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Fernández-Barat L, López-Aladid R, Vázquez N, Cabrera R, Vila J, Ferrer M, Torres A. Bacterial Adaptive Memory in Methicillin-Resistant Staphylococcus aureus from Endotracheal Tubes. Pathogens 2024; 13:144. [PMID: 38392882 PMCID: PMC10892081 DOI: 10.3390/pathogens13020144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/25/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024] Open
Abstract
OBJECTIVES To evaluate the expression dynamics of biofilm genes in methicillin-resistant Staphylococcus aureus (MRSA) retrieved from endotracheal tubes (ETT) and to determine how gene regulation is attenuated in vitro where host-environmental factors are no longer present. METHODS Biofilm was grown (24 h) in tryptic broth soy plus 0.25% glucose for a clinical MRSA isolate in planktonic state and after sessile growth named ETT-MRSA (S2, S3, S4, S5, S6, S7). Gene expression of five biofilm-related genes (icaC, clfB, ebps, fnbB, and RNA III) was assessed consecutively from day 1 to day 4 after ETT growth through real-time PCR. 16S rRNA was used as a control. RESULTS The MRSA isolates retrieved from ETT were capable of producing biofilms dependent on ica. The gene expression dynamics of ETT-MRSA changed progressively compared to planktonic MRSA gene expression under both ambient air (p < 0.001) and ambient air with 5% CO2 (p < 0.001). Dynamic assessment of icaC expression in both atmospheric conditions showed progressive downregulation in vitro compared to in vivo ETT biofilms. The expression patterns of clfB and ebps genes were similar to icaC. In contrast, the expression of the RNA III gene showed progressive upregulation from day 1 to day 4 (p < 0.001). CONCLUSIONS MRSA loses its biofilm gene expression in vitro, by adaptive features across multiple generations, as evidenced by the progressive downregulation of icaC and upregulation of RNA III. These findings underscore the significance of host-environment dependence in regulating bacterial biofilm genes, highlighting its importance in diagnostics. Bacterial strains lose their host-specific characteristics as they are cultured in vitro.
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Affiliation(s)
- Laia Fernández-Barat
- Centro de Investigación Biomedica En Red-Enfermedades Respiratorias (CibeRes, CB06/06/0028) and Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (R.L.-A.); (N.V.); (R.C.); (M.F.)
- University of Barcelona, 08193 Barcelona, Spain;
| | - Ruben López-Aladid
- Centro de Investigación Biomedica En Red-Enfermedades Respiratorias (CibeRes, CB06/06/0028) and Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (R.L.-A.); (N.V.); (R.C.); (M.F.)
- University of Barcelona, 08193 Barcelona, Spain;
| | - Nil Vázquez
- Centro de Investigación Biomedica En Red-Enfermedades Respiratorias (CibeRes, CB06/06/0028) and Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (R.L.-A.); (N.V.); (R.C.); (M.F.)
- University of Barcelona, 08193 Barcelona, Spain;
| | - Roberto Cabrera
- Centro de Investigación Biomedica En Red-Enfermedades Respiratorias (CibeRes, CB06/06/0028) and Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (R.L.-A.); (N.V.); (R.C.); (M.F.)
- University of Barcelona, 08193 Barcelona, Spain;
| | - Jordi Vila
- University of Barcelona, 08193 Barcelona, Spain;
- Microbiology Service at Hospital Clinic and Institute of Global Health (ISGlobal), 08036 Barcelona, Spain
| | - Miquel Ferrer
- Centro de Investigación Biomedica En Red-Enfermedades Respiratorias (CibeRes, CB06/06/0028) and Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (R.L.-A.); (N.V.); (R.C.); (M.F.)
- University of Barcelona, 08193 Barcelona, Spain;
- Pulmonary and Critical Care Unit, Respiratory Institute, Hospital Clinic, 08036 Barcelona, Spain
| | - Antoni Torres
- Centro de Investigación Biomedica En Red-Enfermedades Respiratorias (CibeRes, CB06/06/0028) and Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (R.L.-A.); (N.V.); (R.C.); (M.F.)
- University of Barcelona, 08193 Barcelona, Spain;
- Pulmonary and Critical Care Unit, Respiratory Institute, Hospital Clinic, 08036 Barcelona, Spain
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Kiarostami K, Fernández-Barat L, Battaglini D, Motos A, Bueno-Freire L, Soler-Comas A, Bassi GL, Torres A. The efficacy of telavancin in comparison with linezolid on endotracheal tube biofilm in pigs with methicillin-resistant Staphylococcus aureus pneumonia. Int J Antimicrob Agents 2024; 63:107052. [PMID: 38072170 DOI: 10.1016/j.ijantimicag.2023.107052] [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: 02/21/2023] [Revised: 11/23/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND The effect of systemic treatment of ventilator-associated pneumonia (VAP) with telavancin, a semisynthetic lipoglycopeptide with good penetration in vitro biofilms, has not been tested in vivo during mechanical ventilation. This study examined the efficacy of telavancin compared with linezolid against endotracheal tube (ETT) biofilms in a porcine model of methicillin-resistant Staphylococcus aureus (MRSA) VAP. METHODS VAP was induced in 18 pigs by instilling 107 colony-forming units (CFU/mL) of an MRSA strain susceptible to telavancin and linezolid into each pulmonary lobe. Randomization into three groups was done at pneumonia diagnosis: control (IV glucose 0.5% solution q24); linezolid (10 mg/kg q12) and telavancin groups (22.5 mg/kg q24). After 72 h of MV, data regarding bronchoalveolar lavage (BAL), tracheal aspirate (TA), ETT MRSA biofilm load and thickness measured by scanning electron microscopy were obtained. RESULTS All 18 pigs completed the study. MRSA was isolated in 100% of ETTs from the control and linezolid groups and in 67% from the telavancin group. Telavancin treatment presented a lower MRSA load compared to the control and linezolid treatments (telavancin median [interquartile range (IQR)] = 1.94 [0.00-5.45], linezolid 3.99 [3.22-4.68] and control 4.93 [4.41-5.15], P = 0.236). Telavancin treatment also resulted in the lowest biofilm thickness according to the SEM (4.04 [2.09-6.00], P < 0.001). We found a positive correlation between ETT and BAL load (rho = 0.511, P = 0.045). CONCLUSIONS In our VAP model, systemic telavancin treatment reduced ETT MRSA occurrence, load, and biofilm thickness. Our findings may have a bearing on ICU patients' clinical outcomes.
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Affiliation(s)
- Kasra Kiarostami
- CELLEX research laboratories, CibeRes (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; School of Medicine Department of Medicine, University of Barcelona, Spain; Pulmonology Department, Hospital Clínic, Barcelona, Spain
| | - Laia Fernández-Barat
- CELLEX research laboratories, CibeRes (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; School of Medicine Department of Medicine, University of Barcelona, Spain; Pulmonology Department, Hospital Clínic, Barcelona, Spain.
| | - Denise Battaglini
- CELLEX research laboratories, CibeRes (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Pulmonology Department, Hospital Clínic, Barcelona, Spain; Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy; Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, Genoa, Italy
| | - Anna Motos
- CELLEX research laboratories, CibeRes (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; School of Medicine Department of Medicine, University of Barcelona, Spain; Pulmonology Department, Hospital Clínic, Barcelona, Spain; Institut Clínic Respiratori (ICR), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Leticia Bueno-Freire
- CELLEX research laboratories, CibeRes (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; School of Medicine Department of Medicine, University of Barcelona, Spain; Pulmonology Department, Hospital Clínic, Barcelona, Spain
| | - Alba Soler-Comas
- School of Medicine Department of Medicine, University of Barcelona, Spain; Pulmonology Department, Hospital Clínic, Barcelona, Spain
| | - Gianluigi Li Bassi
- CELLEX research laboratories, CibeRes (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia; Queensland University of Technology, Brisbane, Australia; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, 3015, Rotterdam, the Netherlands
| | - Antoni Torres
- CELLEX research laboratories, CibeRes (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; School of Medicine Department of Medicine, University of Barcelona, Spain; Pulmonology Department, Hospital Clínic, Barcelona, Spain; Institut Clínic Respiratori (ICR), Hospital Clínic de Barcelona, Barcelona, Spain.
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Pesset CM, Fonseca COD, Antunes M, Santos ALLD, Teixeira IM, Ferreira EDO, Penna B. Biofilm formation by Staphylococcus pseudintermedius on titanium implants. BIOFOULING 2024; 40:88-97. [PMID: 38407199 DOI: 10.1080/08927014.2024.2320721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 02/13/2024] [Indexed: 02/27/2024]
Abstract
Osteomyelitis often involves Staphylococcus spp. as the isolated genus in domestic animal cases. Implant-related infections, frequently associated with biofilm-forming microorganisms like staphylococci species, necessitate careful material selection. This study assessed biofilm formation by Staphylococcus pseudintermedius on titanium nuts used in veterinary orthopaedic surgery. Biofilm quantification employed safranin staining and spectrophotometric measurement, while bacterial counts were determined in colony-forming units (CFU). Scanning Electron Microscopy (SEM) evaluated the biofilm morphology on the surface of titanium nuts. All samples had CFU counts. Absorbance values that evidence biofilm formation were observed in seven of the eight samples tested. SEM images revealed robust bacterial colonization, and significant extracellular polymeric substance production, and the negative control displayed surface irregularities on the nut. Whole genome sequencing revealed accessory Gene Regulator (agr) type III in six samples, agr IV and agr II in two each. Genes encoding hlb, luk-S, luk-F, siet, se_int, and the icaADCB operon were identified in all sequenced samples. Other exfoliative toxins were absent. Biofilm formation by S. pseudintermedius was detected in all samples, indicating the susceptibility of orthopaedic titanium alloys to adhesion and biofilm formation by veterinary species. The biofilm formation capacity raises concerns about potential post-surgical complications and associated costs.
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Affiliation(s)
- Camilla Malcher Pesset
- Laboratory of Gram-Positive Cocci, Biomedical Institute, Federal Fluminense University, Niterói, Brazil
| | - Carolina O da Fonseca
- Laboratory of Gram-Positive Cocci, Biomedical Institute, Federal Fluminense University, Niterói, Brazil
| | - Milena Antunes
- Laboratory of Gram-Positive Cocci, Biomedical Institute, Federal Fluminense University, Niterói, Brazil
| | - Ana Luiza L Dos Santos
- Laboratory of Gram-Positive Cocci, Biomedical Institute, Federal Fluminense University, Niterói, Brazil
| | - Izabel Melo Teixeira
- Laboratory of Gram-Positive Cocci, Biomedical Institute, Federal Fluminense University, Niterói, Brazil
| | | | - Bruno Penna
- Laboratory of Gram-Positive Cocci, Biomedical Institute, Federal Fluminense University, Niterói, Brazil
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Fernández-Barat L, Vázquez Burgos N, Alcaraz V, Bueno-Freire L, López-Aladid R, Cabrera R, Gabarrús A, Palomeque A, Oscanoa P, Ceccato A, Motos A, Amaro R, Bernardi T, Provot C, Soler-Comas A, Muñoz L, Vila J, Torres A. The value of biofilm testing to guide antimicrobial stewardship in chronic respiratory diseases. Front Cell Infect Microbiol 2023; 13:1142274. [PMID: 37201119 PMCID: PMC10187140 DOI: 10.3389/fcimb.2023.1142274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 04/04/2023] [Indexed: 05/20/2023] Open
Abstract
Introduction Biofilm production is an important yet currently overlooked aspect of diagnostic microbiology that has implications for antimicrobial stewardship. In this study, we aimed to validate and identify additional applications of the BioFilm Ring Test® (BRT) for Pseudomonas aeruginosa (PA) isolates from patients with bronchiectasis (BE). Materials and methods Sputa were collected from BE patients who had at least one PA positive culture in the previous year. We processed the sputa to isolate both mucoid and non-mucoid PA, and determined their susceptibility pattern, mucA gene status, and presence of ciprofloxacin mutations in QRDR genes. The Biofilm production index (BPI) was obtained at 5 and 24 hours. Biofilms were imaged using Gram staining. Results We collected 69 PA isolates, including 33 mucoid and 36 non-mucoid. A BPI value below 14.75 at 5 hours predicted the mucoid PA phenotype with 64% sensitivity and 72% specificity. Conclusion Overall, our findings suggest that the fitness-cost associated with the mucoid phenotype or ciprofloxacin resistance is shown through a time-dependent BPI profile. The BRT has the potential to reveal biofilm features with clinical implications.
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Affiliation(s)
- Laia Fernández-Barat
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
- *Correspondence: Laia Fernández-Barat, ; Antoni Torres,
| | - Nil Vázquez Burgos
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Victoria Alcaraz
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Leticia Bueno-Freire
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Ruben López-Aladid
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Roberto Cabrera
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Albert Gabarrús
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Andrea Palomeque
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Patricia Oscanoa
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Adrian Ceccato
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Ana Motos
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Rosanel Amaro
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Thierry Bernardi
- BioFilm Pharma SAS, Lyon, France
- BioFilm Control SAS, Saint Beauzire, France
| | - Christian Provot
- BioFilm Pharma SAS, Lyon, France
- BioFilm Control SAS, Saint Beauzire, France
| | - Alba Soler-Comas
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Laura Muñoz
- Microbiology Service, Hospital Clinic, Barcelona, Spain
| | - Jordi Vila
- Microbiology Service, Hospital Clinic, Barcelona, Spain
| | - Antoni Torres
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
- *Correspondence: Laia Fernández-Barat, ; Antoni Torres,
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Endotracheal tube biofilm in critically ill patients during the COVID-19 pandemic : description of an underestimated microbiological compartment. Sci Rep 2022; 12:22389. [PMID: 36575298 PMCID: PMC9794690 DOI: 10.1038/s41598-022-26560-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 12/16/2022] [Indexed: 12/28/2022] Open
Abstract
Biofilm (BF) growth is believed to play a major role in the development of ventilator-associated pneumonia (VAP) in the intensive care unit. Despite concerted efforts to understand the potential implication of endotracheal tube (ETT)-BF dispersal, clinically relevant data are lacking to better characterize the impact of its mesostructure and microbiological singularity on the occurrence of VAP. We conducted a multicenter, retrospective observational study during the third wave of the COVID-19 pandemic, between March and May 2021. In total, 64 ETTs collected from 61 patients were included in the present BIOPAVIR study. Confocal microscopy acquisitions revealed two main morphological aspects of ETT-deposited BF: (1) a thin, continuous ribbon-shaped aspect, less likely monobacterial and predominantly associated with Enterobacter spp., Streptococcus pneumoniae or Viridans streptococci, and (2) a thicker, discontinuous, mushroom-shaped appearance, more likely characterized by the association of bacterial and fungal species in respiratory samples. The microbiological characterization of ETT-deposited BF found higher acquired resistance in more than 80% of analyzed BF phenotypes, compared to other colonization sites from the patient's environment. These findings reveal BF as a singular microbiological compartment, and are of added clinical value, with a view to future ETT-deposited BF-based antimicrobial stewardship in critically ill patients. Trial registration NCT04926493. Retrospectively registered 15 June 2021.
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Narendrakumar L, Ray A. Respiratory tract microbiome and pneumonia. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2022; 192:97-124. [DOI: 10.1016/bs.pmbts.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hollmann B, Perkins M, Chauhan VM, Aylott JW, Hardie KR. Fluorescent nanosensors reveal dynamic pH gradients during biofilm formation. NPJ Biofilms Microbiomes 2021; 7:50. [PMID: 34140515 PMCID: PMC8211749 DOI: 10.1038/s41522-021-00221-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 05/12/2021] [Indexed: 12/12/2022] Open
Abstract
Understanding the dynamic environmental microniches of biofilms will permit us to detect, manage and exploit these communities. The components and architecture of biofilms have been interrogated in depth; however, little is known about the environmental microniches present. This is primarily because of the absence of tools with the required measurement sensitivity and resolution to detect these changes. We describe the application of ratiometric fluorescent pH-sensitive nanosensors, as a tool, to observe physiological pH changes in biofilms in real time. Nanosensors comprised two pH-sensitive fluorophores covalently encapsulated with a reference pH-insensitive fluorophore in an inert polyacrylamide nanoparticle matrix. The nanosensors were used to analyse the real-time three-dimensional pH variation for two model biofilm formers: (i) opportunistic pathogen Pseudomonas aeruginosa and (ii) oral pathogen Streptococcus mutans. The detection of sugar metabolism in real time by nanosensors provides a potential application to identify therapeutic solutions to improve oral health.
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Affiliation(s)
- Birte Hollmann
- Biodiscovery Institute, School of Life Sciences, University Park, University of Nottingham, Nottingham, UK
- Advanced Materials & Healthcare Technologies, School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Mark Perkins
- Biodiscovery Institute, School of Life Sciences, University Park, University of Nottingham, Nottingham, UK
- Advanced Materials & Healthcare Technologies, School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Veeren M Chauhan
- Advanced Materials & Healthcare Technologies, School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Jonathan W Aylott
- Advanced Materials & Healthcare Technologies, School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Kim R Hardie
- Biodiscovery Institute, School of Life Sciences, University Park, University of Nottingham, Nottingham, UK.
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Tomlinson KL, Lung TWF, Dach F, Annavajhala MK, Gabryszewski SJ, Groves RA, Drikic M, Francoeur NJ, Sridhar SH, Smith ML, Khanal S, Britto CJ, Sebra R, Lewis I, Uhlemann AC, Kahl BC, Prince AS, Riquelme SA. Staphylococcus aureus induces an itaconate-dominated immunometabolic response that drives biofilm formation. Nat Commun 2021; 12:1399. [PMID: 33658521 PMCID: PMC7930111 DOI: 10.1038/s41467-021-21718-y] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 02/05/2021] [Indexed: 12/17/2022] Open
Abstract
Staphylococcus aureus is a prominent human pathogen that readily adapts to host immune defenses. Here, we show that, in contrast to Gram-negative pathogens, S. aureus induces a distinct airway immunometabolic response dominated by the release of the electrophilic metabolite, itaconate. The itaconate synthetic enzyme, IRG1, is activated by host mitochondrial stress, which is induced by staphylococcal glycolysis. Itaconate inhibits S. aureus glycolysis and selects for strains that re-direct carbon flux to fuel extracellular polysaccharide (EPS) synthesis and biofilm formation. Itaconate-adapted strains, as illustrated by S. aureus isolates from chronic airway infection, exhibit decreased glycolytic activity, high EPS production, and proficient biofilm formation even before itaconate stimulation. S. aureus thus adapts to the itaconate-dominated immunometabolic response by producing biofilms, which are associated with chronic infection of the human airway.
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Affiliation(s)
- Kira L Tomlinson
- Department of Pediatrics, Columbia University, New York, NY, 10032, USA
| | | | - Felix Dach
- Department of Pediatrics, Columbia University, New York, NY, 10032, USA
- Institute of Medical Microbiology Münster, University Hospital, Münster, 48149, Germany
| | | | | | - Ryan A Groves
- Department of Biological Sciences, University of Calgary, Calgary, T2N 1N4, Canada
| | - Marija Drikic
- Department of Biological Sciences, University of Calgary, Calgary, T2N 1N4, Canada
| | - Nancy J Francoeur
- Department of Genetics and Genomic Sciences, Mt. Sinai Icahn School of Medicine, New York, NY, 10029, USA
| | - Shwetha H Sridhar
- Department of Genetics and Genomic Sciences, Mt. Sinai Icahn School of Medicine, New York, NY, 10029, USA
| | - Melissa L Smith
- Department of Genetics and Genomic Sciences, Mt. Sinai Icahn School of Medicine, New York, NY, 10029, USA
| | - Sara Khanal
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, CT, 06520, USA
| | - Clemente J Britto
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, CT, 06520, USA
| | - Robert Sebra
- Department of Genetics and Genomic Sciences, Mt. Sinai Icahn School of Medicine, New York, NY, 10029, USA
| | - Ian Lewis
- Department of Biological Sciences, University of Calgary, Calgary, T2N 1N4, Canada
| | | | - Barbara C Kahl
- Institute of Medical Microbiology Münster, University Hospital, Münster, 48149, Germany
| | - Alice S Prince
- Department of Pediatrics, Columbia University, New York, NY, 10032, USA
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Akinduti AP, Osiyemi JA, Banjo TT, Ejilude O, El-Ashker M, Adeyemi AG, Obafemi YD, Isibor PO. Clonal diversity and spatial dissemination of multi-antibiotics resistant Staphylococcus aureus pathotypes in Southwest Nigeria. PLoS One 2021; 16:e0247013. [PMID: 33621256 PMCID: PMC7901740 DOI: 10.1371/journal.pone.0247013] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 01/30/2021] [Indexed: 11/19/2022] Open
Abstract
Spread of genetically diverse Staphylococcus aureus characterized with multi-antibiotic resistance and regulated by high level agr functionalities in several communities in southwest Nigeria was investigated and evaluated for infection control. Staphylococcus aureus pathotypes recovered from 256 cases including purulent pus from skin infections, soft tissue aspirates, wounds, otorrhea, eye, throat and endocervical infections were assayed for biofilm and antibiogram. Further genotyped with micro-array, mapped for geospatial distribution and evaluated for clonal diversity and functional accessory gene regulators (agr). Significant Staphylococci infection among the ages (OR:0.021, CI:0.545–1.914) and female gender with prevalence rate of MSSA (53.0%) and MRSA (1.5%) (OR:1.021, CI:0.374–1.785) were observed. More than 52.5% resistance rates to tetracycline and amoxicillin with significant median resistance were observed in all the infection cases (p = 0.001). Resistance rate of 78.8% at MIC50 32μg/ml and MIC90 128μg/ml to amoxicillin-clavulanate, and more than 40% resistance to ceftazidime, ciprofloxacin and tetracycline of MIC90 and MIC50 at 32 μg/ml were observed. Strains with multi-antibiotic resistance index above 0.83, high beta-lactamase and strong biofilm clustered into separate phylo-group. Heterogeneous t442 (wound and pus), t657 (wound), t091 (ear) and t657 (ear and wound) revealed high phylogenetic diversity. Only 4.6% pvl+ MSSA-CC1 agrI, pvl+ MSSA-CC5 (13.6%) and pvl+ MRSA-CC7 agrII (4.6%), expressed enterotoxin, leukocidins, proteases and resistance gene determinants. Livestock clonal types clustered with identified community-associated strains. Clonal dissemination of resistant pvl+ MSSA-CC1 and MRSA-CC5 encoding agr were predominant in several peri-urban communities where adequate geno-surveillance, population-target antimicrobial stewardship, extensive community structured infection control programs are needed to prevent further focal dissemination.
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Affiliation(s)
- Akinniyi Paul Akinduti
- Microbiology Unit, Department of Biological Sciences, Covenant University, Ota, Nigeria
- * E-mail:
| | | | | | - Oluwaseun Ejilude
- Microbiology Laboratory, Sacred Heart Hospital, Lantoro, Abeokuta, Nigeria
| | - Maged El-Ashker
- Department of Internal Medicine and Infectious Diseases, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
| | | | - Yemisi Dorcas Obafemi
- Microbiology Unit, Department of Biological Sciences, Covenant University, Ota, Nigeria
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10
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Lai CS, Ponnusamy Y, Lim GL, Ramanathan S. Antibacterial, antibiofilm and antibiotic-potentiating effects of a polyphenol-rich fraction of Dicranopteris linearis (Burm.f.) Underw. J Herb Med 2021. [DOI: 10.1016/j.hermed.2020.100419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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11
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Lee SW, Phillips KS, Gu H, Kazemzadeh-Narbat M, Ren D. How microbes read the map: Effects of implant topography on bacterial adhesion and biofilm formation. Biomaterials 2020; 268:120595. [PMID: 33360301 DOI: 10.1016/j.biomaterials.2020.120595] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 11/24/2020] [Accepted: 12/06/2020] [Indexed: 12/19/2022]
Abstract
Microbes have remarkable capabilities to attach to the surface of implanted medical devices and form biofilms that adversely impact device function and increase the risk of multidrug-resistant infections. The physicochemical properties of biomaterials have long been known to play an important role in biofilm formation. More recently, a series of discoveries in the natural world have stimulated great interest in the use of 3D surface topography to engineer antifouling materials that resist bacterial colonization. There is also increasing evidence that some medical device surface topographies, such as those designed for tissue integration, may unintentionally promote microbial attachment. Despite a number of reviews on surface topography and biofilm control, there is a missing link between how bacteria sense and respond to 3D surface topographies and the rational design of antifouling materials. Motivated by this gap, we present a review of how bacteria interact with surface topographies, and what can be learned from current laboratory studies of microbial adhesion and biofilm formation on specific topographic features and medical devices. We also address specific biocompatibility considerations and discuss how to improve the assessment of the anti-biofilm performance of topographic surfaces. We conclude that 3D surface topography, whether intended or unintended, is an important consideration in the rational design of safe medical devices. Future research on next-generation smart antifouling materials could benefit from a greater focus on translation to real-world applications.
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Affiliation(s)
- Sang Won Lee
- Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, NY, 13244, United States; Syracuse Biomaterials Institute, Syracuse University, Syracuse, NY, 13244, United States
| | - K Scott Phillips
- United States Food and Drug Administration, Office of Medical Products and Tobacco, Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Division of Biology, Chemistry, and Materials Science, Silver Spring, MD, 20993, United States.
| | - Huan Gu
- Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, NY, 13244, United States; Syracuse Biomaterials Institute, Syracuse University, Syracuse, NY, 13244, United States
| | - Mehdi Kazemzadeh-Narbat
- United States Food and Drug Administration, Office of Medical Products and Tobacco, Center for Devices and Radiological Health, Office of Product Evaluation and Quality, Office of Health Technology 6, Silver Spring, MD, 20993, United States; Musculoskeletal Clinical Regulatory Advisers (MCRA), Washington DC, 20001, United States
| | - Dacheng Ren
- Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, NY, 13244, United States; Syracuse Biomaterials Institute, Syracuse University, Syracuse, NY, 13244, United States; Department of Civil and Environmental Engineering, Syracuse University, Syracuse, NY, 13244, United States; Department of Biology, Syracuse University, Syracuse, NY, 13244, United States.
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12
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Hiebner DW, Barros C, Quinn L, Vitale S, Casey E. Surface functionalization-dependent localization and affinity of SiO 2 nanoparticles within the biofilm EPS matrix. Biofilm 2020; 2:100029. [PMID: 33447814 PMCID: PMC7798476 DOI: 10.1016/j.bioflm.2020.100029] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 05/21/2020] [Accepted: 05/28/2020] [Indexed: 11/30/2022] Open
Abstract
The contribution of the biofilm extracellular polymeric substance (EPS) matrix to reduced antimicrobial susceptibility in biofilms is widely recognised. As such, the direct targeting of the EPS matrix is a promising biofilm control strategy that allows for the disruption of the matrix, thereby allowing a subsequent increase in susceptibility to antimicrobial agents. To this end, surface-functionalized nanoparticles (NPs) have received considerable attention. However, the fundamental understanding of the interactions occurring between engineered NPs and the biofilm EPS matrix has not yet been fully elucidated. An insight into the underlying mechanisms involved when a NP interacts with the EPS matrix will aid in the design of more efficient NPs for biofilm control. Here we demonstrate the use of highly specific fluorescent probes in confocal laser scanning microscopy (CLSM) to illustrate the distribution of EPS macromolecules within the biofilm. Thereafter, a three-dimensional (3D) colocalization analysis was used to assess the affinity of differently functionalized silica NPs (SiNPs) and EPS macromolecules from Pseudomonas fluorescens biofilms. Results show that both the charge and surface functional groups of SiNPs dramatically affected the extent to which SiNPs interacted and localized with EPS macromolecules, including proteins, polysaccharides and DNA. Hypotheses are also presented about the possible physicochemical interactions which may be dominant in EPS matrix-NP interactions. This research not only develops an innovative CLSM-based methodology for elucidating biofilm-nanoparticle interactions but also provides a platform on which to build more efficient NP systems for biofilm control.
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Affiliation(s)
- Dishon Wayne Hiebner
- UCD School of Chemical and Bioprocess Engineering, University College Dublin, Belfield, Dublin 4, Dublin, Ireland
| | - Caio Barros
- UCD School of Chemical and Bioprocess Engineering, University College Dublin, Belfield, Dublin 4, Dublin, Ireland
| | - Laura Quinn
- UCD School of Chemical and Bioprocess Engineering, University College Dublin, Belfield, Dublin 4, Dublin, Ireland
| | - Stefania Vitale
- UCD School of Chemical and Bioprocess Engineering, University College Dublin, Belfield, Dublin 4, Dublin, Ireland
| | - Eoin Casey
- UCD School of Chemical and Bioprocess Engineering, University College Dublin, Belfield, Dublin 4, Dublin, Ireland
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13
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Fernández-Barat L, López-Aladid R, Torres A. Reconsidering ventilator-associated pneumonia from a new dimension of the lung microbiome. EBioMedicine 2020; 60:102995. [PMID: 32950001 PMCID: PMC7492164 DOI: 10.1016/j.ebiom.2020.102995] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/25/2020] [Accepted: 08/25/2020] [Indexed: 12/12/2022] Open
Abstract
Complex microbial communities that reside in the lungs, skin and gut are now appreciated for their role in maintaining organ, tissue and immune homoeostasis. As lungs are currently seen as an ecosystem, the shift in paradigm calls for the consideration of new algorithms related to lung ecology in pulmonology. Evidence of lung microbiota does not solely challenge the traditional physiopathology of ventilator-associated pneumonia (VAP); indeed, it also reinforces the need to include molecular techniques in VAP diagnosis and accelerate the use of immunomodulatory drugs, including corticosteroids, and other supplements such as probiotics for VAP prevention and/or treatment. With that stated, both microbiome and virome, including phageome, can lead to new opportunities in further understanding the relationship between health and dysbiosis in VAP. Previous knowledge may be, however, reconsidered at a microbiome scale.
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Affiliation(s)
- Laia Fernández-Barat
- Cellex Laboratory, CibeRes (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain; School of Medicine, University of Barcelona, Barcelona, Spain.
| | - Ruben López-Aladid
- Cellex Laboratory, CibeRes (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain
| | - Antoni Torres
- Cellex Laboratory, CibeRes (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain; School of Medicine, University of Barcelona, Barcelona, Spain; Department of Pneumology, Thorax Institute, Hospital Clinic of Barcelona, Spain.
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14
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Liu T, Luo J, Bi G, Du Z, Kong J, Chen Y. Antibacterial synergy between linezolid and baicalein against methicillin-resistant Staphylococcus aureus biofilm in vivo. Microb Pathog 2020; 147:104411. [PMID: 32745664 DOI: 10.1016/j.micpath.2020.104411] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 06/09/2020] [Accepted: 07/18/2020] [Indexed: 10/23/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) can form biofilms, which prevents the penetration of antibiotics, decreasing their efficacy. This study investigated whether baicalein has synergistic antibacterial effects with linezolid in vivo. We cultivated MRSA 17546 biofilms on silicone implants and inserted them into the air pouches of rat models. The rats were treated with linezolid, baicalein, or a combination therapy for three consecutive days. All treatments reduced the number of colony-forming units (CFU) in the biofilms compared to the control (p < 0.05). However, by day two, the CFU counts were significantly lower in the combination group than in the individual treatment groups (p < 0.05). Histological analysis of the air pouches showed that the severity of the inflammatory cell infiltration was severe in the combination therapy group. In the combination group, the biofilm structure on the implant's surface was sparse and more free colonies could be seen by scanning electron microscopy (SEM); by day three, no obvious biofilm was observed. The serum levels of Staphylococcus enterotoxin A (SEA), C-reactive protein (CRP), and procalcitonin (PCT) were the lowest in the group where rats were treated with the combination of baicalein and linezolid (p < 0.05) compared to other groups. The results suggest that baicalein may inhibit the accessory gene regulator system, reducing the expression of SEA, thus lowering CRP and PCT levels. Furthermore, the inhibitory effect was more pronounced when baicalein was combined with linezolid. These results provide an important basis for the development of a new combination regimen to treat patients with biofilm-associated MRSA infections.
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Affiliation(s)
- Tangjuan Liu
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, China
| | - Jing Luo
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, China
| | - Guan Bi
- Department of Intensive Care Unit, The Second Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, China
| | - Zhongye Du
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, China
| | - Jinliang Kong
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, China.
| | - Yiqiang Chen
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, China.
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15
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Treffon J, Fotiadis SA, van Alen S, Becker K, Kahl BC. The Virulence Potential of Livestock-Associated Methicillin-Resistant Staphylococcus aureus Cultured from the Airways of Cystic Fibrosis Patients. Toxins (Basel) 2020; 12:E360. [PMID: 32486247 PMCID: PMC7354617 DOI: 10.3390/toxins12060360] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/20/2020] [Accepted: 05/27/2020] [Indexed: 01/25/2023] Open
Abstract
Staphylococcus aureus is one of the most common pathogens that infects the airways of patients with cystic fibrosis (CF) and contributes to respiratory failure. Recently, livestock-associated methicillin-resistant S. aureus (LA-MRSA), usually cultured in farm animals, were detected in CF airways. Although some of these strains are able to establish severe infections in humans, there is limited knowledge about the role of LA-MRSA virulence in CF lung disease. To address this issue, we analyzed LA-MRSA, hospital-associated (HA-) MRSA and methicillin-susceptible S.aureus (MSSA) clinical isolates recovered early in the course of airway infection and several years after persistence in this hostile environment from pulmonary specimens of nine CF patients regarding important virulence traits such as their hemolytic activity, biofilm formation, invasion in airway epithelial cells, cytotoxicity, and antibiotic susceptibility. We detected that CF LA-MRSA isolates were resistant to tetracycline, more hemolytic and cytotoxic than HA-MRSA, and more invasive than MSSA. Despite the residence in the animal host, LA-MRSA still represent a serious threat to humans, as such clones possess a virulence potential similar or even higher than that of HA-MRSA. Furthermore, we confirmed that S. aureus individually adapts to the airways of CF patients, which eventually impedes the success of antistaphylococcal therapy of airway infections in CF.
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Affiliation(s)
- Janina Treffon
- Institute of Medical Microbiology, University Hospital Münster, 48149 Münster, Germany; (J.T.); (S.A.F.); (S.v.A.); (K.B.)
- Institute of Hygiene, University Hospital Münster, 48149 Münster, Germany
| | - Sarah Ann Fotiadis
- Institute of Medical Microbiology, University Hospital Münster, 48149 Münster, Germany; (J.T.); (S.A.F.); (S.v.A.); (K.B.)
| | - Sarah van Alen
- Institute of Medical Microbiology, University Hospital Münster, 48149 Münster, Germany; (J.T.); (S.A.F.); (S.v.A.); (K.B.)
- Business Unit Pain, Grünenthal GmbH, 52222 Stolberg, Germany
| | - Karsten Becker
- Institute of Medical Microbiology, University Hospital Münster, 48149 Münster, Germany; (J.T.); (S.A.F.); (S.v.A.); (K.B.)
- Friedrich Loeffler-Institute of Medical Microbiology, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Barbara C. Kahl
- Institute of Medical Microbiology, University Hospital Münster, 48149 Münster, Germany; (J.T.); (S.A.F.); (S.v.A.); (K.B.)
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16
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Biofilm Formation by Staphylococcus aureus Clinical Isolates is Differentially Affected by Glucose and Sodium Chloride Supplemented Culture Media. J Clin Med 2019; 8:jcm8111853. [PMID: 31684101 PMCID: PMC6912320 DOI: 10.3390/jcm8111853] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/25/2019] [Accepted: 10/29/2019] [Indexed: 12/17/2022] Open
Abstract
Staphylococcus aureus (S. aureus) causes persistent biofilm-related infections. Biofilm formation by S. aureus is affected by the culture conditions and is associated with certain genotypic characteristics. Here, we show that glucose and sodium chloride (NaCl) supplementation of culture media, a common practice in studies of biofilms in vitro, influences both biofilm formation by 40 S. aureus clinical isolates (methicillin-resistant and methicillin-sensitive S. aureus) and causes variations in biofilm quantification. Methicillin-resistant strains formed more robust biofilms than methicillin-sensitive strains in tryptic soy broth (TSB). However, glucose supplementation in TSB greatly promoted and stabilized biofilm formation of all strains, while additional NaCl was less efficient in this respect and resulted in significant variation in biofilm measurements. In addition, we observed that the ST239-SCCmec (Staphylococcal Cassette Chromosome mec) type III lineage formed strong biofilms in TSB supplemented with glucose and NaCl. Links between biofilm formation and accessory gene regulator (agr) status, as assessed by δ-toxin production, and with mannitol fermentation were not found. Our results show that TSB supplemented with 1.0% glucose supports robust biofilm production and reproducible quantification of S. aureus biofilm formation in vitro, whereas additional NaCl results in major variations in measurements of biofilm formation.
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17
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Fernández-Barat L, Motos A, Panigada M, Álvarez-Lerma F, Viña L, Lopez-Aladid R, Ceccato A, Bassi GL, Nicolau DP, Lopez Y, Muñoz L, Guerrero L, Soy D, Israel T, Castro P, Torres A. Comparative efficacy of linezolid and vancomycin for endotracheal tube MRSA biofilms from ICU patients. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2019; 23:251. [PMID: 31291978 PMCID: PMC6617612 DOI: 10.1186/s13054-019-2523-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 06/21/2019] [Indexed: 01/08/2023]
Abstract
PURPOSE To compare the efficacy of systemic treatment with linezolid (LNZ) versus vancomycin (VAN) on methicillin-resistant Staphylococcus aureus (MRSA) burden and eradication in endotracheal tube (ETT) biofilm and ETT cuff from orotracheally intubated patients with MRSA respiratory infection. METHODS Prospective observational clinical study was carried out at four European tertiary hospitals. Plasma and endotracheal aspirate (ETA) levels of LNZ and VAN were determined 72 h after treatment initiation through high-performance liquid chromatography or bioassay. LNZ or VAN concentration in the ETT biofilm and MRSA burden and eradication was determined upon extubation. The minimum inhibitory concentration (MIC) for LNZ and VAN was assessed by E-test strips (Biomerieux®). Scanning electron microscopy images were obtained, and ETT biofilm thickness was compared between groups. RESULTS Twenty-five patients, 15 treated with LNZ and 10 with VAN, were included in the study. LNZ presented a significantly higher concentration (μg/mL) than VAN in ETT biofilm (72.8 [1.3-127.1] vs 0.4 [0.4-1.3], p < 0.001), although both drugs achieved therapeutic plasma levels 72 h after treatment initiation. Systemic treatment with LNZ achieved lower ETT cuff MRSA burdens than systemic treatment with VAN. Indeed, LNZ increased the MRSA eradication rate in ETT cuff compared with VAN (LNZ 75%, VAN 20%, p = 0.031). CONCLUSIONS In ICU patients with MRSA respiratory infection intubated for long periods, systemic treatment with LNZ obtains a greater beneficial effect than VAN in limiting MRSA burden in ETT cuff.
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Affiliation(s)
- Laia Fernández-Barat
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain. .,Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain.
| | - Ana Motos
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain.,Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - Mauro Panigada
- Department of Anesthesiology, Intensive Care and Emergency, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Francisco Álvarez-Lerma
- Critical Care Department, Hospital del Mar, Critical Illness Research Group (GREPAC), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Lucía Viña
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Ruben Lopez-Aladid
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain.,Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - Adrian Ceccato
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain.,Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - Gianluigi Li Bassi
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain.,Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - David P Nicolau
- Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, CT, USA
| | - Yuli Lopez
- Microbiology Department, Hospital Clínic, CRESIB ISglobal, Barcelona, Spain
| | - Laura Muñoz
- Microbiology Department, Hospital Clínic, CRESIB ISglobal, Barcelona, Spain
| | - Laura Guerrero
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain
| | - Dolors Soy
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain.,Pharmacy Service, Division of Medicines, Hospital Clínic, Barcelona, Spain
| | - Trinidad Israel
- Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - Pedro Castro
- Medical Intensive Care Unit, Hospital Clínic, Barcelona, Spain
| | - Antoni Torres
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain. .,Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain.
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