Escherichia coli Eyelid Abscess in a Patient with Alcoholic Cirrhosis

[Antibacterial effect of the antiseptic picloxydine dihydrochloride on conjunctival isolates of gram-negative bacteria]

The preoperative and postoperative use of antiseptics can be an alternative to antibiotics in repeated courses of anti-VEGF therapy for reducing the risk of developing antibiotic resistance in eye microflora. Among gram-negative bacteria, the most frequently isolated pathogen that causes eye infections is Pseudomonas aeruginosa, which is characterized by reduced sensitivity to antibiotics and disinfectants.

PURPOSE

To study the effect of the antiseptic picloxydine dihydrochloride on the gram-negative bacteria Escherichia coli, Pseudomonas luteola and P. aeruginosa isolated from the conjunctiva.

MATERIAL AND METHODS

The identification of bacterial isolates and study of their sensitivity to antibiotics were carried out using the automated bacteriological analyzer BD Phoenix 100. To determine the bactericidal concentration, the method of serial dilutions of the antiseptic in a liquid nutrient medium was used. The binding of cationic molecules of picloxydine dihydrochloride to bacterial cells was detected by neutralizing the bacterial surface with increasing amounts of antiseptic, and measuring the zeta potential on the Zetasizer Nano ZS analyzer. The ultrastructure of bacterial cells was studied using the two-beam scanning ion-electron microscope Quanta 200 3D.

RESULTS

The most resistant was P. aeruginosa. The interaction mechanism of picloxydine dihydrochloride with bacterial cells includes electrostatic binding of positively charged antiseptic molecules to negatively charged cell walls. Picloxydine dihydrochloride has a destructive effect on the bacterial cell wall and plasma membrane, which leads to cell lysis and release of intracellular components.

CONCLUSION

Picloxydine dihydrochloride exhibits bactericidal activity against gram-negative conjunctival isolates and is promising for preventive use during repeated courses of intravitreal injections.

Global gene expression in Escherichia coli, isolated from the diseased ocular surface of the human eye with a potential to form biofilm

Background

Escherichia coli, the gastrointestinal commensal, is also known to cause ocular infections such as conjunctivitis, keratitis and endophthalmitis. These infections are normally resolved by topical application of an appropriate antibiotic. But, at times these E. coli are resistant to the antibiotic and this could be due to formation of a biofilm. In this study ocular E. coli from patients with conjunctivitis, keratitis or endophthalmitis were screened for their antibiotic susceptibility and biofilm formation potential. In addition DNA-microarray analysis was done to identify genes that are involved in biofilm formation and antibiotic resistance.

Results

Out of 12 ocular E. coli isolated from patients ten isolates were resistant to one or more of the nine antibiotics tested and majority of the isolates were positive for biofilm formation. In E. coli L-1216/2010, the best biofilm forming isolate, biofilm formation was confirmed by scanning electron microscopy. Confocal laser scanning microscopic studies indicated that the thickness of the biofilm increased up to 72 h of growth. Further, in the biofilm phase, E. coli L-1216/2010 was 100 times more resistant to the eight antibiotics tested compared to planktonic phase. DNA microarray analysis indicated that in biofilm forming E. coli L-1216/2010 genes encoding biofilm formation such as cell adhesion genes, LPS production genes, genes required for biofilm architecture and extracellular matrix remodeling and genes encoding for proteins that are integral to the cell membrane and those that influence antigen presentation are up regulated during biofilm formation. In addition genes that confer antimicrobial resistance such as genes encoding antimicrobial efflux (mdtM and cycA), virulence (insQ, yjgK), toxin production (sat, yjgK, chpS, chpB and ygjN), transport of amino-acids and other metabolites (cbrB, cbrC, hisI and mglB) are also up regulated. These genes could serve as potential targets for developing strategies for hacking biofilms and overcoming antibiotic resistance.

Conclusions

This is the first study on global gene expression in antibiotic resistant ocular E. coli with a potential to form biofilm. Using native ocular isolates for antibiotic susceptibility testing, for biofilm formation and global gene expression is relevant and more acceptable than using type strains or non clinical strains which do not necessarily mimic the native isolate.

Electronic supplementary material

The online version of this article (doi:10.1186/s13099-017-0164-2) contains supplementary material, which is available to authorized users.