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Noach N, Lavy E, Reifen R, Friedman M, Kirmayer D, Zelinger E, Ritter A, Yaniv D, Reifen E. Zinc chloride is effective as an antibiotic in biofilm prevention following septoplasty. Sci Rep 2023; 13:8344. [PMID: 37221180 DOI: 10.1038/s41598-023-35069-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 05/11/2023] [Indexed: 05/25/2023] Open
Abstract
Biofilm-state bacterial infections associated with inserted medical devices constitute a massive health and financial problem worldwide. Although bacteria exhibit significantly lower susceptibility to antibiotics in the biofilm state, the most common treatment approach still relies on antibiotics, exacerbating the phenomenon of antibiotic-resistant bacteria. In this study, we aimed to assess whether ZnCl2 coating of intranasal silicone splints (ISSs) can reduce the biofilm infections associated with the insertion of these devices and prevent the overuse of antibiotics while minimizing waste, pollution and costs. We tested the ability of ZnCl2 to prevent biofilm formation on ISS both in vitro and in vivo by using the microtiter dish biofilm formation assay, crystal violet staining, and electron and confocal microscopy. We found a significant decrease in biofilm formation between the treatment group and the growth control when ZnCl2-coated splints were placed in patients' nasal flora. According to these results, infections associated with ISS insertion may be prevented by using ZnCl2 coating, thereby obviating the overuse and abuse of antibiotics.
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Affiliation(s)
- Noa Noach
- The Institute of Biochemistry, Food Science and Nutrition. The Robert H. Smith Faculty of Agriculture, Food & Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Eran Lavy
- The Koret School of Veterinary Medicine. The Robert H. Smith Faculty of Agriculture, Food & Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Ram Reifen
- The Institute of Biochemistry, Food Science and Nutrition. The Robert H. Smith Faculty of Agriculture, Food & Environment, The Hebrew University of Jerusalem, Rehovot, Israel.
| | - Michael Friedman
- The School of Pharmacy, The Faculty of Medicine, Ein Kerem Campus, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - David Kirmayer
- The School of Pharmacy, The Faculty of Medicine, Ein Kerem Campus, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Einat Zelinger
- FACSI-Faculty of Agriculture Center for Scientific Imaging. The Robert H. Smith Faculty of Agriculture, Food & Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Amit Ritter
- Department of Otolaryngology, Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
| | - Dan Yaniv
- Department of Otolaryngology, Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
| | - Ella Reifen
- Department of Otolaryngology, Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
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Kasapgil E, Badv M, Cantú CA, Rahmani S, Erbil HY, Anac Sakir I, Weitz JI, Hosseini-Doust Z, Didar TF. Polysiloxane Nanofilaments Infused with Silicone Oil Prevent Bacterial Adhesion and Suppress Thrombosis on Intranasal Splints. ACS Biomater Sci Eng 2021; 7:541-552. [PMID: 33470781 DOI: 10.1021/acsbiomaterials.0c01487] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Like all biofluid-contacting medical devices, intranasal splints are highly prone to bacterial adhesion and clot formation. Despite their widespread use and the numerous complications associated with infected splints, limited success has been achieved in advancing their safety and surface biocompatibility, and, to date, no surface-coating strategy has been proposed to simultaneously enhance the antithrombogenicity and bacterial repellency of intranasal splints. Herein, we report an efficient, highly stable lubricant-infused coating for intranasal splints to render their surfaces antithrombogenic and repellent toward bacterial cells. Lubricant-infused intranasal splints were prepared by creating superhydrophobic polysiloxane nanofilament (PSnF) coatings using surface-initiated polymerization of n-propyltrichlorosilane (n-PTCS) and further infiltrating them with a silicone oil lubricant. Compared with commercially available intranasal splints, lubricant-infused, PSnF-coated splints significantly attenuated plasma and blood clot formation and prevented bacterial adhesion and biofilm formation for up to 7 days, the typical duration for which intranasal splints are kept. We further demonstrated that the performance of our engineered biointerface is independent of the underlying substrate and could be used to enhance the hemocompatibility and repellency properties of other medical implants such as medical-grade catheters.
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Affiliation(s)
- Esra Kasapgil
- Department of Materials Science and Engineering, Gebze Technical University, TR-41400 Gebze, Kocaeli, Turkey.,School of Biomedical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8
| | - Maryam Badv
- School of Biomedical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8.,Department of Mechanical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8
| | - Claudia Alonso Cantú
- Department of Chemical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8
| | - Sara Rahmani
- School of Biomedical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8
| | - H Yildirim Erbil
- Department of Chemical Engineering, Gebze Technical University, TR-41400 Gebze, Kocaeli, Turkey
| | - Ilke Anac Sakir
- Department of Materials Science and Engineering, Gebze Technical University, TR-41400 Gebze, Kocaeli, Turkey
| | - Jeffrey I Weitz
- School of Biomedical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8.,Department of Medicine, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8.,Department of Biochemistry and Biomedical Sciences, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8.,Thrombosis & Atherosclerosis Research Institute (TaARI), 237 Barton Street East, Hamilton, Ontario, Canada L8L 2X2
| | - Zeinab Hosseini-Doust
- School of Biomedical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8.,Department of Chemical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8.,Institute for Infectious Disease Research (IIDR), McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8
| | - Tohid F Didar
- School of Biomedical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8.,Department of Mechanical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8.,Institute for Infectious Disease Research (IIDR), McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8
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Ritter A, Alkan U, Yahav D, Soudry E, Reifen E. Intranasal Septal Splints: Prophylactic Antibiotics and Nasal Microbiology. Ann Otol Rhinol Laryngol 2019; 129:5-11. [PMID: 31390881 DOI: 10.1177/0003489419867976] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Intranasal septal splints are often used in nasal septal surgeries. Routine use of postoperative antibiotics is an accepted practice, although data regarding its efficacy in preventing postsurgical complications are limited. This study aimed to examine bacterial colonization on septal splints following prophylactic antibiotic therapy and the association with postoperative infections. METHODS Fifty-five patients underwent septoplasty by a single surgeon between March 2015 and April 2016. All had intranasal septal splints and were given antibiotic prophylaxis for 7 days until removal of splints. Nasal cultures were taken before surgery, and septal splints were examined for bacterial colonization following their removal. RESULTS Thirty-six patients (65%) had positive nasal culture prior to surgery. The most common isolates were Staphylococcus aureus (30%) and Enterobacteriaceae species (66%). All these patients had postoperative bacterial colonization on septal splints. In 15 patients with negative preoperative cultures, bacteria were isolated postoperatively. An increased resistance profile was documented postoperatively in 9 patients (16%), including two with multidrug resistance. In two of these patients preoperative wild-type strains acquired antibiotic resistance postoperatively. No adverse drug reactions to antibiotics were reported. CONCLUSIONS Increased bacterial growth and emergence of resistant strains were observed on intranasal septal splints despite prophylactic antibiotic treatment. Nonetheless, this did not translate into clinical infection. Thus, considering antibiotics overuse and increasing bacterial resistance, further research is needed to determine the role of antibiotic prophylaxis in the setting of intranasal splints.
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Affiliation(s)
- Amit Ritter
- Department of Otolaryngology, Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Uri Alkan
- Department of Otolaryngology, Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dafna Yahav
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Infectious Diseases Unit, Rabin Medical Center, Petah Tikva, Israel
| | - Ethan Soudry
- Department of Otolaryngology, Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ella Reifen
- Department of Otolaryngology, Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Wickramasinghe S, Navarreto-Lugo M, Ju M, Samia ACS. Applications and challenges of using 3D printed implants for the treatment of birth defects. Birth Defects Res 2018; 110:1065-1081. [PMID: 29851302 DOI: 10.1002/bdr2.1352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 04/25/2018] [Indexed: 11/06/2022]
Abstract
Pediatric implants are a special subclass of a vast number of clinically used medical implants, uniquely designed to address the needs of young patients who are at the onset of their developmental growth stage. Given the vulnerability of the implant receiver, it is crucial that the implants manufactured for small children with birth-associated defects be given careful considerations and great attention to design detail to avoid postoperative complications. In this review, we focus on the most common types of medical implants manufactured for the treatment of birth defects originating from both genetic and environmental causes. Particular emphasis is devoted toward identifying the implant material of choice and manufacturing approaches for the fabrication of pediatric prostheses. Along this line, the emerging role of 3D printing to enable customized implants for infants with congenital disorders is presented, as well as the possible complications associated with prosthetic-related infections that is prevalent in using artificial implants for the treatment of birth malformations.
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Affiliation(s)
| | | | - Minseon Ju
- Department of Chemistry, Case Western Reserve University, Cleveland, Ohio
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Kuboki A, Kikuchi S, Asaka D, Onda N, Nakayama T, Kojima H, Otori N. Nasal silicone splints and quilting sutures using a septum stitch device following septoplasty: a prospective comparative study. Eur Arch Otorhinolaryngol 2018; 275:1803-1809. [PMID: 29796742 DOI: 10.1007/s00405-018-4998-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 05/07/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE Although nasal splints and trans-septal sutures are preferred for septal closure following septoplasty, quilting sutures, also known as continuous mattress sutures, are technically challenging and thus time consuming. Recently, the utility of a novel stitch device was demonstrated for quilting sutures; however, whether it contributes to the technical solution and time management of septal sutures remains unclear. This study aims to quantify the time and cost of septal closure following septoplasty by comparing nasal splints with quilting sutures using the septum stitch device. METHODS We prospectively examined 23 patients who underwent septoplasty and assigned them to the following two groups: group 1, underwent the quilting suture for septal closure following septoplasty; group 2 underwent the nasal silicone splint method. We recorded the total operation time and surgical time for septal closure. Furthermore, we evaluated postoperative symptoms with Visual Analogue Scale (VAS) scores and compared the complication rate. RESULTS We observed no significant difference in the average of total operating time (P = 0.641) and the surgical time for septal closure (P = 0.886). Among postoperative symptoms, only nasal bleeding was significantly worse in group 1 on postoperative day 1 (P = 0.023). In addition, the occurrence of postoperative complications was insignificant between both groups. CONCLUSIONS The septum stitch facilitated safe and easy quilting suturing without significant increase of operation time.
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Affiliation(s)
- Akihito Kuboki
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan.
| | - Shun Kikuchi
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan
| | - Daiya Asaka
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan
| | - Nobuto Onda
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan
| | - Tsuguhisa Nakayama
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan
| | - Hiromi Kojima
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan
| | - Nobuyoshi Otori
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan
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Collismycin C from the Micronesian Marine Bacterium Streptomyces sp. MC025 Inhibits Staphylococcus aureus Biofilm Formation. Mar Drugs 2017; 15:md15120387. [PMID: 29231844 PMCID: PMC5742847 DOI: 10.3390/md15120387] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 12/03/2017] [Accepted: 12/07/2017] [Indexed: 12/16/2022] Open
Abstract
Biofilm formation plays a critical role in antimicrobial resistance in Staphylococcus aureus. Here, we investigated the potential of crude extracts of 79 Micronesian marine microorganisms to inhibit S. aureus biofilm formation. An extract of Streptomyces sp. MC025 inhibited S. aureus biofilm formation. Bioactivity-guided isolation led to the isolation of a series of 2,2′-bipyridines: collismycin B (1), collismycin C (2), SF2738 D (3), SF2738 F (4), pyrisulfoxin A (5), and pyrisulfoxin B (6). Among these bipyridines, collismycin C (2) was found to be the most effective inhibitor of biofilm formation by methicillin-sensitive S. aureus and methicillin-resistant S. aureus (MRSA), and this compound inhibited MRSA biofilm formation by more than 90% at a concentration of 50 μg/mL. The antibiofilm activity of collismycin C was speculated to be related to iron acquisition and the presence and position of the hydroxyl group of 2,2′-bipyridines.
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Antibiofilm agents: A new perspective for antimicrobial strategy. J Microbiol 2017; 55:753-766. [PMID: 28956348 DOI: 10.1007/s12275-017-7274-x] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 08/31/2017] [Accepted: 08/31/2017] [Indexed: 02/08/2023]
Abstract
Biofilms are complex microbial architectures that attach to surfaces and encase microorganisms in a matrix composed of self-produced hydrated extracellular polymeric substances (EPSs). In biofilms, microorganisms become much more resistant to antimicrobial treatments, harsh environmental conditions, and host immunity. Biofilm formation by microbial pathogens greatly enhances survival in hosts and causes chronic infections that result in persistent inflammation and tissue damages. Currently, it is believed over 80% of chronic infectious diseases are mediated by biofilms, and it is known that conventional antibiotic medications are inadequate at eradicating these biofilm-mediated infections. This situation demands new strategies for biofilm-associated infections, and currently, researchers focus on the development of antibiofilm agents that are specific to biofilms, but are nontoxic, because it is believed that this prevents the development of drug resistance. Here, we review the most promising antibiofilm agents undergoing intensive research and development.
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Ozdogan F, Ozel HE, Esen E, Yuce T, Eyisarac S, Genc S, Selcuk A. Optimal time for intranasal splint removal after septoplasty: a prospective clinical study. Eur Arch Otorhinolaryngol 2016; 273:3203-6. [PMID: 27015667 DOI: 10.1007/s00405-016-4004-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 03/21/2016] [Indexed: 11/25/2022]
Abstract
To investigate the effect of intranasal splint removal time on patient comfort and possible complications after septoplasty. One hundred and nine patients who had septoplasty operations were included in this study. The patients were divided into three groups. In the 1st group (n = 36), splints were removed on the 3rd day after septoplasty; in the 2nd group (n = 36), splints were removed on the 5th day; and in the 3rd group (n = 37), splints were removed on the 7th day. Pain and nasal fullness were evaluated with visual analog scale. Synechia, perforation, hematoma, infection and hemorrhage were recorded after the removal of the splints (postoperative 1, 8 and 24 weeks). For the 1st, 2nd, and 3rd groups, respectively, pain score was 1.96, 2.67, and 2.67; and nasal fullness score was 6.23, 6.04, and 5.48. Nasal synechia was detected in two patients in the 1st group and in one patient in the 2nd group. Early hemorrhage was detected in two patients in the 1st group and one patient in the 3rd group. Infection, septal perforation and hematoma were detected in three patients in the 1st group. There was no difference in hemorrhage, hematoma, synechia and perforation rates between the three groups. There are various opinions in the literature about the ideal removal time of intranasal tampons after septoplasty, but there is no consensus on this topic. Our study shows that removal time of intranasal splints has no effect on patient comfort or possible complications.
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Affiliation(s)
- Fatih Ozdogan
- Department of Otolaryngology, Derince Research and Training Hospital, Kocaeli, Turkey.
| | - Halil Erdem Ozel
- Department of Otolaryngology, Derince Research and Training Hospital, Kocaeli, Turkey
| | - Erkan Esen
- Department of Otolaryngology, Derince Research and Training Hospital, Kocaeli, Turkey
| | - Turgut Yuce
- Department of Otolaryngology, Derince Research and Training Hospital, Kocaeli, Turkey
| | - Saban Eyisarac
- Department of Otolaryngology, Derince Research and Training Hospital, Kocaeli, Turkey
| | - Selahattin Genc
- Department of Otolaryngology, Derince Research and Training Hospital, Kocaeli, Turkey
| | - Adin Selcuk
- Department of Otolaryngology, Derince Research and Training Hospital, Kocaeli, Turkey
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