , Portugal and
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36
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Baldan R, Cigana C, Testa F, Bianconi I, De Simone M, Pellin D, Di Serio C, Bragonzi A, Cirillo DM. Adaptation of Pseudomonas aeruginosa in Cystic Fibrosis airways influences virulence of Staphylococcus aureus in vitro and murine models of co-infection. PLoS One 2014; 9:e89614. [PMID: 24603807 PMCID: PMC3945726 DOI: 10.1371/journal.pone.0089614] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 01/23/2014] [Indexed: 12/18/2022] Open
Abstract
Cystic fibrosis (CF) airways disease represents an example of polymicrobial infection whereby different bacterial species can interact and influence each other. In CF patients Staphylococcus aureus is often the initial pathogen colonizing the lungs during childhood, while Pseudomonas aeruginosa is the predominant pathogen isolated in adolescents and adults. During chronic infection, P. aeruginosa undergoes adaptation to cope with antimicrobial therapy, host response and co-infecting pathogens. However, S. aureus and P. aeruginosa often co-exist in the same niche influencing the CF pathogenesis. The goal of this study was to investigate the reciprocal interaction of P. aeruginosa and S. aureus and understand the influence of P. aeruginosa adaptation to the CF lung in order to gain important insight on the interplay occurring between the two main pathogens of CF airways, which is still largely unknown. P. aeruginosa reference strains and eight lineages of clinical strains, including early and late clonal isolates from different patients with CF, were tested for growth inhibition of S. aureus. Next, P. aeruginosa/S. aureus competition was investigated in planktonic co-culture, biofilm, and mouse pneumonia model. P. aeruginosa reference and early strains, isolated at the onset of chronic infection, outcompeted S. aureus in vitro and in vivo models of co-infection. On the contrary, our results indicated a reduced capacity to outcompete S. aureus of P. aeruginosa patho-adaptive strains, isolated after several years of chronic infection and carrying several phenotypic changes temporally associated with CF lung adaptation. Our findings provide relevant information with respect to interspecies interaction and disease progression in CF.
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Affiliation(s)
- Rossella Baldan
- Emerging Bacterial Pathogens Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Cristina Cigana
- Infection and Cystic Fibrosis Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Francesca Testa
- Emerging Bacterial Pathogens Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Irene Bianconi
- Infection and Cystic Fibrosis Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Maura De Simone
- Infection and Cystic Fibrosis Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Danilo Pellin
- University Centre for Statistics in the Biomedical Sciences, Università Vita-Salute San Raffaele, Milan, Italy
| | - Clelia Di Serio
- University Centre for Statistics in the Biomedical Sciences, Università Vita-Salute San Raffaele, Milan, Italy
| | - Alessandra Bragonzi
- Infection and Cystic Fibrosis Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Daniela M. Cirillo
- Emerging Bacterial Pathogens Unit, San Raffaele Scientific Institute, Milan, Italy
- * E-mail:
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37
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Wu X, Hurdle JG. The Membrane as a Novel Target Site for Antibiotics to Kill Persisting Bacterial Pathogens. Antibiotics (Basel) 2013. [DOI: 10.1002/9783527659685.ch8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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38
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Diversity of patients microflora on orthopaedic and dental implants. Int J Artif Organs 2013; 35:727-34. [PMID: 23138700 DOI: 10.5301/ijao.5000144] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2012] [Indexed: 01/10/2023]
Abstract
The aim of this study was to compare the diversity of microbial colonization on implant material from different individuals. Eubacterial DNA was extracted, separated and sequenced from orthopaedic metallic implant material, tissues or body fluids, and skin of 4 patients as well as from identical dental cement material from 10 individuals after revision and routine removal. Additionally, the composition of the bacterial population of the dental cement and the oral swab sample from one individual after direct extraction of bacterial DNA was compared to extraction after conventional microbiological enrichment. The latter investigation proved that the commonly used cultivation technique gave different results than direct extraction of DNA, especially as regards the detection of anaerobes. Comparing the bacterial colonization of implant materials from different patients showed significant individual diversity. The common focus on a constricted pathogen spectrum may have to be expanded toward a multispecies population. Moreover, the dependence of the bacterial population on the individual host has to be integrated in discussing implant colonization and infection.
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39
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Group A streptococcus colonies from a single throat swab can have heterogeneous antimicrobial susceptibility patterns. Pediatr Infect Dis J 2013; 32:296-8. [PMID: 23249905 DOI: 10.1097/inf.0b013e31827c9796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study describes for the first time heterogeneity of antibiotic resistance profiles among group A Streptococcus isolates originating from a single throat swab in patients with acute pharyngitis. For each throat swab, 10 group A Streptococcus colonies were randomly selected from the primary plate and subcultured to a secondary plate. These isolates were characterized by various phenotypic and genotypic methods. Our results demonstrated that differing antibiotic resistance profiles were present in 19% of pediatric patients with acute pharyngitis before antimicrobial treatment. This heterogeneity likely resulted from horizontal gene transfer among streptococcal isolates sharing the same genetic background. As only a minority of colonies displayed antibiotic resistance among these heterogeneous samples, a classical diagnostic antibiogram would have classified them in most instances as "susceptible," although therapeutic failure could be caused by the proliferation of resistant strains after initiation of antibiotic treatment.
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Bragonzi A, Farulla I, Paroni M, Twomey KB, Pirone L, Lorè NI, Bianconi I, Dalmastri C, Ryan RP, Bevivino A. Modelling co-infection of the cystic fibrosis lung by Pseudomonas aeruginosa and Burkholderia cenocepacia reveals influences on biofilm formation and host response. PLoS One 2012; 7:e52330. [PMID: 23284990 PMCID: PMC3528780 DOI: 10.1371/journal.pone.0052330] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 11/12/2012] [Indexed: 02/07/2023] Open
Abstract
The Gram-negative bacteria Pseudomonas aeruginosa and Burkholderia cenocepacia are opportunistic human pathogens that are responsible for severe nosocomial infections in immunocompromised patients and those suffering from cystic fibrosis (CF). These two bacteria have been shown to form biofilms in the airways of CF patients that make such infections more difficult to treat. Only recently have scientists begun to appreciate the complicated interplay between microorganisms during polymicrobial infection of the CF airway and the implications they may have for disease prognosis and response to therapy. To gain insight into the possible role that interaction between strains of P. aeruginosa and B. cenocepacia may play during infection, we characterised co-inoculations of in vivo and in vitro infection models. Co-inoculations were examined in an in vitro biofilm model and in a murine model of chronic infection. Assessment of biofilm formation showed that B. cenocepacia positively influenced P. aeruginosa biofilm development by increasing biomass. Interestingly, co-infection experiments in the mouse model revealed that P. aeruginosa did not change its ability to establish chronic infection in the presence of B. cenocepacia but co-infection did appear to increase host inflammatory response. Taken together, these results indicate that the co-infection of P. aeruginosa and B. cenocepacia leads to increased biofilm formation and increased host inflammatory response in the mouse model of chronic infection. These observations suggest that alteration of bacterial behavior due to interspecies interactions may be important for disease progression and persistent infection.
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Affiliation(s)
- Alessandra Bragonzi
- Division of Immunology, Transplantation and Infectious Diseases, Infections and Cystic Fibrosis Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Ilaria Farulla
- Technical Unit for Sustainable Development and Innovation of Agro-Industrial System, ENEA Casaccia Research Centre, Rome, Italy
| | - Moira Paroni
- Division of Immunology, Transplantation and Infectious Diseases, Infections and Cystic Fibrosis Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Kate B. Twomey
- Department of Microbiology, BioSciences Institute, University College Cork, Cork, Ireland
| | - Luisa Pirone
- Technical Unit for Sustainable Development and Innovation of Agro-Industrial System, ENEA Casaccia Research Centre, Rome, Italy
| | - Nicola Ivan Lorè
- Division of Immunology, Transplantation and Infectious Diseases, Infections and Cystic Fibrosis Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Irene Bianconi
- Division of Immunology, Transplantation and Infectious Diseases, Infections and Cystic Fibrosis Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Claudia Dalmastri
- Technical Unit for Sustainable Development and Innovation of Agro-Industrial System, ENEA Casaccia Research Centre, Rome, Italy
| | - Robert P. Ryan
- Department of Microbiology, BioSciences Institute, University College Cork, Cork, Ireland
| | - Annamaria Bevivino
- Technical Unit for Sustainable Development and Innovation of Agro-Industrial System, ENEA Casaccia Research Centre, Rome, Italy
- * E-mail:
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Hunter RC, Klepac-Ceraj V, Lorenzi MM, Grotzinger H, Martin TR, Newman DK. Phenazine Content in the Cystic Fibrosis Respiratory Tract Negatively Correlates with Lung Function and Microbial Complexity. Am J Respir Cell Mol Biol 2012; 47:738-45. [DOI: 10.1165/rcmb.2012-0088oc] [Citation(s) in RCA: 140] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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42
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Bissonnette L, Bergeron MG. Multiparametric technologies for the diagnosis of syndromic infections. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.clinmicnews.2012.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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43
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Immune modulation by group B Streptococcus influences host susceptibility to urinary tract infection by uropathogenic Escherichia coli. Infect Immun 2012; 80:4186-94. [PMID: 22988014 DOI: 10.1128/iai.00684-12] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Urinary tract infection (UTI) is most often caused by uropathogenic Escherichia coli (UPEC). UPEC inoculation into the female urinary tract (UT) can occur through physical activities that expose the UT to an inherently polymicrobial periurethral, vaginal, or gastrointestinal flora. We report that a common urogenital inhabitant and opportunistic pathogen, group B Streptococcus (GBS), when present at the time of UPEC exposure, undergoes rapid UPEC-dependent exclusion from the murine urinary tract, yet it influences acute UPEC-host interactions and alters host susceptibility to persistent outcomes of bladder and kidney infection. GBS presence results in increased UPEC titers in the bladder lumen during acute infection and reduced inflammatory responses of murine macrophages to live UPEC or purified lipopolysaccharide (LPS), phenotypes that require GBS mimicry of host sialic acid residues. Taken together, these studies suggest that despite low titers, the presence of GBS at the time of polymicrobial UT exposure may be an overlooked risk factor for chronic pyelonephritis and recurrent UTI in susceptible groups, even if it is outcompeted and thus absent by the time of diagnosis.
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Lutz L, Pereira DC, Paiva RM, Zavascki AP, Barth AL. Macrolides decrease the minimal inhibitory concentration of anti-pseudomonal agents against Pseudomonas aeruginosa from cystic fibrosis patients in biofilm. BMC Microbiol 2012; 12:196. [PMID: 22958421 PMCID: PMC3485169 DOI: 10.1186/1471-2180-12-196] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 08/31/2012] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Biofilm production is an important mechanism for bacterial survival and its association with antimicrobial resistance represents a challenge for the patient treatment. In this study we evaluated the in vitro action of macrolides in combination with anti-pseudomonal agents on biofilm-grown Pseudomonas aeruginosa recovered from cystic fibrosis (CF) patients. RESULTS A total of 64 isolates were analysed. The biofilm inhibitory concentration (BIC) results were consistently higher than those obtained by the conventional method, minimal inhibitory concentration, (MIC) for most anti-pseudomonal agents tested (ceftazidime: P = 0.001, tobramycin: P = 0.001, imipenem: P < 0.001, meropenem: P = 0.005). When macrolides were associated with the anti-pseudomonal agents, the BIC values were reduced significantly for ceftazidime (P < 0.001) and tobramycin (P < 0.001), regardless the concentration of macrolides. Strong inhibitory quotient was observed when azithromycin at 8 mg/L was associated with all anti-pseudomonal agents tested in biofilm conditions. CONCLUSIONS P. aeruginosa from CF patients within biofilms are highly resistant to antibiotics but macrolides proved to augment the in vitro activity of anti-pseudomonal agents.
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Affiliation(s)
- Larissa Lutz
- Unidade de Microbiologia, Serviço de Patologia Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Dariane Castro Pereira
- Unidade de Microbiologia, Serviço de Patologia Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Rodrigo Minuto Paiva
- Unidade de Biologia Molecular, Serviço de Patologia Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Afonso Luis Barth
- Serviço de Patologia Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Lossi NS, Manoli E, Simpson P, Jones C, Hui K, Dajani R, Coulthurst SJ, Freemont P, Filloux A. The archetypePseudomonas aeruginosaproteins TssB and TagJ form a novel subcomplex in the bacterial type VI secretion system. Mol Microbiol 2012; 86:437-56. [DOI: 10.1111/j.1365-2958.2012.08204.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2012] [Indexed: 12/25/2022]
Affiliation(s)
- Nadine S. Lossi
- MRC Centre for Molecular Bacteriology and Infection (CMBI); Division of Cell and Molecular Biology; Imperial College London; London; SW7 2AZ; UK
| | - Eleni Manoli
- MRC Centre for Molecular Bacteriology and Infection (CMBI); Division of Cell and Molecular Biology; Imperial College London; London; SW7 2AZ; UK
| | - Pete Simpson
- Division of Molecular Biosciences; Imperial College London; London; SW7 2AZ; UK
| | - Cerith Jones
- MRC Centre for Molecular Bacteriology and Infection (CMBI); Division of Cell and Molecular Biology; Imperial College London; London; SW7 2AZ; UK
| | - Kailyn Hui
- MRC Centre for Molecular Bacteriology and Infection (CMBI); Division of Cell and Molecular Biology; Imperial College London; London; SW7 2AZ; UK
| | - Rana Dajani
- MRC Centre for Molecular Bacteriology and Infection (CMBI); Division of Cell and Molecular Biology; Imperial College London; London; SW7 2AZ; UK
| | - Sarah J. Coulthurst
- Division of Molecular Microbiology; College of Life Sciences; University of Dundee; Dow Street; Dundee; DD1 5EH; UK
| | - Paul Freemont
- Division of Molecular Biosciences; Imperial College London; London; SW7 2AZ; UK
| | - Alain Filloux
- MRC Centre for Molecular Bacteriology and Infection (CMBI); Division of Cell and Molecular Biology; Imperial College London; London; SW7 2AZ; UK
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Rogers GB, Carroll MP, Bruce KD. Enhancing the utility of existing antibiotics by targeting bacterial behaviour? Br J Pharmacol 2012; 165:845-57. [PMID: 21864314 DOI: 10.1111/j.1476-5381.2011.01643.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The discovery of novel classes of antibiotics has slowed dramatically. This has occurred during a time when the appearance of resistant strains of bacteria has shown a substantial increase. Concern is therefore mounting over our ability to continue to treat infections in an effective manner using the antibiotics that are currently available. While ongoing efforts to discover new antibiotics are important, these must be coupled with strategies that aim to maintain as far as possible the spectrum of activity of existing antibiotics. In many instances, the resistance to antibiotics exhibited by bacteria in chronic infections is mediated not by direct resistance mechanisms, but by the adoption of modes of growth that confer reduced susceptibility. These include the formation of biofilms and the occurrence of subpopulations of 'persister' cells. As our understanding of these processes has increased, a number of new potential drug targets have been revealed. Here, advances in our ability to disrupt these systems that confer reduced susceptibility, and in turn increase the efficacy of antibiotic therapy, are discussed.
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Affiliation(s)
- Geraint B Rogers
- Molecular Microbiology Research Laboratory, Institute of Pharmaceutical Sciences, King's College London, London, UK.
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47
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Bissonnette L, Bergeron MG. Infectious Disease Management through Point-of-Care Personalized Medicine Molecular Diagnostic Technologies. J Pers Med 2012; 2:50-70. [PMID: 25562799 PMCID: PMC4251365 DOI: 10.3390/jpm2020050] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 04/13/2012] [Accepted: 04/28/2012] [Indexed: 12/13/2022] Open
Abstract
Infectious disease management essentially consists in identifying the microbial cause(s) of an infection, initiating if necessary antimicrobial therapy against microbes, and controlling host reactions to infection. In clinical microbiology, the turnaround time of the diagnostic cycle (>24 hours) often leads to unnecessary suffering and deaths; approaches to relieve this burden include rapid diagnostic procedures and more efficient transmission or interpretation of molecular microbiology results. Although rapid nucleic acid-based diagnostic testing has demonstrated that it can impact on the transmission of hospital-acquired infections, we believe that such life-saving procedures should be performed closer to the patient, in dedicated 24/7 laboratories of healthcare institutions, or ideally at point of care. While personalized medicine generally aims at interrogating the genomic information of a patient, drug metabolism polymorphisms, for example, to guide drug choice and dosage, personalized medicine concepts are applicable in infectious diseases for the (rapid) identification of a disease-causing microbe and determination of its antimicrobial resistance profile, to guide an appropriate antimicrobial treatment for the proper management of the patient. The implementation of point-of-care testing for infectious diseases will require acceptance by medical authorities, new technological and communication platforms, as well as reimbursement practices such that time- and life-saving procedures become available to the largest number of patients.
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Affiliation(s)
- Luc Bissonnette
- Département de microbiologie-infectiologie et d'immunologie, Faculté de médecine, Université Laval, Centre de recherche du CHUQ, 2705 Laurier blvd., Québec City (Québec), G1V 4G2, Canada.
| | - Michel G Bergeron
- Département de microbiologie-infectiologie et d'immunologie, Faculté de médecine, Université Laval, Centre de recherche du CHUQ, 2705 Laurier blvd., Québec City (Québec), G1V 4G2, Canada.
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Abstract
Cystic fibrosis (CF) is an inherited chronic disease that remains a common cause of morbidity and mortality in affected patients, mostly in the young. A wealth of knowledge has been gained into the genetics, pathophysiology, and clinical manifestation of the disease. In parallel with these new insights into the disease, novel treatments have been developed or are under development that have had a major impact on quality of life and survival. Improvement in the delivery of care to patients in CF centers, using a team-based approach, and constant review of process, and by quality improvement projects, have also had an impact on outcomes in CF.
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Affiliation(s)
- Jason Lobo
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of North Carolina, Chapel Hill, 27599-7020, USA
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A quantitative analysis of Ureaplasma urealyticum and Ureaplasma parvum compared with host immune response in preterm neonates at risk of developing bronchopulmonary dysplasia. J Clin Microbiol 2011; 50:909-14. [PMID: 22189123 DOI: 10.1128/jcm.06625-11] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Multiplex, real-time PCR for the identification of Ureaplasma urealyticum and Ureaplasma parvum was performed on nucleic acids extracted from sequential endotracheal aspirates obtained from preterm neonates born at <29 weeks of gestation and ventilated for more than 48 h admitted to two level 3 neonatal intensive care units. Specimens were obtained shortly after birth and sequentially up until extubation. One hundred fifty-two specimens (93.8%) contained material suitable for analysis. Ureaplasma spp. were identified in 5 of 13 neonates studied. In most cases, the DNA load of the detected Ureaplasma species was low and decreased over time. In addition, changes in detectable Ureaplasma species DNA did not relate to changes in the inflammatory marker C-reactive protein (CRP) or respiratory status. All but two blood samples obtained at times of suspected sepsis were culture positive for other microorganisms; the species cultured were typically coagulase-negative staphylococci and were associated with increased levels of CRP (>10 mg/liter). This study was limited by the small number of patients examined and does not have the power to support or contradict the hypothesis that postnatal lung infection with Ureaplasma parvum is causally related to bronchopulmonary dysplasia (BPD) or adverse respiratory outcomes after preterm birth. However, in this study, increases in CRP levels were not associated with patients in whom Ureaplasma parvum was detected, in contrast to the detection of other bacterial species.
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50
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Twomey KB, O'Connell OJ, McCarthy Y, Dow JM, O'Toole GA, Plant BJ, Ryan RP. Bacterial cis-2-unsaturated fatty acids found in the cystic fibrosis airway modulate virulence and persistence of Pseudomonas aeruginosa. ISME JOURNAL 2011; 6:939-50. [PMID: 22134647 DOI: 10.1038/ismej.2011.167] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is an increasing appreciation of the polymicrobial nature of many bacterial infections such as those associated with cystic fibrosis (CF) and of the potentially important role for interspecies interactions in influencing both bacterial virulence and response to therapy. Patients with CF are often co-infected with Pseudomonas aeruginosa and other pathogens including Burkholderia cenocepacia and Stenotrophomonas maltophilia. These latter bacteria produce signal molecules of the diffusible signal factor (DSF) family, which are cis-2-unsaturated fatty acids. We have previously shown by in vitro studies that DSF from S. maltophilia leads to altered biofilm formation and increased resistance to antibiotics by P. aeruginosa; these responses of P. aeruginosa require the sensor kinase PA1396. Here we show that DSF signals are present in sputum taken from patients with CF. Presence of these DSF signals was correlated with patient colonization by S. maltophilia and/or B. cenocepacia. Analysis of 50 clinical isolates of P. aeruginosa showed that each responded to the presence of synthetic DSF by increased antibiotic resistance and these strains demonstrated little sequence variation in the PA1396 gene. In animal experiments using CF transmembrane conductance regulator knockout mice, the presence of DSF promoted P. aeruginosa persistence. Furthermore, antibiotic resistance of P. aeruginosa biofilms grown on human airway epithelial cells was enhanced in the presence of DSF. Taken together, these data provide substantial evidence that interspecies DSF-mediated bacterial interactions occur in the CF lung and may influence the efficacy of antibiotic treatment, particularly for chronic infections involving persistence of bacteria.
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Affiliation(s)
- Kate B Twomey
- BIOMERIT Research Centre, Department of Microbiology, Biosciences Institute, University College Cork, Cork, Ireland
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