Application of bioelectric effect to reduce the antibiotic resistance of subgingival plaque biofilm: An in vitro study

Revealing detrimental effects of various DC electrical energy conditions on different multidrug resistant bacteria: a comprehensive study

The arbitrary discharge of contaminated wastes, especially that encompass multidrug resistant microbes (MDR), would broaden the circle of epidemic diseases such as COVID-19, which in turn deteriorate definitely the whole socioeconomics. Therefore, the employment of electrical stimulation techniques such as direct current (DC) with low energy considers being effective tool to impede spontaneous changes in microbial genetic makeup, which increases the prevalence of MDR phenomenon. Herein, the influence of different electric energies generated by DC electric field, volts and time on MDR-bacteria that are categorized among the highly ranked nosocomial pathogens, was scrutinized. Wherein, Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus and Enterococcus faecalis were examined as paradigms of Gram-negative and Gram-positive pathogens. The results declared the significant superior antagonizing potency of electric energy in a dose-dependent modality rather than the applied volts or exposure time. Notably, the exposure of bacterial cultures to140 J inhibited the bacterial count by > 78% and the range of 47-73% for Gram-negative and Gram-positive, respectively. While the suppression in their metabolic activity assessed by > 75% and 41-68%, respectively; reflecting the capability of electrical energy to induce viable but non-culturable (VBNC) state. Similarly, the results of total protein, extracellular protein content and lactate dehydrogenase activity emphasized the cell wall deterioration and losing of cell membrane integrity. Additionally, the elevating in ROS upon DC-exposure participated in DNA fragmentation and plasmid decomposability by the range of 33-60%. Further, SEM micrographs depicted drastic morphological deformations after electrical treatment. Strikingly, DC-treatment impaired antibiotic resistance of the examined strains against several antibiotics by > 64.2%. Generally, our comparative detailed study revealed deleterious potentiality of different DC-protocols in defeating microbial pollution, which could be invested as efficient disinfectant alternative in various sectors such as milk sterilization and wastewater purification.

Significant removal of bacterial biofilm induced by multiple-Short ranges of electric interventions

BACKGROUND

Biofilm-related infections are serious problems in the Orthopedics field, and Staphylococcus aureus are the most popular causative agents of bacterial infections associated with arthroplasty. Several studies demonstrated a synergistic effect of the electric intervention (EI) and the antibiotic administration in killing bacteria in biofilm; however, a constant, long-time EI was needed. In the present study, the effective removal of biofilm formed with S. aureus on a titanium ring by multiple times of one minute-EI was observed and described.

METHODS

A methicillin-sensitive S. aureus clinical isolate was used to form biofilm on a titanium ring. After applying a series of EI with various combinations of the frequencies and timings, the amount and principal components of biofilms were assessed with crystal violet staining, live bacterial cell count, and fluorescence staining with confocal laser scanning microscopy.

RESULTS

More than 60% biofilm removal was observed in the 2-time EI applied at 24 (1) and 72 (3) h (days) post bacterial exposure (PBE) and in the 3-time EI at 0 (0), 24 (1), and 72 (3) h (days) PBE, or at 24 (1), 48 (2), and 72 (3) h (days) PBE. The live bacterial cell numbers, the proportion of live and dead cells, and the amount of extracellular polysaccharide substances (EPS) of biofilm were similar with or without EI. It was assumed that an excess amount of the biofilm removal shown in the several EI was not attributed to the effect of the electrolysis.

CONCLUSIONS

The effective removal of biofilm was observed when multiple times 1 min EI was applied without any changes in the proportion of live and dead bacteria or the amount of EPS. The mechanisms to explain extra biofilm removal remain to be elucidated.

Smart dental materials for antimicrobial applications

Smart biomaterials can sense and react to physiological or external environmental stimuli (e.g., mechanical, chemical, electrical, or magnetic signals). The last decades have seen exponential growth in the use and development of smart dental biomaterials for antimicrobial applications in dentistry. These biomaterial systems offer improved efficacy and controllable bio-functionalities to prevent infections and extend the longevity of dental devices. This review article presents the current state-of-the-art of design, evaluation, advantages, and limitations of bioactive and stimuli-responsive and autonomous dental materials for antimicrobial applications. First, the importance and classification of smart biomaterials are discussed. Second, the categories of bioresponsive antibacterial dental materials are systematically itemized based on different stimuli, including pH, enzymes, light, magnetic field, and vibrations. For each category, their antimicrobial mechanism, applications, and examples are discussed. Finally, we examined the limitations and obstacles required to develop clinically relevant applications of these appealing technologies.

Weak direct current exerts synergistic effect with antibiotics and reduces the antibiotic resistance: An in vitro subgingival plaque biofilm model

BACKGROUND AND OBJECTIVE

Weak direct current (DC) exerts killing effect and synergistic killing effect with antibiotics in some specific bacteria biofilms. However, the potential of weak DC alone or combined with periodontal antibiotics in controlling periodontal pathogens and plaque biofilms remains unclear. The objective of this study was to investigate whether weak DC could exert the anti-biofilm effect or enhance the killing effect of metronidazole (MTZ) and/or amoxicillin-clavulanate potassium (AMC) on subgingival plaque biofilms, by constructing an in vitro subgingival plaque biofilm model.

METHODS

The pooled subgingival plaque and saliva of patients with periodontitis (n = 10) were collected and cultured anaerobically on hydroxyapatite disks in vitro for 48 h to construct the subgingival plaque biofilm model. Then such models were stimulated with 0 μA DC alone (20 min/12 h), 1000 μA DC alone (20 min/12 h), 16 μg/ml MTZ, 16 μg/ml AMC or their combination, respectively. Through viable bacteria counting, metabolic activity assay, quantitative real-time PCR absolute quantification and 16S rDNA sequencing analysis, the anti-biofilm effect of 1000 μA DC and enhanced killing effects of 1000 μA DC combined with antibiotics (MTZ, AMC or MTZ+AMC) were explored.

RESULTS

The old subgingival plaque model (48 h) had no significant difference in total bacterial loads from subgingival plaque in situ, which achieved a similarity of 80%. The 1000 μA DC plus MTZ or AMC for 12 h showed a stronger synergistic killing effect than the same combination for 20 min. The metabolic activity was reduced to the lowest by DC plus MTZ+AMC, as 37.4% of that in the control group, while average synergistic killing effect reached 1.06 log units and average total bacterial loads decreased to 0.87 log units. Furthermore, the relative abundance of the genera Porphyromonas, Prevotella, Treponema_2, and Tannerella were decreased significantly.

CONCLUSION

The presence of weak DC (1000 μA) improved the killing effect of antibiotics on subgingival plaque biofilms, which might provide a novel strategy to reduce their antibiotic resistance.

Comparisons of the killing effect of direct current partially mediated by reactive oxygen species on Porphyromonas gingivalis and Prevotella intermedia in planktonic state and biofilm state - an in vitro study

Background/purpose

Bacterial biofilms formed on the surface of tissues and biomaterials are major causes of chronic infections in humans. Among them, Porphyromonas gingivalis (P. gingivalis) and Prevotella intermedia (P. intermedia) are anaerobic pathogens causing dental infections associated with periodontitis. In this study, we evaluated the killing effect and underlying mechanisms of direct current (DC) as an antimicrobial method in vitro.

Materials and methods

We chose P. gingivalis and P. intermedia in different states to make comparisons of the killing effect of DC. By viable bacteria counting, fluorescent live/dead staining, reactive oxygen species (ROS) assay, addition of ROS scavenger DMTU and mRNA expression assay of ROS scavenging genes, the role of ROS in the killing effect was explored.

Results

The planktonic and biofilm states of two bacteria could be effectively killed by low-intensity DC. For the killing effect of 1000 μA DC, there were significant differences whether on planktonic P. gingivalis and P. intermedia (mean killing values: 2.40 vs 2.62 log₁₀ CFU/mL) or on biofilm state of those (mean killing values: 0.63 vs 0.98 log₁₀ CFU/mL). 1000 μA DC greatly induced ROS production and the mRNA expression of ROS scavenging genes. DMTU could partially decrease the killing values of DC and downregulate corresponding gene’s expression.

Conclusion

1000 μA DC can kill P. gingivalis and P. intermedia in two states by promoting overproduction of ROS, and P. intermedia is more sensitive to DC than P. gingivalis. These findings indicate low-intensity DC may be a promising approach in treating periodontal infections.

Direct current exerts electricidal and bioelectric effects on Porphyromonas gingivalis biofilms partially via promoting oxidative stress and antibiotic transport

Low electric current can inhibit certain microbial biofilms and enhance the efficacy of antimicrobials against them. This study investigated the electricidal and bioelectric effects of direct current (DC) against Porphyromonas gingivalis biofilms as well as the underlying mechanisms. Here, we firstly showed that DC significantly suppressed biofilm formation of P. gingivalis in time- and intensity-dependent manners, and markedly inhibited preformed P. gingivalis biofilms. Moreover, DC enhanced the killing efficacy of metronidazole (MTZ) and amoxicillin with clavulanate potassium (AMC) against the biofilms. Notably, DC-treated biofilms displayed upregulated intracellular ROS and expression of ROS related genes (sod, feoB, and oxyR) as well as porin gene. Interestingly, DC-induced killing of biofilms was partially reversed by ROS scavenger N-dimethylthiourea (DMTU), and the synergistic effect of DC with MTZ/AMC was weakened by small interfering RNA of porin gene (si-Porin). In conclusion, DC can exert electricidal and bioelectric effects against P. gingivalis biofilms partially via promotion of oxidative stress and antibiotic transport, which offers a promising approach for effective management of periodontitis.