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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Alcaraz-Serrano V, Sanz-Fraile H, Bueno-Freire L, Farré R, Otero J, Vázquez N, Rovira-Ribalta N, Oscanoa P, Torres A, Fernández-Barat L. Association between viscoelastic characteristics and sputum colour in patients with bronchiectasis. Arch Bronconeumol 2023:S0300-2896(23)00039-X. [PMID: 37019740 DOI: 10.1016/j.arbres.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/26/2023]
Affiliation(s)
- Victoria Alcaraz-Serrano
- Clinic Foundation for Biomedical Research, Hospital Clinic of Barcelona, Villarroel Street, 170, 08036 Barcelona, Spain; Barcelona Institute for Global Health (ISGlobal), Dr. Aiguader Street, 88, 08003 Barcelona, Spain; Blanquerna School of Health Science, Ramon Llull University, Padilla Street, 326, 08025 Barcelona, Spain
| | - Héctor Sanz-Fraile
- Unit of Biophysics and Bioengineering, School of Medicine and Health Sciences, Universitat de Barcelona, Casanova Street, 143, 08036 Barcelona, Spain
| | - Leticia Bueno-Freire
- Clinic Foundation for Biomedical Research, Hospital Clinic of Barcelona, Villarroel Street, 170, 08036 Barcelona, Spain
| | - Ramón Farré
- Unit of Biophysics and Bioengineering, School of Medicine and Health Sciences, Universitat de Barcelona, Casanova Street, 143, 08036 Barcelona, Spain; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Monforte de Lemos Avenue, 3-5, 28029 Madrid, Spain; Institut d'investigacions Biomèdiques Agustí Pi i Sunyer, Rosselló Street, 149, 08036 Barcelona, Spain
| | - Jorge Otero
- Unit of Biophysics and Bioengineering, School of Medicine and Health Sciences, Universitat de Barcelona, Casanova Street, 143, 08036 Barcelona, Spain; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Monforte de Lemos Avenue, 3-5, 28029 Madrid, Spain
| | - Nil Vázquez
- Clinic Foundation for Biomedical Research, Hospital Clinic of Barcelona, Villarroel Street, 170, 08036 Barcelona, Spain; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Monforte de Lemos Avenue, 3-5, 28029 Madrid, Spain; Institut d'investigacions Biomèdiques Agustí Pi i Sunyer, Rosselló Street, 149, 08036 Barcelona, Spain
| | - Nona Rovira-Ribalta
- Clinic Foundation for Biomedical Research, Hospital Clinic of Barcelona, Villarroel Street, 170, 08036 Barcelona, Spain; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Monforte de Lemos Avenue, 3-5, 28029 Madrid, Spain; Institut d'investigacions Biomèdiques Agustí Pi i Sunyer, Rosselló Street, 149, 08036 Barcelona, Spain
| | - Patricia Oscanoa
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Monforte de Lemos Avenue, 3-5, 28029 Madrid, Spain; Respiratory Department, Hospital Clínic de Barcelona, Villarroel Street, 170, 08036 Barcelona, Spain
| | - Antoni Torres
- Clinic Foundation for Biomedical Research, Hospital Clinic of Barcelona, Villarroel Street, 170, 08036 Barcelona, Spain; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Monforte de Lemos Avenue, 3-5, 28029 Madrid, Spain; Institut d'investigacions Biomèdiques Agustí Pi i Sunyer, Rosselló Street, 149, 08036 Barcelona, Spain; Respiratory Department, Hospital Clínic de Barcelona, Villarroel Street, 170, 08036 Barcelona, Spain.
| | - Laia Fernández-Barat
- Clinic Foundation for Biomedical Research, Hospital Clinic of Barcelona, Villarroel Street, 170, 08036 Barcelona, Spain; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Monforte de Lemos Avenue, 3-5, 28029 Madrid, Spain; Institut d'investigacions Biomèdiques Agustí Pi i Sunyer, Rosselló Street, 149, 08036 Barcelona, Spain.
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Fernández-Barat L, Vázquez Burgos N, Alcaraz V, Bueno-Freire L, López-Aladid R, Cabrera R, Gabarrús A, Palomeque A, Oscanoa P, Ceccato A, Motos A, Amaro R, Bernardi T, Provot C, Soler-Comas A, Muñoz L, Vila J, Torres A. The value of biofilm testing to guide antimicrobial stewardship in chronic respiratory diseases. Front Cell Infect Microbiol 2023; 13:1142274. [PMID: 37201119 PMCID: PMC10187140 DOI: 10.3389/fcimb.2023.1142274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 04/04/2023] [Indexed: 05/20/2023] Open
Abstract
Introduction Biofilm production is an important yet currently overlooked aspect of diagnostic microbiology that has implications for antimicrobial stewardship. In this study, we aimed to validate and identify additional applications of the BioFilm Ring Test® (BRT) for Pseudomonas aeruginosa (PA) isolates from patients with bronchiectasis (BE). Materials and methods Sputa were collected from BE patients who had at least one PA positive culture in the previous year. We processed the sputa to isolate both mucoid and non-mucoid PA, and determined their susceptibility pattern, mucA gene status, and presence of ciprofloxacin mutations in QRDR genes. The Biofilm production index (BPI) was obtained at 5 and 24 hours. Biofilms were imaged using Gram staining. Results We collected 69 PA isolates, including 33 mucoid and 36 non-mucoid. A BPI value below 14.75 at 5 hours predicted the mucoid PA phenotype with 64% sensitivity and 72% specificity. Conclusion Overall, our findings suggest that the fitness-cost associated with the mucoid phenotype or ciprofloxacin resistance is shown through a time-dependent BPI profile. The BRT has the potential to reveal biofilm features with clinical implications.
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Affiliation(s)
- Laia Fernández-Barat
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
- *Correspondence: Laia Fernández-Barat, ; Antoni Torres,
| | - Nil Vázquez Burgos
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Victoria Alcaraz
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Leticia Bueno-Freire
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Ruben López-Aladid
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Roberto Cabrera
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Albert Gabarrús
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Andrea Palomeque
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Patricia Oscanoa
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Adrian Ceccato
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Ana Motos
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Rosanel Amaro
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Thierry Bernardi
- BioFilm Pharma SAS, Lyon, France
- BioFilm Control SAS, Saint Beauzire, France
| | - Christian Provot
- BioFilm Pharma SAS, Lyon, France
- BioFilm Control SAS, Saint Beauzire, France
| | - Alba Soler-Comas
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Laura Muñoz
- Microbiology Service, Hospital Clinic, Barcelona, Spain
| | - Jordi Vila
- Microbiology Service, Hospital Clinic, Barcelona, Spain
| | - Antoni Torres
- Cellex Laboratory, CibeRes (CB06/06/0028)-Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
- Pneumology Service, Respiratory Institute, Hospital Clinic, Barcelona, Spain
- *Correspondence: Laia Fernández-Barat, ; Antoni Torres,
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Cabrera R, Fernández-Barat L, Vázquez N, Alcaraz-Serrano V, Bueno-Freire L, Amaro R, López-Aladid R, Oscanoa P, Muñoz L, Vila J, Torres A. OUP accepted manuscript. J Antimicrob Chemother 2022; 77:1600-1610. [PMID: 35323912 PMCID: PMC9155640 DOI: 10.1093/jac/dkac084] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 02/14/2022] [Indexed: 11/25/2022] Open
Abstract
Background Non-cystic fibrosis bronchiectasis (BE) is a chronic structural lung condition that facilitates chronic colonization by different microorganisms and courses with recurrent respiratory infections and frequent exacerbations. One of the main pathogens involved in BE is Pseudomonas aeruginosa. Objectives To determine the molecular mechanisms of resistance and the molecular epidemiology of P. aeruginosa strains isolated from patients with BE. Methods A total of 43 strains of P. aeruginosa were isolated from the sputum of BE patients. Susceptibility to the following antimicrobials was analysed: ciprofloxacin, meropenem, imipenem, amikacin, tobramycin, aztreonam, piperacillin/tazobactam, ceftazidime, ceftazidime/avibactam, ceftolozane/tazobactam, cefepime and colistin. The resistance mechanisms present in each strain were assessed by PCR, sequencing and quantitative RT–PCR. Molecular epidemiology was determined by MLST. Phylogenetic analysis was carried out using the eBURST algorithm. Results High levels of resistance to ciprofloxacin (44.19%) were found. Mutations in the gyrA, gyrB, parC and parE genes were detected in ciprofloxacin-resistant P. aeruginosa strains. The number of mutated QRDR genes was related to increased MIC. Different β-lactamases were detected: blaOXA50, blaGES-2, blaIMI-2 and blaGIM-1. The aac(3)-Ia, aac(3)-Ic, aac(6″)-Ib and ant(2″)-Ia genes were associated with aminoglycoside-resistant strains. The gene expression analysis showed overproduction of the MexAB-OprM efflux system (46.5%) over the other efflux system. The most frequently detected clones were ST619, ST676, ST532 and ST109. Conclusions Resistance to first-line antimicrobials recommended in BE guidelines could threaten the treatment of BE and the eradication of P. aeruginosa, contributing to chronic infection.
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Affiliation(s)
- Roberto Cabrera
- Hospital Clínic, Cellex Laboratory, CIBERES (Center for net Biomedical Research Respiratory diseases, 06/06/0028) - Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Spain
- Respiratory Intensive Care Unit, Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - Laia Fernández-Barat
- Hospital Clínic, Cellex Laboratory, CIBERES (Center for net Biomedical Research Respiratory diseases, 06/06/0028) - Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Spain
- Respiratory Intensive Care Unit, Pneumology Department, Hospital Clínic, Barcelona, Spain
- Corresponding author. E-mail:
| | - Nil Vázquez
- Hospital Clínic, Cellex Laboratory, CIBERES (Center for net Biomedical Research Respiratory diseases, 06/06/0028) - Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Spain
- Respiratory Intensive Care Unit, Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - Victoria Alcaraz-Serrano
- Hospital Clínic, Cellex Laboratory, CIBERES (Center for net Biomedical Research Respiratory diseases, 06/06/0028) - Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Spain
- Respiratory Intensive Care Unit, Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - Leticia Bueno-Freire
- Hospital Clínic, Cellex Laboratory, CIBERES (Center for net Biomedical Research Respiratory diseases, 06/06/0028) - Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Spain
- Respiratory Intensive Care Unit, Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - Rosanel Amaro
- Hospital Clínic, Cellex Laboratory, CIBERES (Center for net Biomedical Research Respiratory diseases, 06/06/0028) - Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Spain
- Respiratory Intensive Care Unit, Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - Rubén López-Aladid
- Hospital Clínic, Cellex Laboratory, CIBERES (Center for net Biomedical Research Respiratory diseases, 06/06/0028) - Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Spain
- Respiratory Intensive Care Unit, Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - Patricia Oscanoa
- Hospital Clínic, Cellex Laboratory, CIBERES (Center for net Biomedical Research Respiratory diseases, 06/06/0028) - Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Spain
- Respiratory Intensive Care Unit, Pneumology Department, Hospital Clínic, Barcelona, Spain
| | - Laura Muñoz
- Barcelona Global Health Institute, Department of Clinical Microbiology, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Jordi Vila
- Barcelona Global Health Institute, Department of Clinical Microbiology, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Antoni Torres
- Hospital Clínic, Cellex Laboratory, CIBERES (Center for net Biomedical Research Respiratory diseases, 06/06/0028) - Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Spain
- Respiratory Intensive Care Unit, Pneumology Department, Hospital Clínic, Barcelona, Spain
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