Ultrasound frequency of sonication applied in microbiological diagnostics has a major impact on viability of bacteria causing PJI

Improve anti-biofilm efficacy of ultrasound by modulating the phase transition of exopolysaccharides

This study focused on the adverse sonochemical effect of ultrasound on biofilm extracellular polysaccharide and the adaptive biofilm responses for ultrasound resistance. Results showed ultrasound triggered phase transition of polysaccharides within biofilm from solation to gelation, which induced following biofilm viscoelasticity enhancement, consequential failure of biofilm removal and bacteria killing. Introducing additional cationic polysaccharide, 1.25 % chitosan, inhibited the ultrasound responsive polysaccharides gelation and biofilm viscoelasticity enhancement, exerted synergistic antibacterial (97.40 %) and antibiofilm (96.38 %) effects with 120 W ultrasound combined on S. aureus biofilm, prolonged the preservation time of milk 2.45 times longer compared with ultrasound alone. These findings indicated the possible mechanism and solution to improve ultrasound efficacy on biofilm control and bacteria suppression, exhibit the promising prospect of ultrasound combined strategy in hygiene issues of food and medical industry.

The effects of ultrasound on probiotic functionality: an updated review

The effects of ultrasound (US) on probiotics, as health-promoting microbes, have attracted the attention of researchers in fermentation and healthy food production. This paper aims to review recent advances in the application of the US for enhancing probiotic cells' activity, elaborate on the mechanisms involved, explain how probiotic-related industries can benefit from this emerging food processing technology, and discuss the perspective of this innovative approach. Data showed that US could enhance fermentation, which is increasingly used to enrich agri-food products with probiotics. Among the probiotics, recent studies focused on Lactiplantibacillus plantarum, Lactobacillus brevis, Lactococcus lactis, Lactobacillus casei, Leuconostoc mesenteroides, Bifidobacteria. These bacteria proliferated in the log phase when treated with US at relatively low-intensities. Also, this non-thermal technology increased extracellular enzymes, mainly β-galactosidase, and effectively extracted antioxidants and bioactive compounds such as phenolics, flavonoids, and anthocyanins. Accordingly, better functional and physicochemical properties of prebiotic-based foods (e.g., fermented dairy products) can be expected after ultrasonication at appropriate conditions. Besides, the US improved fermentation efficiency by reducing the production time, making probiotics more viable with lower lactose content, more oligosaccharide, and reduced unpleasant taste. Also, US can enhance the rheological characteristics of probiotic-based food by altering the acidity. Optimizing US settings is suggested to preserve probiotics viability to achieve high-quality food production and contribute to food nutrition improvement and sustainable food manufacturing.

Sonication protocols and their contributions to the microbiological diagnosis of implant-associated infections: a review of the current scenario

Addressing the existing problem in the microbiological diagnosis of infections associated with implants and the current debate about the real power of precision of sonicated fluid culture (SFC), the objective of this review is to describe the methodology and analyze and compare the results obtained in current studies on the subject. Furthermore, the present study also discusses and suggests the best parameters for performing sonication. A search was carried out for recent studies in the literature (2019-2023) that addressed this research topic. As a result, different sonication protocols were adopted in the studies analyzed, as expected, and consequently, there was significant variability between the results obtained regarding the sensitivity and specificity of the technique in relation to the traditional culture method (periprosthetic tissue culture - PTC). Coagulase-negative Staphylococcus (CoNS) and Staphylococcus aureus were identified as the main etiological agents by SFC and PTC, with SFC being important for the identification of pathogens of low virulence that are difficult to detect. Compared to chemical biofilm displacement methods, EDTA and DTT, SFC also produced variable results. In this context, this review provided an overview of the most current scenarios on the topic and theoretical support to improve sonication performance, especially with regard to sensitivity and specificity, by scoring the best parameters from various aspects, including sample collection, storage conditions, cultivation methods, microorganism identification techniques (both phenotypic and molecular) and the cutoff point for colony forming unit (CFU) counts. This study demonstrated the need for standardization of the technique and provided a theoretical basis for a sonication protocol that aims to achieve the highest levels of sensitivity and specificity for the reliable microbiological diagnosis of infections associated with implants and prosthetic devices, such as prosthetic joint infections (PJIs). However, practical application and additional complementary studies are still needed.

Novel methods to monitor the biodegradation of polylactic acid (PLA) by Amycolatopsis orientalis and Amycolatopsis thailandensis

Plastics are essential in modern life, but their conventional production is problematic due to environmental pollution and waste management issues. Polylactic acid (PLA) is a widely used bioplastic that is bio-based and biodegradable, making it a key player in the bioeconomy. PLA has been proven to be degradable in various settings, including aqueous, soil, and compost environments. However, monitoring and optimizing PLA biodegradation remains challenging. This study proposes methods to improve the quantification of PLA biodegradation by Amycolatopsis spp. Ultrasound treatments (10 s) significantly improved the enumeration of viable Amycolatopsis cells by breaking the pellets into quantifiable individual cells. A separation technique combining ultrasound (120 s) and 40 μm cell strainers effectively isolated PLA particles from biomass to quantify PLA weight loss. This enabled the monitoring of PLA biofragmentation. Finally, CO2 production was measured according to ISO 14852 to quantify mineralization. Integrating these methods provides an improved quantification for PLA biodegradation along its different stages. In a case study, this led to the construction of a carbon balance where 85.1% of initial carbon content was successfully tracked. The developed techniques for monitoring of PLA biodegradation are essential to design future waste management strategies for biodegradable plastics.

Biofilm and How It Relates to Prosthetic Joint Infection

Prosthetic joint infection following total joint arthroplasty is a devastating complication, resulting in increased morbidity and mortality for the patient. The formation of a biofilm on implanted hardware contributes to the difficulty in successful identification and eradication of the infection. Antibiotic therapy and surgical intervention are necessary for addressing this condition; we present a discussion on different treatment options, including those that are not yet routinely utilized in the clinical setting or are under investigation, to highlight the present and future of PJI management.

Anticorrosion and Antimicrobial Tannic Acid-Functionalized Ti-Metallic Glass Ribbons for Dental Abutment

In this study, a recently reported Ti-based metallic glass (MG), without any toxic element, but with a significant amount of metalloid (Si-Ge-B, 18 atom %) and minor soft element (Sn, 2 atom %), was produced in ribbon form using conventional single-roller melt-spinning. The produced Ti60Zr20Si8Ge7B3Sn2 ribbons were investigated by differential scanning calorimetry and X-ray diffraction to confirm their amorphous structure, and their corrosion properties were further investigated by open-circuit potential and cyclic polarization tests. The ribbon's surface was functionalized by tannic acid, a natural plant-based polyphenol, to enhance its performance in terms of corrosion prevention and antimicrobial efficacy. These properties can potentially be exploited in the premucosal parts of dental implants (abutments). The Folin and Ciocalteu test was used for the quantification of tannic acid (TA) grafted on the ribbon surface and of its redox activity. Fluorescent microscopy and ζ-potential measurements were used to confirm the presence of TA on the surfaces of the ribbons. The cytocompatibility evaluation (indirect and direct) of TA-functionalized Ti60Zr20Si8Ge7B3Sn2 MG ribbons toward primary human gingival fibroblast demonstrated that no significant differences in cell viability were detected between the functionalized and as-produced (control) MG ribbons. Finally, the antibacterial investigation of TA-functionalized samples against Staphylococcus aureus demonstrated the specimens' antimicrobial properties, shown by scanning electron microscopy images after 24 h, presenting a few single colonies remaining on their surfaces. The thickness of bacterial aggregations (biofilm-like) that were formed on the surface of the as-produced samples reduced from 3.5 to 1.5 μm.

Chemical Method for Recovery and Regeneration of Graphene Oxide

Graphene oxide (GO) has been developed as a very effective medium for filtration and removal of microbial contaminants in fuel. GO is capable of filtering out microorganisms without needing micrometer and submicrometer pores for filtration. Our previous studies showed that microorganisms are attracted by GO and bind irreversibly to GO without promoting bacterial growth. Therefore, GO was tested as a filter medium to remove microorganisms in fuel. The characterization results showed that GO removed microbes in diesel fuel with >99% efficiency. However, the synthesis of GO using Hummers' method is labor intensive and a time-consuming. We present in this paper an economical, less labor intensive and a simple chemical approach to recover GO after it has been used as a filtration medium for the removal of microorganisms in fuels. In the GO recovery process, microbial and fuel contaminated GO is washed with hexane to remove any fuel from the GO sample. The hexane-washed GO is further washed with acetone and mixed with ethanol to kill and remove any microorganisms. After washing with ethanol, the GO sample is sonicated in water to remove impurities and re-establish the oxygen functionalities. The final recovered-GO (rec-GO) is obtained after removing water by rotary evaporation. The chemical characterization of rec-GO showed that rec-GO is similar in both chemical and physical properties compared to freshly synthesized-GO (as-syn-GO). Rec-GO was shown to perform similarly to as-syn-GO in filtration of biocontaminated fuel. We estimate that our rec-GO is at least 90% cheaper than high quality commercially available GO.

Global Cluster Analysis and Network Visualization in Prosthetic Joint Infection: A Scientometric Mapping

OBJECTIVE

Prosthetic joint infection (PJI) is the main reason of failure of total joint arthroplasty (TJA). This study aimed to investigate the global trends and network visualization in research of PJI.

METHODS

Publications in PJI search during 1980-2022 were extracted from the Science Citation Index-Expanded of Web of Science Core Collection database (WoSCC). The source data was investigated and analyzed by bibliometric methodology. For network visualization, VOS viewer and R software was used to perform bibliographic coupling, co-citation, co-authorship and co-occurrence analysis and to predict the publication trends in PJI research.

RESULTS

There were 7288 articles included. The number of publications and relative research interests increased gradually per year globally. The USA made the highest contributions in the world and with the highest H-index and the most citations. Journal of Arthroplasty published the highest number of articles in this area. The Mayo Clinic, Thomas Jefferson University (Rothman Institute), Hospital Special Surgery and the Rush University were the most contributive institutions by network visualization. Included studies were divided into four clusters: bacterial pathogenic mechanism and antibacterial drugs study, TJA complications, risk factors and epidemiology of PJI, diagnosis of PJI, and revision surgical management. More articles in PJI could be published over the next few years.

CONCLUSION

The number of publications about PJI will be increasing dramatically based on the global trends and network visualization. The USA made the highest contributions in PJI. Diagnosis and revision management may be the next hot spots in this field.

Is sonication superior to dithiothreitol in diagnosis of periprosthetic joint infections? A meta-analysis

PURPOSE

Even though effective techniques in diagnosis of periprosthetic joint infections (PJIs) have been developed, the optimal modality has yet to be determined. The present meta-analysis aimed to compare the diagnostic accuracy of dithiothreitol (DTT) and sonication against the Musculoskeletal Infection Society criteria in patients undergoing revision joint surgery.

METHODS

We searched the PubMed, Scopus, and Central Cochrane register of controlled trials as well as gray literature until the 9th of November, 2021. We included articles considering the comparative diagnostic accuracy of sonication and DTT in adult patients having revision hip and knee arthroplasty for septic or aseptic reasons. We calculated pooled sensitivity, specificity, and diagnostic accuracy of the above diagnostic techniques against the Musculoskeletal Infection Society (MSIS) criteria and created receiver operating characteristics (ROC) curves to enable comparisons between each other. The quality of included papers was evaluated utilizing QUADAS-2 and QUADAS-C tools.

RESULTS

Data from five comparative studies totaling 726 implants were pooled together. The diagnostic accuracy of DTT and sonication were 86.7% (95% CI 82.7 to 90.1) and 83.9% (95% CI 79.7 to 87.5), respectively. Pooled sensitivity and specificity showed no statistically significant differences between DTT and sonication (0.7 [95% CI 0.62 to 0.77] vs 0.72 [95% CI 0.65 to 0.78], p = 0.14; and 0.99 [95% CI 0.97 to 1] vs 0.97 [95% CI 0.93 to 0.99], p = 5.5, respectively).

CONCLUSIONS

This meta-analysis did not identify any clinically meaningful difference between the diagnostic potential of sonication and the chemical-based biofilm dislodgment methods. This finding remained robust after adjusting for the administration of antibiotics prophylaxis, implementation of the polymerase chain reaction of sonicated fluid, and study quality.

Tissue sampling is non-inferior in comparison to sonication in orthopedic revision surgery

BACKGROUND

The aim of this study was to assess the role of sonication fluid cultures in detecting musculoskeletal infections in orthopedic revision surgery in patients suspected of having peri-prosthetic joint infection (PJI), fracture-related infections (FRI), or postoperative spinal implant infections (PSII).

METHODS

Between 2016 and 2019, 149 cases with a data set including sonication fluid cultures and tissue specimen and histological analysis were included. Accuracy of each diagnostic tool as well as the influence of antibiotic therapy was analyzed. Pathogens identified in the sonication cultures and in the associated tissue samples were compared based on the matching of the antibiograms. Therapeutic benefits were then assessed.

RESULTS

Of 149 cases, 43.6% (n = 65) were identified as PJI, 2.7% (n = 4) as FRI, 12.8% (n = 19) as PSII, 6.7% (n = 10) as aseptic non-union, and 34.2% (n = 51) as aseptic implant loosening. The sensitivity and specificity of tissue and synovial specimens showed no significant difference with respect to sonication fluid cultures (sensitivity/specificity: tissue: 68.2%/96.7%; sonication fluid cultures: 60.2%/98.4%). The administration of antibiotics over 14 days prior to microbiological sampling (n = 40) resulted in a lower sensitivity of 42.9% each. Histological analysis showed a sensitivity 86.3% and specificity of 97.4%. In 83.9% (n = 125) of the cases, the results of sonication fluid cultures and tissue specimens were identical. Different microorganisms were found in only four cases. In 17 cases, tissue samples (n = 5) or sonication (n = 12) were false-negatives.

CONCLUSION

Sonication fluid culture showed no additional benefit compared to conventional microbiological diagnostics of tissue and synovial fluid cultures. Preoperative administration of antibiotics had a clearly negative effect on microbiologic test accuracy. In over 83.9% of the cases, sonication fluid and tissue cultures showed identical results. In the other cases, sonication fluid culture did not further contribute to the therapy decision, whereas other factors, such as fistulas, cell counts, or histological analysis, were decisive in determining therapy.

Ultrasonic pre-treatment of Bacillus velezensis for improved electrogenic response in a single chambered microbial fuel cell

Various microbial strains and techniques are being used to improve power production in microbial fuel cells. Cow dung is a peculiar source of anaerobic and micro-aerophilic organisms that were employed in this study to isolate exo-electrogenic microorganisms. To validate their exo-electrogenic nature, all eight visually distinct bacterial single-cell colonies were tested using the ferrocyanide reduction assay, which resulted in the selection of one bacterial strain AD1-ELB with the ability to reduce ferrocyanide for further biochemical, physiological and electrochemical characterization. The selected strain AD1-ELB was identified as Bacillus velezensis by 16 s rRNA gene sequencing. When used in a single-chambered MFC, the isolated AD1-ELB strain produced a maximum open-circuit voltage of 455 mV with a maximum current density of 51.78 µA/cm² and maximum power density of 4.33 µW/cm² on the 16th day. Bacillus velezensis AD1-ELB strain was treated with low-frequency ultrasound (40 kHz) for 1, 2, 3, 4, and 5 min to assess the effect of ultrasonic pre-treatment on an isolated pure culture-based microbial fuel cell. A 3-min exposure to low-frequency ultrasonic therapy resulted in an increase in maximum power of 4.33 µW/cm² with a current density of 51.78 µA/cm² in the MFC, which decreases significantly after 4 and 5 min. Thus, the overall power density achieved was 1.89 times greater than in MFCs with untreated strain. These findings support the use of low-frequency ultrasonic stimulation to improve the performance of microbial fuel cell devices and are restricted to the pure, single-cell strain AD1-ELB, with the potential for variation if some other isolated strain is utilized, hence requiring further study to determine its relative variations.

Assessment of phage-mediated control of antibiotic-resistant Salmonella Typhimurium during the transition from planktonic to biofilm cells

This study was designed to evaluate the abilities of phage P22 to lyse, eradiate, and disperse the biofilm cells of Salmonella enterica serovar Typhimurium ATCC 19585 (ST^WT), ciprofloxacin-induced Typhimurium ATCC 19585 (ST^CIP), S. Typhimurium KCCM 40253 (ST^KCCM), and multidrug-resistant S. Typhimurium CCARM 8009 (ST^CCARM) in association with hydrophobicity, auto-aggregation, motility, protein content, extracellular DNA, and depolymerase activity. The affinity to hexadecane was significantly increased in ST^WT, ST^KCCM, and ST^CCARM cells after P22 infection. All strains tested showed relatively higher auto-aggregation abilities in the presence of P22 than the absence of P22. ST^KCCM showed the greatest auto-aggregative ability (23%) in the presence of P22, while ST^WT showed the least auto-aggregative ability (9%) in the absence of P22. The bacterial swimming motility affected the bacterial attachment at the early stage of biofilm formation. The red, dry and rough morphotype was observed for all strains tested. The numbers of ST^WT, ST^CIP, and ST^KCCM planktonic cells were considerably reduced by 7.2, 5.0, and 5.0 log CFU/ml, respectively, and ST^WT, ST^CIP, and ST^KCCM biofilm-forming cells were reduced by 5.8, 4.5, and 4.9 log, respectively, after 24 h of phage infection. The depolymerase produced by phages were confirmed by the presence of outer rim of plaques. Phages could be considered as promising alternatives for the control of biofilms due to their advantages including enzymatic degradation of extracellular biofilm matrix. The study would provide useful information for understanding the dynamic interactions between phages and biofilms and also designing the effective phage-based control system as an alterative strategy against biofilms.

Time-dependent behavior of the Staphylococcus aureus biofilm following exposure to cold atmospheric pressure plasma

Objective(s):

Formation of Staphylococcus aureus biofilm leads to persistent infection in tissue or on exter-nal and indwelling devices in patients. Cold atmospheric plasma (CAP) is used for eradication of bacterial biofilms and it has diverse applications in the healthcare system. However, there is not sufficient information on the behavior of biofilms during the CAP exposure period.

Materials and Methods:

Pre-established S. aureus biofilms were exposed to CAP for 0 to 360 sec, then subjected to washing steps and sonication. Subsequently, biomass, number of colonies, vitality of bacteria, structure of colonies, size of produced particles, and viability of bacteria were evaluated by different assays including crystal violet, colony-forming unit, MTT, scanning electron mi-croscopy, confocal laser scanning microscopy, and dynamic light scattering assays.

Results:

The results showed that the strength of biomass increased in the first 60 sec, then decreased to less than no-CAP treated controls. Moreover, short CAP exposure (≤60 sec) ehances the fusion of the biofilm extracellular matrix and other components, which results in preservation of bacteria during ultra-sonication and washing steps compared with control biofilms. The S. aureus biofilm structure only breaks down following more CAP exposure (> 90 sec) and demolition. Interestingly, the 60 sec CAP exposure could cause the fusion of biofilm compo-nents, and large particles are detectable.

Conclusion:

According to this study, an inadequate CAP exposure period prevents absolute eradication of biofilm and enhances the preservation of bacteria in stronger biofilm compartments.