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Zhang K, Limwongyut J, Moreland AS, Wei SCJ, Jim Jia Min T, Sun Y, Shin SJ, Kim SY, Jhun BW, Pethe K, Bazan GC. An anti-mycobacterial conjugated oligoelectrolyte effective against Mycobacterium abscessus. Sci Transl Med 2024; 16:eadi7558. [PMID: 38381846 DOI: 10.1126/scitranslmed.adi7558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 01/29/2024] [Indexed: 02/23/2024]
Abstract
Infections caused by nontuberculous mycobacteria have increased more than 50% in the past two decades and more than doubled in the elderly population. Mycobacterium abscessus (Mab), one of the most prevalent of these rapidly growing species, is intrinsically resistant to numerous antibiotics. Current standard-of-care treatments are not satisfactory, with high failure rate and notable adverse effects. We report here a potent anti-Mab compound from the flexible molecular framework afforded by conjugated oligoelectrolytes (COEs). A screen of structurally diverse, noncytotoxic COEs identified a lead compound, COE-PNH2, which was bactericidal against replicating, nonreplicating persisters and intracellular Mab.COE-PNH2 had low propensity for resistance development, with a frequency of resistance below 1.25 × 10-9 and showed no detectable resistance upon serial passaging. Mechanism of action studies were in line with COE-PNH2 affecting the physical and functional integrity of the bacterial envelope and disrupting the mycomembrane and associated essential bioenergetic pathways. Moreover, COE-PNH2 was well-tolerated and efficacious in a mouse model of Mab lung infection. This study highlights desirable in vitro and in vivo potency and safety index of this COE structure, which represents a promising anti-mycobacterial to tackle an unmet medical need.
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Affiliation(s)
- Kaixi Zhang
- Department of Chemistry, National University of Singapore, 4 Science Drive 2, 117543 Singapore, Singapore
| | - Jakkarin Limwongyut
- Department of Chemistry, National University of Singapore, 4 Science Drive 2, 117543 Singapore, Singapore
- Center for Polymers and Organic Solids, Department of Chemistry and Biochemistry, University of California, Santa Barbara, Santa Barbara, CA 93106, USA
| | - Alex S Moreland
- Center for Polymers and Organic Solids, Department of Chemistry and Biochemistry, University of California, Santa Barbara, Santa Barbara, CA 93106, USA
| | - Samuel Chan Jun Wei
- Department of Chemistry, National University of Singapore, 4 Science Drive 2, 117543 Singapore, Singapore
| | - Tania Jim Jia Min
- Department of Chemistry, National University of Singapore, 4 Science Drive 2, 117543 Singapore, Singapore
| | - Yan Sun
- Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive, 636921 Singapore, Singapore
| | - Sung Jae Shin
- Department of Microbiology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - Su-Young Kim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Byung Woo Jhun
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Kevin Pethe
- Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive, 636921 Singapore, Singapore
- Singapore Centre on Environmental Life Sciences Engineering (SCELSE), 60 Nanyang Drive, 639798 Singapore, Singapore
- National Centre for Infectious Diseases (NCID), 16 Jalan Tan Tock Seng, 308442 Singapore, Singapore
| | - Guillermo C Bazan
- Department of Chemistry, National University of Singapore, 4 Science Drive 2, 117543 Singapore, Singapore
- Center for Polymers and Organic Solids, Department of Chemistry and Biochemistry, University of California, Santa Barbara, Santa Barbara, CA 93106, USA
- Singapore Centre on Environmental Life Sciences Engineering (SCELSE), 60 Nanyang Drive, 639798 Singapore, Singapore
- Institute for Functional Intelligent Materials (I-FIM), National University of Singapore, 117544 Singapore, Singapore
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2
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Ulmann V, Modrá H, Babak V, Weston RT, Pavlik I. Recovery of Mycobacteria from Heavily Contaminated Environmental Matrices. Microorganisms 2021; 9:microorganisms9102178. [PMID: 34683499 PMCID: PMC8538195 DOI: 10.3390/microorganisms9102178] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 11/22/2022] Open
Abstract
For epidemiology studies, a decontamination method using a solution containing 4.0% NaOH and 0.5% tetradecyltrimethylammonium bromide (TDAB) represents a relatively simple and universal procedure for processing heavily microbially contaminated matrices together with increase of mycobacteria yield and elimination of gross contamination. A contamination rate only averaging 7.3% (2.4% in Cluster S; 6.9% in Cluster R and 12.6% in Cluster E) was found in 787 examined environmental samples. Mycobacteria were cultured from 28.5% of 274 soil and water sediments samples (Cluster S), 60.2% of 251 samples of raw and processed peat and other horticultural substrates (Cluster R), and 29.4% of 262 faecal samples along with other samples of animal origin (Cluster E). A total of 38 species of slow and rapidly growing mycobacteria were isolated. M. avium ssp. hominissuis, M. fortuitum and M. malmoense were the species most often isolated. The parameters for the quantitative detection of mycobacteria by PCR can be significantly refined by treating the sample suspension before DNA isolation with PMA (propidium monoazide) solution. This effectively eliminates DNA residue from both dead mycobacterial cells and potentially interfering DNA segments present from other microbial flora. In terms of human exposure risk assessment, the potential exposure to live non-tuberculous mycobacteria can be more accurately determined.
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Affiliation(s)
- Vit Ulmann
- Public Health Institute in Ostrava, Partyzanske Nam. 7, 702 00 Ostrava, Czech Republic;
| | - Helena Modrá
- Faculty of Regional Development and International Studies, Mendel University in Brno, Tr. Generala Piky 7, 613 00 Brno, Czech Republic;
| | - Vladimir Babak
- Veterinary Research Institute, v.v.i., Hudcova 70, 621 00 Brno, Czech Republic;
| | - Ross Tim Weston
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, Melbourne, VIC 3086, Australia;
| | - Ivo Pavlik
- Faculty of Regional Development and International Studies, Mendel University in Brno, Tr. Generala Piky 7, 613 00 Brno, Czech Republic;
- Correspondence: ; Tel.: +420-773-491-836
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3
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Singh K, Nooreyezdan S. Nonvascular Complications of Injectable Fillers-Prevention and Management. Indian J Plast Surg 2020; 53:335-343. [PMID: 33500603 PMCID: PMC7822713 DOI: 10.1055/s-0040-1721872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Injectable filler treatments have increased in popularity because of enhanced safety profile and improved physical characteristics. ISAPS (International Society of Plastic Surgery) put out global data showing 3.7 million hyaluronic acid (HA) filler procedures in 2018, making it the second most often performed procedure in the world, after botulinum toxin. And these are only ‘those’ performed by qualified plastic surgeons. There was a concomitant increase in both the nonvascular and vascular complications, which coincided with the number and type of filler procedures performed. Filler complications were reviewed from existing literature, and an attempt was made to understand etiology, elucidate clinical features, and clarify optimum treatment strategies for each. Complications can be early or delayed in presentation, early consisting of injection site complications like bruising, edema, and hypersensitivity, Tyndall effect, and intravascular injection. Delayed complications included hypersensitivity type IV, acute infections like cellulitis, abscesses, and herpes and delayed ones like granulomas, biofilms, and atypical mycobacterial infections. These were analyzed and treatment options, protocols, and consensus guidelines were suggested. A clear understanding of facial anatomy, physical characteristics of all fillers used, early recognition, and treatment options of complications will ensure optimum outcomes.
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Affiliation(s)
- Kuldeep Singh
- Department of Aesthetic, Plastic & Reconstructive Surgery, Indraprastha Apollo Hospital, New Delhi, India
| | - Shahin Nooreyezdan
- Department of Aesthetic, Plastic & Reconstructive Surgery, Indraprastha Apollo Hospital, New Delhi, India
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4
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de Carvalho CCCR, Teixeira R, Fernandes P. Mycobacterium vaccae Adaptation to Disinfectants and Hand Sanitisers, and Evaluation of Cross-Tolerance with Antimicrobials. Antibiotics (Basel) 2020; 9:antibiotics9090544. [PMID: 32867093 PMCID: PMC7559525 DOI: 10.3390/antibiotics9090544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/20/2020] [Accepted: 08/26/2020] [Indexed: 12/12/2022] Open
Abstract
Mycobacterium vaccae is being considered as an adjuvant to antituberculosis therapy, tested for the treatment of autoimmune diseases, and as an anti-depressive agent. This bacterium is ubiquitous in the environment and the widespread use of disinfectants and sanitisers may lead to its adaptation to these compounds. In the present study, M. vaccae cells adapted to these compounds mainly by making adjustments in their lipid composition and net surface charge. The modifications in the lipid composition led to changes in membrane permeability which resulted in increased tolerance towards levofloxacin, thioridazine, and omeprazole.
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Affiliation(s)
- Carla C. C. R. de Carvalho
- Department of Bioengineering, iBB–Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001 Lisbon, Portugal; (R.T.); (P.F.)
- Correspondence: ; Tel.: +351-21-841-9594
| | - Raquel Teixeira
- Department of Bioengineering, iBB–Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001 Lisbon, Portugal; (R.T.); (P.F.)
| | - Pedro Fernandes
- Department of Bioengineering, iBB–Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001 Lisbon, Portugal; (R.T.); (P.F.)
- DREAMS and Faculty of Engineering, Universidade Lusófona de Humanidades e Tecnologias, 1749-024 Lisbon, Portugal
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5
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Castellano Realpe OJ, Gutiérrez JC, Sierra DA, Pazmiño Martínez LA, Prado Palacios YY, Echeverría G, de Waard JH. Dental Unit Waterlines in Quito and Caracas Contaminated with Nontuberculous Mycobacteria: A Potential Health Risk in Dental Practice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2348. [PMID: 32244267 PMCID: PMC7177417 DOI: 10.3390/ijerph17072348] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/16/2020] [Accepted: 02/20/2020] [Indexed: 11/17/2022]
Abstract
Three cases of severe odontogenic infections due to nontuberculous mycobacteria (NTM) in Venezuela that were directly associated with dental procedures and the finding of dental unit waterlines (DUWLs) in dental offices that were colonized with mycobacteria species was the reason for assessing the water quality of DUWLs in dental offices in two capital cities in South America, namely, Quito and Caracas. The main water supplies and the water from 143 DUWLs in both cities were sampled and especially checked for contamination with NTM. To measure the overall bacteriological quality of the water also the presence of heterotrophic bacteria, coliform bacteria, and Pseudomonas was determined. Results showed that respectively 3% and 56% of the DUWLs in Quito and Caracas yielded NTM species (up to 1000 colony-forming units (CFU)/mL). Furthermore, high and unacceptable total viable counts of heterotrophic bacteria and/or coliform bacteria and Pseudomonas were detected in 73% of the samples. We conclude that, in both cities, the water in the majority of DUWLs was contaminated with NTM and other potential pathogens, presenting a risk to human health. The detection of NTM in DUWL water with acceptable heterotrophic bacteria counts shows the need to include NTM in water quality testing. Mycobacteria are more resistant to disinfection procedures than other types of vegetative bacteria, and most testing protocols for DUWLs do not assess mycobacteria and thus do not guarantee risk-free water.
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Affiliation(s)
| | - Johanna C. Gutiérrez
- Facultad de Medicina. Escuela de Bioanálisis, Universidad Central de Venezuela, 1053 Caracas, Venezuela
- Instituto de Biomedicina “Dr. Jacinto Convit”, Universidad Central de Venezuela, 1010 Caracas, Venezuela
| | - Deisy A. Sierra
- Facultad de Medicina. Escuela de Bioanálisis, Universidad Central de Venezuela, 1053 Caracas, Venezuela
- Instituto de Biomedicina “Dr. Jacinto Convit”, Universidad Central de Venezuela, 1010 Caracas, Venezuela
| | | | - Yrneh Y. Prado Palacios
- Instituto de Biomedicina “Dr. Jacinto Convit”, Universidad Central de Venezuela, 1010 Caracas, Venezuela
| | - Gustavo Echeverría
- Instituto de Investigación en Salud Pública y Zoonosis CIZ, Universidad Central del Ecuador, 170521 Quito, Ecuador
| | - Jacobus H. de Waard
- Instituto de Biomedicina “Dr. Jacinto Convit”, Universidad Central de Venezuela, 1010 Caracas, Venezuela
- One Health Research Group, Facultad de Ciencias de la Salud, Universidad De Las Américas, 170504 Quito, Ecuador
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6
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Baker AW, Lewis SS, Alexander BD, Chen LF, Wallace RJ, Brown-Elliott BA, Isaacs PJ, Pickett LC, Patel CB, Smith PK, Reynolds JM, Engel J, Wolfe CR, Milano CA, Schroder JN, Davis RD, Hartwig MG, Stout JE, Strittholt N, Maziarz EK, Saullo JH, Hazen KC, Walczak RJ, Vasireddy R, Vasireddy S, McKnight CM, Anderson DJ, Sexton DJ. Two-Phase Hospital-Associated Outbreak of Mycobacterium abscessus: Investigation and Mitigation. Clin Infect Dis 2017; 64:902-911. [PMID: 28077517 DOI: 10.1093/cid/ciw877] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 01/03/2017] [Indexed: 12/17/2022] Open
Abstract
Background Nontuberculous mycobacteria (NTM) commonly colonize municipal water supplies and cause healthcare-associated outbreaks. We investigated a biphasic outbreak of Mycobacterium abscessus at a tertiary care hospital. Methods Case patients had recent hospital exposure and laboratory-confirmed colonization or infection with M. abscessus from January 2013 through December 2015. We conducted a multidisciplinary epidemiologic, field, and laboratory investigation. Results The incidence rate of M. abscessus increased from 0.7 cases per 10000 patient-days during the baseline period (January 2013-July 2013) to 3.0 cases per 10000 patient-days during phase 1 of the outbreak (August 2013-May 2014) (incidence rate ratio, 4.6 [95% confidence interval, 2.3-8.8]; P < .001). Thirty-six of 71 (51%) phase 1 cases were lung transplant patients with positive respiratory cultures. We eliminated tap water exposure to the aerodigestive tract among high-risk patients, and the incidence rate decreased to baseline. Twelve of 24 (50%) phase 2 (December 2014-June 2015) cases occurred in cardiac surgery patients with invasive infections. Phase 2 resolved after we implemented an intensified disinfection protocol and used sterile water for heater-cooler units of cardiopulmonary bypass machines. Molecular fingerprinting of clinical isolates identified 2 clonal strains of M. abscessus; 1 clone was isolated from water sources at a new hospital addition. We made several water engineering interventions to improve water flow and increase disinfectant levels. Conclusions We investigated and mitigated a 2-phase clonal outbreak of M. abscessus linked to hospital tap water. Healthcare facilities with endemic NTM should consider similar tap water avoidance and engineering strategies to decrease risk of NTM infection.
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Affiliation(s)
- Arthur W Baker
- Duke Program for Infection Prevention and Healthcare Epidemiology, Duke University Hospital, Durham, North Carolina.,Division of Infectious Diseases, Duke University Hospital, Durham, North Carolina
| | - Sarah S Lewis
- Duke Program for Infection Prevention and Healthcare Epidemiology, Duke University Hospital, Durham, North Carolina.,Division of Infectious Diseases, Duke University Hospital, Durham, North Carolina
| | - Barbara D Alexander
- Division of Infectious Diseases, Duke University Hospital, Durham, North Carolina.,Duke University Clinical Microbiology Laboratory, Durham, North Carolina
| | - Luke F Chen
- Duke Program for Infection Prevention and Healthcare Epidemiology, Duke University Hospital, Durham, North Carolina.,Division of Infectious Diseases, Duke University Hospital, Durham, North Carolina
| | - Richard J Wallace
- Duke University Clinical Microbiology Laboratory, Durham, North Carolina
| | | | - Pamela J Isaacs
- Duke Program for Infection Prevention and Healthcare Epidemiology, Duke University Hospital, Durham, North Carolina
| | - Lisa C Pickett
- Division of Trauma and Critical Care, Duke University Hospital, Durham, North Carolina
| | - Chetan B Patel
- Division of Cardiology, Duke University Hospital, Durham, North Carolina
| | - Peter K Smith
- Division of Cardiovascular and Thoracic Surgery, Duke University Hospital, Durham, North Carolina
| | - John M Reynolds
- Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Hospital, Durham, North Carolina
| | - Jill Engel
- Duke University Hospital, Durham, North Carolina
| | - Cameron R Wolfe
- Division of Infectious Diseases, Duke University Hospital, Durham, North Carolina
| | - Carmelo A Milano
- Division of Cardiovascular and Thoracic Surgery, Duke University Hospital, Durham, North Carolina
| | - Jacob N Schroder
- Division of Cardiovascular and Thoracic Surgery, Duke University Hospital, Durham, North Carolina
| | - Robert D Davis
- Division of Cardiovascular and Thoracic Surgery, Duke University Hospital, Durham, North Carolina
| | - Matthew G Hartwig
- Division of Cardiovascular and Thoracic Surgery, Duke University Hospital, Durham, North Carolina
| | - Jason E Stout
- Division of Infectious Diseases, Duke University Hospital, Durham, North Carolina
| | - Nancy Strittholt
- Duke Program for Infection Prevention and Healthcare Epidemiology, Duke University Hospital, Durham, North Carolina
| | - Eileen K Maziarz
- Division of Infectious Diseases, Duke University Hospital, Durham, North Carolina
| | - Jennifer Horan Saullo
- Duke Program for Infection Prevention and Healthcare Epidemiology, Duke University Hospital, Durham, North Carolina
| | - Kevin C Hazen
- Division of Infectious Diseases, Duke University Hospital, Durham, North Carolina
| | - Richard J Walczak
- Perfusion Services, Duke University Hospital, Durham, North Carolina
| | - Ravikiran Vasireddy
- Mycobacteria/Nocardia Research Laboratory, Department of Microbiology, University of Texas Health Science Center, Tyler
| | - Sruthi Vasireddy
- Mycobacteria/Nocardia Research Laboratory, Department of Microbiology, University of Texas Health Science Center, Tyler
| | - Celeste M McKnight
- Duke University Clinical Microbiology Laboratory, Durham, North Carolina
| | - Deverick J Anderson
- Duke Program for Infection Prevention and Healthcare Epidemiology, Duke University Hospital, Durham, North Carolina.,Division of Infectious Diseases, Duke University Hospital, Durham, North Carolina
| | - Daniel J Sexton
- Duke Program for Infection Prevention and Healthcare Epidemiology, Duke University Hospital, Durham, North Carolina.,Division of Infectious Diseases, Duke University Hospital, Durham, North Carolina
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In Vitro Evaluation of Povidone-Iodine and Chlorhexidine against Outbreak and Nonoutbreak Strains of Mycobacterium abscessus Using Standard Quantitative Suspension and Carrier Testing. Antimicrob Agents Chemother 2017; 62:AAC.01364-17. [PMID: 29061748 DOI: 10.1128/aac.01364-17] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 10/17/2017] [Indexed: 12/23/2022] Open
Abstract
Povidone-iodine (PI) and chlorhexidine (CHX) are widely used antiseptics active against conventional Staphylococcus aureus, Enterobacteriaceae, Candida species, and viruses, but their efficacy against Mycobacterium abscessus remains unproven. We determined the in vitro potency of alcoholic PI and CHX against M. abscessus subsp. abscessus (ATCC 19977), M. abscessus subsp. bolletii (BCRC 16915), and our outbreak strain of M. abscessus subsp. massiliense (TPE 101) in reference to Staphylococcus aureus (ATCC 29213) by standard quantitative suspension and carrier methods (EN 14563). By suspension, all mycobacterial strains compared to S. aureus were significantly more resistant to CHX, but not PI. By carrier, the mean logarithmic reductions (LR) achieved by PI under clean (dirty) conditions were 6.575 (2.482), 5.540 (2.298), 4.595 (1.967), and 1.173 (0.889), while those achieved by CHX under clean (dirty) conditions were 3.164 (5.445), 5.307 (2.564), 3.844 (2.232), and 0.863 (0.389) for S. aureus, M. abscessus subsp. bolletii, M. abscessus subsp. abscessus, and M. abscessus subsp. massiliense, respectively. M. abscessus subsp. massiliense (outbreak strain) was significantly more resistant than the other tested strains to PI and CHX. By both methods, the mean LR achieved by PI was higher than for CHX for all mycobacterial strains, but under dirty conditions, neither antiseptic was effectively mycobactericidal (LR < 5). These preliminary findings caution against the universal replacement of PI with CHX as the first-line skin antiseptic, since all M. abscessus isolates were resistant to CHX. More studies are needed to establish the best practice for skin antisepsis if mycobacterial infections are also to be prevented.
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8
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Sebastian G, Nagaraja S, Vishwanatha T, Voderhobli M, Vijayalakshmi N, Kumar P. Non-Tuberculosis mycobacterium speciation using HPLC under Revised National TB Control Programme (RNTCP) in India. J Appl Microbiol 2017; 124:267-273. [DOI: 10.1111/jam.13604] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 09/21/2017] [Accepted: 10/02/2017] [Indexed: 11/29/2022]
Affiliation(s)
- G. Sebastian
- Bharathiar University; Coimbatore India
- National Tuberculosis Institute; Bangalore India
| | | | | | | | | | - P. Kumar
- National Tuberculosis Institute; Bangalore India
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9
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An Antipersister Strategy for Treatment of Chronic Pseudomonas aeruginosa Infections. Antimicrob Agents Chemother 2017; 61:AAC.00987-17. [PMID: 28923873 DOI: 10.1128/aac.00987-17] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 09/08/2017] [Indexed: 12/21/2022] Open
Abstract
Bacterial persisters are a quasidormant subpopulation of cells that are tolerant to antibiotic treatment. The combination of the aminoglycoside tobramycin with fumarate as an antibacterial potentiator utilizes an antipersister strategy that is aimed at reducing recurrent Pseudomonas aeruginosa infections by enhancing the killing of P. aeruginosa persisters. Stationary-phase cultures of P. aeruginosa were used to generate persister cells. A range of tobramycin concentrations was tested with a range of metabolite concentrations to determine the potentiation effect of the metabolite under a variety of conditions, including a range of pH values and in the presence of azithromycin or cystic fibrosis (CF) patient sputum. In addition, 96-well dish biofilm and colony biofilm assays were performed, and the cytotoxicity of the tobramycin-fumarate combination was determined utilizing a lactate dehydrogenase (LDH) assay. Enhanced killing of up to 6 orders of magnitude of P. aeruginosa persisters over a range of CF isolates, including mucoid and nonmucoid strains, was observed for the tobramycin-fumarate combination compared to killing with tobramycin alone. Furthermore, significant fumarate-mediated potentiation was seen in the presence of azithromycin or CF patient sputum. Fumarate also reduced the cytotoxicity of tobramycin-treated P. aeruginosa to human epithelial airway cells. Finally, in mucoid and nonmucoid CF isolates, complete eradication of P. aeruginosa biofilm was observed in the colony biofilm assay due to fumarate potentiation. These data suggest that a combination of tobramycin with fumarate as an antibacterial potentiator may be an attractive therapeutic for eliminating recurrent P. aeruginosa infections in CF patients through the eradication of bacterial persisters.
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Disinfectant Susceptibility Profiling of Glutaraldehyde-Resistant Nontuberculous Mycobacteria. Infect Control Hosp Epidemiol 2017; 38:784-791. [PMID: 28462746 DOI: 10.1017/ice.2017.75] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Activated alkaline glutaraldehyde (GTA) remains one of the most widely used high-level disinfectants worldwide. However, several reports have highlighted the potential for nontuberculous mycobacteria to develop high-level resistance to this product. Because aldehyde resistance may lead to cross-resistance to other biocides, we investigated the susceptibility profile of GTA-resistant Mycobacterium chelonae and M. abscessus isolates to various disinfectant chemistries. METHODS High-level disinfectants commonly used in the reprocessing of endoscopes and other heat-sensitive, semicritical medical equipment, including different formulations of aldehyde-based products and oxidizing agents, were tested against 10 slow- and fast-growing, GTA-susceptible and GTA-resistant, Mycobacterium isolates in suspension tests and carrier tests at different temperatures. RESULTS While peracetic acid- and hydrogen peroxide-based disinfectants (S40, Resert XL, Reliance DG) efficiently killed all of the Mycobacterium isolates, GTA- and ortho-phthalaldehyde-based products (ie, Cidex, Aldahol, Cidex OPA) showed variable efficacy against GTA-resistant strains despite the ability of some formulations (Aldahol) to overcome the resistance of some of these isolates, especially when the temperature was increased from 20°C to 25°C. CONCLUSIONS Application permitting, oxidizing chemistries may provide a safe alternative to aldehyde-based products, particularly in GTA-resistant mycobacterial outbreaks. Infect Control Hosp Epidemiol 2017;38:784-791.
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Cortesia C, Bello T, Lopez G, Franzblau S, de Waard J, Takiff H. Use of green fluorescent protein labeled non-tuberculous mycobacteria to evaluate the activity quaternary ammonium compound disinfectants and antibiotics. Braz J Microbiol 2016; 48:151-158. [PMID: 27789202 PMCID: PMC5221367 DOI: 10.1016/j.bjm.2016.09.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Accepted: 04/25/2016] [Indexed: 11/24/2022] Open
Abstract
Although infections with NonTuberculous Mycobacteria have become less common in AIDS patients, they are important opportunistic infections after surgical procedures, likely because they are ubiquitous and not efficiently killed by many commonly used disinfectants. In Venezuela there have recently been many non-tuberculous mycobacteria soft tissue infections after minor surgical procedures, some apparently related to the use of a commercial disinfectant based on a Quaternary Ammonium Compound. We studied the activity of this and other quaternary ammonium compounds on different non-tuberculous mycobacteria by transforming the mycobacteria with a dnaA-gfp fusion and then monitoring fluorescence to gauge the capacity of different quaternary ammonium compounds to inhibit bacterial growth. The minimum inhibitory concentration varied for the different quaternary ammonium compounds, but M. chelonae and M. abscessus were consistently more resistant than M. smegmatis, and M. terrae more resistant than M. bovis BCG.
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Affiliation(s)
- Claudia Cortesia
- Instituto Venezolano de Investigaciones Científicas, Laboratorio de Genética Molecular, Altos de Pipe, Miranda, Venezuela
| | - Teresita Bello
- Universidad Central de Venezuela (UCV), Laboratorio de Tuberculosis, Instituto de Biomedicina, Caracas, Venezuela
| | - Gustavo Lopez
- Instituto Venezolano de Investigaciones Científicas, Laboratorio de Genética Molecular, Altos de Pipe, Miranda, Venezuela
| | - Scott Franzblau
- University of Illinois at Chicago, Institute for Tuberculosis Research, Department of Medicinal Chemistry and Pharmacognosy, Chicago, United States
| | - Jacobus de Waard
- Universidad Central de Venezuela (UCV), Laboratorio de Tuberculosis, Instituto de Biomedicina, Caracas, Venezuela
| | - Howard Takiff
- Instituto Venezolano de Investigaciones Científicas, Laboratorio de Genética Molecular, Altos de Pipe, Miranda, Venezuela.
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Lee MR, Tsai CJ, Hu JY, Lee SW, Ko JC, Wang HC, Yu CJ, Lee LN, Hsueh PR. Acquisition of Mycobacterium abscessus among ventilator-dependent patients in Taiwan chronic respiratory care facilities. Future Microbiol 2016; 11:491-500. [PMID: 27064349 DOI: 10.2217/fmb.16.6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM To investigate the acquisition of Mycobacterium abscessus among ventilator-dependent patients. MATERIALS & METHODS We prospectively recruited ventilator-dependent patients in five respiratory care wards (RCWs). Respiratory specimens were cultured for mycobacteria on day 1 (D1), 3 months (M3) and 6 months (M6) after enrollment. RESULTS 72 patients had cultures taken at all three time points. The proportion of patients with a culture positive for M. abscessus increased from 15.3% (11/72) on D1 to 30.6% (22/72) at M3 and 38.9% (28/72) at M6. Two M. abscessus subspecies abscessus isolates obtained from different patients had identical randomly amplified polymorphic DNA patterns. Being in RCW D and advanced age were significantly associated with initial cultures positivity. CONCLUSION Our study reveals that acquisition of M. abscessus was common among ventilator-dependent patients.
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Affiliation(s)
- Meng-Rui Lee
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan.,Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.,Institute of Preventive Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health & Welfare, Taoyuan City, Taiwan
| | - Chia-Jung Tsai
- Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health & Welfare, Taoyuan City, Taiwan
| | - Jia-Ying Hu
- Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health & Welfare, Taoyuan City, Taiwan
| | - Shih-Wei Lee
- Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health & Welfare, Taoyuan City, Taiwan
| | - Jen-Chung Ko
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Hao-Chien Wang
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chong-Jen Yu
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Li-Na Lee
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Laboratory Medicine, National Taiwan University College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Po-Ren Hsueh
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Laboratory Medicine, National Taiwan University College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Elkholy YS, Hegab AS, Ismail DK, Hassan RM. Evaluation of a novel commercial quaternary ammonium compound for eradication of Mycobacteria, HCV and HBV in Egypt. J Microbiol 2016; 54:39-43. [PMID: 26727900 DOI: 10.1007/s12275-016-5530-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 12/15/2015] [Accepted: 12/16/2015] [Indexed: 11/30/2022]
Abstract
Endoscopes are a common source of outbreaks of healthcare-associated infections. It is therefore important to identify high-level disinfectants capable of eliminating or killing all vegetative bacteria, mycobacteria, and viruses. Aldehydebased disinfectants are most commonly used in clinical practice but resistance has recently been detected and side effects associated with these disinfectants are well documented. In this study, we evaluated Virusolve+® EDS, a novel quaternary ammonium compound formulation supplied by Amity international, against Mycobacterium bovis (ATCC-27289), hepatitis C virus (HCV)-positive serum and hepatitis B surface antigen-positive serum. We also compared its efficacy against Cidex® (glutaraldehyde 2%), an aldehyde-based disinfectant. M. bovis showed no growth after 10 weeks with either Virusolve+® or Cidex®. Virusolve+® achieved a 10(4)- fold reduction in the initial 10(6) HCV load under clean conditions (without red blood cells) for 20 min, whereas Cidex® achieved this reduction under clean and dirty conditions (without and with red blood cells, respectively) after both 10 and 20 min. Both Virusolve+® and Cidex® were able to eradicate hepatitis B virus (HBV) infectivity under clean conditions after 10 and 20 min, whereas under dirty conditions they were only able to eradicate virus infectivity after 20 min. Virusolve+® EDS when compared with Cidex® showed equal mycobactericidal activity completely eradicating M. bovis. However, both showed comparable virucidal activity against HBV, which was more effective under clean conditions, emphasizing the importance of the cleaning step in endoscope reprocessing. Cidex® was more effective at eradicating HCV under dirty conditions after a short contact time.
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Affiliation(s)
- Yasmine Samy Elkholy
- Department of Medical Microbiology and Immunology, Cairo University, Cairo, 11562, Egypt
| | - Asmaa Sayed Hegab
- Department of Medical Microbiology and Immunology, Cairo University, Cairo, 11562, Egypt
| | - Dalia Kadry Ismail
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, 11562, Egypt
| | - Reem Mostafa Hassan
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, 11562, Egypt.
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Abstract
Effective and economical mycobactericidal disinfectants are needed to kill both Mycobacterium tuberculosis and non-M. tuberculosis mycobacteria. We found that acetic acid (vinegar) efficiently kills M. tuberculosis after 30 min of exposure to a 6% acetic acid solution. The activity is not due to pH alone, and propionic acid also appears to be bactericidal. M. bolletii and M. massiliense nontuberculous mycobacteria were more resistant, although a 30-min exposure to 10% acetic acid resulted in at least a 6-log10 reduction of viable bacteria. Acetic acid (vinegar) is an effective mycobactericidal disinfectant that should also be active against most other bacteria. These findings are consistent with and extend the results of studies performed in the early and mid-20th century on the disinfectant capacity of organic acids. IMPORTANCE Mycobacteria are best known for causing tuberculosis and leprosy, but infections with nontuberculous mycobacteria are an increasing problem after surgical or cosmetic procedures or in the lungs of cystic fibrosis and immunosuppressed patients. Killing mycobacteria is important because Mycobacterium tuberculosis strains can be multidrug resistant and therefore potentially fatal biohazards, and environmental mycobacteria must be thoroughly eliminated from surgical implements and respiratory equipment. Currently used mycobactericidal disinfectants can be toxic, unstable, and expensive. We fortuitously found that acetic acid kills mycobacteria and then showed that it is an effective mycobactericidal agent, even against the very resistant, clinically important Mycobacterium abscessus complex. Vinegar has been used for thousands of years as a common disinfectant, and if it can kill mycobacteria, the most disinfectant-resistant bacteria, it may prove to be a broadly effective, economical biocide with potential usefulness in health care settings and laboratories, especially in resource-poor countries.
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Heterogeneity of clinical and environmental isolates of Mycobacterium fortuitum using repetitive element sequence-based PCR: municipal water an unlikely source of community-acquired infections. Epidemiol Infect 2014; 142:2057-64. [PMID: 24398184 DOI: 10.1017/s0950268813003257] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
M. fortuitum is a rapidly growing mycobacterium associated with community-acquired and nosocomial wound, soft tissue, and pulmonary infections. It has been postulated that water has been the source of infection especially in the hospital setting. The aim of this study was to determine if municipal water may be the source of community-acquired or nosocomial infections in the Brisbane area. Between 2007 and 2009, 20 strains of M. fortuitum were recovered from municipal water and 53 patients' isolates were submitted to the reference laboratory. A wide variation in strain types was identified using repetitive element sequence-based PCR, with 13 clusters of ⩾2 indistinguishable isolates, and 28 patterns consisting of individual isolates. The clusters could be grouped into seven similar groups (>95% similarity). Municipal water and clinical isolates collected during the same time period and from the same geographical area consisted of different strain types, making municipal water an unlikely source of sporadic human infection.
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Rodriguez JM, Xie YL, Winthrop KL, Schafer S, Sehdev P, Solomon J, Jensen B, Toney NC, Lewis PF. Mycobacterium chelonae facial infections following injection of dermal filler. Aesthet Surg J 2013; 33:265-9. [PMID: 23335647 DOI: 10.1177/1090820x12471944] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED A cluster of 3 facial Mycobacterium chelonae infections occurred after cosmetic dermal filler injections at a plastic surgery clinic. Pulsed-field gel electrophoresis showed that M chelonae isolated from the clinic tap water were identical to the patient wound isolates. Review of injection procedures identified application of nonsterile ice to the skin prior to injection as a possible source of M chelonae. Surveys of regional laboratories and a national plastic surgery listserv identified no other cases related to the injection of this brand of dermal filler. This is the first report of cutaneous M chelonae infections following the injection of dermal fillers. It adds to a growing body of literature on postinjection M chelonae infections and reinforces the importance of optimal skin disinfection steps prior to percutaneous procedures. LEVEL OF EVIDENCE 5.
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Affiliation(s)
- Jan M Rodriguez
- Clackamas County Community Health, 2051 SE Kaen Rd, Oregon City, OR 97045, USA
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Amábile-Cuevas CF. Antibiotic resistance: from Darwin to Lederberg to Keynes. Microb Drug Resist 2012; 19:73-87. [PMID: 23046150 DOI: 10.1089/mdr.2012.0115] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The emergence and spread of antibiotic-resistant bacteria reflects both, a gradual, completely Darwinian evolution, which mostly yields slight decreases in antibiotic susceptibility, along with phenotypes that are not precisely characterized as "resistance"; and sudden changes, from full susceptibility to full resistance, which are driven by a vast array of horizontal gene transfer mechanisms. Antibiotics select for more than just antibiotic resistance (i.e., increased virulence and enhanced gene exchange abilities); and many non-antibiotic agents or conditions select for or maintain antibiotic resistance traits as a result of a complex network of underlying and often overlapping mechanisms. Thus, the development of new antibiotics and thoughtful, integrated anti-infective strategies is needed to address the immediate and long-term threat of antibiotic resistance. Since the biology of resistance is complex, these new drugs and strategies will not come from free-market forces, or from "incentives" for pharmaceutical companies.
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19
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Martin-Sanchez PM, Nováková A, Bastian F, Alabouvette C, Saiz-Jimenez C. Use of biocides for the control of fungal outbreaks in subterranean environments: the case of the Lascaux Cave in France. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2012; 46:3762-3770. [PMID: 22380699 DOI: 10.1021/es2040625] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The Lascaux Cave in France suffered an outbreak of the fungus Fusarium solani in 2001. Biocides were applied for three years to control this outbreak. Four months after the initial biocide application, a new outbreak appeared in the form of black stains that progressively invaded the cave. The black stains on the ceiling and passage banks were so evident by 2007 that they became one of the cave's major problems. Therefore, biocides were used again in 2008. The present study investigated the fungal communities associated with the black stains and the effectiveness of the biocides applied, by using cloning, denaturing gradient gel electrophoresis, and culture-dependent methods. A novel species, Ochroconis lascauxensis, was the most abundant fungus in samples collected between 2007 and 2008, and the biocides applied were not effective in eliminating this fungus; on the contrary, they appeared to increase the fungal diversity. The fungal communities represented in the samples collected in 2010 were quite different from those collected in 2008 and 2009: the major OTUs corresponded to black yeasts belonging to the Herpotrichiellaceae family. The origin and evolution of these microorganisms are probably linked to the intensive biocide treatments and to the anthropogenic changes introduced by cave management.
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Sabagh BP, Souto ADSS, Reis LM, Silva SAD, Pereira DCR, Neves MDC, Pinheiro RR, Duarte RS, Miyazaki NHT, Bôas MHSV. Comparative study with two different enrichments in the culture media used in the disinfectant efficacy assay. J Microbiol Methods 2011; 88:255-62. [PMID: 22197720 DOI: 10.1016/j.mimet.2011.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 12/06/2011] [Accepted: 12/07/2011] [Indexed: 10/14/2022]
Abstract
Recent changes in Brazilian legislation for commercial disinfectants have been published due to the recent epidemic of nosocomial infections caused by rapidly growing mycobacteria (RGM) in many states of Brazil over the last 8years. One of these documents requires that all the manufacturers provide evidence of efficacy of sterilizing and disinfectant products, used for semi critical medical devices, against the Mycobacterium bovis BCG Moreau and Mycobacterium abscessus subsp. bolletii INCQS 00594 strains by using the Confirmative in vitro Test for Determining Tuberculocidal Activity of Disinfectants recommended by the Association of Official Analytical Chemists. These changes have caused additional costs and increased problems for importation of enrichment products at national laboratories where disinfectant efficacy assay service is performed. Middlebrook ADC Enrichment (ADC) is provided by a unique manufacturer and used in the official protocol. The aim of the present study was to evaluate an alternative in house low-cost enrichment composed of fetal bovine serum and glucose (FBSG) with ADC for performance of disinfectant efficacy assay against mycobacteria. After obtaining the growth curves for M. abscessus ATCC 19977, M. abscessus subsp. bolletii INCQS 00594, Mycobacterium chelonae ATCC 35752, and Mycobacterium fortuitum ATCC 6841 by using ADC enrichment and FBSG in Kirchners and 7H9 culture media. Through statistical analysis via the Kruskal-Wallis test on the evaluation of microorganism growth rate, it was observed that there was no inhibition of RGM growth by any of the enrichments used. These results suggest that low-cost enrichment FBSG may be used as a potential substitute of ADC for composition of media for mycobacterial growth, including in disinfectant tests.
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Affiliation(s)
- Bruna Peres Sabagh
- Departamento de Microbiologia, Instituto Nacional de Controle de Qualidade em Saúde, Fundação Oswaldo Cruz, Av Brasil 4365, 21040-900 Rio de Janeiro, Brazil.
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Ariza-Heredia EJ, Dababneh AS, Wilhelm MP, Wengenack NL, Razonable RR, Wilson JW. Mycobacterium wolinskyi: a case series and review of the literature. Diagn Microbiol Infect Dis 2011; 71:421-7. [DOI: 10.1016/j.diagmicrobio.2011.08.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Revised: 08/03/2011] [Accepted: 08/03/2011] [Indexed: 11/30/2022]
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