Adhesion of Pseudomonas aeruginosa to collagen biomaterials: effect of amikacin and ciprofloxacin on the colonization and survival of the adherent organisms

Fabrication of collagen with polyhexamethylene biguanide: A potential scaffold for infected wounds

Bacterial infection remains a great challenge in wound healing, especially in chronic wounds. Multidrug-resistant organisms are increasing in acute and chronic wound infections, which compromise the chance of therapeutics. Resistance to conventional antibiotics has created an urge to study new approach/system that can effectively control wound infection and enhance healing. Wound cover/dressing must exhibit biocompatibility and effectiveness in reducing bioburden at the wound site. Collagen, a natural biopolymer, possesses advantages over synthetic and other natural materials due to its unique biological properties. It can act as an excellent wound dressing and controlled drug delivery system. Currently, antiseptic agents such as silver, iodine, and polyhexamethylene biguanide (PHMB)-incorporated scaffolds have become widely accepted in chronic wound healing. In this study, PHMB-incorporated collagen scaffold has been prepared and characterized using Fourier transform infrared spectroscopy (FTIR), circular dichroism (CD), and differential scanning calorimetry (DSC), which showed retention of collagen nativity and integration of PHMB. The scanning electron microscopy (SEM) analysis revealed the porous structures of scaffolds. The cytotoxicity analysis showed PHMB is nontoxic at the concentration of 0.01% (wt/wt). The agar diffusion test and bacterial adhesion study demonstrated the effectiveness of PHMB-incorporated collagen scaffold against both gram positive and negative strains. This study concludes that PHMB-incorporated collagen scaffold could have the potential for infected wound healing.

Evaluation of the biofilm formation of Staphylococcus aureus and Pseudomonas aeruginosa on human umbilical cord CD146+ stem cells and stem cell-based decellularized matrix

This study aims to evaluate the CD146+ stem cells obtained from the human umbilical cord and their extracellular matrix proteins on in vitro Pseudomonas aeruginosa and Staphylococcus aureus biofilms to understand their possible antimicrobial activity. CD146+ stem cells were determined according to cell surface markers and differentiation capacity. Characterization of the decellularized matrix was done with DAPI, Masson's Trichrome staining and proteome analysis. Cell viability/proliferation of cells in co-cultures was evaluated by WST-1 and crystal-violet staining. The effects of cells and decellularized matrix proteins on biofilms were investigated on a drip flow biofilm reactor and their effects on gene expression were determined by RT-qPCR. We observed that CD146/105+ stem cells could differentiate adipogenically and decellularized matrix showed negative DAPI and positive collagen staining with Masson' s Trichrome. Proteome analysis of the decellularized matrix revealed some matrix components and growth factors. Although the decellularized matrix significantly reduced the cell counts of P. aeruginosa, no significant difference was observed for S. aureus cells in both groups. Supporting data was obtained from the gene expression results of P. aeruginosa with the significant down-regulation of rhlR and lasR. For S. aureus, icaADBC genes were significantly up-regulated when grown on the decellularized matrix.

Improvement of the Physical Properties of Guided Bone Regeneration Membrane from Porcine Pericardium by Polyphenols-Rich Pomace Extract

To achieve optimal performances, guided bone regeneration membranes should have several properties, in particular, proper stiffness and tear resistance for space maintenance, appropriate resorption time, and non-cytotoxic effect. In this work, polyphenol-rich pomace extract (PRPE), from a selected grape variety (Nebbiolo), rich in proanthocyanidins and flavonols (e.g., quercetin), was used as a rich source of polyphenols, natural collagen crosslinkers, to improve the physical properties of the porcine pericardium membrane. The incorporation of polyphenols in the collagen network of the membrane was clearly identified by infra-red spectroscopy through the presence of a specific peak between 1360–1380 cm⁻¹. Polyphenols incorporated into the pericardium membrane bind to collagen with high affinity and reduce enzymatic degradation by 20% compared to the native pericardium. The release study shows a release of active molecules from the membrane, suggesting a possible use in patients affected by periodontitis, considering the role of polyphenols in the control of this pathology. Mechanical stiffness is increased making the membrane easier to handle. Young’s modulus of pericardium treated with PRPE was three-fold higher than the one measured on native pericardium. Tear and suture retention strength measurement suggest favorable properties in the light of clinical practice requirements.

Ionic silver functionalized ovine forestomach matrix - a non-cytotoxic antimicrobial biomaterial for tissue regeneration applications

BACKGROUND

Antimicrobial technologies, including silver-containing medical devices, are increasingly utilized in clinical regimens to mitigate risks of microbial colonization. Silver-functionalized resorbable biomaterials for use in wound management and tissue regeneration applications have a narrow therapeutic index where antimicrobial effectiveness may be outweighed by adverse cytotoxicity. We examined the effects of ionic silver functionalization of an extracellular matrix (ECM) biomaterial derived from ovine forestomach (OFM-Ag) in terms of material properties, antimicrobial effectiveness and cytotoxicity profile.

METHODS

Material properties of OFM-Ag were assessed by via biochemical analysis, microscopy, atomic absorption spectroscopy (AAS) and differential scanning calorimetry. The silver release profile of OFM-Ag was profiled by AAS and antimicrobial effectiveness testing utilized to determine the minimum effective concentration of silver in OFM-Ag in addition to the antimicrobial spectrum and wear time. Biofilm prevention properties of OFM-Ag in comparison to silver containing collagen dressing materials was quantified via in vitro crystal violet assay using a polymicrobial model. Toxicity of ionic silver, OFM-Ag and silver containing collagen dressing materials was assessed toward mammalian fibroblasts using elution cytoxicity testing.

RESULTS

OFM-Ag retained the native ECM compositional and structural characteristic of non-silver functionalized ECM material while imparting broad spectrum antimicrobial effectiveness toward 11 clinically relevant microbial species including fungi and drug resistant strains, maintaining effectiveness over a wear time duration of 7-days. OFM-Ag demonstrated significant prevention of polymicrobial biofilm formation compared to non-antimicrobial and silver-containing collagen dressing materials. Where silver-containing collagen dressing materials exhibited cytotoxic effects toward mammalian fibroblasts, OFM-Ag was determined to be non-cytotoxic, silver elution studies indicated sustained retention of silver in OFM-Ag as a possible mechanism for the attenuated cytotoxicity.

CONCLUSIONS

This work demonstrates ECM biomaterials may be functionalized with silver to favourably shift the balance between detrimental cytotoxic potential and beneficial antimicrobial effects, while preserving the ECM structure and function of utility in tissue regeneration applications.

Quantification of initial adhesion of Enterococcus faecalis to medical grade polymers using a DNA-based fluorescence assay

This paper reports on the use of a DNA-based fluorescence assay to study and quantify the initial interactions of the uropathogen Enterococcus faecalis with different polymers commonly used for the fabrication of medical devices and implants, including polyurethane (PU), silicone (SI), high-density polyethylene (HDPE), polyamide (PA), poly(methyl methacrylate) (PMMA) and polytetrafluoroethylene (PTFE). To follow the kinetics of E. faecalis adhesion, polymer samples were incubated in bacterial solution for various times and the relative concentration of adhered bacteria was obtained using two methods: commonly used CFU plate counting and a DNA quantification assay. Results obtained from DNA-based fluorescence assays showed that E. faecalis adhesion on PU is 3-times higher than that on PTFE following exposure to bacteria for 180 min. Neither surface wettability nor surface roughness of the studied polymers was found to correlate with E. faecalis adhesion, suggesting the involvement of much more complex adhesion mechanisms of bacteria onto surfaces. SEM micrographs of adhered bacteria illustrated that adhesion was different depending on the type of polymeric substrate: adhesion on PU samples was characterized by the aggregation of bacterial cells in dense clusters, as well as by the presence of fimbriae between cells and the substrate, which could explain the high adhesion to PU compared to the other polymers. This work demonstrated that the bacterial adhesion to polymers occurs at an early stage of the contact and suggests that the initial adhesion stage should be controlled, in order to prevent subsequent biofilm formation and, thus, reduce the risk of implant-associated infections.

Possible role of the adhesin ace and collagen adherence in conveying resistance to disinfectants on Enterococcus faecalis

INTRODUCTION

This study aimed to evaluate whether the presence of the ace gene and Ace-mediated binding to collagen confers on Enterococcus faecalis resistance against common endodontic disinfectants.

METHODS

Isogenic strains of E. faecalis: OG1RF (wild-type) and TX5256 (ace insertion mutant of OG1RF) were grown in brain-heart infusion broth at 46 degrees C overnight. Standardized bacterial suspensions were pretreated for 1 h either with acid-soluble collagen or acidified phosphate-buffered saline (ac-PBS). Bacteria were challenged with chlorhexidine digluconate (CHX), iodine potassium-iodide (IKI), sodium hypochlorite (NaOCl), and calcium hydroxide [Ca(OH)(2)]. Samples were removed at 1, 3, and 6 h, and cultured on Todd-Hewitt agar plates. Colonies were counted, the absolute values were log transformed, and the data were statistically analyzed using Fisher's least significant differences test and t-test.

RESULTS

OG1RF was more resistant than TX5256 to IKI, NaOCl, and Ca(OH)(2) (P < 0.05). Collagen-exposed OG1RF was more resistant than the ac-PBS-pretreated OG1RF against CHX at 3 h and against IKI at 1 h (P < 0.05); no significant difference was found against NaOCl. As expected, the ace mutant strain, TX5256, pretreated with collagen or ac-PBS did not differ significantly in viability when challenged with CHX, IKI, and NaOCl. An unexpected result was found for Ca(OH)(2): collagen-pretreated OG1RF and TX5256 were both more susceptible than ac-PBS-pretreated OG1RF and TX5256, respectively (P < 0.05).

CONCLUSION

The presence of the ace gene confers resistance against IKI, NaOCl, and Ca(OH)(2) on E. faecalis. Exposure to collagen makes the wild-type bacterium more resistant against CHX and IKI; however, exposure to collagen apparently decreases resistance to Ca(OH)(2).

The resistance of collagen-associated, planktonic cells of Enterococcus faecalis to calcium hydroxide

This study examined whether collagen association by an endodontic isolate of Enterococcus faecalis conferred resistance to the bacterium against calcium hydroxide. E. faecalis A197A was grown at 46 degrees C until early stationary phase. Standardized bacterial suspensions were pretreated for 1 hour either with acid-soluble collagen or acidified phosphate-buffered saline (ac-PBS) and cultured to determine the baseline viable bacterial numbers. The bacterial suspensions were challenged with calcium hydroxide solution. Samples were removed at 6, 12, and 24 hours and cultured on tryptone soy agar plates. An adherence assay was performed to confirm that the collagen in the pretreatment medium was bound by the bacteria. Significantly more bacteria were cultivated at 12 hours in the collagen-pretreated group than the ac-PBS-pretreated group (p < 0.01). No bacteria could be cultivated at 24 hours in either group. Collagen association by E. faecalis A197A was found to increase the tolerance of the bacterium to calcium hydroxide.

Preparation and drug release activity of scaffolds containing collagen and poly(caprolactone)

A new biodegradable polymeric scaffold was prepared by using collagen and poly(caprolatctone) (PCL). These scaffolds were found to be soft, spongy, and transparent in nature and characterized by thermogravimetric analysis and FTIR spectrum. To these biodegradable polymeric scaffolds, antibiotic drugs namely amikacin and gentamycin were incorporated separately to study their release pattern from scaffolds. Amikacin and gentamycin release activity of the scaffolds containing a constant quantity of collagen but different quantities of PCL were studied at various time intervals viz. 1, 4, 24, and 48 h by measuring the optical density at 257 and 255 nm, respectively.

Influence of sialic acid and bacterial sialidase on differential adhesion of Pseudomonas aeruginosa to epithelial cells

Epithelial cell lines from several tissues show a differential sensitivity to Pseudomonas aeruginosa adherence. A549 (lung), HepG2 (liver) and Caco-2 (colon) cells presented an adhesion index of about 3, 1.5 and 5 CFU/cell, respectively, whereas Mz-Ch cell lines (gallbladder cholangiocytes) presented adhesion indexes up to 35. These variations could be associated with the variable amount of sialic acid in cell surface glycoconjugates. Moreover, the presence of free sialic acid in culture media induces the secretion by P. aeruginosa of a sialidase which is able to hydrolyze glycoconjugate-linked sialic acid. As shown with A549 cells, this specific hydrolysis increases bacterial adhesion, probably by unmasking new binding sites onto the cell surface.

Surface-Imprinted Polyurethane Having Affinity Sites for Ampicillin

Affinity sites for an antibacterial drug, ampicillin, were created on the surface of polyurethane using the technique of non-covalent molecular imprinting. This was achieved by polymerizing aminophenylboronic acid in the presence of the ampicillin as a template. The extent of adsorption of the drug by the imprinted surface is nearly five times higher than the non-imprinted surface. The in vitro release studies have shown that the drug is retained for a prolonged period on the imprinted surface while it is rapidly released from the non-imprinted surface. These modified materials were subjected to interactions with two bacterial strains, E. Coli and S. aureus. These species could not adhere to the imprinted surface, further showing the ability of the surface to retain the drug for a prolonged period of time. The non-imprinted surface retained the bacterial strains, reflecting the lack of the drug on the surface. This novel approach seems to be useful for creating surfaces capable of retaining components of interest through non-covalent interactions to impart specific features, such as improved blood compatibility and antibacterial properties. [diagram in text].

Probing surface adhesion forces of Enterococcus faecalis to medical-grade polymers using atomic force microscopy

The aim of this study was to compare the initial adhesion forces of the uropathogen Enterococcus faecalis with the medical-grade polymers polyurethane (PU), polyamide (PA), and poly(tetrafluoroethylene) (PTFE). To quantify the cell-substrate adhesion forces, a method was developed using atomic force microscopy (AFM) in liquid that allows for the detachment of individual live cells from a polymeric surface through the application of increasing force using unmodified cantilever tips. Results show that the lateral force required to detach E. faecalis cells from a substrate differed depending on the nature of the polymeric surface: a force of 19 +/- 4 nN was required to detach cells from PU, 6 +/- 4 nN from PA, and 0.7 +/- 0.3 nN from PTFE. Among the unfluorinated polymers (PU and PA), surface wettability was inversely proportional to the strength of adhesion. AFM images also demonstrated qualitative differences in bacterial adhesion; PU was covered by clusters of cells with few cell singlets present, whereas PA was predominantly covered by individual cells. Moreover, extracellular material could be observed on some clusters of PU-adhered cells as well as in the adjacent region surrounding cells adhered on PA. E. faecalis adhesion to the fluorinated polymer (PTFE) showed different characteristics; only a few individual cells were found, and bacteria were easily damaged, and thus detached, by the tip. This work demonstrates the utility of AFM for measurement of cell-substrate lateral adhesion forces and the contribution these forces make toward understanding the initial stages of bacterial adhesion. Further, it suggests that initial adhesion can be controlled, through appropriate biomaterial design, to prevent subsequent formation of aggregates and biofilms.

Inhibition ofPseudomonas aeruginosaadhesion to fibronectin by PA-IL and monosaccharides: involvement of a lectin-like process

Pseudomonas aeruginosa adherence to fibronectin has been shown to be important to bacterial colonization and infection. To better understand the mechanisms involved in this interaction, the role of the carbohydrate moiety of the fibronectin molecule in P. aeruginosa adhesion was studied. Strain NK 125 502 adhered to immobilized fibronectin with an adherence index of 4.8 × 105CFU/µg. Periodic oxidation of fibronectin markedly reduced the adhesion of P. aeruginosa, while a neuraminidase treatment increased bacteria adhesion. N-Acetylgalactosamine, N-acetylglucosamine, sialic acid, and also lectin PA-IL worked as efficient inhibitors in adhesion assays: 59%, 70.7%, 100%, and 60% of inhibition, respectively. We have demonstrated here the involvement of a lectin-like process in the interaction of P. aeruginosa NK 125 502 with immobilized fibronectin.Key words: Pseudomonas aeruginosa, fibronectin, adherence, lectins.

Improved collagen bilayer dressing for the controlled release of drugs

A novel bilayer dressing has been developed from bovine succinylated collagen. The dressing contains an antibiotic, Ciprofloxacin, for both immediate and time-regulated release for controlling the infection, as the infected open wounds need special care. The dressing consists of a sponge and a film, both prepared from succinylated bovine collagen. The sponge has a smooth surface on one side; its rough surface on the other side forms the bilayer system with the film. Both sponge and film act as an anionic reservoir to hold the cationic Ciprofloxacin. The drug, after dispersing in poly (N-vinyl-2-pyrrolidione) (PVP) solution is allowed to spread in the bilayer system by diffusion. The drug stays in the bilayer system because of ionic binding, but starts releasing when comes in contact with the wound. Release of the drug is immediate, but it is regulated by ionic binding between the drug and succinylated collagen. The wound exudates, and there is a polarity-controlled release of the drug from the bilayer system. The PVP and bilayer system permits only time-regulated release, and the system lasts up to 5 days with therapeutically sufficient drug availability.

An infection-preventing bilayered collagen membrane containing antibiotic-loaded hyaluronan microparticles: physical and biological properties

An infection-preventing bilayered membrane consisting of a dense and porous collagen membrane has been developed. The membrane was fabricated using a combined freeze-drying/air-drying method. Hyaluronan (HA) microparticles containing silver sulfadiazine (AgSD) were fabricated by gelling an HA solution with calcium chloride and were incorporated into collagen layers to allow the sustained release of AgSD. In vitro biodegradability of the membrane and the release of AgSD from the membrane could be controlled by cross-linking the membrane with ultraviolet (UV) irradiation. In a cytotoxicity test, cellular damage was minimized by the sustained release of AgSD from dressings. The antibacterial capacity of the material against Pseudomonas aeruginosa was investigated using the Bauer-Kirby disk diffusion test, and bacterial growth was found to be inhibited for 4 days. In vivo tests showed that the bilayered membrane was associated with greater tissue regeneration than a polymeric membrane and with no infection-related biological signs.

Synthesis and characterization of a novel biodegradable antimicrobial polymer

Bacterial infection is a frequent complication associated with the use of medical devices. In an effort to address this problem, antibacterial agents have been incorporated or applied directly onto the surfaces of numerous types of medical devices. This study assessed the feasibility of using a novel biodegradable polymer to release antibiotic drugs in response to inflammatory related enzymes. A model drug polymer was synthesized using 1,6-hexane diisocyanate (HDI), polycaprolactone diol (PCL), and a fluoroquinolone antibiotic, ciprofloxacin. Polymers were characterized by size-exclusion chromatography (SEC), and elemental analysis. Biodegradation studies were carried out by incubating the polymers with solutions of cholesterol esterase (CE) or phosphate buffer (pH 7.0) for 30 days at 37 degrees C. The degradation was assessed by high-performance liquid chromatography (HPLC), mass spectrometry (MS) and 14C radiolabel release. Subsequently, the activity of the released antibiotic was assessed against a clinical isolate of Pseudomonas aeruginosa. HPLC analysis showed the release of multiple degradation products which were identified, by tandem MS, to include ciprofloxacin and derivatives of ciprofloxacin. The microbiological assessment showed that the released ciprofloxacin possessed antimicrobial activity; 1 microg/ml was measured after 10 days. The results of this study suggest that these novel bioresponsive antimicrobial polymers or similar analogs show promise for use in the control of medical device associated infections.