Effects of chelating agent and environmental stresses on microbial biofilms: relevance to clinical microbiology

Restoring colistin sensitivity in colistin-resistant Salmonella and Escherichia coli: combinatorial use of berberine and EDTA with colistin

The appearance and prevalence of multidrug-resistance (MDR) Gram-negative bacteria (GNB) have limited our antibiotic capacity to control bacterial infections. The clinical efficacy of colistin (COL), considered as the "last resort" for treating GNB infections, has been severely hindered by its increased use as well as the emergence and prevalence of mobile colistin resistance (MCR)-mediated acquired drug resistance. Identifying promising compounds to restore antibiotic activity is becoming an effective strategy to alleviate the crisis of increasing MDR. We first demonstrated that the combination of berberine (BBR) and EDTA substantially restored COL sensitivity against COL-resistant Salmonella and Escherichia coli. Molecular docking indicated that BBR can interact with MCR-1 and the efflux pump system AcrAB-TolC, and BBR combined with EDTA downregulated the expression level of mcr-1 and tolC. Mechanically, BBR combined with EDTA could increase bacterial membrane damage, inhibit the function of multidrug efflux pump, and promote oxidative damage, thereby boosting the action of COL. In addition, transcriptome analysis found that the combination of BBR and EDTA can accelerate the tricarboxylic acid cycle, inhibit cationic antimicrobial peptide (CAMP) resistance, and attenuate Salmonella virulence. Notably, the combination of BBR and EDTA with COL significantly reduced the bacterial load in the liver and spleen of a mice model infected with Salmonella. Our findings revealed that BBR and EDTA can be used as adjuvants collectively with COL to synergistically reverse the COL resistance of bacteria.

IMPORTANCE

Colistin is last-resort antibiotic used to treat serious clinical infections caused by MDR bacterial pathogens. The recent emergence of transferable plasmid-mediated COL resistance gene mcr-1 has raised the specter of a rapid worldwide spread of COL resistance. Coupled with the fact of barren antibiotic development pipeline nowadays, a critical approach is to revitalize existing antibiotics using antibiotic adjuvants. Our research showed that berberine combined with EDTA effectively reversed COL resistance both in vivo and in vitro through multiple modes of action. The discovery of berberine in combination with EDTA as a new and safe COL adjuvant provides a therapeutic regimen for combating Gram-negative bacteria infections. Our findings provide a potential therapeutic option using existing antibiotics in combination with antibiotic adjuvants and address the prevalent infections caused by MDR Gram-negative pathogens worldwide.

Mechanical Alloying Integrated with Cold Spray Coating for Fabrication Cu50(Ti50-xNix), x; 10, 20, 30, and 40 at.% Antibiofilm Metallic Glass Coated/SUS304 Sheets

Antibacterial agents derived from conventional organic compounds have traditionally been employed as a biofilm protective coating for many years. These agents, on the other hand, often include toxic components that are potentially hazardous to humans. Multiple approaches have been investigated over the last two decades, including the use of various metallic and oxide materials, in order to produce a diverse variety of usable coating layers. When it comes to material coating approaches, the cold spray technique, which is a solid-state method that works well with nanopowders, has shown superior performance. Its capacity to produce unique material coating in ways that are not possible with other thermal methods is the primary reason for its importance in contemporary production. The present work has been addressed in part to explore the possibility of employing mechanically alloyed Cu50(Ti50-xNix)x; x = 10, 20, 30, and 40 at.% metallic glass powders, for producing an antibiofilm/SUS304 surface protective coating, using the cold spray approach. In this study, elemental Cu, Ti, and Ni powders were low-energy ball milled for 100 h to fabricate metallic glassy powders with different Ni contents. The as-prepared metallic glassy powders were utilized to coat SUS304 sheets, using the cold spraying process. With high nanohardness values, the as-fabricated coating material, in particular Cu50Ti20Ni30, demonstrated remarkable performance in comparison to other materials in its class. Furthermore, it displayed excellent wear resistance while maintaining a low coefficient of friction, with values ranging from 0.32 to 0.45 in the tested range. E. coli biofilms were formed on 20 mm2 SUS304 sheet coated coupons, which had been injected with 1.5 108 CFU mL-1 of the bacterium. With the use of nanocrystalline Cu-based powders, it is feasible to achieve considerable biofilm inhibition, which is a practical strategy for accomplishing the suppression of biofilm formation.

Effects of environmental conditions (temperature, pH, and glucose) on biofilm formation of Salmonella enterica serotype Kentucky and virulence gene expression

Salmonella is a foodborne pathogen and an emerging zoonotic bacterial threat in the food industry. The aim of this study was to evaluate the biofilm formation by a cocktail culture of 3 wild isolates of Salmonella enterica serotype Kentucky on plastic (PLA), silicon rubber (SR), and chicken skin surfaces under various temperatures (4, 10, 25, 37, and 42°C) and pH values (4.0, 5.0, 6.0, 7.0, and 8.0). Then, at the optimum temperature and pH, the effects of supplementation with glucose (0, 0.025, 0.05, and 0.4% w/v) on biofilm formation were assessed on each of the surfaces. The results indicated that higher temperatures (25 to 42°C) and pH values (7.0 and 8.0) led to more robust biofilm formation than lower temperatures (4 and 10°C) and lower pH levels (4.0 to 6.0). Moreover, biofilm formation was induced by 0.025% glucose during incubation at the optimum temperature (37°C) and pH (7.0) but inhibited by 0.4% glucose. Consistent with this finding, virulence related gene (rpoS, rpoH, hilA, and avrA) expression was increased at 0.025% glucose and significantly reduced at 0.4% glucose. This results also confirmed by field emission scanning electron microscope, confocal laser scanning microscopy, and autoinducer-2 determination. This study concluded that optimum environmental conditions (temperature 37°C, pH 7.0, and 0.25% glucose) exhibited strong biofilm formation on food and food contract surfaces as well as increased the virulence gene expression levels, indicating that these environmental conditions might be threating conditions for food safety.

In vitro and in vivo activity of EDTA and antibacterial agents against the biofilm of mucoid Pseudomonas aeruginosa

PURPOSE

Refractory infection caused by bacterial biofilm is an important clinical problem. Pseudomonas aeruginosa is a common pathogen responsible for persistent and chronic biofilm infections. We aimed to explore the in vitro and in vivo activity of ethylenediamine tetraacetic acid (EDTA) in combination with antibacterial agents against mucoid P. aeruginosa biofilm.

METHODS

The minimal inhibitory concentration (MIC) and minimal bactericidal concentration of ciprofloxacin, gentamicin, and ampicillin alone or with EDTA against P. aeruginosa were determined in vitro. Extracellular polysaccharides (EPS) and structural parameters of the biofilm were monitored. P. aeruginosa was aerosolized and delivered into the lungs of guinea pigs, which were treated with ciprofloxacin with or without EDTA. The colony-forming units (CFUs) of P. aeruginosa were determined from the lungs.

RESULTS

EDTA reduced the MIC of ciprofloxacin and ampicillin by about 30-fold and that of gentamicin by twofold. EDTA reduced the biofilm EPS and the proportion of viable bacteria. The thickness, average diffusion distance, and textural entropy of EDTA-treated biofilm were significantly decreased. EDTA plus antibiotics reduced the colony counting from 10⁷ to 10³ CFU/mL. In vivo, EDTA plus ciprofloxacin had a significantly lower mean CFU/g of lung tissue (EDTA + ciprofloxacin 1.3 ± 0.19; EDTA 4.4 ± 0.57; ciprofloxacin 4.2 ± 0.47), and lung lesions were less severe compared with the single treatment groups.

CONCLUSIONS

EDTA can destroy the biofilm structures of mucoid P. aeruginosa in vitro. Moreover, EDTA and ciprofloxacin had a significant bactericidal effect against biofilm in vivo.

Potential applications of cold sprayed Cu50Ti20Ni30 metallic glassy alloy powders for antibacterial protective coating in medical and food sectors

Mechanical alloying was utilized for synthesizing of metallic glassy Cu50Ti20Ni30 alloy powders, using a low energy ball milling technique. The metallic glassy powders obtained after 100 h of ball milling had an average particle size of 1.7 mm in diameter and possessed excellent thermal stability, indexed by a relatively high glass transition temperature (358.3 °C) with a wide supercooled liquid region (61 °C). This amorphous phase crystallized into Ti2Cu and CuTiNi2 ordered phases through two overlapped crystallization temperatures at 419.3 °C and 447.5 °C, respectively. The total enthalpy change of crystallization was -4.8 kJ/mol. The glassy powders were employed as feedstock materials to double-face coating the surface of SUS 304 substrate, using cold spraying process under helium gas pressure at 400 °C. This coating material had an extraordinary high nanohardness value of 3.1 GPa. Moreover, it showed a high resistance to wear with a low value of the coefficient of friction ranging from 0.45 to 0.45. Biofilms were grown on 20-mm(2) SUS304 sheets coated coupons inoculated with 1.5 × 10(8) CFU ml(-1)E. coli. Significant biofilm inhibition (p The inhibition of biofilm formation by nanocrystalline powders of Cu-based provides a practical approach to achieve the inhibition of biofilms formation.

The expanding horizon of prosthetic joint infections

Prosthetic joint infection (PJI) is a serious and potentially devastating complication of arthroplasty. Prior arthroplasty, immunosuppression, severe comorbid conditions, and prolonged surgical duration are important risk factors for PJI. More than half of the cases of PJI are caused by Staphylococcus aureus and coagulase-negative staphylococci. The biofilm plays a central role in its pathogenesis. The diagnosis of PJI requires the presence of purulence, sinus tract, evidence of inflammation on histopathology, or positive microbiologic cultures. The use of diagnostic imaging techniques is generally limited but may be helpful in selected cases. The most effective way to prevent PJI is to optimize the health of patients, using antibiotic prophylaxis in a proper and timely fashion. Management of PJI frequently requires removal of all hardware and administration of intravenous antibiotics. This review summarizes and analyzes the results of previous reports of PJI and assesses the prevention and management of this important entity.

The alternative role of enterobactin as an oxidative stress protector allows Escherichia coli colony development

Numerous bacteria have evolved different iron uptake systems with the ability to make use of their own and heterologous siderophores. However, there is growing evidence attributing alternative roles for siderophores that might explain the potential adaptive advantages of microorganisms having multiple siderophore systems. In this work, we show the requirement of the siderophore enterobactin for Escherichia coli colony development in minimal media. We observed that a strain impaired in enterobactin production (entE mutant) was unable to form colonies on M9 agar medium meanwhile its growth was normal on LB agar medium. Given that, neither iron nor citrate supplementation restored colony growth, the role of enterobactin as an iron uptake-facilitator would not explain its requirement for colony development. The absence of colony development was reverted either by addition of enterobactin, the reducing agent ascorbic acid or by incubating in anaerobic culture conditions with no additives. Then, we associated the enterobactin requirement for colony development with its ability to reduce oxidative stress, which we found to be higher in media where the colony development was impaired (M9) compared with media where the strain was able to form colonies (LB). Since oxyR and soxS mutants (two major stress response regulators) formed colonies in M9 agar medium, we hypothesize that enterobactin could be an important piece in the oxidative stress response repertoire, particularly required in the context of colony formation. In addition, we show that enterobactin has to be hydrolyzed after reaching the cell cytoplasm in order to enable colony development. By favoring iron release, hydrolysis of the enterobactin-iron complex, not only would assure covering iron needs, but would also provide the cell with a molecule with exposed hydroxyl groups (hydrolyzed enterobactin). This molecule would be able to scavenge radicals and therefore reduce oxidative stress.

From in vitro to in vivo Models of Bacterial Biofilm-Related Infections

The influence of microorganisms growing as sessile communities in a large number of human infections has been extensively studied and recognized for 30–40 years, therefore warranting intense scientific and medical research. Nonetheless, mimicking the biofilm-life style of bacteria and biofilm-related infections has been an arduous task. Models used to study biofilms range from simple in vitro to complex in vivo models of tissues or device-related infections. These different models have progressively contributed to the current knowledge of biofilm physiology within the host context. While far from a complete understanding of the multiple elements controlling the dynamic interactions between the host and biofilms, we are nowadays witnessing the emergence of promising preventive or curative strategies to fight biofilm-related infections. This review undertakes a comprehensive analysis of the literature from a historic perspective commenting on the contribution of the different models and discussing future venues and new approaches that can be merged with more traditional techniques in order to model biofilm-infections and efficiently fight them.

Effect of long-term starvation in salty microcosm on biofilm formation and motility in Pseudomonas aeruginosa

The development of antibiotic resistance in the opportunistic pathogen Pseudomonas aeruginosa is a major cause of the pathogen's morbidity and is strongly correlated with the biofilm formation. Motility and adherence capacity in long-term stressed cells have not been extensively analyzed even though P. aeruginosa considered a model organism for the study of biofilm formation. In this investigation, P. aeruginosa ATCC 27853 strain has been stored for 12 months in LB broth with 0.5 M NaCl. Several experiments demonstrated that the strain recovery from the salty microcosm had the ability to increase the biofilm formation and to reduce motility comparing with that of the original strain. To identify genes involved in the regulation of biofilm and/or in stress response by the recovered P. aeruginosa, differential display "DDRT-PCR" technique was used. The genes speD and ccoN2, coding, respectively, for an S-adenosylmethionine decarboxylase and Cbb3-type cytochrome oxidase, were identified in recovered strain of P. aeruginosa ATCC 27853 as two differentially expressed gene fragments. A comparison of the biofilm produced by the wild-type strain PA14 and the transposon insertion mutant for speD gene suggested that spermidine has a potential role in the adaptive response in P. aeruginosa incubated in long-term stress conditions.

Periprosthetic Joint Infection: What is on the Horizon?

Periprosthetic joint infection (PJI) will emerge as one of the most important issues for both orthopedic surgeons and researchers active in the field over the coming decades. Although the rate of PJI has not changed significantly over the past decade, the affected patients (hosts) being treated often present with more comorbidities than in the past, and the organisms responsible for these infections are evolving to become more difficult to treat. Fortunately, though, major strides in basic, translational, and clinical research have occurred in recent years that have armed the clinician with an armamentarium of techniques and technologies to better diagnose, prevent, and treat PJI. Advances in diagnostics, including refinements in established biomarkers, the introduction of point of service tests, developments in molecular techniques, and new techniques in advanced imaging will allow us to correctly identify the infecting pathogens and their virulence factors. Utilizing developed risk indexes to stratify and medically optimize our patients, modifying implants to incorporate antimicrobial and anti-biofilm properties, and developing clinically applicable vaccines and biofilm inhibiting enzymes will address our struggles in preventing PJI. Success of our future treatment strategies will hinge on refining the indications and technique of our current surgical procedures as well as the rational use of biofilm disrupting technologies and photodynamic therapy. Finally, the field of metabolomics, though still relatively in its infancy, likely holds the key to a novel diagnostic and treatment approach to infection and a more profound understanding of the pathophysiology of PJI on the human body.