Review: Antimicrobial efficacy validation using in vitro and in vivo testing methods

Unraveling resistance mechanisms in combination therapy: A comprehensive review of recent advances and future directions

Antimicrobial resistance is a global health threat. Misuse and overuse of antimicrobials are the main drivers in developing drug-resistant bacteria. The emergence of the rapid global spread of multi-resistant bacteria requires urgent multisectoral action to generate novel treatment alternatives. Combination therapy offers the potential to exploit synergistic effects for enhanced antibacterial efficacy of drugs. Understanding the complex dynamics and kinetics of drug interactions in combination therapy is crucial. Therefore, this review outlines the current advances in antibiotic resistance's evolutionary and genetic dynamics in combination therapies-exposed bacteria. Moreover, we also discussed four pivotal future research areas to comprehend better the development of antibiotic resistance in bacteria treated with combination strategies.

Antibiofilm properties of silver nanoparticles incorporated into polymethyl methacrylate used for dental applications

BACKGROUND

Acrylic resins used in dental and biomedical applications do not have antimicrobial properties, their surface is susceptible to colonization of microorganisms.

OBJECTIVE

The aim of this study was to evaluate the antibiofilm properties of silver nanoparticles (AgNPs) deposited in a polymethyl methacrylate (PMMA) surface against a Staphylococcus aureus biofilm.

METHODS

The PMMA was impregnated with AgNPs by using the in-situ polymerization method. To determine the solubility of the incorporated silver (Ag+) atomic absorption spectrophotometry was used (AAS) at 24 h, 48 h, 7 days, and 30 days. Thirty specimens of PMMA with AgNPs and without NP (control group) were assembled in the CDC Biofilm Bioreactor system with a cell suspension of S. aureus. The specimens were removed at 6, 12, 24, 48, and 72 h to determine the viability profile and quantify the Arbitrary Fluorescence Units (AFU).

RESULTS

The AgNPs showed an irregular and quasispherical shape with an average size of 25 nm. AAS analysis demonstrated a low solubility of Ag+. The formation of the S. aureus biofilm increased as the evaluation periods continued up to 72 h. The experimental group showed poor growth, and a decrease in the intensity of the fluorescence demonstrated a statistically significant inhibition of the formation of the biofilm (P < 0.05) in relation to the control group at 6, 12, 24, 48, and 72 h.

CONCLUSION

AgNPs incorporated into PMMA decreased the growth and maturation of S. aureus biofilm.

Generating bioactive and antiseptic interfaces with nano-silver hydroxyapatite-based coatings by pulsed electrochemical deposition for long-term efficient cervical soft tissue sealing

Infections related to osseointegrated implants have sparked the interest in studying titanium modification for long-term effective soft tissue sealing. Constructing a silver (Ag)-hydroxyapatite (HA) coating is regarded as an effective strategy for integrating antibiosis with osteanagenesis; however, the outcome for long-term cervical soft tissue sealing in vivo is compromised. It is challenging to construct an Ag-HA coating for long-term efficient soft tissue integration that instills a maximum antibacterial effect while retaining favorable bioactivity to normal gingival mesenchymal cells in vivo. In this study, we employed gradient concentrations of Ag/CaP by pulsed electrochemical deposition to fabricate optimal Ag-HA nanocoatings. By physicochemical analyses, these uniform coatings were mainly formed with spherical metallic and hydroxyapatite nanoparticles, which facilitated good hydrophilicity, moderate rough surfaces and corrosion protection. Furthermore, the nanocoating of the 1.5Ag/CaP group exhibited superior performances in dental follicle cells' proliferation, osteogenic differentiation and antibacterial properties mainly through direct contact inhibition and partially through sustained silver ion release, which resulted in functional cervical soft tissue sealing in beagles lasting for one year. Our investigations provide a feasible strategy to balance the long-term antibacterial demand and bioactive induction around osseointegrated implants for long-term efficient cervical soft tissue sealing.

Characterization of Inflammatory and Fibrotic Encapsulation Responses of Implanted Materials with Bacterial Infection

Medical device infections are costly, while preclinical assessment of antimicrobial properties for new materials is time intensive and imperfect at capturing the interrelated aspects of infection response and wound resolution. Herein, we developed an in vivo model for quantification of inflammatory and biocompatibility responses in the presence of a sustained implant-associated infection. The antimicrobial effectiveness of commercially available polymer materials was compared to that of thermoplastic polyurethane (TPU) materials modified with putative antimicrobial strategies as example test materials. Materials were incubated with bioluminescent Escherichia coli prior to implantation in a dorsal subcutaneous pocket in rats with an additional intraluminal bolus of bacteria. Infection kinetics were monitored with bioluminescence, and inflammatory infiltrate and fibrous capsule thickness were determined from stained histological sections. Our model resulted in a persistent infection, sensitive to antimicrobial effects, as the materials modified with a putative antimicrobial surface were able to significantly reduce the level of infection in animals at day 4 postimplantation with efficacy similar to that of commercially available antimicrobial drug-eluting polymers (positive controls). At day 30 postimplantation, the antimicrobial surface modified TPU tubing was found to promote complete elimination of intraluminal bacteria in the absence of antibiotics. Differences were also measurable in acute inflammation, as Wright-Giemsa staining demonstrated reduced inflammatory cell infiltration at day 4 postimplantation for antimicrobial TPU materials. Additionally, antimicrobial materials exhibited reduced fibrous capsule thickness coinciding with infection resolution, as compared to unmodified TPU controls. The developed model can be utilized for testing antimicrobial polymers in the context of a prolonged infection while also revealing concurrent differences in the infiltrating immune cell profiles and fibrous capsule thickness, thus improving the relevance of preclinical medical device material testing.

Preparation of Bioactive Polysaccharide Nanoparticles with Enhanced Radical Scavenging Activity and Antimicrobial Activity

Because of their biocompatibility and biodegradability in vivo, natural polysaccharides are effective nanocarriers for delivery of active ingredients or drugs. Moreover, bioactive polysaccharides, such as tea, Ganoderma lucidum, and Momordica charantia polysaccharides (TP, GLP, and MCP), have antibacterial, antioxidant, antitumor, and antiviral properties. In this study, tea, Ganoderma lucidum, and Momordica charantia polysaccharide nanoparticles (TP-NPs, GLP-NPs, and MCP-NPs) were prepared via the nanoprecipitation approach. When the ethanol to water ratio was 10:1, the diameter of the spherical polysaccharide nanoparticles was the smallest, and the mean particle size of the TP-NPs, GLP-NPs, and MCP-NPs was 99 ± 15, 95 ± 7, and 141 ± 9 nm, respectively. When exposed to heat, increased ionic strength and pH levels, the nanoparticles exhibited superior stability and higher activity than the corresponding polysaccharides. In physiological conditions (pH 7.4), the nanoparticles underwent different protein adsorption capacities in the following order: MCP-NPs> TP-NPs> GLP-NPs. Moreover, the 2,2-diphenyl-1-picrylhydrazyl (DPPH), hydroxyl radical, and superoxide anion radical scavenging rates of the nanoparticles were increased by 9-25% as compared to the corresponding polysaccharides. Compared to the bioactive polysaccharides, the nanoparticles enhanced antimicrobial efficacy markedly and exhibited long-acting antibacterial activity.