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Elawady R, Aboulela AG, Gaballah A, Ghazal AA, Amer AN. Antimicrobial Sub-MIC induces Staphylococcus aureus biofilm formation without affecting the bacterial count. BMC Infect Dis 2024; 24:1065. [PMID: 39342123 PMCID: PMC11438285 DOI: 10.1186/s12879-024-09790-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 08/21/2024] [Indexed: 10/01/2024] Open
Abstract
BACKGROUND Biofilm formation is an essential virulence factor that creates a highly protected growth mode for Staphylococcus aureus (S. aureus) to survive in any hostile environment. Antibiotic sub-minimal inhibitory concentration (sub-MIC) may modulate the biofilm formation ability of bacterial pathogens, thereby affecting bacterial pathogenesis and infection outcomes. Intense antimicrobial therapy to treat biofilm-associated infections can control the pathogenic infection aggravation but cannot guarantee its complete eradication. OBJECTIVE This study aimed to assess the sub-MICs effect of 5 different antimicrobial classes on biofilm-forming capacity among Staphylococcus aureus clinical isolates using three different biofilm quantitation techniques. METHODS In this study, the effects of 5 different antimicrobial agents, namely, azithromycin, gentamicin, ciprofloxacin, doxycycline, and imipenem, at sub-MICs of 12.5%, 25%, and 50% were tested on 5 different clinical isolates of S. aureus. The biofilms formed in the absence and presence of different antimicrobial sub-MICs were then assessed using the following three different techniques: the crystal violet (CV) staining method, the quantitative PCR (qPCR) method, and the spread plate method (SPM). RESULTS Biofilm formation was significantly induced in 64% of the tested conditions using the CV technique. On the other hand, the qPCR quantifying the total bacterial count and the SPM quantifying the viable bacterial count showed significant induction only in 24% and 17.3%, respectively (Fig. 1). The difference between CV and the other techniques indicates an increase in biofilm biomass without an increase in bacterial growth. As expected, sub-MICs did not reduce the viable cell count, as shown by the SPM. The CV staining method revealed that sub-MICs of imipenem and ciprofloxacin had the highest significance rate (80%) showing an inductive effect on the biofilm development. On the other hand, doxycycline, azithromycin, and gentamicin displayed lower significance rates of 73%, 53%, and 47%, respectively. CONCLUSION Exposure to sub-MIC doses of antimicrobial agents induces the biofilm-forming capacity of S. aureus via increasing the total biomass without significantly affecting the bacterial growth of viable count.
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Affiliation(s)
- Raghda Elawady
- Department of Microbiology, Medical Research Institute, Alexandria University, Alexandria, Egypt.
| | - Aliaa G Aboulela
- Department of Microbiology, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Ahmed Gaballah
- Department of Microbiology, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Abeer A Ghazal
- Department of Microbiology, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Ahmed N Amer
- Department of Pharmaceutical Microbiology and Immunology, Faculty of Pharmacy and Drug Manufacturing, Pharos University, Alexandria, Egypt
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Kiarostami K, Fernández-Barat L, Battaglini D, Motos A, Bueno-Freire L, Soler-Comas A, Bassi GL, Torres A. The efficacy of telavancin in comparison with linezolid on endotracheal tube biofilm in pigs with methicillin-resistant Staphylococcus aureus pneumonia. Int J Antimicrob Agents 2024; 63:107052. [PMID: 38072170 DOI: 10.1016/j.ijantimicag.2023.107052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 11/23/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND The effect of systemic treatment of ventilator-associated pneumonia (VAP) with telavancin, a semisynthetic lipoglycopeptide with good penetration in vitro biofilms, has not been tested in vivo during mechanical ventilation. This study examined the efficacy of telavancin compared with linezolid against endotracheal tube (ETT) biofilms in a porcine model of methicillin-resistant Staphylococcus aureus (MRSA) VAP. METHODS VAP was induced in 18 pigs by instilling 107 colony-forming units (CFU/mL) of an MRSA strain susceptible to telavancin and linezolid into each pulmonary lobe. Randomization into three groups was done at pneumonia diagnosis: control (IV glucose 0.5% solution q24); linezolid (10 mg/kg q12) and telavancin groups (22.5 mg/kg q24). After 72 h of MV, data regarding bronchoalveolar lavage (BAL), tracheal aspirate (TA), ETT MRSA biofilm load and thickness measured by scanning electron microscopy were obtained. RESULTS All 18 pigs completed the study. MRSA was isolated in 100% of ETTs from the control and linezolid groups and in 67% from the telavancin group. Telavancin treatment presented a lower MRSA load compared to the control and linezolid treatments (telavancin median [interquartile range (IQR)] = 1.94 [0.00-5.45], linezolid 3.99 [3.22-4.68] and control 4.93 [4.41-5.15], P = 0.236). Telavancin treatment also resulted in the lowest biofilm thickness according to the SEM (4.04 [2.09-6.00], P < 0.001). We found a positive correlation between ETT and BAL load (rho = 0.511, P = 0.045). CONCLUSIONS In our VAP model, systemic telavancin treatment reduced ETT MRSA occurrence, load, and biofilm thickness. Our findings may have a bearing on ICU patients' clinical outcomes.
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Affiliation(s)
- Kasra Kiarostami
- CELLEX research laboratories, CibeRes (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; School of Medicine Department of Medicine, University of Barcelona, Spain; Pulmonology Department, Hospital Clínic, Barcelona, Spain
| | - Laia Fernández-Barat
- CELLEX research laboratories, CibeRes (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; School of Medicine Department of Medicine, University of Barcelona, Spain; Pulmonology Department, Hospital Clínic, Barcelona, Spain.
| | - Denise Battaglini
- CELLEX research laboratories, CibeRes (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Pulmonology Department, Hospital Clínic, Barcelona, Spain; Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy; Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, Genoa, Italy
| | - Anna Motos
- CELLEX research laboratories, CibeRes (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; School of Medicine Department of Medicine, University of Barcelona, Spain; Pulmonology Department, Hospital Clínic, Barcelona, Spain; Institut Clínic Respiratori (ICR), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Leticia Bueno-Freire
- CELLEX research laboratories, CibeRes (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; School of Medicine Department of Medicine, University of Barcelona, Spain; Pulmonology Department, Hospital Clínic, Barcelona, Spain
| | - Alba Soler-Comas
- School of Medicine Department of Medicine, University of Barcelona, Spain; Pulmonology Department, Hospital Clínic, Barcelona, Spain
| | - Gianluigi Li Bassi
- CELLEX research laboratories, CibeRes (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia; Queensland University of Technology, Brisbane, Australia; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, 3015, Rotterdam, the Netherlands
| | - Antoni Torres
- CELLEX research laboratories, CibeRes (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; School of Medicine Department of Medicine, University of Barcelona, Spain; Pulmonology Department, Hospital Clínic, Barcelona, Spain; Institut Clínic Respiratori (ICR), Hospital Clínic de Barcelona, Barcelona, Spain.
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3
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Plotniece A, Sobolev A, Supuran CT, Carta F, Björkling F, Franzyk H, Yli-Kauhaluoma J, Augustyns K, Cos P, De Vooght L, Govaerts M, Aizawa J, Tammela P, Žalubovskis R. Selected strategies to fight pathogenic bacteria. J Enzyme Inhib Med Chem 2023; 38:2155816. [PMID: 36629427 PMCID: PMC9848314 DOI: 10.1080/14756366.2022.2155816] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/02/2022] [Accepted: 12/02/2022] [Indexed: 01/12/2023] Open
Abstract
Natural products and analogues are a source of antibacterial drug discovery. Considering drug resistance levels emerging for antibiotics, identification of bacterial metalloenzymes and the synthesis of selective inhibitors are interesting for antibacterial agent development. Peptide nucleic acids are attractive antisense and antigene agents representing a novel strategy to target pathogens due to their unique mechanism of action. Antisense inhibition and development of antisense peptide nucleic acids is a new approach to antibacterial agents. Due to the increased resistance of biofilms to antibiotics, alternative therapeutic options are necessary. To develop antimicrobial strategies, optimised in vitro and in vivo models are needed. In vivo models to study biofilm-related respiratory infections, device-related infections: ventilator-associated pneumonia, tissue-related infections: chronic infection models based on alginate or agar beads, methods to battle biofilm-related infections are discussed. Drug delivery in case of antibacterials often is a serious issue therefore this review includes overview of drug delivery nanosystems.
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Affiliation(s)
- Aiva Plotniece
- Latvian Institute of Organic Synthesis, Riga, Latvia
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Riga Stradiņš University, Riga, Latvia
| | | | - Claudiu T. Supuran
- Department of NEUROFARBA, Section of Pharmaceutical and Nutraceutical Sciences, University of Florence, Firenze, Italy
| | - Fabrizio Carta
- Department of NEUROFARBA, Section of Pharmaceutical and Nutraceutical Sciences, University of Florence, Firenze, Italy
| | - Fredrik Björkling
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, Center for Peptide-Based Antibiotics, University of Copenhagen, Copenhagen East, Denmark
| | - Henrik Franzyk
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, Center for Peptide-Based Antibiotics, University of Copenhagen, Copenhagen East, Denmark
| | - Jari Yli-Kauhaluoma
- Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, Drug Research Program, University of Helsinki, Helsinki, Finland
| | - Koen Augustyns
- Infla-Med, Centre of Excellence, University of Antwerp, Antwerp, Belgium
- Laboratory of Medicinal Chemistry, University of Antwerp, Antwerp, Belgium
| | - Paul Cos
- Department of Pharmaceutical Sciences, Laboratory for Microbiology, Parasitology and Hygiene (LMPH), University of Antwerp, Antwerp, Belgium
| | - Linda De Vooght
- Department of Pharmaceutical Sciences, Laboratory for Microbiology, Parasitology and Hygiene (LMPH), University of Antwerp, Antwerp, Belgium
| | - Matthias Govaerts
- Department of Pharmaceutical Sciences, Laboratory for Microbiology, Parasitology and Hygiene (LMPH), University of Antwerp, Antwerp, Belgium
| | - Juliana Aizawa
- Department of Pharmaceutical Sciences, Laboratory for Microbiology, Parasitology and Hygiene (LMPH), University of Antwerp, Antwerp, Belgium
| | - Päivi Tammela
- Division of Pharmaceutical Biosciences, Faculty of Pharmacy, Drug Research Program, University of Helsinki, Helsinki, Finland
| | - Raivis Žalubovskis
- Latvian Institute of Organic Synthesis, Riga, Latvia
- Faculty of Materials Science and Applied Chemistry, Institute of Technology of Organic Chemistry, Riga Technical University, Riga, Latvia
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4
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Misra T, Tare M, Jha PN. Insights Into the Dynamics and Composition of Biofilm Formed by Environmental Isolate of Enterobacter cloacae. Front Microbiol 2022; 13:877060. [PMID: 35865928 PMCID: PMC9294512 DOI: 10.3389/fmicb.2022.877060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/27/2022] [Indexed: 11/13/2022] Open
Abstract
Bacterial biofilms are clinically admissible and illustrate an influential role in infections, particularly those related to the implant of medical devices. The characterization of biofilms is important to understand the etiology of the diseases. Enterobacter cloacae are known for causing infections by forming biofilms on various abiotic surfaces, such as medical devices. However, a detailed characterization in terms of morphology and the molecular composition of the formed biofilms by this bacterium is sparse. The present study provides insights into the biofilm formation of E. cloacae SBP-8, an environmental isolate, on various surfaces. We performed assays to understand the biofilm-forming capability of the SBP-8 strain and characterized the adhering potential of the bacteria on the surface of different medical devices (foley latex catheter, enteral feeding tube, and glass) at different temperatures. We found that medical devices exhibited strong colonization by E. cloacae SBP-8. Using field emission-scanning electron microscopy (FE-SEM) studies, we characterized the biofilms as a function of time. It indicated stronger biofilm formation in terms of cellular density and EPS production on the surfaces. Further, we characterized the biofilm employing surface-enhanced Raman spectroscopy (SERS) and identified the vast heterogenic nature of the biofilm-forming molecules. Interestingly, we also found that this heterogeneity varies from the initial stages of biofilm formation until the maturation and dispersion. Our studies provide insights into biofilm composition over a period of time, which might aid in understanding the biofilm dispersion phases, to enhance the presently available treatment strategies.
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Affiliation(s)
| | - Meghana Tare
- Department of Biological Sciences, Birla Institute of Technology and Science, Pilani, India
| | - Prabhat Nath Jha
- Department of Biological Sciences, Birla Institute of Technology and Science, Pilani, India
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5
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Guzmán-Soto I, McTiernan C, Gonzalez-Gomez M, Ross A, Gupta K, Suuronen EJ, Mah TF, Griffith M, Alarcon EI. Mimicking biofilm formation and development: Recent progress in in vitro and in vivo biofilm models. iScience 2021; 24:102443. [PMID: 34013169 PMCID: PMC8113887 DOI: 10.1016/j.isci.2021.102443] [Citation(s) in RCA: 103] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Biofilm formation in living organisms is associated to tissue and implant infections, and it has also been linked to the contribution of antibiotic resistance. Thus, understanding biofilm development and being able to mimic such processes is vital for the successful development of antibiofilm treatments and therapies. Several decades of research have contributed to building the foundation for developing in vitro and in vivo biofilm models. However, no such thing as an "all fit" in vitro or in vivo biofilm models is currently available. In this review, in addition to presenting an updated overview of biofilm formation, we critically revise recent approaches for the improvement of in vitro and in vivo biofilm models.
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Affiliation(s)
- Irene Guzmán-Soto
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON, K1Y4W7, Canada
| | - Christopher McTiernan
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON, K1Y4W7, Canada
| | - Mayte Gonzalez-Gomez
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON, K1Y4W7, Canada
| | - Alex Ross
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON, K1Y4W7, Canada
- Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, K1H8M5, Canada
| | - Keshav Gupta
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON, K1Y4W7, Canada
| | - Erik J. Suuronen
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON, K1Y4W7, Canada
| | - Thien-Fah Mah
- Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, K1H8M5, Canada
| | - May Griffith
- Centre de Recherche Hôpital Maisonneuve-Rosemont, Montréal, QC, H1T 2M4, Canada
- Département d'ophtalmologie, Université de Montréal, Montréal, QC, H3T1J4, Canada
| | - Emilio I. Alarcon
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON, K1Y4W7, Canada
- Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, K1H8M5, Canada
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6
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Shaqour B, Aizawa J, Guarch-Pérez C, Górecka Ż, Christophersen L, Martinet W, Choińska E, Riool M, Verleije B, Beyers K, Moser C, Święszkowski W, Zaat SAJ, Cos P. Coupling Additive Manufacturing with Hot Melt Extrusion Technologies to Validate a Ventilator-Associated Pneumonia Mouse Model. Pharmaceutics 2021; 13:pharmaceutics13060772. [PMID: 34064276 PMCID: PMC8224298 DOI: 10.3390/pharmaceutics13060772] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/08/2021] [Accepted: 05/18/2021] [Indexed: 12/02/2022] Open
Abstract
Additive manufacturing is widely used to produce highly complex structures. Moreover, this technology has proven its superiority in producing tools which can be used in different applications. We designed and produced an extrusion nozzle that allowed us to hot melt extrude drug-loaded tubes. The tubes were an essential part of a new mouse ventilator-associated pneumonia (VAP) model. Ciprofloxacin (CPX) was selected for its expected activity against the pathogen Staphylococcus aureus and ease of incorporation into thermoplastic polyurethane (TPU). TPU was selected as the carrier polymer for its biocompatibility and use in a variety of medical devices such as tubing and catheters. The effect of loading CPX within the TPU polymeric matrix and the physicochemical properties of the produced tubes were investigated. CPX showed good thermal stability and in vitro activity in preventing S. aureus biofilm formation after loading within the tube’s polymeric matrix. Moreover, the produced tubes showed anti-infective efficacy in vivo. The produced tubes, which were extruded via our novel nozzle, were vital for the validation of our mouse VAP model. This model can be adopted to investigate other antibacterial and antibiofilm compounds incorporated in polymeric tubes using hot melt extrusion.
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Affiliation(s)
- Bahaa Shaqour
- Laboratory for Microbiology, Parasitology and Hygiene (LMPH), Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Universiteitsplein 1 S.7, 2610 Wilrijk, Belgium; (J.A.); (P.C.)
- Mechanical and Mechatronics Engineering Department, Faculty of Engineering & Information Technology, An-Najah National University, Nablus P.O. Box 7, Palestine
- Correspondence:
| | - Juliana Aizawa
- Laboratory for Microbiology, Parasitology and Hygiene (LMPH), Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Universiteitsplein 1 S.7, 2610 Wilrijk, Belgium; (J.A.); (P.C.)
| | - Clara Guarch-Pérez
- Department of Medical Microbiology and Infection Prevention, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (C.G.-P.); (M.R.); (S.A.J.Z.)
| | - Żaneta Górecka
- Faculty of Materials Sciences and Engineering, Warsaw University of Technology, Woloska 141, 02-507 Warsaw, Poland; (Ż.G.); (E.C.); (W.Ś.)
- Centre for Advanced Materials and Technologies CEZAMAT, Warsaw University of Technology, Poleczki 19, 02-822 Warsaw, Poland
| | - Lars Christophersen
- Department for Clinical Microbiology, Rigshospitalet, Henrik Harpestrengsvej 4A, Afsnit 93.01, 2100 Copenhagen, Denmark; (L.C.); (C.M.)
| | - Wim Martinet
- Laboratory of Physiopharmacology, University of Antwerp, Universiteitsplein 1 T.2, 2610 Wilrijk, Belgium;
| | - Emilia Choińska
- Faculty of Materials Sciences and Engineering, Warsaw University of Technology, Woloska 141, 02-507 Warsaw, Poland; (Ż.G.); (E.C.); (W.Ś.)
| | - Martijn Riool
- Department of Medical Microbiology and Infection Prevention, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (C.G.-P.); (M.R.); (S.A.J.Z.)
| | - Bart Verleije
- Voxdale bv, Bijkhoevelaan 32, 2110 Wijnegem, Belgium; (B.V.); (K.B.)
| | - Koen Beyers
- Voxdale bv, Bijkhoevelaan 32, 2110 Wijnegem, Belgium; (B.V.); (K.B.)
| | - Claus Moser
- Department for Clinical Microbiology, Rigshospitalet, Henrik Harpestrengsvej 4A, Afsnit 93.01, 2100 Copenhagen, Denmark; (L.C.); (C.M.)
| | - Wojciech Święszkowski
- Faculty of Materials Sciences and Engineering, Warsaw University of Technology, Woloska 141, 02-507 Warsaw, Poland; (Ż.G.); (E.C.); (W.Ś.)
| | - Sebastian A. J. Zaat
- Department of Medical Microbiology and Infection Prevention, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (C.G.-P.); (M.R.); (S.A.J.Z.)
| | - Paul Cos
- Laboratory for Microbiology, Parasitology and Hygiene (LMPH), Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Universiteitsplein 1 S.7, 2610 Wilrijk, Belgium; (J.A.); (P.C.)
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Biofilm viability checker: An open-source tool for automated biofilm viability analysis from confocal microscopy images. NPJ Biofilms Microbiomes 2021; 7:44. [PMID: 33990612 PMCID: PMC8121819 DOI: 10.1038/s41522-021-00214-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 03/12/2021] [Indexed: 12/15/2022] Open
Abstract
Quantifying biofilm formation on surfaces is challenging because traditional microbiological methods, such as total colony-forming units (CFUs), often rely on manual counting. These are laborious, resource intensive techniques, more susceptible to human error. Confocal laser scanning microscopy (CLSM) is a high-resolution technique that allows 3D visualisation of biofilm architecture. In combination with a live/dead stain, it can be used to quantify biofilm viability on both transparent and opaque surfaces. However, there is little consensus on the appropriate methodology to apply in confocal micrograph processing. In this study, we report the development of an image analysis approach to repeatably quantify biofilm viability and surface coverage. We also demonstrate its use for a range of bacterial species and translational applications. This protocol has been created with ease of use and accessibility in mind, to enable researchers who do not specialise in computational techniques to be confident in applying these methods to analyse biofilm micrographs. Furthermore, the simplicity of the method enables the user to adapt it for their bespoke needs. Validation experiments demonstrate the automated analysis is robust and accurate across a range of bacterial species and an improvement on traditional microbiological analysis. Furthermore, application to translational case studies show the automated method is a reliable measurement of biomass and cell viability. This approach will ensure image analysis is an accessible option for those in the microbiology and biomaterials field, improve current detection approaches and ultimately support the development of novel strategies for preventing biofilm formation by ensuring comparability across studies.
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8
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Mi X, Hu J, Zhang S, Wang S, Zhao W, Wang L, Jiang Y. Effect of lactic acid stress on biofilm formation of
Escherichia coli
O26
at different temperatures. J Food Saf 2020. [DOI: 10.1111/jfs.12877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Xiaoyu Mi
- School of Food Science and Pharmaceutical Engineering Nanjing Normal University Nanjing China
| | - Jie Hu
- School of Food Science and Pharmaceutical Engineering Nanjing Normal University Nanjing China
| | - Su Zhang
- School of Food Science and Pharmaceutical Engineering Nanjing Normal University Nanjing China
| | - Siqi Wang
- School of Food Science and Pharmaceutical Engineering Nanjing Normal University Nanjing China
| | - Wangchen Zhao
- School of Food Science and Pharmaceutical Engineering Nanjing Normal University Nanjing China
| | - Longfeng Wang
- School of Food Science and Pharmaceutical Engineering Nanjing Normal University Nanjing China
| | - Yun Jiang
- School of Food Science and Pharmaceutical Engineering Nanjing Normal University Nanjing China
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9
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Pérez-Granda MJ, Alonso B, Zavala R, Latorre MC, Hortal J, Samaniego R, Bouza E, Muñoz P, Guembe M. Selective digestive decontamination solution used as "lock therapy" prevents and eradicates bacterial biofilm in an in vitro bench-top model. Ann Clin Microbiol Antimicrob 2020; 19:44. [PMID: 32972419 PMCID: PMC7513905 DOI: 10.1186/s12941-020-00387-7] [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: 06/24/2020] [Accepted: 09/10/2020] [Indexed: 02/07/2023] Open
Abstract
Background Most preventing measures for reducing ventilator-associated pneumonia (VAP) are based mainly on the decolonization of the internal surface of the endotracheal tubes (ETTs). However, it has been demonstrated that bacterial biofilm can also be formed on the external surface of ETTs. Our objective was to test in vitro the efficacy of selective digestive decontamination solution (SDDs) onto ETT to prevent biofilm formation and eradicate preformed biofilms of three different microorganisms of VAP. Methods We used an in vitro model in which we applied, at the subglottic space of ETT, biofilms of either P. aeruginosa ATCC 15442, or E. coli ATCC 25922, or S. aureus ATCC 29213, and the SDDs at the same time (prophylaxis) or after 72 h of biofilm forming (treatment). ETT were incubated during 5 days with a regimen of 2 h-locks. ETT fragments were analyzed by sonication and confocal laser scanning microscopy to calculate the percentage reduction of cfu and viable cells, respectively. Results Median (IQR) percentage reduction of live cells and cfu/ml counts after treatment were, respectively, 53.2% (39.4%—64.1%) and 100% (100%–100.0%) for P. aeruginosa, and 67.9% (46.7%–78.7%) and 100% (100%–100.0%) for E. coli. S. aureus presented a complete eradication by both methods. After prophylaxis, there were absence of live cells and cfu/ml counts for all microorganisms. Conclusions SDDs used as “lock therapy” in the subglottic space is a promising prophylactic approach that could be used in combination with the oro-digestive decontamination procedure in the prevention of VAP.
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Affiliation(s)
- María Jesús Pérez-Granda
- Cardiac Surgery Postoperative Care Unit, Hospital General Universitario Gregorio Marañón, Madrid, 28007, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, 28009, Spain.,CIBER Enfermedades Respiratorias-CIBERES, CB06/06/0058), Madrid, Spain
| | - Beatriz Alonso
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, 28009, Spain. .,Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, 28007, Spain. .,Servicio de Microbiología Clínica y Enfermedades Infecciosas, Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario "Gregorio Marañón", C/. Dr. Esquerdo, 46, Madrid, 28007, Spain.
| | - Ricardo Zavala
- Biology Department, School of Biology, Universidad Complutense de Madrid, Madrid, 28040, Spain
| | - María Consuelo Latorre
- Biology Department, School of Biology, Universidad Complutense de Madrid, Madrid, 28040, Spain
| | - Javier Hortal
- Cardiac Surgery Postoperative Care Unit, Hospital General Universitario Gregorio Marañón, Madrid, 28007, Spain.,CIBER Enfermedades Respiratorias-CIBERES, CB06/06/0058), Madrid, Spain
| | - Rafael Samaniego
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, 28009, Spain.,Confocal Laser Scanning Microscopy Unit, Hospital General Universitario Gregorio Marañón, Madrid, 28007, Spain
| | - Emilio Bouza
- Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, 28040, Spain
| | - Patricia Muñoz
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, 28009, Spain.,CIBER Enfermedades Respiratorias-CIBERES, CB06/06/0058), Madrid, Spain.,Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, 28007, Spain.,Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, 28040, Spain
| | - María Guembe
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, 28009, Spain. .,Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, 28007, Spain. .,Servicio de Microbiología Clínica y Enfermedades Infecciosas, Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario "Gregorio Marañón", C/. Dr. Esquerdo, 46, Madrid, 28007, Spain.
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10
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Phumat P, Khongkhunthian S, Wanachantararak P, Okonogi S. Comparative inhibitory effects of 4-allylpyrocatechol isolated from Piper betle on Streptococcus intermedius, Streptococcus mutans, and Candida albicans. Arch Oral Biol 2020; 113:104690. [PMID: 32155466 DOI: 10.1016/j.archoralbio.2020.104690] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/14/2020] [Accepted: 03/02/2020] [Indexed: 10/24/2022]
Abstract
Streptococcus intermedius, Streptococcus mutans, and Candida albicans are harmful oral pathogens and prone to resist chemical antimicrobial agents. Active ingredients from plants are of increasing interest as an alternative. This study aims to compare antimicrobial effects of 4-allylpyrocatechol (APC) extracted from Piper betle on these oral pathogens. Minimum concentration of APC against the tested pathogens was determined using a broth microdilution assay. Killing kinetic study of APC was carried out within 24 h. Morphology of the pathogenic cells was assessed using scanning electron microscopy (SEM). Anti-biofilm was investigated using crystal violet assay and confocal laser scanning microscopy (CLSM). The results showed that the mechanism of inhibition of APC was bactericidal and fungicidal effects. APC at minimum concentration of 400 μg/mL could completely kill Streptococcus and Candida spp., however, the killing rate on S. intermedius and C. albicans was significantly faster than on S. mutans. APC inhibited biofilm formation of C. albicans more efficiently than that of the bacterial cells. Cell morphology from SEM indicated that APC caused bacterial cell membrane destruction and inhibited fungal budding or tubing formation. CLSM images confirmed the killing potential of APC and suggested that bacterial dead cells could be easier washed out than the fungal dead cells. It is concluded that APC potentially inhibits growth and biofilms of oral Streptococcus and Candida spp. in different mechanism of action and killing rate. APC can be considered as a promising agent for preventing and treating dental disorders caused by S. intermedius, S. mutans, and C. albicans.
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Affiliation(s)
- Pimpak Phumat
- Interdisciplinary Program in Nanoscience and Nanotechnology, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Sakornrat Khongkhunthian
- Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand; Research Center of Pharmaceutical Nanotechnology, Chiang Mai University, Chiang Mai, Thailand
| | | | - Siriporn Okonogi
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand; Research Center of Pharmaceutical Nanotechnology, Chiang Mai University, Chiang Mai, Thailand.
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11
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Ferreira EG, Yatsuda F, Pini M, Jarros IC, Veiga FF, de Oliveira AG, Negri M, Svidzinski TIE. Implications of the presence of yeasts in tracheobronchial secretions of critically ill intubated patients. EXCLI JOURNAL 2019; 18:801-811. [PMID: 31645841 PMCID: PMC6806203 DOI: 10.17179/excli2019-1631] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 09/03/2019] [Indexed: 12/28/2022]
Abstract
The presence of some microorganisms in the respiratory tract is a known risk factor for the infection of air passages; however, it is not clear whether this holds true for Candida spp. Thus, our objective was to determine the frequency of yeast colonization in the tracheobronchial secretions of critically ill intubated patients and to assess the presence of these yeasts in the infra-cuff region of the endotracheal tube (ET). Patients aged 18 years or older who had been using an endotracheal tube for 48 hours were recruited. Tracheal secretions were collected; after extubation, the ETs were cut into two fragments in the infra-cuff region. One of these fragments was placed in a solution containing antibiotics and sent to the lab for culture and identification of yeasts. The remaining fragment was fixed and subjected to scanning electron microscopy (SEM). In total, 20 patients with an average age of 73.3 years (± 13.1) participated in this study. These patients remained under endotracheal intubation and invasive mechanical ventilation for an average of 6.4 (± 1.8) and 13.5 days (± 15), respectively. Of these patients, 45 % showed respiratory tract colonization by yeasts of the Candida genus, with C. albicans being the most frequently isolated species (66.7 %). Moreover, in almost 90 % of these patients, blastoconidia of the same yeast were found in the infra-cuff portion of the ET, as evidenced by SEM, strongly fixed on the ET surface. Yeasts isolated from both the infra-cuff region and the tracheobronchial secretions were susceptible to amphotericin B and fluconazole. In conclusion, our results show that the frequency of colonization by yeasts of the Candida genus in the tracheobronchial secretions of intubated patients within 48 hours is high, and that these species can also be found as a biofilm on the ET surface.
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Affiliation(s)
- Elenice Gomes Ferreira
- Graduate Programme in Health Sciences, Universidade Estadual de Maringá (UEM), Maringá, PR, Brazil.,Department of Physiotherapy UniCesumar, Maringá, PR, Brazil
| | - Fabrício Yatsuda
- Department of Physiotherapy UniCesumar, Maringá, PR, Brazil.,PIC/UniCesumar/ICETI (Instituto Cesumar de Ciência, Tecnologia e Inovação)
| | - Marcio Pini
- Department of Physiotherapy UniCesumar, Maringá, PR, Brazil.,PIC/UniCesumar/ICETI (Instituto Cesumar de Ciência, Tecnologia e Inovação)
| | - Isabele Carrilho Jarros
- Graduate Programme in Health Sciences, Universidade Estadual de Maringá (UEM), Maringá, PR, Brazil
| | - Flávia Franco Veiga
- Graduate Programme in Health Sciences, Universidade Estadual de Maringá (UEM), Maringá, PR, Brazil
| | | | - Melyssa Negri
- Division of Medical Mycology, Teaching and Research Laboratory in Clinical Analyses, Department of Clinical Analysis of State University of Maringa, Avenida Colombo 5790, 87020-900 Maringá, PR, Brazil
| | - Terezinha Inez Estivalet Svidzinski
- Division of Medical Mycology, Teaching and Research Laboratory in Clinical Analyses, Department of Clinical Analysis of State University of Maringa, Avenida Colombo 5790, 87020-900 Maringá, PR, Brazil
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12
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Fernández-Barat L, Motos A, Panigada M, Álvarez-Lerma F, Viña L, Lopez-Aladid R, Ceccato A, Bassi GL, Nicolau DP, Lopez Y, Muñoz L, Guerrero L, Soy D, Israel T, Castro P, Torres A. Comparative efficacy of linezolid and vancomycin for endotracheal tube MRSA biofilms from ICU patients. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2019; 23:251. [PMID: 31291978 PMCID: PMC6617612 DOI: 10.1186/s13054-019-2523-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 06/21/2019] [Indexed: 01/08/2023]
Abstract
PURPOSE To compare the efficacy of systemic treatment with linezolid (LNZ) versus vancomycin (VAN) on methicillin-resistant Staphylococcus aureus (MRSA) burden and eradication in endotracheal tube (ETT) biofilm and ETT cuff from orotracheally intubated patients with MRSA respiratory infection. METHODS Prospective observational clinical study was carried out at four European tertiary hospitals. Plasma and endotracheal aspirate (ETA) levels of LNZ and VAN were determined 72 h after treatment initiation through high-performance liquid chromatography or bioassay. LNZ or VAN concentration in the ETT biofilm and MRSA burden and eradication was determined upon extubation. The minimum inhibitory concentration (MIC) for LNZ and VAN was assessed by E-test strips (Biomerieux®). Scanning electron microscopy images were obtained, and ETT biofilm thickness was compared between groups. RESULTS Twenty-five patients, 15 treated with LNZ and 10 with VAN, were included in the study. LNZ presented a significantly higher concentration (μg/mL) than VAN in ETT biofilm (72.8 [1.3-127.1] vs 0.4 [0.4-1.3], p < 0.001), although both drugs achieved therapeutic plasma levels 72 h after treatment initiation. Systemic treatment with LNZ achieved lower ETT cuff MRSA burdens than systemic treatment with VAN. Indeed, LNZ increased the MRSA eradication rate in ETT cuff compared with VAN (LNZ 75%, VAN 20%, p = 0.031). CONCLUSIONS In ICU patients with MRSA respiratory infection intubated for long periods, systemic treatment with LNZ obtains a greater beneficial effect than VAN in limiting MRSA burden in ETT cuff.
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Affiliation(s)
- Laia Fernández-Barat
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain. .,Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain.
| | - Ana Motos
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain.,Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - Mauro Panigada
- Department of Anesthesiology, Intensive Care and Emergency, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Francisco Álvarez-Lerma
- Critical Care Department, Hospital del Mar, Critical Illness Research Group (GREPAC), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Lucía Viña
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Ruben Lopez-Aladid
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain.,Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - Adrian Ceccato
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain.,Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - Gianluigi Li Bassi
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain.,Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - David P Nicolau
- Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, CT, USA
| | - Yuli Lopez
- Microbiology Department, Hospital Clínic, CRESIB ISglobal, Barcelona, Spain
| | - Laura Muñoz
- Microbiology Department, Hospital Clínic, CRESIB ISglobal, Barcelona, Spain
| | - Laura Guerrero
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain
| | - Dolors Soy
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain.,Pharmacy Service, Division of Medicines, Hospital Clínic, Barcelona, Spain
| | - Trinidad Israel
- Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - Pedro Castro
- Medical Intensive Care Unit, Hospital Clínic, Barcelona, Spain
| | - Antoni Torres
- Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain. .,Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain.
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13
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Assessment of in vivo versus in vitro biofilm formation of clinical methicillin-resistant Staphylococcus aureus isolates from endotracheal tubes. Sci Rep 2018; 8:11906. [PMID: 30093624 PMCID: PMC6085380 DOI: 10.1038/s41598-018-30494-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/31/2018] [Indexed: 12/31/2022] Open
Abstract
Our aim was to demonstrate that biofilm formation in a clinical strain of methicillin-resistant Staphylococcus aureus (MRSA) can be enhanced by environment exposure in an endotracheal tube (ETT) and to determine how it is affected by systemic treatment and atmospheric conditions. Second, we aimed to assess biofilm production dynamics after extubation. We prospectively analyzed 70 ETT samples obtained from pigs randomized to be untreated (controls, n = 20), or treated with vancomycin (n = 32) or linezolid (n = 18). A clinical MRSA strain (MRSA-in) was inoculated in pigs to create a pneumonia model, before treating with antibiotics. Tracheally intubated pigs with MRSA severe pneumonia, were mechanically ventilated for 69 ± 16 hours. All MRSA isolates retrieved from ETTs (ETT-MRSA) were tested for their in vitro biofilm production by microtiter plate assay. In vitro biofilm production of MRSA isolates was sequentially studied over the next 8 days post-extubation to assess biofilm capability dynamics over time. All experiments were performed under ambient air (O2) or ambient air supplemented with 5% CO2. We collected 52 ETT-MRSA isolates (placebo N = 19, linezolid N = 11, and vancomycin N = 22) that were clonally identical to the MRSA-in. Among the ETT-MRSA isolates, biofilm production more than doubled after extubation in 40% and 50% under 5% CO2 and O2, respectively. Systemic antibiotic treatment during intubation did not affect this outcome. Under both atmospheric conditions, biofilm production for MRSA-in was at least doubled for 9 ETT-MRSA isolates, and assessment of these showed that biofilm production decreased progressively over a 4-day period after extubation. In conclusion, a weak biofilm producer MRSA strain significantly enhances its biofilm production within an ETT, but it is influenced by the ETT environment rather than by the systemic treatment used during intubation or by the atmospheric conditions used for bacterial growth.
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14
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Pérez-Granda MJ, Latorre MC, Alonso B, Hortal J, Samaniego R, Bouza E, Guembe M. Eradication of P. aeruginosa biofilm in endotracheal tubes based on lock therapy: results from an in vitro study. BMC Infect Dis 2017; 17:746. [PMID: 29202722 PMCID: PMC5715999 DOI: 10.1186/s12879-017-2856-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 11/26/2017] [Indexed: 02/08/2023] Open
Abstract
Background Despite the several strategies available for the management of biofilm-associated ventilator-associated pneumonia, data regarding the efficacy of applying antibiotics to the subglottic space (SS) are scarce. We created an in vitro model to assess the efficacy of antibiotic lock therapy (ALT) applied in the SS for eradication of Pseudomonas aeruginosa biofilm in endotracheal tubes (ETTs). Methods We applied 2 h of ALT to a P. aeruginosa biofilm in ETTs using a single dose (SD) and a 5-day therapy model (5D). We used sterile saline lock therapy (SLT) as the positive control. We compared colony count and the percentage of live cells between both models. Results The median (IQR) cfu counts/ml and percentage of live cells in the SD-ALT and SD-SLT groups were, respectively, 3.12 × 105 (9.7 × 104-0) vs. 8.16 × 107 (7.0 × 107-0) (p = 0.05) and 53.2% (50.9%-57.2%) vs. 91.5% (87.3%-93.9%) (p < 0.001). The median (IQR) cfu counts/ml and percentage of live cells in the 5D-ALT and 5D-SLT groups were, respectively, 0 (0-0) vs. 3.2 × 107 (2.32 × 107-0) (p = 0.03) and 40.6% (36.6%-60.0%) vs. 90.3% (84.8%-93.9%) (p < 0.001). Conclusion We demonstrated a statistically significant decrease in the viability of P. aeruginosa biofilm after application of 5D-ALT in the SS. Future clinical studies to assess ALT in patients under mechanical ventilation are needed.
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Affiliation(s)
- María Jesús Pérez-Granda
- Cardiac Surgery Postoperative Care Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain
| | | | - Beatriz Alonso
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Javier Hortal
- Cardiac Surgery Postoperative Care Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain
| | - Rafael Samaniego
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Confocal Laser Scanning Microscopy Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Emilio Bouza
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain.,Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - María Guembe
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain. .,Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain. .,Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario "Gregorio Marañón", C/. Dr. Esquerdo, 46, 28007, Madrid, Spain.
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15
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Wang H, Qi J, Dong Y, Li Y, Xu X, Zhou G. Characterization of attachment and biofilm formation by meat-borne Enterobacteriaceae strains associated with spoilage. Lebensm Wiss Technol 2017. [DOI: 10.1016/j.lwt.2017.08.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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16
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Diagnostic Value of Endotracheal Aspirates Sonication on Ventilator-Associated Pneumonia Microbiologic Diagnosis. Microorganisms 2017; 5:microorganisms5030062. [PMID: 28930178 PMCID: PMC5620653 DOI: 10.3390/microorganisms5030062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 09/15/2017] [Accepted: 09/17/2017] [Indexed: 12/21/2022] Open
Abstract
Microorganisms are able to form biofilms within respiratory secretions. Methods to disaggregate such biofilms before utilizing standard, rapid, or high throughput diagnostic technologies may aid in pathogen detection during ventilator associated pneumonia (VAP) diagnosis. Our aim was to determine if sonication of endotracheal aspirates (ETA) would increase the sensitivity of qualitative, semi-quantitative, and quantitative bacterial cultures in an animal model of pneumonia caused by Pseudomonas aeruginosa or by methicillin resistant Staphylococcus aureus (MRSA). Material and methods: P. aeruginosa or MRSA was instilled into the lungs or the oropharynx of pigs in order to induce severe VAP. Time point assessments for qualitative and quantitative bacterial cultures of ETA and bronchoalveolar lavage (BAL) samples were performed at 24, 48, and 72 h after bacterial instillation. In addition, at 72 h (autopsy), lung tissue was harvested to perform quantitative bacterial cultures. Each ETA sample was microbiologically processed with and without applying sonication for 5 min at 40 KHz before bacterial cultures. Sensitivity and specificity were determined using BAL as a gold-standard. Correlation with BAL and lung bacterial burden was also determined before and after sonication. Assessment of biofilm clusters and planktonic bacteria was performed through both optical microscopy utilizing Gram staining and Confocal Laser Scanning Microscopy utilizing the LIVE/DEAD®BacLight kit. Results: 33 pigs were included, 27 and 6 from P. aeruginosa and MRSA pneumonia models, respectively. Overall, we obtained 85 ETA, 69 (81.2%) from P. aeruginosa and 16 (18.8%) from MRSA challenged pigs. Qualitative cultures did not significantly change after sonication, whereas quantitative ETA cultures did significantly increase bacterial counting. Indeed, sonication consistently increased bacterial burden in ETAs at 24, 48, and 72 h after bacterial challenge. Sonication also improved sensitivity of ETA quantitative cultures and maintained specificity at levels previously reported and accepted for VAP diagnosis. Conclusion: The use of sonication in ETA respiratory samples needs to be clinically validated since sonication could potentially improve pathogen detection before standard, rapid, or high throughput diagnostic methods used in routine microbial diagnostics.
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17
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Buzón-Durán L, Alonso-Calleja C, Riesco-Peláez F, Capita R. Effect of sub-inhibitory concentrations of biocides on the architecture and viability of MRSA biofilms. Food Microbiol 2017; 65:294-301. [DOI: 10.1016/j.fm.2017.01.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Revised: 12/08/2016] [Accepted: 01/07/2017] [Indexed: 02/08/2023]
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18
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Capita R, Buzón-Durán L, Riesco-Peláez F, Alonso-Calleja C. Effect of Sub-Lethal Concentrations of Biocides on the Structural Parameters and Viability of the Biofilms Formed by Salmonella Typhimurium. Foodborne Pathog Dis 2017; 14:350-356. [DOI: 10.1089/fpd.2016.2241] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Rosa Capita
- Department of Food Hygiene and Technology, University of León, León, Spain
- Institute of Food Science and Technology, University of León, León, Spain
| | - Laura Buzón-Durán
- Department of Food Hygiene and Technology, University of León, León, Spain
- Institute of Food Science and Technology, University of León, León, Spain
| | - Félix Riesco-Peláez
- Department of Electrical Engineering and Systems Engineering and Automatic Control, University of León, León, Spain
| | - Carlos Alonso-Calleja
- Department of Food Hygiene and Technology, University of León, León, Spain
- Institute of Food Science and Technology, University of León, León, Spain
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19
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Fernández-Barat L, Torres A. Biofilms in ventilator-associated pneumonia. Future Microbiol 2016; 11:1599-1610. [DOI: 10.2217/fmb-2016-0040] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Biofilms develop rapidly following endotracheal intubation and represent a persistent source of unnecessary pathogens in the critically ill patient. Overall, the imbalance in the lung microbiome caused by an endotracheal tube and its role in biofilm formation and in ventilator-associated pneumonia is still unclear. Although endotracheal tube–biofilm preventive measures are being tested, no outcome impact has ever been demonstrated, and therefore no approach has been clinically recommended. Nonetheless, an accurate description of the actual biofilm morphology in vivo could be useful to implement effective preventive measures. The combined use of in vitro biofilm models, in vivo animal models and clinical research is vitally important to the attainment of a comprehensive understanding of biofilms in ventilator-associated pneumonia in the near future.
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Affiliation(s)
- Laia Fernández-Barat
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (Ciberes), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universtitat de Barcelona (UB), Barcelona, Spain
| | - Antoni Torres
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (Ciberes), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universtitat de Barcelona (UB), Barcelona, Spain
- Unidad de cuidados Intensivos respiratorios (UVIR), Servicio de Neumología, Hospital Clínic, Barcelona, Spain
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20
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Fernández-Barat L, Ciofu O, Kragh KN, Pressler T, Johansen U, Motos A, Torres A, Hoiby N. Phenotypic shift in Pseudomonas aeruginosa populations from cystic fibrosis lungs after 2-week antipseudomonal treatment. J Cyst Fibros 2016; 16:222-229. [PMID: 27651273 DOI: 10.1016/j.jcf.2016.08.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 08/25/2016] [Accepted: 08/25/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND The influence of suppressive therapy on the different P. aeruginosa phenotypes harbored in the lungs of cystic fibrosis (CF) patients remains unclear. Our aim was to investigate the phenotypic changes (mucoidy, hypermutability, antibiotic resistance, transcriptomic profiles and biofilm) in P. aeruginosa populations before and after a 2-week course of suppressive antimicrobial therapy in chronically infected CF patients in Denmark. MATERIAL AND METHODS Prospective observational clinical study. Sputum samples were assessed before and after treatment for P. aeruginosa, with regard to: a) colony-forming units (CFU/mL), b) frequency of mucoids and non-mucoids, c) resistance pattern to anti-pseudomonal drugs, d) hypermutability, e) transcriptomic profiles, and f) presence of biofilms. RESULTS We collected 23 sputum samples (12 before antibiotic treatment and 11 after) and 77 P. aeruginosa from different CF patients. After treatment, the P. aeruginosa burden diminished but antimicrobial resistance to aztreonam, tobramycin and ceftazidime rose; non-mucoid phenotypes presented increased resistance to colistin, tobramycin, meropenem, and ciprofloxacin, and hypermutable phenotypes to ciprofloxacin. In spite of biofilm persistence, a down-regulation of genes involved in denitrification was detected. CONCLUSION A 2-week course of suppressive therapy reduces P. aeruginosa lung colonization and influences nitrogen metabolism genes, but also promotes antimicrobial resistance while P. aeruginosa persists in biofilms.
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Affiliation(s)
- Laia Fernández-Barat
- Centro de Investigación Biomedica En Red-Enfermedades Respiratorias (CibeRes, CB06/06/0028), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CELLEX Laboratories, School of Medicine, University of Barcelona, Spain.
| | - Oana Ciofu
- Department of Immunology and Microbiology, Costerton Biofilm Center, Copenhagen, Denmark; Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark
| | - Kasper N Kragh
- Department of Immunology and Microbiology, Costerton Biofilm Center, Copenhagen, Denmark; Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark
| | - Tania Pressler
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark; CF Center, Rigshospitalet, Denmark
| | - Ulla Johansen
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark
| | - Anna Motos
- Centro de Investigación Biomedica En Red-Enfermedades Respiratorias (CibeRes, CB06/06/0028), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CELLEX Laboratories, School of Medicine, University of Barcelona, Spain
| | - Antoni Torres
- Centro de Investigación Biomedica En Red-Enfermedades Respiratorias (CibeRes, CB06/06/0028), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CELLEX Laboratories, School of Medicine, University of Barcelona, Spain; Pneumology Service, Clinical Thorax Institute, Hospital Clinic, Barcelona, Spain
| | - Niels Hoiby
- Department of Immunology and Microbiology, Costerton Biofilm Center, Copenhagen, Denmark; Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark
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Aguilera Xiol E, Li Bassi G, Wyncoll D, Ntoumenopoulos G, Fernandez-Barat L, Marti JD, Comaru T, De Rosa F, Rigol M, Rinaudo M, Ferrer M, Torres A. Tracheal tube biofilm removal through a novel closed-suctioning system: an experimental study. Br J Anaesth 2016; 115:775-83. [PMID: 26475806 DOI: 10.1093/bja/aev340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Tracheal tube biofilm develops during mechanical ventilation. We compared a novel closed-suctioning system vs standard closed-suctioning system in the prevention of tracheal tube biofilm. METHODS Eighteen pigs, on mechanical ventilation for 76 h, with P. aeruginosa pneumonia were randomized to be tracheally suctioned via the KIMVENT* closed-suctioning system (control group) or a novel closed-suctioning system (treatment group), designed to remove tracheal tube biofilm through saline jets and an inflatable balloon. Upon autopsy, two tracheal tube hemi-sections were dissected for confocal and scanning electron microscopy. Biofilm area, maximal and minimal thickness were computed. Biofilm stage was assessed. RESULTS Sixteen animals were included in the final analysis. In the treatment and control group, the mean (sd) pulmonary burden was 3.34 (1.28) and 4.17 (1.09) log cfu gr(-1), respectively (P=0.18). Tracheal tube P. aeruginosa colonization was 5.6 (4.9-6.3) and 6.2 (5.6-6.9) cfu ml(-1) (median and interquartile range) in the treatment and control group, respectively (P=0.23). In the treatment group, median biofilm area was 3.65 (3.22-4.21) log10 μm2 compared with 4.49 (4.27-4.52) log10 μm2 in the control group (P=0.031). In the treatment and control groups, the maximal biofilm thickness was 48.3 (26.7-71.2) µm (median and interquartile range) and 88.8 (43.8-125.7) µm, respectively. The minimal thickness in the treatment and control group was 0.6 (0-4.0) µm and 23.7 (5.3-27.8) µm (P=0.040) (P=0.017). Earlier stages of biofilm development were found in the treatment group (P<0.001). CONCLUSIONS The novel CSS reduces biofilm accumulation within the tracheal tube. A clinical trial is required to confirm these findings and the impact on major outcomes.
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Affiliation(s)
- E Aguilera Xiol
- Department of Pulmonary and Critical Care Medicine, Division of Animal Experimentation, Thorax Institute, Hospital Clínic, Barcelona, Spain Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain Centro de Investigación Biomédica en Red Enfermedades Respiratorias, Mallorca, Spain
| | - G Li Bassi
- Department of Pulmonary and Critical Care Medicine, Division of Animal Experimentation, Thorax Institute, Hospital Clínic, Barcelona, Spain Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain Centro de Investigación Biomédica en Red Enfermedades Respiratorias, Mallorca, Spain University of Barcelona, Barcelona, Spain
| | - D Wyncoll
- Critical Care Unit, Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom
| | - G Ntoumenopoulos
- Critical Care Unit, Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom Physiotherapy Department, Guy's & St Thomas' NHS Foundation Trust, United Kingdom School of Physiotherapy, Australian Catholic University, North Sydney Campus, North Sydney, Australia
| | - L Fernandez-Barat
- Department of Pulmonary and Critical Care Medicine, Division of Animal Experimentation, Thorax Institute, Hospital Clínic, Barcelona, Spain Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain Centro de Investigación Biomédica en Red Enfermedades Respiratorias, Mallorca, Spain
| | - J D Marti
- Department of Pulmonary and Critical Care Medicine, Division of Animal Experimentation, Thorax Institute, Hospital Clínic, Barcelona, Spain Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain Centro de Investigación Biomédica en Red Enfermedades Respiratorias, Mallorca, Spain
| | - T Comaru
- Department of Pulmonary and Critical Care Medicine, Division of Animal Experimentation, Thorax Institute, Hospital Clínic, Barcelona, Spain Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain Centro de Investigación Biomédica en Red Enfermedades Respiratorias, Mallorca, Spain
| | - F De Rosa
- Department of Pulmonary and Critical Care Medicine, Division of Animal Experimentation, Thorax Institute, Hospital Clínic, Barcelona, Spain University of Milan, Milan, Italy
| | - M Rigol
- Department of Pulmonary and Critical Care Medicine, Division of Animal Experimentation, Thorax Institute, Hospital Clínic, Barcelona, Spain Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain Centro de Investigación Biomédica en Red Enfermedades Respiratorias, Mallorca, Spain Department of Cardiology, Hospital Clinic, Barcelona, Spain
| | - M Rinaudo
- Department of Pulmonary and Critical Care Medicine, Division of Animal Experimentation, Thorax Institute, Hospital Clínic, Barcelona, Spain Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain Centro de Investigación Biomédica en Red Enfermedades Respiratorias, Mallorca, Spain
| | - M Ferrer
- Department of Pulmonary and Critical Care Medicine, Division of Animal Experimentation, Thorax Institute, Hospital Clínic, Barcelona, Spain Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain Centro de Investigación Biomédica en Red Enfermedades Respiratorias, Mallorca, Spain University of Barcelona, Barcelona, Spain
| | - A Torres
- Department of Pulmonary and Critical Care Medicine, Division of Animal Experimentation, Thorax Institute, Hospital Clínic, Barcelona, Spain Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain Centro de Investigación Biomédica en Red Enfermedades Respiratorias, Mallorca, Spain University of Barcelona, Barcelona, Spain
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22
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Høiby N, Bjarnsholt T, Moser C, Bassi G, Coenye T, Donelli G, Hall-Stoodley L, Holá V, Imbert C, Kirketerp-Møller K, Lebeaux D, Oliver A, Ullmann A, Williams C. ESCMID∗ guideline for the diagnosis and treatment of biofilm infections 2014. Clin Microbiol Infect 2015; 21 Suppl 1:S1-25. [DOI: 10.1016/j.cmi.2014.10.024] [Citation(s) in RCA: 451] [Impact Index Per Article: 50.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 10/14/2014] [Accepted: 10/14/2014] [Indexed: 01/22/2023]
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23
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Li Bassi G, Fernandez-Barat L, Saucedo L, Giunta V, Marti JD, Tavares Ranzani O, Aguilera Xiol E, Rigol M, Roca I, Muñoz L, Luque N, Esperatti M, Saco MA, Ramirez J, Vila J, Ferrer M, Torres A. Endotracheal tube biofilm translocation in the lateral Trendelenburg position. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2015; 19:59. [PMID: 25887536 PMCID: PMC4355496 DOI: 10.1186/s13054-015-0785-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 02/03/2015] [Indexed: 12/11/2022]
Abstract
Introduction Laboratory studies demonstrated that the lateral Trendelenburg position (LTP) is superior to the semirecumbent position (SRP) in the prevention of ventilator-associated pulmonary infections. We assessed whether the LTP could also prevent pulmonary colonization and infections caused by an endotracheal tube (ETT) biofilm. Methods Eighteen pigs were intubated with ETTs colonized by Pseudomonas aeruginosa biofilm. Pigs were positioned in LTP and randomized to be on mechanical ventilatin (MV) up to 24 hour, 48 hour, 48 hour with acute lung injury (ALI) by oleic acid and 72 hour. Bacteriologic and microscopy studies confirmed presence of biofilm within the ETT. Upon autopsy, samples from the proximal and distal airways were excised for P.aeruginosa quantification. Ventilator-associated tracheobronchitis (VAT) was confirmed by bronchial tissue culture ≥3 log colony forming units per gram (cfu/g). In pulmonary lobes with gross findings of pneumonia, ventilator-associated pneumonia (VAP) was confirmed by lung tissue culture ≥3 log cfu/g. Results P.aeruginosa colonized the internal lumen of 16 out of 18 ETTs (88.89%), and a mature biofilm was consistently present. P.aeruginosa colonization did not differ among groups, and was found in 23.6% of samples from the proximal airways, and in 7.1% from the distal bronchi (P = 0.001). Animals of the 24 hour group never developed respiratory infections, whereas 20%, 60% and 25% of the animals in group 48 hour, 48 hour-ALI and 72 hour developed P.aeruginosa VAT, respectively (P = 0.327). Nevertheless, VAP never developed. Conclusions Our findings imply that during the course of invasive MV up to 72 hour, an ETT P.aeruginosa biofilm hastily colonizes the respiratory tract. Yet, the LTP compartmentalizes colonization and infection within the proximal airways and VAP never develops.
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Affiliation(s)
- Gianluigi Li Bassi
- Pulmonary and Critical Care Unit, Hospital Clínic, Calle Villarroel 170, Esc 6/8 Planta 2, 08036, Barcelona, Spain. .,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. .,Centro de Investigación Biomedica En Red- Enfermedades Respiratorias (CIBERES), Mallorca, Spain.
| | - Laia Fernandez-Barat
- Pulmonary and Critical Care Unit, Hospital Clínic, Calle Villarroel 170, Esc 6/8 Planta 2, 08036, Barcelona, Spain. .,Centro de Investigación Biomedica En Red- Enfermedades Respiratorias (CIBERES), Mallorca, Spain.
| | - Lina Saucedo
- Pulmonary and Critical Care Unit, Hospital Clínic, Calle Villarroel 170, Esc 6/8 Planta 2, 08036, Barcelona, Spain. .,Centro de Investigación Biomedica En Red- Enfermedades Respiratorias (CIBERES), Mallorca, Spain.
| | | | - Joan Daniel Marti
- Pulmonary and Critical Care Unit, Hospital Clínic, Calle Villarroel 170, Esc 6/8 Planta 2, 08036, Barcelona, Spain. .,Centro de Investigación Biomedica En Red- Enfermedades Respiratorias (CIBERES), Mallorca, Spain.
| | - Otavio Tavares Ranzani
- Pulmonary and Critical Care Unit, Hospital Clínic, Calle Villarroel 170, Esc 6/8 Planta 2, 08036, Barcelona, Spain. .,Centro de Investigación Biomedica En Red- Enfermedades Respiratorias (CIBERES), Mallorca, Spain. .,Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Pulmonary Intensive Care Unit, São Paulo, Brazil.
| | - Eli Aguilera Xiol
- Pulmonary and Critical Care Unit, Hospital Clínic, Calle Villarroel 170, Esc 6/8 Planta 2, 08036, Barcelona, Spain. .,Centro de Investigación Biomedica En Red- Enfermedades Respiratorias (CIBERES), Mallorca, Spain.
| | - Montserrat Rigol
- Pulmonary and Critical Care Unit, Hospital Clínic, Calle Villarroel 170, Esc 6/8 Planta 2, 08036, Barcelona, Spain. .,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. .,Centro de Investigación Biomedica En Red- Enfermedades Respiratorias (CIBERES), Mallorca, Spain.
| | - Ignasi Roca
- Department of Clinical Microbiology, School of Medicine, and Barcelona Centre for International Health Research, (CRESIB) Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
| | - Laura Muñoz
- Department of Clinical Microbiology, School of Medicine, and Barcelona Centre for International Health Research, (CRESIB) Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
| | - Nestor Luque
- Pulmonary and Critical Care Unit, Hospital Clínic, Calle Villarroel 170, Esc 6/8 Planta 2, 08036, Barcelona, Spain.
| | - Mariano Esperatti
- Pulmonary and Critical Care Unit, Hospital Clínic, Calle Villarroel 170, Esc 6/8 Planta 2, 08036, Barcelona, Spain.
| | | | - Jose Ramirez
- Pathology Department, Hospital Clinic, Barcelona, Spain.
| | - Jordi Vila
- Department of Clinical Microbiology, School of Medicine, and Barcelona Centre for International Health Research, (CRESIB) Hospital Clínic, Universitat de Barcelona, Barcelona, Spain. .,University of Barcelona, Barcelona, Spain.
| | - Miguel Ferrer
- Pulmonary and Critical Care Unit, Hospital Clínic, Calle Villarroel 170, Esc 6/8 Planta 2, 08036, Barcelona, Spain. .,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. .,Centro de Investigación Biomedica En Red- Enfermedades Respiratorias (CIBERES), Mallorca, Spain.
| | - Antoni Torres
- Pulmonary and Critical Care Unit, Hospital Clínic, Calle Villarroel 170, Esc 6/8 Planta 2, 08036, Barcelona, Spain. .,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. .,Centro de Investigación Biomedica En Red- Enfermedades Respiratorias (CIBERES), Mallorca, Spain. .,University of Barcelona, Barcelona, Spain.
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Lebeaux D, Chauhan A, Rendueles O, Beloin C. From in vitro to in vivo Models of Bacterial Biofilm-Related Infections. Pathogens 2013; 2:288-356. [PMID: 25437038 PMCID: PMC4235718 DOI: 10.3390/pathogens2020288] [Citation(s) in RCA: 308] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 05/01/2013] [Accepted: 05/08/2013] [Indexed: 12/13/2022] Open
Abstract
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.
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Affiliation(s)
- David Lebeaux
- Institut Pasteur, Unité de Génétique des Biofilms, 25 rue du Dr. Roux, 75724 Paris cedex 15, France.
| | - Ashwini Chauhan
- Institut Pasteur, Unité de Génétique des Biofilms, 25 rue du Dr. Roux, 75724 Paris cedex 15, France.
| | - Olaya Rendueles
- Institut Pasteur, Unité de Génétique des Biofilms, 25 rue du Dr. Roux, 75724 Paris cedex 15, France.
| | - Christophe Beloin
- Institut Pasteur, Unité de Génétique des Biofilms, 25 rue du Dr. Roux, 75724 Paris cedex 15, France.
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25
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A combined pharmacodynamic quantitative and qualitative model reveals the potent activity of daptomycin and delafloxacin against Staphylococcus aureus biofilms. Antimicrob Agents Chemother 2013; 57:2726-37. [PMID: 23571532 DOI: 10.1128/aac.00181-13] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Biofilms are associated with persistence of Staphylococcus aureus infections and therapeutic failures. Our aim was to set up a pharmacodynamic model comparing antibiotic activities against biofilms and examining in parallel their effects on viability and biofilm mass. Biofilms of S. aureus ATCC 25923 (methicillin-sensitive S. aureus [MSSA]) or ATCC 33591 (methicillin-resistant S. aureus [MRSA]) were obtained by culture in 96-well plates for 6 h/24 h. Antibiotic activities were assessed after 24/48 h of exposure to concentrations ranging from 0.5 to 512 times the MIC. Biofilm mass and bacterial viability were quantified using crystal violet and the redox indicator resazurin. Biofilms stained with Live/Dead probes were observed by using confocal microscopy. Concentration-effect curves fitted sigmoidal regressions, with a 50% reduction toward both matrix and viability obtained at sub-MIC or low multiples of MICs against young biofilms for all antibiotics tested. Against mature biofilms, maximal efficacies and potencies were reduced, with none of the antibiotics being able to completely destroy the matrix. Delafloxacin and daptomycin were the most potent, reducing viability by more than 50% at clinically achievable concentrations against both strains, as well as reducing biofilm depth, as observed in confocal microscopy. Rifampin, tigecycline, and moxifloxacin were effective against mature MRSA biofilms, while oxacillin demonstrated activity against MSSA. Fusidic acid, vancomycin, and linezolid were less potent overall. Antibiotic activity depends on biofilm maturity and bacterial strain. The pharmacodynamic model developed allows ranking of antibiotics with respect to efficacy and potency at clinically achievable concentrations and highlights the potential utility of daptomycin and delafloxacin for the treatment of biofilm-related infections.
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