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Singh M, Anees M, Afreen A, Kalyanasundaram D, Bhatnagar N, Singh H. Development of iodine based sustained release antimicrobial coatings for polyurethane voice prostheses. J Mater Chem B 2024; 12:5907-5916. [PMID: 38804192 DOI: 10.1039/d4tb00439f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Voice prostheses are known to fail in few weeks to several months of implantation due to the clogging mainly caused by microbial biofilm formation, which is a cause of concern. Iodine is a known broad-spectrum biocide and is reported to easily form complexes with various polymers. For long term device disinfection, strong iodine complexation that offers sustained iodine release for a prolonged period is essential. The present research work deals with the synthesis of a poly(methyl methacrylate-n-butyl acrylate-N-vinyl-2-pyrrolidone) (poly[MMA-BA-NVP]) tercopolymer through free radical polymerization for surface coating thermoplastic polyurethane (TPU) based voice prostheses. The NVP content in the tercopolymer was varied from 20% to 50% to optimise iodine loading and subsequent release. Base TPU coated with the tercopolymer was treated with 4% aqueous iodine solution at room temperature (28 ± 3 °C) for two hours. It was observed that the tercopolymer containing 35% N-vinyl-2-pyrrolidone (NVP), 32.5% methyl methacrylate (MMA) and 32.5% butyl acrylate (nBA) gave a stable coating on TPUs together with sustained iodine release for a prolonged period. Furthermore, the tercopolymer coated and iodine loaded TPUs exhibited excellent antimicrobial activity against Candida albicans, Staphylococcus aureus and Escherichia coli.
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Affiliation(s)
- Manjeet Singh
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, 110016, India.
| | - Mohd Anees
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, 110016, India.
| | - Aiman Afreen
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, 110016, India.
| | - Dinesh Kalyanasundaram
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, 110016, India.
| | - Naresh Bhatnagar
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, New Delhi, 110016, India
| | - Harpal Singh
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, 110016, India.
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Immordino A, Dispenza F, Sireci F, Anzalone R, Immordino P, Calà C, Gallina S, Lorusso F. Is Oral Microflora Related to Development of Malfunction in Patients Using Voice Prosthesis? J Clin Med 2024; 13:3492. [PMID: 38930023 PMCID: PMC11204478 DOI: 10.3390/jcm13123492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 06/10/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
Background: this prospective study investigated the correlation between the oral bacterial microflora and the microflora found in voice prostheses (VPs) among 20 patients who had undergone laryngectomy. The aim was to explore the associations between the microflora's presence and the malfunction of VPs, along with the association between the predominant microorganism and the longevity of VPs. Methods: the research process included gathering medical histories, conducting ENT examinations, replacing VPs, and performing check-ups every four months for a period of 15.5 months. Additionally, microbiological examinations, blood tests, and voice change surveys were conducted. Results: a correlation between the microflora isolated from VPs and that from oral rinses was demonstrated in a large percentage of patients who experienced a loss of prosthetic functional efficiency. The correlation analysis between the type of microorganism and the lifespan of VPs showed a non-significant Pearson correlation coefficient (r = 0.043, p = 0.678). Conclusions: there is no significant linear correlation between the predominant microorganism and the average lifespan of VPs.
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Affiliation(s)
- Angelo Immordino
- Otorhinolaryngology Section, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, 90127 Palermo, Italy; (A.I.); (F.D.); (R.A.); (S.G.)
| | - Francesco Dispenza
- Otorhinolaryngology Section, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, 90127 Palermo, Italy; (A.I.); (F.D.); (R.A.); (S.G.)
| | - Federico Sireci
- Otorhinolaryngology Section, Department Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, 90127 Palermo, Italy;
| | - Riccardo Anzalone
- Otorhinolaryngology Section, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, 90127 Palermo, Italy; (A.I.); (F.D.); (R.A.); (S.G.)
| | - Palmira Immordino
- Hygiene and Preventive Medicine Section, Department of Health Promotion, Maternal and Infant Care, Internal Medicine, and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy;
| | - Cinzia Calà
- Microbiology and Virology Complex Operative Unit, University Hospital “P. Giaccone”, 90127 Palermo, Italy;
| | - Salvatore Gallina
- Otorhinolaryngology Section, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, 90127 Palermo, Italy; (A.I.); (F.D.); (R.A.); (S.G.)
| | - Francesco Lorusso
- Otorhinolaryngology Section, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, 90127 Palermo, Italy; (A.I.); (F.D.); (R.A.); (S.G.)
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Johnson F, Knopf A. The Localisation of a Tracheoesophageal Shunt during Laryn(-gopharyn)gectomy Determines the Risk of Shunt Insufficiency. J Clin Med 2023; 12:7628. [PMID: 38137697 PMCID: PMC10743495 DOI: 10.3390/jcm12247628] [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: 10/11/2023] [Revised: 12/01/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Tracheoesophageal shunt insufficiency (TESI) is a common and potentially life-threatening complication after laryn(-gopharyn)gectomy (L(P)E). We investigated whether TESI could be the result of a specific shunt location. METHODS A monocentric, retrospective cohort analysis of 171 consecutively treated L(P)E patients was performed. Patients with a secondary prosthesis instillation and patients with insufficient postoperative imaging were excluded. Disease related data as well as location of primary voice prosthesis were assessed. RESULTS The cohort was divided into 62 TESI-positive and 109 TESI-negative individuals. The mean time from surgery to TESI was 32 months. No differences were observed in gender, age, tumor localization, T/R/M-status. Surgery without adjuvant therapy was more often performed in TESI-negative individuals when compared with their positive counterparts. However, Cox regression including T/N status, therapy and categorized distance of the tracheoesophageal shunt to the manubrium (≤1.5 cm vs. >1.5 cm) revealed that a distance of ≤1.5 cm was associated with a 2.1-fold increased risk of TESI, while all other parameters did not influence the event-free survival. CONCLUSIONS Primary shunt positioning ≤1.5 cm to the ridge of the manubrium is associated with an increased risk of TESI. In these individuals secondary shunt operation resulting in a position >1.5 cm distant to the manubrium should be recommended.
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Affiliation(s)
- Felix Johnson
- Department of Otorhinolaryngology, Head and Neck Surgery, Technical University of Munich, 80333 Munich, Germany;
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Innsbruck, 6020 Innsbruck, Austria
| | - Andreas Knopf
- Department of Otorhinolaryngology, Head and Neck Surgery, Technical University of Munich, 80333 Munich, Germany;
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Freiburg, 79085 Freiburg im Breisgau, Germany
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Ramage G, Borghi E, Rodrigues CF, Kean R, Williams C, Lopez-Ribot J. Our current clinical understanding of Candida biofilms: where are we two decades on? APMIS 2023; 131:636-653. [PMID: 36932821 DOI: 10.1111/apm.13310] [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: 02/27/2023] [Accepted: 03/12/2023] [Indexed: 03/19/2023]
Abstract
Clinically we have been aware of the concept of Candida biofilms for many decades, though perhaps without the formal designation. Just over 20 years ago the subject emerged on the back of progress made from the bacterial biofilms, and academic progress pace has continued to mirror the bacterial biofilm community, albeit at a decreased volume. It is apparent that Candida species have a considerable capacity to colonize surfaces and interfaces and form tenacious biofilm structures, either alone or in mixed species communities. From the oral cavity, to the respiratory and genitourinary tracts, wounds, or in and around a plethora of biomedical devices, the scope of these infections is vast. These are highly tolerant to antifungal therapies that has a measurable impact on clinical management. This review aims to provide a comprehensive overight of our current clinical understanding of where these biofilms cause infections, and we discuss existing and emerging antifungal therapies and strategies.
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Affiliation(s)
- Gordon Ramage
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
- Study Group for Biofilms (ESGB), European Society for Clinical Microbiology and Infectious Disease, Basel, Switzerland
| | - Elisa Borghi
- Study Group for Biofilms (ESGB), European Society for Clinical Microbiology and Infectious Disease, Basel, Switzerland
- Department of Health Sciences, San Paolo Medical School, Università Degli Studi di Milano, Milan, Italy
| | - Célia Fortuna Rodrigues
- Study Group for Biofilms (ESGB), European Society for Clinical Microbiology and Infectious Disease, Basel, Switzerland
- LEPABE-Department of Chemical Engineering, Faculty of Engineering, Cooperativa de Ensino Superior Politécnico e Universitário-CESPU, Gandra, Portugal
- ALiCE-Associate Laboratory in Chemical Engineering, Faculty of Engineering, Cooperativa de Ensino Superior Politécnico e Universitário-CESPU, Gandra, Portugal
- TOXRUN-Toxicology Research Unit, Cooperativa de Ensino Superior Politécnico e Universitário-CESPU, Gandra, Portugal
| | - Ryan Kean
- Study Group for Biofilms (ESGB), European Society for Clinical Microbiology and Infectious Disease, Basel, Switzerland
- Department of Biological Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Craig Williams
- Study Group for Biofilms (ESGB), European Society for Clinical Microbiology and Infectious Disease, Basel, Switzerland
- Microbiology Department, Morecambe Bay NHS Trust, Lancaster, UK
| | - Jose Lopez-Ribot
- Department of Biology and the South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio, San Antonio, Texas, USA
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Wynne KJ, Zolotarskaya O, Jarrell R, Wang C, Amin Y, Brunson K. Facile Modification of Medical-Grade Silicone for Antimicrobial Effectiveness and Biocompatibility: A Potential Therapeutic Strategy against Bacterial Biofilms. ACS APPLIED MATERIALS & INTERFACES 2023; 15:46626-46638. [PMID: 37782835 DOI: 10.1021/acsami.3c08734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
A one-step modification of biomedical silicone tubing with N,N-dimethyltetradecylamine, C14, results in a composition designated WinGard-1 (WG-1, 1.1 wt % C14). A surface-active silicon-amine phase (SAP) is proposed to account for increased wettability and increased surface charge. To understand the mechanism of antimicrobial effectiveness, several procedures were employed to detect whether C14 leaching occurred. An immersion-growth (IG) test was developed that required knowing the bacterial Minimum Inhibitory Concentrations (MICs) and Minimum Biocidal Concentrations (MBCs). The C14 MIC and MBC for Gm- uropathogenic E. coli (UPEC), commonly associated with catheter-associated urinary tract infections (CAUTI), were 10 and 20 μg/mL, respectively. After prior immersion of WG-1 silicone segments in a growth medium from 1 to 28 d, the IG test for the medium showed normal growth for UPEC over 24 h, indicating that the concentration of C14 must be less than the MIC, 10 μg/mL. GC-MS and studies of the medium inside and outside a dialysis bag containing WG-1 silicone segments supported de minimis leaching. Consequently, a 5 log UPEC reduction (99.999% kill) in 24 h using the shake flask test (ASTM E2149) cannot be due to leaching and is ascribed to contact kill. Interestingly, although the MBC was greater than 100 μg/mL for Pseudomonas aeruginosa, WG-1 silicone affected an 80% reduction via a 24 h shake flask test. For other bacteria and Candida albicans, greater than 99.9% shake flask kill may be understood by proposing increased wettability and concentration of charge illustrated in the TOC. De minimis leaching places WG-1 silicone at an advantage over conventional anti-infectives that rely on leaching of an antibiotic or heavy metals such as silver. The facile process for preparation of WG-1 silicone combined with biocidal effectiveness comprises progress toward the goals of device designation from the FDA for WG-1 and clearance.
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Affiliation(s)
- Kenneth J Wynne
- Virginia Bio+Tech Park, WynnVision LLC, Suite 57 800 East Leigh Street Richmond, Virginia 23219-1551, United States
| | - Olga Zolotarskaya
- Virginia Bio+Tech Park, WynnVision LLC, Suite 57 800 East Leigh Street Richmond, Virginia 23219-1551, United States
| | - Rebecca Jarrell
- Virginia Bio+Tech Park, WynnVision LLC, Suite 57 800 East Leigh Street Richmond, Virginia 23219-1551, United States
| | - Chenyu Wang
- Virginia Bio+Tech Park, WynnVision LLC, Suite 57 800 East Leigh Street Richmond, Virginia 23219-1551, United States
| | - Youssef Amin
- Virginia Bio+Tech Park, WynnVision LLC, Suite 57 800 East Leigh Street Richmond, Virginia 23219-1551, United States
| | - Kennard Brunson
- Virginia Bio+Tech Park, WynnVision LLC, Suite 57 800 East Leigh Street Richmond, Virginia 23219-1551, United States
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Zaidi S, Ali K, Khan AU. It's all relative: analyzing microbiome compositions, its significance, pathogenesis and microbiota derived biofilms: Challenges and opportunities for disease intervention. Arch Microbiol 2023; 205:257. [PMID: 37280443 DOI: 10.1007/s00203-023-03589-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/06/2023] [Accepted: 05/18/2023] [Indexed: 06/08/2023]
Abstract
Concept of microorganisms has largely been perceived from their pathogenic view point. Nevertheless, it is being gradually revisited in terms of its significance to human health and now appears to be the most dominant force that shapes the immune system of the human body and also determines an individual's predisposition to diseases. Human inhabits bacterial diversity (which is predominant among all microbial communities in human body) occupying 0.3% of body mass, known as microbiota. On birth, a part of microbiota that child obtains is essentially a mother's legacy. So, the review was initiated with this critical topic of microbiotal inheritance. Since, each body site has distinct physiological specifications; therefore, they contain discrete microbiome composition that has been separately discussed along with dysbiosis-induced pathologies originating in different body organs. Factors affecting microbiome composition and may cause dysbiosis like antibiotics, delivery, feeding method etc. as well as the strategies that immune system adopts to prevent dysbiosis have been highlighted. We also tried to bring into attention the topic of dysbiosis induced biofilms, that enables cohort to survive stresses, evolve, disseminate and infection resurgence that is still in dormancy. Eventually, we put spotlight on microbiome significance in medical therapeutics. We didn't merely confine article to gut microbiota, that is being studied more extensively. Numerous community forms at diverse body sites are inter-related, and being exposed to awfully variable perturbations appear to be challenging to evaluate perturbation risks holistically. All aspects have been elaborately discussed to achieve a global depiction of human microbiota in order to meet urgent necessity for protocol standardisation. Demonstrates that environmental challenges (antibiotic use, alterations in diet, stress, smoking etc.) might cause dysbiosis i.e. transition of healthy microbiome composition to the one in which pathogenic microorganisms become more abundant, and eventually results in an infected state.
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Affiliation(s)
- Sahar Zaidi
- Medical Microbiology and Molecular Biology Laboratory, Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh, 202002, India
| | - Khursheed Ali
- Medical Microbiology and Molecular Biology Laboratory, Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh, 202002, India
| | - Asad U Khan
- Medical Microbiology and Molecular Biology Laboratory, Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh, 202002, India.
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Gautam V, Panda S, Singh CA, Thakar A. Troubleshooting recalcitrant tracheoesophageal prosthesis site leak with internal mammary artery perforator flap: a case report. THE EGYPTIAN JOURNAL OF OTOLARYNGOLOGY 2022. [DOI: 10.1186/s43163-022-00358-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Background
An enlarged tracheoesophageal puncture (TEP) site is a grave complication of voice prosthesis rehabilitation.
Case presentation
We report a case of periprosthetic leakage with an enlarged tracheoesophageal fistula causing aspiration, not responding to conservative management and primary closure. Internal mammary artery perforator (IMAP) flap was subsequently used in the management. The flap was successfully taken up at the recipient site with no leak post-operatively as confirmed by barium swallow, thereby preventing further aspiration.
Conclusion
Though minor degrees of TEP leak usually respond to conservative management, the recalcitrant ones require active intervention which one should be aware of.
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Spałek J, Daniluk T, Godlewski A, Deptuła P, Wnorowska U, Ziembicka D, Cieśluk M, Fiedoruk K, Ciborowski M, Krętowski A, Góźdź S, Durnaś B, Savage PB, Okła S, Bucki R. Assessment of Ceragenins in Prevention of Damage to Voice Prostheses Caused by Candida Biofilm Formation. Pathogens 2021; 10:pathogens10111371. [PMID: 34832527 PMCID: PMC8622639 DOI: 10.3390/pathogens10111371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the potential application of ceragenins (CSAs) as new candidacidal agents to prevent biofilm formation on voice prostheses (VPs). The deterioration of the silicone material of VPs is caused by biofilm growth on the device which leads to frequent replacement procedures and sometimes serious complications. A significant proportion of these failures is caused by Candida species. We found that CSAs have significant candidacidal activities in vitro (MIC; MFC; MBIC), and they effectively eradicate species of yeast responsible for VP failure. Additionally, in our in vitro experimental setting, when different Candida species were subjected to CSA-13 and CSA-131 during 25 passages, no tested Candida strain showed the significant development of resistance. Using liquid chromatography–mass spectrometry (LC-MS), we found that VP immersion in an ethanol solution containing CSA-131 results in silicon impregnation with CSA-131 molecules, and in vitro testing revealed that fungal biofilm formation on such VP surfaces was inhibited by embedded ceragenins. Future in vivo studies will validate the use of ceragenin-coated VP for improvement in the life quality and safety of patients after a total laryngectomy.
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Affiliation(s)
- Jakub Spałek
- Institute of Medical Science, Collegium Medicum, Jan Kochanowski University of Kielce, IX Wieków Kielc 19A, 25-317 Kielce, Poland; (J.S.); (S.G.); (B.D.); (S.O.)
- Department of Otolaryngology, Head and Neck Surgery, Holy-Cross Cancer Center, Artwińskiego 3, 25-734 Kielce, Poland
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Bialystok, Mickiewicza 2C, 15-222 Bialystok, Poland; (T.D.); (P.D.); (U.W.); (M.C.); (K.F.)
| | - Tamara Daniluk
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Bialystok, Mickiewicza 2C, 15-222 Bialystok, Poland; (T.D.); (P.D.); (U.W.); (M.C.); (K.F.)
| | - Adrian Godlewski
- Metabolomics Laboratory, Clinical Research Centre, Medical University of Białystok, 15-089 Białystok, Poland; (A.G.); (M.C.); (A.K.)
| | - Piotr Deptuła
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Bialystok, Mickiewicza 2C, 15-222 Bialystok, Poland; (T.D.); (P.D.); (U.W.); (M.C.); (K.F.)
| | - Urszula Wnorowska
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Bialystok, Mickiewicza 2C, 15-222 Bialystok, Poland; (T.D.); (P.D.); (U.W.); (M.C.); (K.F.)
| | - Dominika Ziembicka
- Department of Public Health, Medical University of Białystok, 15-089 Białystok, Poland;
| | - Mateusz Cieśluk
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Bialystok, Mickiewicza 2C, 15-222 Bialystok, Poland; (T.D.); (P.D.); (U.W.); (M.C.); (K.F.)
| | - Krzysztof Fiedoruk
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Bialystok, Mickiewicza 2C, 15-222 Bialystok, Poland; (T.D.); (P.D.); (U.W.); (M.C.); (K.F.)
| | - Michał Ciborowski
- Metabolomics Laboratory, Clinical Research Centre, Medical University of Białystok, 15-089 Białystok, Poland; (A.G.); (M.C.); (A.K.)
| | - Adam Krętowski
- Metabolomics Laboratory, Clinical Research Centre, Medical University of Białystok, 15-089 Białystok, Poland; (A.G.); (M.C.); (A.K.)
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Białystok, 15-089 Białystok, Poland
| | - Stanisław Góźdź
- Institute of Medical Science, Collegium Medicum, Jan Kochanowski University of Kielce, IX Wieków Kielc 19A, 25-317 Kielce, Poland; (J.S.); (S.G.); (B.D.); (S.O.)
| | - Bonita Durnaś
- Institute of Medical Science, Collegium Medicum, Jan Kochanowski University of Kielce, IX Wieków Kielc 19A, 25-317 Kielce, Poland; (J.S.); (S.G.); (B.D.); (S.O.)
| | - Paul B. Savage
- Department of Chemistry and Biochemistry, Brigham Young University, Provo, UT 84602, USA;
| | - Sławomir Okła
- Institute of Medical Science, Collegium Medicum, Jan Kochanowski University of Kielce, IX Wieków Kielc 19A, 25-317 Kielce, Poland; (J.S.); (S.G.); (B.D.); (S.O.)
- Department of Otolaryngology, Head and Neck Surgery, Holy-Cross Cancer Center, Artwińskiego 3, 25-734 Kielce, Poland
| | - Robert Bucki
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Bialystok, Mickiewicza 2C, 15-222 Bialystok, Poland; (T.D.); (P.D.); (U.W.); (M.C.); (K.F.)
- Correspondence: ; Tel.: +48-85-748-54-83
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Prado A, Brito RO, Pereira ECA, Correa JL, Neto MG, Dayyeh BKA, Negri M, Svidzinski TIE. First Study of Naturally Formed Fungal Biofilms on the Surface of Intragastric Balloons. Obes Surg 2021; 31:5348-5357. [PMID: 34570305 DOI: 10.1007/s11695-021-05730-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Intragastric balloon (IGB) is a medical device used in the endoscopic treatment of pre-obesity and obesity. The involvement of IGB with biofilms has been previously reported; however, little is still known. We determine the frequency of biofilms naturally formed on the external surface of IGB, as well as some variables related to IGB types and patients features, species of fungi involved, and biofilm evidence. METHODS A retrospective study was conducted based on endoscopies and medical records of patients with explanted IGB between 2015 and 2018, which had masses strongly adhered to the surface of the balloon, suspecting the presence of a biofilm. From 2018, the samples of those masses were investigated seeking biofilm characterization based on mycological and structural aspects. RESULTS A total of 149 endoscopies were surveyed; 27 IGBs (18.12%) showed signs suggesting biofilm formation. There was no significant difference between biofilm involvement in IGB and the anthropometric and demographic profile of the patients. On the other hand, there was a significant difference regarding the IGB type, 24.05% of the adjustable IGB were compromised by biofilm, while in non-adjustable IGB, it was 11.43% (p = 0.04; OR 2.45; 95% CI, 0.98-6.12). Candida glabrata was the most isolated fungal species from the well-organized fungal biofilm. CONCLUSIONS The frequency of fungal biofilm naturally formed on the external surface of IGB was elevated. The risk of biofilm formation was increased for the adjustable IGB, but it did not relate to the demographic data and anthropometric patient profile.
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Affiliation(s)
- Andressa Prado
- Medical Mycology Laboratory, Laboratory for Teaching and Research in Clinical Analysis, State University of Maringa, Maringa, Brazil
| | - Rubens O Brito
- Department of Diagnostic and Therapeutic Endoscopy, Mgastro Digestive Tract Medical Center, Maringa, Brazil
| | - Elton C A Pereira
- Medical Mycology Laboratory, Laboratory for Teaching and Research in Clinical Analysis, State University of Maringa, Maringa, Brazil
| | - Jakeline L Correa
- Medical Mycology Laboratory, Laboratory for Teaching and Research in Clinical Analysis, State University of Maringa, Maringa, Brazil
| | - Manoel G Neto
- Division of Gastrointestinal Endoscopy, ABC Medical School, São Paulo, Brazil
| | - Barham K A Dayyeh
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Melyssa Negri
- Medical Mycology Laboratory, Laboratory for Teaching and Research in Clinical Analysis, State University of Maringa, Maringa, Brazil
| | - Terezinha I E Svidzinski
- Medical Mycology Laboratory, Laboratory for Teaching and Research in Clinical Analysis, State University of Maringa, Maringa, Brazil.
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10
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Voice Prosthesis Coated with Sustained Release Varnish Containing Clotrimazole Shows Long-Term Protection against Candida albicans: An In Vitro Study. Molecules 2021; 26:molecules26175395. [PMID: 34500827 PMCID: PMC8434179 DOI: 10.3390/molecules26175395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 11/28/2022] Open
Abstract
Fungal biofilm formation on voice prosthesis (VP) is a major health problem that requires repeated replacement of the prosthesis. Candida albicans is one of the pathogens that frequently inhabits the VP. We proposed that coating VPs with sustained-release varnish (SRV) containing clotrimazole (CTZ) might prevent fungal biofilm formation. The long-term antifungal activities of SRV-CTZ- versus SRV-placebo-coated VPs was tested daily by measuring the inhibition zone of C. albicans seeded on agar plates or by measuring the fungal viability of C. albicans in suspension. The extent of biofilm formation on coated VPs was analyzed by confocal microscopy and scanning electron microscopy. We observed that SRV-CTZ-coated VPs formed a significant bacterial inhibition zone around the VPs and prevented the growth of C. albicans in suspension during the entire testing period of 60 days. Fungal biofilms were formed on placebo-coated VPs, while no significant biofilms were observed on SRV-CTZ-coated VPs. HPLC analysis shows that CTZ is continuously released during the whole test period of 60 days at a concentration above the minimal fungistatic concentration. In conclusion, coating VPs with an SRV-CTZ film is a potential effective method for prevention of fungal infections and biofilm formation on VPs.
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11
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CO 2 enhances the formation, nutrient scavenging and drug resistance properties of C. albicans biofilms. NPJ Biofilms Microbiomes 2021; 7:67. [PMID: 34385462 PMCID: PMC8361082 DOI: 10.1038/s41522-021-00238-z] [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: 03/31/2020] [Accepted: 07/16/2021] [Indexed: 02/07/2023] Open
Abstract
C. albicans is the predominant human fungal pathogen and frequently colonises medical devices, such as voice prostheses, as a biofilm. It is a dimorphic yeast that can switch between yeast and hyphal forms in response to environmental cues, a property that is essential during biofilm establishment and maturation. One such cue is the elevation of CO2 levels, as observed in exhaled breath for example. However, despite the clear medical relevance, the effect of CO2 on C. albicans biofilm growth has not been investigated to date. Here we show that physiologically relevant CO2 elevation enhances each stage of the C. albicans biofilm-forming process: from attachment through maturation to dispersion. The effects of CO2 are mediated via the Ras/cAMP/PKA signalling pathway and the central biofilm regulators Efg1, Brg1, Bcr1 and Ndt80. Biofilms grown under elevated CO2 conditions also exhibit increased azole resistance, increased Sef1-dependent iron scavenging and enhanced glucose uptake to support their rapid growth. These findings suggest that C. albicans has evolved to utilise the CO2 signal to promote biofilm formation within the host. We investigate the possibility of targeting CO2-activated processes and propose 2-deoxyglucose as a drug that may be repurposed to prevent C. albicans biofilm formation on medical airway management implants. We thus characterise the mechanisms by which CO2 promotes C. albicans biofilm formation and suggest new approaches for future preventative strategies.
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12
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Sahal G, Woerdenbag HJ, Hinrichs WLJ, Visser A, van der Mei HC, Bilkay IS. Candida Biofilm Formation Assay on Essential Oil Coated Silicone Rubber. Bio Protoc 2021; 11:e3941. [PMID: 33796615 DOI: 10.21769/bioprotoc.3941] [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: 09/13/2020] [Revised: 01/06/2021] [Accepted: 01/12/2021] [Indexed: 11/02/2022] Open
Abstract
Development of biofilm associated candidemia for patients with implanted biomaterials causes an urgency to develop antimicrobial and biofilm inhibitive coatings in the management of recalcitrant Candida infections. Recently, there is an increase in the number of patients with biofilm formation and resistance to antifungal therapy. Therefore, there is a growing interest to use essential oils as coating agents in order to prevent biomaterial-associated Candida infections. Often high costs, complicated and laborious technologies are used for both applying the coating and determination of the antibiofilm effects hampering a rapid screening of essential oils. In order to determine biofilm formation of Candida on essential oil coated surfaces easier, cheaper and faster, we developed an essential oil (lemongrass oil) coated surface (silicone-rubber) by using a hypromellose ointment/essential oil mixture. Furthermore, we modified the "crystal violet binding assay" to quantify the biofilm mass of Candida biofilm formed on the lemongrass oil coated silicone rubber surface. The essential oil coating and the biomass determination of biofilms on silicone rubber can be easily applied with simple and accessible equipment, and will therefore provide rapid information about whether or not a particular essential oil is antiseptic, also when it is used as a coating agent.
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Affiliation(s)
- Gulcan Sahal
- Hacettepe University, Faculty of Sciences, Department of Biology (Biotechnology Division), Beytepe, Ankara, Turkey
| | - Herman J Woerdenbag
- University of Groningen, Department of Pharmaceutical Technology and Biopharmacy, Antonius Deusinglaan 1, Groningen, the Netherlands
| | - Wouter L J Hinrichs
- University of Groningen, Department of Pharmaceutical Technology and Biopharmacy, Antonius Deusinglaan 1, Groningen, the Netherlands
| | - Anita Visser
- University of Groningen and University Medical Center Groningen, Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, Groningen, the Netherlands.,University of Groningen and University Medical Center Groningen, Department of Geriatric Dentistry, Dental school, Center for Dentistry and Oral Hygiene, Groningen, the Netherlands
| | - Henny C van der Mei
- University of Groningen and University Medical Center Groningen, Department of Biomedical Engineering, Antonius Deusinglaan 1, Groningen, the Netherlands
| | - Isil Seyis Bilkay
- Hacettepe University, Faculty of Sciences, Department of Biology (Biotechnology Division), Beytepe, Ankara, Turkey
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13
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Tong JY, Pasick LJ, Benito DA, Sataloff RT. Complications associated with tracheoesophageal voice prostheses from 2010 to 2020: A MAUDE study. Am J Otolaryngol 2020; 41:102652. [PMID: 32711236 DOI: 10.1016/j.amjoto.2020.102652] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 07/04/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Tracheoesophageal puncture with voice prosthesis placement remains the gold standard for voice restoration following total laryngectomy, but may cause various complications. This study aims to summarize patient-related and device-related adverse events associated with tracheoesophageal puncture and voice prosthesis placement. MATERIALS AND METHODS The U.S. Food and Drug Administration's Manufacturer and User Facility Device Experience database was queried for reports of adverse events related to tracheoesophageal puncture with voice prosthesis placement from January 1, 2010, to April 30, 2020. Data were extracted from reports pertaining to tracheoesophageal prostheses. RESULTS Seventy-seven reports involving tracheoesophageal voice prostheses were identified, from which 111 adverse events were extracted. Of these, 58 (52.3%) were patient-related, while 53 (47.7%) were device-related. The most frequently reported patient-related adverse events were aspirated prosthesis (24 [41.4%]), foreign body during placement (11 [19.0%]), aspiration pneumonia (9 [15.5%]), and aspirated brush tip (8 [13.8%]). The most common device-related adverse events were detached brush tip (15 [28.3%]), leak (14 [26.4%]), and torn esophageal flange (11 [20.8%]). CONCLUSIONS While tracheoesophageal puncture with voice prosthesis placement has revolutionized voice rehabilitation following total laryngectomy, the procedure may be associated with adverse events both at the time of placement and later. Interventions aimed at improving both physician and patient education may help reduce adverse events attributed to improper use. Further research is needed to clarify optimal approaches to education.
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14
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Biofilm Growth Causes Damage to Silicone Voice Prostheses in Patients after Surgical Treatment of Locally Advanced Laryngeal Cancer. Pathogens 2020; 9:pathogens9100793. [PMID: 32993180 PMCID: PMC7601089 DOI: 10.3390/pathogens9100793] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/23/2020] [Accepted: 09/25/2020] [Indexed: 12/16/2022] Open
Abstract
Voice prosthesis implantation with the creation of a tracheoesophageal fistula is the gold standard procedure for voice rehabilitation in patients after a total laryngectomy. All patients implanted with a voice prosthesis (VP) have biofilms of fungi and bacteria grow on their surface. Biofilm colonization is one of the main reasons for VP degradation that can lead to VP dysfunction, which increases the high risk of pneumonia. In a 20-month evaluation period, 129 cases of prostheses after replacement procedures were investigated. Microbiological examination of the biofilms revealed that there were four of the most common fungi species (Candida spp.) and a large variety of bacterial species present. We studied the relationship between the time of proper function of Provox VP, the microorganism composition of the biofilm present on it, and the degradation level of the silicone material. Evaluation of the surface of the removed VP using an atomic force microscope (AFM) has demonstrated that biofilm growth might drastically change the silicone's mechanical properties. Changes in silicone stiffness and thermal properties might contribute to the failure of VP function. Our data can serve in future studies for the development of methods to prevent or inhibit biofilm formation on the VP surface that would translate to an increase in their durability and safety.
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15
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Cocuzza S, Maniaci A, Grillo C, Ferlito S, Spinato G, Coco S, Merlino F, Stilo G, Santoro GP, Iannella G, Vicini C, La Mantia I. Voice-Related Quality of Life in Post-Laryngectomy Rehabilitation: Tracheoesophageal Fistula's Wellness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124605. [PMID: 32604875 PMCID: PMC7344397 DOI: 10.3390/ijerph17124605] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/21/2020] [Accepted: 06/24/2020] [Indexed: 02/07/2023]
Abstract
(1) Introduction: Laryngeal cancer is one of the most common types of cancer affecting the upper aerodigestive tract. Despite ensuring good oncological outcome in many locoregionally advanced cases, total laryngectomy is associated with relevant physical and psychological sequelae. Treatment through tracheo-esophageal speech, if promising, can lead to very variable outcomes. Not all laryngectomee patients with vocal prosthesis benefit from the same level of rehabilitation mainly due to the development of prosthetic or fistula related problems. The relating sequelae in some cases are even more decisive in the patient quality of life, having a higher impact than communicational or verbal skills. (2) Material and Methods: A retrospective study was conducted on 63 patients initially enrolled with a history of total laryngectomy and voice rehabilitation, treated at the University Hospital of Catania from 1 January 2010 to 31 December 2018. Quality of life (QoL) evaluation through validated self-administrated questionnaires was performed. (3) Results: The Voice-Related Quality of Life questionnaire revealed significantly better outcomes in both socio-emotional and functional domains of the tracheoesophageal patient group compared to the esophageal group (p = 0.01; p = 0.01, respectively), whereas in the Voice Handicap Index assessment, statistically significant scores were not achieved (p = 0.33). (4) Discussion: The significant differences reported through the V-RQOL and Voice Handicap Index scales in the presence of fistula related problems and device lifetime reduction when compared to the oesophageal speech group have demonstrated, as supported by the literature, a crucial role in the rehabilitative prognosis. (5) Conclusions: The criteria of low resistance to airflow, optimal tracheoesophageal retention, prolonged device life, simple patient maintenance, and comfortable outpatient surgery are the reference standard for obtaining good QoL results, especially over time. Furthermore, the correct phenotyping of the patient based on the main outcomes achieved at clinical follow-up guarantees the primary objective of the identification of a better quality of life.
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Affiliation(s)
- Salvatore Cocuzza
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy; (S.C.); (C.G.); (S.F.); (S.C.); (F.M.); (G.S.); (I.L.M.)
| | - Antonino Maniaci
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy; (S.C.); (C.G.); (S.F.); (S.C.); (F.M.); (G.S.); (I.L.M.)
- Correspondence:
| | - Calogero Grillo
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy; (S.C.); (C.G.); (S.F.); (S.C.); (F.M.); (G.S.); (I.L.M.)
| | - Salvatore Ferlito
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy; (S.C.); (C.G.); (S.F.); (S.C.); (F.M.); (G.S.); (I.L.M.)
| | - Giacomo Spinato
- Section of Otorhinolaryngology, University of Padova, 31100 Treviso, Italy;
| | - Salvatore Coco
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy; (S.C.); (C.G.); (S.F.); (S.C.); (F.M.); (G.S.); (I.L.M.)
| | - Federico Merlino
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy; (S.C.); (C.G.); (S.F.); (S.C.); (F.M.); (G.S.); (I.L.M.)
| | - Giovanna Stilo
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy; (S.C.); (C.G.); (S.F.); (S.C.); (F.M.); (G.S.); (I.L.M.)
| | - Giovanni Paolo Santoro
- Head and Neck and Robotic Surgery, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy;
| | - Giannicola Iannella
- Head and Neck Department, ENT & Oral Surgery Unit, G.B. Morgagni, L. Pierantoni Hospital, 47121 Forlì, Italy; (G.I.); (C.V.)
- Department of Organi di Senso, University “Sapienza”, 00185 Rome, Italy
| | - Claudio Vicini
- Head and Neck Department, ENT & Oral Surgery Unit, G.B. Morgagni, L. Pierantoni Hospital, 47121 Forlì, Italy; (G.I.); (C.V.)
- Department of Otolaryngology, Head and Neck Surgery, University of Ferrara, 44121 Ferrara, Italy
| | - Ignazio La Mantia
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy; (S.C.); (C.G.); (S.F.); (S.C.); (F.M.); (G.S.); (I.L.M.)
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16
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Vallieres C, Hook AL, He Y, Crucitti VC, Figueredo G, Davies CR, Burroughs L, Winkler DA, Wildman RD, Irvine DJ, Alexander MR, Avery SV. Discovery of (meth)acrylate polymers that resist colonization by fungi associated with pathogenesis and biodeterioration. SCIENCE ADVANCES 2020; 6:eaba6574. [PMID: 32548270 PMCID: PMC7274803 DOI: 10.1126/sciadv.aba6574] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 04/08/2020] [Indexed: 05/31/2023]
Abstract
Fungi have major, negative socioeconomic impacts, but control with bioactive agents is increasingly restricted, while resistance is growing. Here, we describe an alternative fungal control strategy via materials operating passively (i.e., no killing effect). We screened hundreds of (meth)acrylate polymers in high throughput, identifying several that reduce attachment of the human pathogen Candida albicans, the crop pathogen Botrytis cinerea, and other fungi. Specific polymer functional groups were associated with weak attachment. Low fungal colonization materials were not toxic, supporting their passive, anti-attachment utility. We developed a candidate monomer formulation for inkjet-based 3D printing. Printed voice prosthesis components showed up to 100% reduction in C. albicans biofilm versus commercial materials. Furthermore, spray-coated leaf surfaces resisted fungal infection, with no plant toxicity. This is the first high-throughput study of polymer chemistries resisting fungal attachment. These materials are ready for incorporation in products to counteract fungal deterioration of goods, food security, and health.
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Affiliation(s)
- Cindy Vallieres
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Andrew L. Hook
- School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Yinfeng He
- Faculty of Engineering, University of Nottingham, Nottingham, UK
| | | | | | | | | | - David A. Winkler
- School of Pharmacy, University of Nottingham, Nottingham, UK
- Monash Institute of Pharmaceutical Sciences, Monash University, Australia
- La Trobe Institute for Molecular Science, La Trobe University, Australia
- CSIRO Manufacturing, Clayton, Australia
| | - Ricky D. Wildman
- Faculty of Engineering, University of Nottingham, Nottingham, UK
| | - Derek J. Irvine
- Faculty of Engineering, University of Nottingham, Nottingham, UK
| | | | - Simon V. Avery
- School of Life Sciences, University of Nottingham, Nottingham, UK
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17
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Pentland DR, Stevens S, Williams L, Baker M, McCall C, Makarovaite V, Balfour A, Mühlschlegel FA, Gourlay CW. Precision Antifungal Treatment Significantly Extends Voice Prosthesis Lifespan in Patients Following Total Laryngectomy. Front Microbiol 2020; 11:975. [PMID: 32508787 PMCID: PMC7251058 DOI: 10.3389/fmicb.2020.00975] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 04/22/2020] [Indexed: 11/13/2022] Open
Abstract
Indwelling silicone valves called voice prostheses (VPs) are the gold standard for speech rehabilitation in patients with laryngeal cancer following total laryngectomy. Reported VP lifespans amongst these patients are highly variable but when devices fail patients experience loss of voice and an increase risk of chest infection. Early failure of VP is a current clinical concern that is associated with regular hospital visits, reduced quality of life and associated medical cost. Poly-microbial biofilms comprised of both bacterial and fungal microorganisms readily colonize VPs and are linked to loss of device performance and its early failure in addition to providing a reservoir for potential infection. Our detailed analysis of poly-microbial biofilm composition on 159 early failing VPs from 48 total laryngectomy patients confirmed Candida albicans as the predominant fungal species and Staphylococcus aureus as the most common bacterial colonizer within our patient cohort. Using a combination of microbiological analysis, patient data and a high-throughput antifungal test assay mimicking in vivo conditions we established an evidence based precision antifungal treatment approach to VP management. Our approach has allowed us to implement a personalized VP management pathway, which increases device in situ lifespan by an average of 270%. Our study represents a significant step forward in both our understanding of the cause of VP failure and a new effective treatment pathway that offers tangible benefit to patients.
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Affiliation(s)
- Daniel R Pentland
- Kent Fungal Group, School of Biosciences, University of Kent, Kent, United Kingdom
| | - Sarah Stevens
- East Kent Hospitals, University NHS Foundation Trust, Kent, United Kingdom
| | - Leila Williams
- East Kent Hospitals, University NHS Foundation Trust, Kent, United Kingdom
| | - Mark Baker
- East Kent Hospitals, University NHS Foundation Trust, Kent, United Kingdom
| | - Carolyn McCall
- East Kent Hospitals, University NHS Foundation Trust, Kent, United Kingdom
| | | | - Alistair Balfour
- East Kent Hospitals, University NHS Foundation Trust, Kent, United Kingdom
| | | | - Campbell W Gourlay
- Kent Fungal Group, School of Biosciences, University of Kent, Kent, United Kingdom
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18
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Recent advances in the implant-based drug delivery in otorhinolaryngology. Acta Biomater 2020; 108:46-55. [PMID: 32289495 DOI: 10.1016/j.actbio.2020.04.012] [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: 02/18/2020] [Revised: 03/31/2020] [Accepted: 04/03/2020] [Indexed: 12/13/2022]
Abstract
The surgical implant is an interdisciplinary therapeutic modality that offers unique advantages in the daily practice of otorhinolaryngology. Some well-known examples include cochlear implants, bone-anchored hearing aids, sinus stents, and tracheostomy tubes. Neuroprotective, osteogenic, anti-inflammatory, and antimicrobial effects are among their established or pursued functions. Implant-based drug delivery affords an efficient and potent approach to enhancing these therapeutic functions. Recent innovations have infiltrated all four elements of a drug-eluting implant. The purpose of this pre-clinical, biotechnology-oriented review is to discuss these developments in terms of the implant biomaterial, loaded medication, delivery pattern, and system fabrication. Cell-mediated neurotrophin release, fabrication of a hydroxyapatite-supported system, biodegradable polymer-based implants, and multiclass and multidrug delivery are some representative advancements. The ultimate goal here is to bridge the gap between biotechnology advances and clinical needs. The review is concluded with a perspective regarding the future opportunities and challenges in this popular and rapidly developing subject of research. STATEMENT OF SIGNIFICANCE: Surgical implants and local drug delivery are representative modern modalities of surgical treatment and medical treatment, respectively. Their synergy offers unique therapeutic advantages, such as minimal systemic side effects, proximity-related high efficiency, and potential absorbability. The applications of implant-based drug delivery have infiltrated otorhinolaryngology and head & neck surgery, which is well known for its related tissue diversity and surgical complexity. Examples discussed here include cochlear implants, bone-anchored hearing aids, sinus stents, and airway tubes. This timely review focuses primarily on the four fundamental components of an implant-based drug delivery system, namely implant biomaterial, loaded medication, delivery pattern, and system fabrication. A particular emphasis is placed upon the in vitro cellular and in vivo animal studies that demonstrate pre-clinical potentials.
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19
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Mutlu A, Koroglu E, Erdogan S. A Single Voice Prosthesis Utilized For 17 Years. IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY 2019; 31:387-389. [PMID: 31857984 PMCID: PMC6914323 DOI: 10.22038/ijorl.2019.30795.2007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Introduction Surgical procedures, especially total laryngectomy, have a profound adverse effect on the patient's physical, functional, as well as emotional health, and strongly decrease quality of life. Tracheoesophageal puncture is one of the most significant method that is widely performed successfully by physicians. Current valve technology enables long expiring duration; however, general duration for all types of valve appears to be approximately 3 to 6 months. Case Report A 72-year-old patient with total laryngectomy and tracheoesophageal voice prosthesis (VP) presented our voice clinic with difficulty in swallowing and leakage around the valve of VP. In this report, we aim to present the patient who has used a single voice prosthesis for 17 years without a complication. Conclusion In our case, the nutritional habits of our patient may have allowed him to use VP for 17 years without complications. We strongly advise following the suggested renewal time of voice prosthesis.
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Affiliation(s)
- Ahmet Mutlu
- Department of Otorhinolaryngology, Istanbul Medeniyet University Goztepe Research and Training Hospital, Istanbul, Turkey
| | - Erdem Koroglu
- Department of Otorhinolaryngology, Kocaeli University Medical Faculty, Kocaeli, Turkey
| | - Selvet Erdogan
- Department of Otorhinolaryngology, Kocaeli University Medical Faculty, Kocaeli, Turkey
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20
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Kulkarni M, Stolp ZD, Hardwick JM. Targeting intrinsic cell death pathways to control fungal pathogens. Biochem Pharmacol 2019; 162:71-78. [PMID: 30660496 DOI: 10.1016/j.bcp.2019.01.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 01/11/2019] [Indexed: 02/07/2023]
Abstract
Fungal pathogens pose an increasing threat to public health. Limited clinical drug regimens and emerging drug-resistant isolates challenge infection control. The global burden of human fungal pathogens is estimated at 1 billion infections and 1.5 million deaths annually. In addition, plant fungal pathogens increasingly threaten global food resources. Novel strategies are needed to combat emerging fungal diseases and pan-resistant fungi. An untapped mechanistically novel approach is to pharmacologically activate the intrinsic cell death pathways encoded by pathogenic fungi. This strategy is analogous to new anti-cancer therapeutics now entering the clinic. Here we summarize the best understood examples of cell death mechanisms encoded by pathogenic fungi, contrast these to mammalian cell death pathways, and highlight the gaps in knowledge towards identifying potential death effectors as druggable targets.
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Affiliation(s)
- Madhura Kulkarni
- Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, USA
| | - Zachary D Stolp
- Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, USA
| | - J Marie Hardwick
- Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, USA; Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, USA.
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21
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Tan Y, Leonhard M, Moser D, Ma S, Schneider-Stickler B. Antibiofilm efficacy of curcumin in combination with 2-aminobenzimidazole against single- and mixed-species biofilms of Candida albicans and Staphylococcus aureus. Colloids Surf B Biointerfaces 2018; 174:28-34. [PMID: 30412864 DOI: 10.1016/j.colsurfb.2018.10.079] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 09/28/2018] [Accepted: 10/31/2018] [Indexed: 12/18/2022]
Abstract
Mixed fungal and bacterial biofilm associated infections of implants have been a huge challenge in health care because of the increased resistance to antimicrobials and the critical biological differences between fungi and bacteria. In this study, we evaluated the 2-aminobenzimidazole (2ABI) and curcumin (CUR) alone to inhibit planktonic cell growth, adhesion as well as single and mixed species biofilms of Candida albicans and Staphylococcus aureus on silicone. The combined effects between 2ABI and CUR on mixed species biofilm formation and pre-formed biofilm were assessed. Our work showed that 2ABI or CUR alone was effective as a sole agent, inhibiting planktonic growth, adhesion and the biofilm formation of bacteria and fungi on the silicone surface. The combination of 2ABI and CUR exhibited the enhanced effect on mixed biofilm compared to mono-drug therapy. The biofilm architecture was investigated by scanning electron microscopy (SEM) and the distinction of living/dead organisms within biofilm was examined by confocal laser scanning microscopy (CLSM). The combination activity was most potent on mixed biofilm. These results suggest the potential applicability of 2ABI and CUR to treatment of biofilm related device infections.
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Affiliation(s)
- Yulong Tan
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
| | - Matthias Leonhard
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
| | - Doris Moser
- Department of Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria.
| | - Su Ma
- Biocatalysis and Biosensor Research Group, Division of Food Biotechnology, Department of Food Science and Technology, BOKU-University of Natural Resources and Life Sciences, Vienna, Austria.
| | - Berit Schneider-Stickler
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
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22
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Galli J, Calo L, Meucci D, Giuliani M, Lucidi D, Paludetti G, Torelli R, Sanguinetti M, Parrilla C. Biofilm in voice prosthesis: A prospective cohort study and laboratory tests using sonication and SEM analysis. Clin Otolaryngol 2018; 43:1260-1265. [PMID: 29768730 DOI: 10.1111/coa.13141] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2018] [Indexed: 10/16/2022]
Abstract
OBJECTIVE The objective of the study was to compare the biofilm growing pattern and its morphological extent on silicone and a teflon-like material using a sonication process and a Scanning Electron Microscope (SEM). DESIGN A prospective cohort study and a laboratory study. SETTING Otolaryngology -Head and Neck surgery Department and the Microbiology Institute. PARTICIPANTS The participants included fifteen laryngectomised patients with phonatory prostheses, which were removed because of device failure, and two different kinds of phonatory prostheses from the laboratory (Provox 2 and ActiValve) that were artificially colonised by Candida albicans. MAIN OUTCOME MEASURES Tracheo-oesophageal puncture (TEP) is currently considered the gold standard for post-laryngectomy voice rehabilitation. "Leakage" represents the most common cause of substitution and is generated by biofilm colonisation of the prosthesis by mixed mycotic and bacterial agents. New biomaterials have been developed that are deemed to be more resistant to the colonisation of micro-organisms and material deformation. RESULTS The devices showed colonisation by mixed bacterial flora (Staphylococci 13%, Streptococci 9%, and Haemophilus influenzae 5%) and by yeasts (Candida albicans 12%). Moreover, we observed a different distribution of biofilm layers in Provox ActiValve (22.56%) compared to Provox 2 (56.82%) after experimental colonisation by the previously isolated Candida strain. CONCLUSION Resident microbiological species from the upper airways unavoidably colonise the polymer surfaces, and no strategies have been effective except for the manipulation of the chemical-physical properties of the device's polymer. Our study confirms that Provox ActiValve, which is made with a fluoroplastic material (teflon-like), is less subject to in vitro colonisation by Candida, and thus showed a higher clinical resistance to biofilm and a longer lifespan. The sonication seems to significantly improve the knowledge of bacterial and mycotic flora in biofilm colonisation. The design of a device for the daily cleaning capable to reach and brush the oesophageal flange of the prosthesis preserving the valve mechanism could represent a practical and simple help in this still unsolved problem.
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Affiliation(s)
- J Galli
- Department of Head and Neck Surgery, Institute of Otorhinolaryngology and Institute of Microbiology, Catholic University School of Medicine and Surgery, Rome, Italy
| | - L Calo
- Department of Head and Neck Surgery, Institute of Otorhinolaryngology and Institute of Microbiology, Catholic University School of Medicine and Surgery, Rome, Italy
| | - D Meucci
- Department of Head and Neck Surgery, Institute of Otorhinolaryngology and Institute of Microbiology, Catholic University School of Medicine and Surgery, Rome, Italy
| | - M Giuliani
- Department of Head and Neck Surgery, Institute of Otorhinolaryngology and Institute of Microbiology, Catholic University School of Medicine and Surgery, Rome, Italy
| | - D Lucidi
- Department of Head and Neck Surgery, Institute of Otorhinolaryngology and Institute of Microbiology, Catholic University School of Medicine and Surgery, Rome, Italy
| | - G Paludetti
- Department of Head and Neck Surgery, Institute of Otorhinolaryngology and Institute of Microbiology, Catholic University School of Medicine and Surgery, Rome, Italy
| | - R Torelli
- Department of Head and Neck Surgery, Institute of Otorhinolaryngology and Institute of Microbiology, Catholic University School of Medicine and Surgery, Rome, Italy
| | - M Sanguinetti
- Department of Head and Neck Surgery, Institute of Otorhinolaryngology and Institute of Microbiology, Catholic University School of Medicine and Surgery, Rome, Italy
| | - C Parrilla
- Department of Head and Neck Surgery, Institute of Otorhinolaryngology and Institute of Microbiology, Catholic University School of Medicine and Surgery, Rome, Italy
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23
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Leonhard M, Zatorska B, Moser D, Tan Y, Schneider-Stickler B. Evaluation of combined growth media for in vitro cultivation of oropharyngeal biofilms on prosthetic silicone. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2018; 29:45. [PMID: 29633010 PMCID: PMC5891558 DOI: 10.1007/s10856-018-6051-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 03/19/2018] [Indexed: 06/08/2023]
Abstract
In the upper aerodigestive tract, biofilm deposits by oropharyngeal microbes can cause failure of medical polymer devices like voice prostheses. Previous studies on testing of inhibitive strategies still lack of comparability due to varying study protocols concerning growth media, microbial species and growth conditions. Goal of the study was therefore to test cultivation of a mixed biofilm of isolated oropharyngeal microbes under in vitro growth conditions using mixtures of common growth media. Mixtures of yeast peptone dextrose medium (YPD), fetal bovine serum (FBS), RPMI 1640, Yeast nitrogen base medium (YNB) and brain heart infusion (BHI) were tested to grow mixed biofilm deposits of Candida albicans, Candida tropicalis, Staphylococcus aureus, Streptococcus epidermidis, Rothia dentocariosa and Lactobacillus gasseri on medical grade silicone. Periodic assessment of living biofilm was performed over 22 days by a digital microscope and the cultivated biofilm structures were analyzed by scanning electron microscopy after completion of the study. Mixtures of BHI, YPD and FBS improved microscopic growth of multispecies biofilm deposits over time, while addition of RPMI and YNB resulted in reduction of visible biofilm deposit sizes. A mixtures of FBS 30% + YPD 70% and BHI 30% + YPD 70% showed enhanced support of permanent surface growth on silicone. Growth kinetics of in vitro multispecies biofilms can be manipulated by using mixtures of common growth media. Using mixtures of growth media can improve growth of longterm multispecies oropharyngeal biofilm models used for in vitro testing of antibiofilm materials or coatings for voice prostheses.
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Affiliation(s)
- M Leonhard
- Department of Otorhinolaryngology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | - B Zatorska
- Department of Otorhinolaryngology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - D Moser
- Department of Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Y Tan
- Department of Otorhinolaryngology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - B Schneider-Stickler
- Department of Otorhinolaryngology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
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24
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Leonhard M, Zatorska B, Tan Y, Moser D, Schneider-Stickler B. In vitro biofilm growth on modern voice prostheses. Head Neck 2017; 40:763-769. [DOI: 10.1002/hed.25053] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 09/07/2017] [Accepted: 11/16/2017] [Indexed: 11/05/2022] Open
Affiliation(s)
- Matthias Leonhard
- Department of Otorhinolaryngology; Medical University of Vienna; Vienna Austria
| | - Beata Zatorska
- Department of Otorhinolaryngology; Medical University of Vienna; Vienna Austria
| | - Yulong Tan
- Department of Otorhinolaryngology; Medical University of Vienna; Vienna Austria
| | - Doris Moser
- Department of Cranio-Maxillofacial and Oral Surgery; Medical University of Vienna; Vienna Austria
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25
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Pentland DR, Piper-Brown E, Mühlschlegel FA, Gourlay CW. Ras signalling in pathogenic yeasts. MICROBIAL CELL 2017; 5:63-73. [PMID: 29417055 PMCID: PMC5798406 DOI: 10.15698/mic2018.02.612] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The small GTPase Ras acts as a master regulator of growth, stress response and cell death in eukaryotic cells. The control of Ras activity is fundamental, as highlighted by the oncogenic properties of constitutive forms of Ras proteins. Ras also plays a crucial role in the pathogenicity of fungal pathogens where it has been found to regulate a number of adaptions required for virulence. The importance of Ras in fungal disease raises the possibility that it may provide a useful target for the development of new treatments at a time when resistance to available antifungals is increasing. New findings suggest that important regulatory sequences found within fungal Ras proteins that are not conserved may prove useful in the development of new antifungals. Here we review the roles of Ras protein function and signalling in the major human yeast pathogens Candida albicans and Cryptococcus neoformans and discuss the potential for targeting Ras as a novel approach to anti-fungal therapy.
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Affiliation(s)
- Daniel R Pentland
- Kent Fungal Group, School of Biosciences, University of Kent, Canterbury, Kent, United Kingdom, CT2 7NJ
| | - Elliot Piper-Brown
- Kent Fungal Group, School of Biosciences, University of Kent, Canterbury, Kent, United Kingdom, CT2 7NJ
| | - Fritz A Mühlschlegel
- Kent Fungal Group, School of Biosciences, University of Kent, Canterbury, Kent, United Kingdom, CT2 7NJ.,Laboratoire national de santé, 1, Rue Louis Rech, L-3555 Dudelange, Luxembourg
| | - Campbell W Gourlay
- Kent Fungal Group, School of Biosciences, University of Kent, Canterbury, Kent, United Kingdom, CT2 7NJ
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26
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Tan Y, Ma S, Leonhard M, Moser D, Schneider-Stickler B. β-1,3-glucanase disrupts biofilm formation and increases antifungal susceptibility of Candida albicans DAY185. Int J Biol Macromol 2017; 108:942-946. [PMID: 29104052 DOI: 10.1016/j.ijbiomac.2017.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 10/31/2017] [Accepted: 11/01/2017] [Indexed: 11/27/2022]
Abstract
β-1,3-glucan plays a role in Candida biofilm formation and survival of biofilm-forming Candida to stresses. In this study, we evaluated the antibiofilm activity of β-1,3-glucanase, which can degrade poly-β(1→3)-glucose of Candida albicans biofilms. Biofilm was dispersed by 55.96%. β-1,3-glucanase had no effect on Candida planktonic growth as well as adhesion. β-1,3-glucanase markedly enhanced the antifungal susceptibility of fluconazole and amphotericin B. The examination using confocal laser scanning microscopy and scanning electron microscope confirmed the antibiofilm activity of β-1,3-glucanase. Our findings demonstrate that β-1,3-glucanase may be useful as an antibiofilm agent.
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Affiliation(s)
- Yulong Tan
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
| | - Su Ma
- Food Biotechnology Laboratory, Department of Food Sciences and Technology, BOKU-University of Natural Resources and Life Sciences, 1190 Vienna, Austria
| | - Matthias Leonhard
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Doris Moser
- Department of Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria
| | - Berit Schneider-Stickler
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
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27
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Chen Q, Zhu Z, Wang J, Lopez AI, Li S, Kumar A, Yu F, Chen H, Cai C, Zhang L. Probiotic E. coli Nissle 1917 biofilms on silicone substrates for bacterial interference against pathogen colonization. Acta Biomater 2017; 50:353-360. [PMID: 28069496 DOI: 10.1016/j.actbio.2017.01.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 12/06/2016] [Accepted: 01/05/2017] [Indexed: 12/25/2022]
Abstract
Bacterial interference is an alternative strategy to fight against device-associated bacterial infections. Pursuing this strategy, a non-pathogenic bacterial biofilm is used as a live, protective barrier to fence off pathogen colonization. In this work, biofilms formed by probiotic Escherichia coli strain Nissle 1917 (EcN) are investigated for their potential for long-term bacterial interference against infections associated with silicone-based urinary catheters and indwelling catheters used in the digestive system, such as feeding tubes and voice prostheses. We have shown that EcN can form stable biofilms on silicone substrates, particularly those modified with a biphenyl mannoside derivative. These biofilms greatly reduced the colonization by pathogenic Enterococcus faecalis in Lysogeny broth (LB) for 11days. STATEMENT OF SIGNIFICANCE Bacterial interference is an alternative strategy to fight against device-associated bacterial infections. Pursuing this strategy, we use non-pathogenic bacteria to form a biofilm that serves as a live, protective barrier against pathogen colonization. Herein, we report the first use of preformed probiotic E. coli Nissle 1917 biofilms on the mannoside-presenting silicone substrates to prevent pathogen colonization. The biofilms serve as a live, protective barrier to fence off the pathogens, whereas current antimicrobial/antifouling coatings are subjected to gradual coverage by the biomass from the rapidly growing pathogens in a high-nutrient environment. It should be noted that E. coli Nissle 1917 is commercially available and has been used in many clinical trials. We also demonstrated that this probiotic strain performed significantly better than the non-commercial, genetically modified E. coli strain that we previously reported.
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28
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Tan Y, Leonhard M, Moser D, Ma S, Schneider-Stickler B. Inhibition of mixed fungal and bacterial biofilms on silicone by carboxymethyl chitosan. Colloids Surf B Biointerfaces 2016; 148:193-199. [PMID: 27595894 DOI: 10.1016/j.colsurfb.2016.08.061] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Revised: 08/01/2016] [Accepted: 08/30/2016] [Indexed: 01/01/2023]
Abstract
Mixed biofilms with fungi and bacteria are the leading cause for the failure of medical silicone devices, such as voice prostheses in laryngectomy. In this study, we determined the effect of carboxymethyl chitosan (CM-chitosan) on mixed biofilm formation of fungi and bacteria on silicone which is widely used for construction of medical devices. Mixed biofilm formations were inhibited 72.87% by CM-chitosan. Furthermore, CM-chitosan significantly decreased the metabolic activity of the biofilms using 2, 3-bis (2-methoxy-4-nitro-5-sulfo-phenyl)-2H-tetrazolium-5 carboxanilide (XTT) reduction assay. The examination using confocal laser scanning microscopy and scanning electron microscope confirmed that CM-chitosan inhibited the mixed biofilm and damaged the cells. Effects of CM-chitosan on different stages of biofilms were also evaluated. CM-chitosan inhibited the adhesion of fungi and bacteria with an efficiency of >90%. It prevented biofilm formation at efficiencies of 69.86%, 50.88% and 46.58% when CM-chitosan was added at 90min, 12h and 24h after biofilm initiation, respectively. Moreover, CM-chitosan inhibited Candida yeast-to-hyphal transition. CM-chitosan was not only able to inhibit the metabolic activity of biofilms, but also active upon the establishment and development of biofilm. Therefore, CM-chitosan may serve as a possible antibiofilm agent to limit biofilm formation on voice prostheses.
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Affiliation(s)
- Yulong Tan
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
| | - Matthias Leonhard
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
| | - Doris Moser
- Department of Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria.
| | - Su Ma
- Food Biotechnology Laboratory, Department of Food Sciences and Technology, BOKU-University of Natural Resources and Life Sciences, 1190 Vienna, Austria.
| | - Berit Schneider-Stickler
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
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29
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Biofilm on the tracheoesophageal voice prosthesis: considerations for oral decontamination. Eur Arch Otorhinolaryngol 2016; 274:405-413. [PMID: 27400694 DOI: 10.1007/s00405-016-4193-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 06/30/2016] [Indexed: 10/21/2022]
Abstract
The tracheoesophageal puncture (TEP) restores verbal communication after total laryngectomy using a one-way valved voice prosthesis (VP). Microbial colonization can shorten VP device life. Our aims were to investigate patterns of prosthetic and oral colonization, and record changes in VP device life after targeted decontamination. We conducted a retrospective review of TEP clinic patients who underwent microbial analysis of the VP between 01/2003 and 07/2013. Two subgroups were analyzed: (1) patients with microbial analysis of the VP and the mouth were analyzed to identify patterns of common contamination, and (2) patients who were prescribed targeted oral decontamination on the basis of the microbial analysis of the VP were analyzed to evaluate effects on device life. Among 42 patients, 3 patients had only fungal, 5 only bacterial, and 33 had polyspecies fungal and bacterial colonization. In the TEP-oral microflora subgroup (n = 15), 7 had common microorganisms in the mouth and on the VP. Among the decontamination subgroup (n = 23), 6 patients received broad spectrum rinse, 16 antifungal agents and 13 antibiotics, or a combination thereof. After targeted decontamination, the median device life of prostheses improved from 7.89 to 10.82 weeks (p = 0.260). The majority of patients with a suboptimal VP device life in this pilot had polyspecies bacterial and fungal colonization. VPs rarely had fungal contamination alone (3 %), and non-albicans fungal species were more common than expected. For these reasons, we are exploring the use of targeted decontamination regimens that were associated with 1.4-fold improvement in VP duration.
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30
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Tan Y, Leonhard M, Moser D, Ma S, Schneider-Stickler B. Long-term antibiofilm activity of carboxymethyl chitosan on mixed biofilm on silicone. Laryngoscope 2016; 126:E404-E408. [DOI: 10.1002/lary.26096] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 04/12/2016] [Accepted: 04/25/2016] [Indexed: 11/10/2022]
Affiliation(s)
- Yulong Tan
- Department of Otorhinolaryngology and Head and Neck Surgery; Medical University of Vienna; Vienna Austria
| | - Matthias Leonhard
- Department of Otorhinolaryngology and Head and Neck Surgery; Medical University of Vienna; Vienna Austria
| | - Doris Moser
- Department of Cranio-Maxillofacial and Oral Surgery; Medical University of Vienna; Vienna Austria
| | - Su Ma
- Food Biotechnology Laboratory; Department of Food Sciences and Technology, BOKU-University of Natural Resources and Life Sciences; Vienna Austria
| | - Berit Schneider-Stickler
- Department of Otorhinolaryngology and Head and Neck Surgery; Medical University of Vienna; Vienna Austria
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31
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Antimicrobial activity of plumbagin, a naturally occurring naphthoquinone from Plumbago rosea, against Staphylococcus aureus and Candida albicans. Int J Med Microbiol 2016; 306:237-48. [DOI: 10.1016/j.ijmm.2016.05.004] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 05/03/2016] [Accepted: 05/08/2016] [Indexed: 01/08/2023] Open
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32
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Bujdáková H. Management of Candida biofilms: state of knowledge and new options for prevention and eradication. Future Microbiol 2016; 11:235-51. [PMID: 26849383 DOI: 10.2217/fmb.15.139] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Biofilms formed by Candida species (spp.) on medical devices represent a potential health risk. The focus of current research is searching for new options for the treatment and prevention of biofilm-associated infections using different approaches including modern nanotechnology. This review summarizes current information concerning the most relevant resistance/tolerance mechanisms to conventional drugs and a role of additional factors contributing to these phenomena in Candida spp. (mostly Candida albicans). Additionally, it provides an information update in prevention and eradication of a Candida biofilm including experiences with 'lock' therapy, potential utilization of small molecules in biomedical applications, and perspectives of using photodynamic inactivation in the control of a Candida biofilm.
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Affiliation(s)
- Helena Bujdáková
- Comenius University in Bratislava, Faculty of Natural Sciences, Department of Microbiology & Virology, Mlynská dolina, Ilkovičova 6, 842 15 Bratislava, Slovak Republic
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33
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O'Donnell LE, Millhouse E, Sherry L, Kean R, Malcolm J, Nile CJ, Ramage G. PolymicrobialCandidabiofilms: friends and foe in the oral cavity. FEMS Yeast Res 2015; 15:fov077. [DOI: 10.1093/femsyr/fov077] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2015] [Indexed: 12/26/2022] Open
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34
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Cannon R, Holmes A. Learning the ABC of oral fungal drug resistance. Mol Oral Microbiol 2015; 30:425-37. [DOI: 10.1111/omi.12109] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2015] [Indexed: 01/07/2023]
Affiliation(s)
- R.D. Cannon
- Sir John Walsh Research Institute; University of Otago; Dunedin New Zealand
| | - A.R. Holmes
- Sir John Walsh Research Institute; University of Otago; Dunedin New Zealand
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35
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Primary Prosthetic Voice Rehabilitation in Patients After Laryngectomy: Applications and Pitfalls. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2014; 852:11-6. [DOI: 10.1007/5584_2014_104] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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