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Hussaini IM, Oyewole OA, Sulaiman MA, Dabban AI, Sulaiman AN, Tarek R. Microbial anti-biofilms: types and mechanism of action. Res Microbiol 2024; 175:104111. [PMID: 37844786 DOI: 10.1016/j.resmic.2023.104111] [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: 03/12/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 10/18/2023]
Abstract
Biofilms have been recognized as a serious threat to public health as it protects microbes from antimicrobials, immune defence mechanisms, chemical treatments and nutritional stress. Biofilms are also a source of concern in industries and water treatment because their presence compromises the integrity of equipment. To overcome these problems, it is necessary to identify novel anti-biofilm compounds. Products of microorganisms have been identified as promising broad-spectrum anti-biofilm agents. These natural products include biosurfactants, antimicrobial peptides, enzymes and bioactive compounds. Anti-biofilm products of microbial origin are chemically diverse and possess a broad spectrum of activities against biofilms. The objective of this review is to give an overview of the different types of microbial anti-biofilm products and their mechanisms of action.
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Affiliation(s)
| | - Oluwafemi Adebayo Oyewole
- Department of Microbiology, School of Life Sciences, Federal University of Technology, Minna, Nigeria; African Center of Excellence for Mycotoxin and Food Safety, Federal University of Technology Minna, Nigeria.
| | | | | | - Asmau Nna Sulaiman
- Department of Microbiology, Faculty of Life Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Reham Tarek
- Department of Biotechnology, Cairo University, Egypt
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2
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Dukka H, Taal MW, Bayston R. Potential clinical value of catheters impregnated with antimicrobials for the prevention of infections associated with peritoneal dialysis. Expert Rev Med Devices 2023; 20:459-466. [PMID: 37138535 PMCID: PMC11182215 DOI: 10.1080/17434440.2023.2205587] [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: 10/31/2022] [Accepted: 04/18/2023] [Indexed: 05/05/2023]
Abstract
INTRODUCTION Peritoneal dialysis (PD) is a widely used dialysis modality, which offers the advantage of being a home therapy but is associated with a risk of potentially serious infections, including exit site infection, catheter tunnel infection, and peritonitis that may result in morbidity, technique failure, and increased mortality. Catheters impregnated with antimicrobials hold promise as a novel technique to reduce PD associated infections. AREAS COVERED We describe PD modalities, catheters, technique, complications, and the microbiology of associated infections, as well as standard measures to reduce the risk of infection. A novel technique for the impregnation of silicone devices with antimicrobial agents has been used to produce antimicrobial impregnated ventricular shunt catheters with proven clinical efficacy that have now been adopted as the standard of care to reduce neurosurgical infections. Using the same technology, we have developed PD and urinary catheters impregnated with sparfloxacin, triclosan, and rifampicin. Safety and tolerability have been demonstrated in urinary catheters, and a similar study is planned in PD catheters. EXPERT OPINION Catheters impregnated with antimicrobials offer a simple technique to reduce PD associated infections and thereby enable more people to enjoy the advantages of PD. Clinical trials are needed to establish efficacy.
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Affiliation(s)
- Hari Dukka
- Consultant Nephrologist, Department of Renal Medicine, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Maarten W. Taal
- Consultant Nephrologist, Department of Renal Medicine, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
- Professor of Medicine, Centre for Kidney Research and Innovation, Academic Unit for Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Roger Bayston
- Emeritus Professor, Academic Unit for Injury, Repair and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK
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Sachar M, Shah A. Epidemiology, management, and prevention of exit site infections in peritoneal dialysis patients. Ther Apher Dial 2021; 26:275-287. [PMID: 34435734 DOI: 10.1111/1744-9987.13726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 08/04/2021] [Accepted: 08/22/2021] [Indexed: 11/29/2022]
Abstract
Exit site infection (ESI) is a leading complication of peritoneal dialysis (PD), at an incidence of 0.6 episodes per year in the United States, and a major risk factor for catheter removal and peritonitis. An estimated 20% of all peritonitis cases are preceded by an ESI, with up to 50% of Staphylococcus aureus peritonitis associated with ESI. Gram-negative ESIs are less associated with succeeding peritonitis than their gram-positive counterparts, though when present, are associated with a lower peritonitis cure rate. The rate of catheter removal for refractory ESI is relatively highest in ESI due to mycobacteria (up to 40%), S. aureus (35%), Pseudomonas aeruginosa (28%), followed by Corynebacterium, Serratia, and fungi. In review of relevant literature, we found no prophylactic benefit of dressings over nondressings, specific antiseptics over normal saline, or topical honey over topical antibiotic prophylaxis, and thus recommend individualized exit site hygiene. We found topical gentamicin effective for prevention of most ESIs, including gram-negative ESIs, and thus recommend consideration of prophylactic topical gentamicin in areas of high gram-negative peritonitis incidence. With long-term use, observational studies detect up to 25% of gram-positive and 14% of gram-negative ESIs may be mupirocin and gentamicin resistant, respectively. We review empiric and targeted ESI management, including indications for ultrasound, anti-VMRSA, anti-Pseudomonal, and anti-mycobacterial antibiotic use, and catheter removal. We recommend further investigation into the earlier use of second-line treatment agents and the utility of treating post-infectious exit site colonization as avenues to decrease refractory and repeat ESI.
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Affiliation(s)
- Moniyka Sachar
- Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Ankur Shah
- Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Division of Nephrology, Rhode Island Hospital, Providence, Rhode Island, USA.,Providence Veterans Affairs Medical Center, Providence, Rhode Island, USA
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Muhammad MH, Idris AL, Fan X, Guo Y, Yu Y, Jin X, Qiu J, Guan X, Huang T. Beyond Risk: Bacterial Biofilms and Their Regulating Approaches. Front Microbiol 2020; 11:928. [PMID: 32508772 PMCID: PMC7253578 DOI: 10.3389/fmicb.2020.00928] [Citation(s) in RCA: 270] [Impact Index Per Article: 67.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 04/20/2020] [Indexed: 12/24/2022] Open
Abstract
Bacterial biofilms are complex surface attached communities of bacteria held together by self-produced polymer matrixs mainly composed of polysaccharides, secreted proteins, and extracellular DNAs. Bacterial biofilm formation is a complex process and can be described in five main phases: (i) reversible attachment phase, where bacteria non-specifically attach to surfaces; (ii) irreversible attachment phase, which involves interaction between bacterial cells and a surface using bacterial adhesins such as fimbriae and lipopolysaccharide (LPS); (iii) production of extracellular polymeric substances (EPS) by the resident bacterial cells; (iv) biofilm maturation phase, in which bacterial cells synthesize and release signaling molecules to sense the presence of each other, conducing to the formation of microcolony and maturation of biofilms; and (v) dispersal/detachment phase, where the bacterial cells depart biofilms and comeback to independent planktonic lifestyle. Biofilm formation is detrimental in healthcare, drinking water distribution systems, food, and marine industries, etc. As a result, current studies have been focused toward control and prevention of biofilms. In an effort to get rid of harmful biofilms, various techniques and approaches have been employed that interfere with bacterial attachment, bacterial communication systems (quorum sensing, QS), and biofilm matrixs. Biofilms, however, also offer beneficial roles in a variety of fields including applications in plant protection, bioremediation, wastewater treatment, and corrosion inhibition amongst others. Development of beneficial biofilms can be promoted through manipulation of adhesion surfaces, QS and environmental conditions. This review describes the events involved in bacterial biofilm formation, lists the negative and positive aspects associated with bacterial biofilms, elaborates the main strategies currently used to regulate establishment of harmful bacterial biofilms as well as certain strategies employed to encourage formation of beneficial bacterial biofilms, and highlights the future perspectives of bacterial biofilms.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Tianpei Huang
- State Key Laboratory of Ecological Pest Control for Fujian and Taiwan Crops & Key Laboratory of Biopesticide and Chemical Biology of Ministry of Education, College of Life Sciences & College of Plant Protection & International College, Fujian Agriculture and Forestry University, Fuzhou, China
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Bnaya A, Wiener-Well Y, Soetendorp H, Einbinder Y, Paitan Y, Kunin M, Tanasiychuk T, Kushnir D, Kruzel-Davila E, Gershkovitz R, Rosenberg R, Bloch A, Doviner V, Assous MV, Peretz O, Shavit L, Ben-Chetrit E. Nontuberculous mycobacteria infections of peritoneal dialysis patients: A multicenter study. Perit Dial Int 2020; 41:284-291. [PMID: 32400280 DOI: 10.1177/0896860820923461] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES Nontuberculous mycobacteria (NTM) infections pose a diagnostic challenge in peritoneal dialysis (PD) patients. In this study, we sought to identify findings that are suggestive of NTM infection in PD adult patients. METHODS All patients with NTM exit-site infection (ESI) with/without tunnel infection and peritonitis identified during the last decade in eight medical centers in Israel were included. Clinical, microbiological, and outcome data were collected and analyzed. RESULTS Thirty patients were identified; 16 had ESI (53%) and 14 had peritonitis (47%). Median age was 65 years (interquartile range 52-76). Abdominal pain and cloudy PD fluid were reported in all patients with peritonitis, whereas exit-site discharge and granulation tissue were common in patients with ESI. Fourteen patients (47%) had negative cultures prior NTM diagnosis, and isolation of diphtheroids or Corynebacterium spp. was reported in 9 of 30 patients (30%). Antimicrobial treatment prior to diagnosis was documented in 13 of 30 patients (43%). Delayed diagnosis was frequent. Treatment regimens and duration of therapy varied widely. In 26 of 30 (87%) patients, catheter was removed and 19 of 30 patients (63%) required permanent transition to hemodialysis. Two patients with peritonitis (2 of 14, 14%) and seven with ESI (7 of 16, 44%) were eligible for continuation of PD. CONCLUSIONS Culture negative peritonitis, isolation of diphtheroids or Corynebacterium spp., previous exposure to antibiotics, and/or a refractory infection should all prompt consideration of PD-related NTM infection and timely workup. Catheter removal is recommended aside prolonged antimicrobial therapy. In select patients with ESI, continuation of PD may be feasible.
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Affiliation(s)
- Alon Bnaya
- Institute of Nephrology, 26743Shaare Zedek Medical Center, Affiliated with the Hebrew University, Jerusalem, Israel
| | - Yonit Wiener-Well
- Infectious Diseases Unit, 26743Shaare Zedek Medical Center, Affiliated with the Hebrew University, Jerusalem, Israel
| | - Hila Soetendorp
- Department of Nephrology, Sourasky Medical Center, Affiliated with the Tel Aviv University, Israel
| | - Yael Einbinder
- Department of Nephrology, Meir Medical Center, Kfar Saba, Affiliated with the Tel Aviv University, Israel
| | - Yossi Paitan
- Department of Clinical Microbiology and Immunology, 37253Meir Medical Center, Kfar Saba, Affiliated with the Tel Aviv University, Israel
| | - Margarita Kunin
- Institue of Nephrology and Hypertension, 26744Sheba Medical Center, Ramat Gan, Affiliated with the Tel Aviv University, Israel
| | - Tatiana Tanasiychuk
- Department of Nephrology, 37255Carmel Medical Center, Affiliated with the Technion - Israel Institute of Technology, Haifa, Israel
| | - Daniel Kushnir
- Department of Nephrology, 37255Carmel Medical Center, Affiliated with the Technion - Israel Institute of Technology, Haifa, Israel
| | - Etty Kruzel-Davila
- Department of Nephrology and Hypertension, 58878Rambam Health Care Campus, Affiliated with the Technion - Israel Institute of Technology, Haifa, Israel
| | - Regina Gershkovitz
- Israel Institute of Nephrology and Hypertension, 26736Hillel Yaffe Medical Center, Hadera, Affiliated with the Tel Aviv University, Israel
| | - Roza Rosenberg
- Division of Nephrology, 37256Assaf Harofeh Medical Center, Be'er Ya'akov, Affiliated with the Tel Aviv University, Israel
| | - Aharon Bloch
- Department of Nephrology and Hypertension, 58884Hadassah Medical Center, Affiliated with the Hebrew University, Jerusalem, Israel
| | - Victoria Doviner
- Department of Pathology, 26743Shaare Zedek Medical Center, Affiliated with the Hebrew University, Jerusalem, Israel
| | - Marc V Assous
- Clinical Microbiology Laboratory, 26743Shaare Zedek Medical Center, Affiliated with the Hebrew University, Jerusalem, Israel
| | - Orly Peretz
- Institute of Nephrology, 26743Shaare Zedek Medical Center, Affiliated with the Hebrew University, Jerusalem, Israel
| | - Linda Shavit
- Institute of Nephrology, 26743Shaare Zedek Medical Center, Affiliated with the Hebrew University, Jerusalem, Israel
| | - Eli Ben-Chetrit
- Infectious Diseases Unit, 26743Shaare Zedek Medical Center, Affiliated with the Hebrew University, Jerusalem, Israel
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Viron C, Lobbedez T, Lanot A, Bonnamy C, Ficheux M, Guillouet S, Bechade C. Simultaneous Removal And Reinsertion of the PD Catheter in Relapsing Peritonitis. Perit Dial Int 2019; 39:282-288. [PMID: 30852521 DOI: 10.3747/pdi.2018.00230] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/14/2019] [Indexed: 11/15/2022] Open
Abstract
Background:Relapsing peritonitis in peritoneal dialysis (PD) is associated with lower cure rates and more hemodialysis (HD) transfers, as catheter removal is recommended in these situations. The aim of our study was to evaluate the continuation of PD without perioperative transfer to HD in patients who underwent a simultaneous catheter removal and replacement for relapsing peritonitis.Methods:This was a retrospective monocentric study. Patients with simultaneous catheter removal and replacement for relapsing peritonitis or peritonitis at high risk of relapse (fungal or Pseudomonas infection) between 1 January 2007 and 31 December 2016 were included. The events of interest were the continuation of PD without perioperative transfer to HD, postoperative complications, new infection with the same organism, and technique survival.Results:Of the 271 incident patients in PD during this period, 11 had a simultaneous catheter removal and replacement for relapsing peritonitis (8) or high risk of relapse peritonitis (3). Eight (72.7%) patients pursued PD without transfer to HD. Six infections were due to microorganisms other than gram-positive cocci. At 1 year, 7 (63.6%) of the 11 patients were still on PD. After the surgery, there were no peritonitis or catheter-related infections caused by the same organism.Conclusion:Simultaneous catheter removal and replacement for peritonitis appears to be an effective procedure for maintaining patients on PD.
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Affiliation(s)
- Caroline Viron
- CHU de Caen, Department of Nephrology - Dialysis - Transplantation, Caen, France
| | - Thierry Lobbedez
- CHU de Caen, Department of Nephrology - Dialysis - Transplantation, Caen, France .,RDPLF, Pontoise, France
| | - Antoine Lanot
- CHU de Caen, Department of Nephrology - Dialysis - Transplantation, Caen, France
| | - Cécile Bonnamy
- CH de Bayeux, Department of General Surgery, Bayeux, France
| | - Maxence Ficheux
- CHU de Caen, Department of Nephrology - Dialysis - Transplantation, Caen, France
| | - Sonia Guillouet
- CHU de Caen, Department of Nephrology - Dialysis - Transplantation, Caen, France
| | - Clémence Bechade
- CHU de Caen, Department of Nephrology - Dialysis - Transplantation, Caen, France.,U1086 INSERM - ANTICIPE - Centre Régional de Lutte contre le Cancer François Baclesse, Caen, France
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7
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Archaeal tetraether lipid coatings-A strategy for the development of membrane analog spacer systems for the site-specific functionalization of medical surfaces. Biointerphases 2018; 13:011004. [PMID: 29382205 DOI: 10.1116/1.5008816] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The primary goal of our investigation was the development of a versatile immobilization matrix based on archaeal tetraether lipids that meets the most important prerequisites to render an implant surface bioactive by binding specific functional groups or functional polymers with the necessary flexibility and an optimal spatial arrangement to be bioavailable. From this point of view, it appears obvious that numerous efforts made recently to avoid initial bacterial adhesion on catheter surfaces as an important prerequisite of material associated infection episodes have shown only a limited efficiency since the bioactive entities could not be presented in an optimal conformation and a stable density. A significant improvement of this situation can be achieved by highly specific biomimetic modifications of the catheter surfaces. The term "biomimetic" originates from the fact that specific archaeal tetraether lipids were introduced to form a membrane analog monomolecular spacer system, which (1) can be immobilized on nearly all solid surfaces and (2) chemically modified to present a tailor-made functionality in contact with aqueous media either to avoid or inhibit surface fouling or to equip any implant surface with the necessary chemical functionality to enable cell adhesion and tissue integration. Ultrathin films based on tetraether lipids isolated from archaea Thermoplasma acidophilum were used as a special biomimetic immobilization matrix on the surface of commercial medical silicon elastomers. A complete performance control of the membrane analog coatings was realized in addition to biofunctionality tests, including the proof of cytotoxicity and hemocompatibility according to DIN EN ISO 10993. In order to make sure that the developed immobilization matrix including the grafted functional groups are biocompatible under in vivo-conditions, specific animal tests were carried out to examine the in vivo-performance. It can be concluded that the tetraether lipid based coating systems on silicone have shown no signs of cytotoxicity and a good hemocompatibility. Moreover, no mutagenic effects, no irritation effects, and no sensitization effects could be demonstrated. After an implantation period of 28 days, no irregularities were found.
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Basic-Jukic N, Furic-Cunko V, Juric I, Katalinic L, Rukavina A, Kocman M, Knezevic T. Acute Peritonitis Caused by Propionibacterium Acnes in a Peritoneal Dialysis Patient. BANTAO JOURNAL 2017. [DOI: 10.1515/bj-2017-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Propionibacterium acnes is a gram-positive human skin commensal that is involved in the pathogenesis of acne and prefers anaerobic growth conditions. It has been considered as a low virulence pathogen in different clinical conditions. We present the case of acute peritonitis caused by Propionibacterium acnes in a peritoneal dialysis patient.
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Affiliation(s)
- Nikolina Basic-Jukic
- Department of nephrology, arterial hypertension, dialysis and transplantation, University hospital centre Zagreb, Zagreb , Croatia
| | - Vesna Furic-Cunko
- Department of nephrology, arterial hypertension, dialysis and transplantation, University hospital centre Zagreb, Zagreb , Croatia
| | - Ivana Juric
- Department of nephrology, arterial hypertension, dialysis and transplantation, University hospital centre Zagreb, Zagreb , Croatia
| | - Lea Katalinic
- Department of nephrology, arterial hypertension, dialysis and transplantation, University hospital centre Zagreb, Zagreb , Croatia
| | - Ana Rukavina
- Department of nephrology, arterial hypertension, dialysis and transplantation, University hospital centre Zagreb, Zagreb , Croatia
| | - Monika Kocman
- Department of nephrology, arterial hypertension, dialysis and transplantation, University hospital centre Zagreb, Zagreb , Croatia
| | - Tamara Knezevic
- Department of nephrology, arterial hypertension, dialysis and transplantation, University hospital centre Zagreb, Zagreb , Croatia
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Biomarker research to improve clinical outcomes of peritoneal dialysis: consensus of the European Training and Research in Peritoneal Dialysis (EuTRiPD) network. Kidney Int 2017; 92:824-835. [PMID: 28797473 DOI: 10.1016/j.kint.2017.02.037] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 02/16/2017] [Accepted: 02/27/2017] [Indexed: 12/15/2022]
Abstract
Peritoneal dialysis (PD) therapy substantially requires biomarkers as tools to identify patients who are at the highest risk for PD-related complications and to guide personalized interventions that may improve clinical outcome in the individual patient. In this consensus article, members of the European Training and Research in Peritoneal Dialysis Network (EuTRiPD) review the current status of biomarker research in PD and suggest a selection of biomarkers that can be relevant to the care of PD patients and that are directly accessible in PD effluents. Currently used biomarkers such as interleukin-6, interleukin-8, ex vivo-stimulated interleukin-6 release, cancer antigen-125, and advanced oxidation protein products that were collected through a Delphi procedure were first triaged for inclusion as surrogate endpoints in a clinical trial. Next, novel biomarkers were selected as promising candidates for proof-of-concept studies and were differentiated into inflammation signatures (including interleukin-17, M1/M2 macrophages, and regulatory T cell/T helper 17), mesothelial-to-mesenchymal transition signatures (including microRNA-21 and microRNA-31), and signatures for senescence and inadequate cellular stress responses. Finally, the need for defining pathogen-specific immune fingerprints and phenotype-associated molecular signatures utilizing effluents from the clinical cohorts of PD patients and "omics" technologies and bioinformatics-biostatistics in future joint-research efforts was expressed. Biomarker research in PD offers the potential to develop valuable tools for improving patient management. However, for all biomarkers discussed in this consensus article, the association of biological rationales with relevant clinical outcomes remains to be rigorously validated in adequately powered, prospective, independent clinical studies.
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10
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Neoh KG, Li M, Kang ET, Chiong E, Tambyah PA. Surface modification strategies for combating catheter-related complications: recent advances and challenges. J Mater Chem B 2017; 5:2045-2067. [DOI: 10.1039/c6tb03280j] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This review summarizes the progress made in addressing bacterial colonization and other surface-related complications arising from catheter use.
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Affiliation(s)
- Koon Gee Neoh
- Department of Chemical and Biomolecular Engineering
- National University of Singapore
- Singapore 119077
| | - Min Li
- Department of Chemical and Biomolecular Engineering
- National University of Singapore
- Singapore 119077
| | - En-Tang Kang
- Department of Chemical and Biomolecular Engineering
- National University of Singapore
- Singapore 119077
| | - Edmund Chiong
- Department of Surgery
- National University of Singapore
- Singapore 119077
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Peptide-Mediated PEGylation of Polysulfone Reduces Protein Adsorption and Leukocyte Activation. ASAIO J 2016; 61:710-7. [PMID: 26181712 DOI: 10.1097/mat.0000000000000265] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The exposure of blood to bioincompatible materials used for dialysis triggers leukocyte activation and protein adsorption. We describe a single-step, postmanufacturing method for surface modification to create biomaterials used in medical devices and dialysis with altered surface characteristics. Peptides derived from the receptor-binding domain of the type IV pilin of Pseudomonas aeruginosa were synthesized using L and D-amino acids to generate L-K122-4, enantiomer D-K122-4, and D-retroinverso RI-K122-4 peptides. L-K122-4, D-K122-4, and RI-K122-4 peptides, but not control peptides, bound durably to the surfaces of materials used in medical devices and dialysis including silicone and polysulfone. D-K122-4 enantiomeric peptides were protease resistant on polysulfone and could remain bound to the surface for up to 28 days. To demonstrate that K122-4 peptides could be used to modify material surfaces, D-K122-4 peptide was conjugated to polyethylene glycol (D-K122-4-PEG) and applied to polysulfone. When compared with untreated material, D-K122-4-PEG reduced the surface adsorption of albumin or immunoglobulin G to polysulfone. In coincubation experiments, although uncoated polysulfone induced pro-interleukin-1β cytokine expression in leukocytes, cellular activation was prevented when leukocytes were incubated with D-K122-4-PEG-modified polysulfone. These data demonstrate the proof of principle that K122-4 peptides can be applied to modify the surface characteristics of materials used for dialysis.
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12
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McGuire AL, Bennett SC, Lansley SM, Popowicz ND, Varano della Vergiliana JF, Wong D, Lee YCG, Chakera A. Preclinical assessment of adjunctive tPA and DNase for peritoneal dialysis associated peritonitis. PLoS One 2015; 10:e0119238. [PMID: 25742006 PMCID: PMC4351066 DOI: 10.1371/journal.pone.0119238] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 01/11/2015] [Indexed: 12/21/2022] Open
Abstract
A major complication of peritoneal dialysis is the development of peritonitis, which is associated with reduced technique and patient survival. The inflammatory response elicited by infection results in a fibrin and debris-rich environment within the peritoneal cavity, which may reduce the effectiveness of antimicrobial agents and predispose to recurrence or relapse of infection. Strategies to enhance responses to antimicrobial agents therefore have the potential to improve patient outcomes. This study presents pre-clinical data describing the compatibility of tPA and DNase in combination with antimicrobial agents used for the treatment of PD peritonitis. tPA and DNase were stable in standard dialysate solution and in the presence of antimicrobial agents, and were safe when given intraperitoneally in a mouse model with no evidence of local or systemic toxicity. Adjunctive tPA and DNase may have a role in the management of patients presenting with PD peritonitis.
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Affiliation(s)
- Amanda L. McGuire
- Translational Renal Research Group, Harry Perkins Institute of Medical Research, Perth, Australia
- University of Western Australia, School of Medicine and Pharmacology, Perth, Australia
| | - Sophia C. Bennett
- Translational Renal Research Group, Harry Perkins Institute of Medical Research, Perth, Australia
- University of Western Australia, School of Medicine and Pharmacology, Perth, Australia
| | - Sally M. Lansley
- Pleural Disease Unit, Lung Institute of Western Australia, Centre for Asthma, Allergy Respiratory Research, School of Medicine and Pharmacology, Perth, Australia
| | - Natalia D. Popowicz
- Pleural Disease Unit, Lung Institute of Western Australia, Centre for Asthma, Allergy Respiratory Research, School of Medicine and Pharmacology, Perth, Australia
| | - Julius F. Varano della Vergiliana
- Pleural Disease Unit, Lung Institute of Western Australia, Centre for Asthma, Allergy Respiratory Research, School of Medicine and Pharmacology, Perth, Australia
| | - Daniel Wong
- Department of Anatomical Pathology, PathWest Laboratory Medicine WA, QEII Medical Centre, Perth, Australia
| | - Y. C. Gary Lee
- Pleural Disease Unit, Lung Institute of Western Australia, Centre for Asthma, Allergy Respiratory Research, School of Medicine and Pharmacology, Perth, Australia
- Respiratory Department, Sir Charles Gairdner Hospital, Perth, Australia
| | - Aron Chakera
- Translational Renal Research Group, Harry Perkins Institute of Medical Research, Perth, Australia
- University of Western Australia, School of Medicine and Pharmacology, Perth, Australia
- Renal Department, Sir Charles Gairdner Hospital, Perth, Australia
- * E-mail:
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13
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Propionibacterium acnes: from commensal to opportunistic biofilm-associated implant pathogen. Clin Microbiol Rev 2015; 27:419-40. [PMID: 24982315 DOI: 10.1128/cmr.00092-13] [Citation(s) in RCA: 407] [Impact Index Per Article: 45.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Propionibacterium acnes is known primarily as a skin commensal. However, it can present as an opportunistic pathogen via bacterial seeding to cause invasive infections such as implant-associated infections. These infections have gained more attention due to improved diagnostic procedures, such as sonication of explanted foreign materials and prolonged cultivation time of up to 14 days for periprosthetic biopsy specimens, and improved molecular methods, such as broad-range 16S rRNA gene PCR. Implant-associated infections caused by P. acnes are most often described for shoulder prosthetic joint infections as well as cerebrovascular shunt infections, fibrosis of breast implants, and infections of cardiovascular devices. P. acnes causes disease through a number of virulence factors, such as biofilm formation. P. acnes is highly susceptible to a wide range of antibiotics, including beta-lactams, quinolones, clindamycin, and rifampin, although resistance to clindamycin is increasing. Treatment requires a combination of surgery and a prolonged antibiotic treatment regimen to successfully eliminate the remaining bacteria. Most authors suggest a course of 3 to 6 months of antibiotic treatment, including 2 to 6 weeks of intravenous treatment with a beta-lactam. While recently reported data showed a good efficacy of rifampin against P. acnes biofilms, prospective, randomized, controlled studies are needed to confirm evidence for combination treatment with rifampin, as has been performed for staphylococcal implant-associated infections.
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Vuotto C, Donelli G. Anaerobes in Biofilm-Based Healthcare-Associated Infections. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 830:97-112. [DOI: 10.1007/978-3-319-11038-7_6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Davies SJ. Peritoneal Solute Transport and Inflammation. Am J Kidney Dis 2014; 64:978-86. [DOI: 10.1053/j.ajkd.2014.06.030] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 06/19/2014] [Indexed: 11/11/2022]
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Martins M, Rodrigues A, Pedrosa JM, Carvalho MJ, Cabrita A, Oliveira R. Update on the challenging role of biofilms in peritoneal dialysis. BIOFOULING 2013; 29:1015-1027. [PMID: 23998251 DOI: 10.1080/08927014.2013.824566] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Biofilms are commonly associated with an increased risk of patient infection. In peritoneal dialysis (PD), catheter associated infection, especially peritonitis, remains a clinically relevant problem. Although the presence of a biofilm is recognized in relapsing, repeat, and catheter-related peritonitis, it remains poorly characterized. In this review, an update on the role of biofilms in PD infections is presented. The emerging concept that host cells and tissue associated biofilms, in addition to the biofilms on the catheters themselves, contribute to the recalcitrance of infections is discussed. Furthermore, the evidence of biofilms on PD catheters, their developmental stages, and the possible influence of the PD environment are reviewed. The focus is given to ex vivo and in vitro studies that contribute to the elucidation of the interplay between host, microbial, and dialysis factors. The key issues that are still to be answered and the challenges to clinical practice are discussed.
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Affiliation(s)
- Margarida Martins
- IBB-Institute for Biotechnology and Bioengineering, Centre of Biological Engineering, University of Minho, Braga, Portugal
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