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Al-Sawarees DK, Darwish RM, Abu-Zurayk R, Masri MA. Assessing silver nanoparticle and antimicrobial combinations for antibacterial activity and biofilm prevention on surgical sutures. J Appl Microbiol 2024; 135:lxae063. [PMID: 38471695 DOI: 10.1093/jambio/lxae063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/28/2024] [Accepted: 03/11/2024] [Indexed: 03/14/2024]
Abstract
AIMS To evaluate the effect of silver nanoparticles alone and in combination with Triclosan, and trans-cinnamaldehyde against Staphylococcus aureus and Escherichia coli biofilms on sutures to improve patients' outcomes. METHODS AND RESULTS Silver nanoparticles were prepared by chemical method and characterized by UV-visible spectrophotometer and dynamic light scattering. The minimum inhibitory concentration was assessed by the Microdilution assay. The antibiofilm activity was determined using crystal violet assay. A checkerboard assay using the fractional inhibitory concentration index and time-kill curve was used to investigate the synergistic effect of silver nanoparticle combinations. The hemolytic activity was determined using an erythrocyte hemolytic assay. Our results revealed that silver nanoparticles, Triclosan, and trans-cinnamaldehyde (TCA) inhibited S.aureus and E.coli biofilms. Silver nanoparticles with TCA showed a synergistic effect (FICI values 0.35 and 0.45 against S. aureus and E. coli biofilms, respectively), and silver nanoparticles with Triclosan showed complete inhibition of S. aureus biofilm. The hemolytic activity was <2.50% for the combinations.
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Affiliation(s)
- Diana K Al-Sawarees
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, University of Jordan, Amman 11942, Jordan
| | - Rula M Darwish
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, University of Jordan, Amman 11942, Jordan
| | - Rund Abu-Zurayk
- Hamdi Mango Center for Scientific Research, The University of Jordan, Amman 11942, Jordan
| | - Mahmoud Al Masri
- King Hussain Cancer center, Surgery Department, Amman 11941, Jordan
- School of Medicine, The University of Jordan, Amman 11942, Jordan
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Kahrovic A, Angleitner P, Herkner H, Werner P, Poschner T, Alajbegovic L, Kocher A, Ehrlich M, Laufer G, Andreas M. Automated titanium fastener vs. hand-tied knots for prosthesis fixation in infective endocarditis. Front Cardiovasc Med 2024; 11:1363336. [PMID: 38322769 PMCID: PMC10844476 DOI: 10.3389/fcvm.2024.1363336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 01/08/2024] [Indexed: 02/08/2024] Open
Abstract
Objectives To date, there is no evidence regarding the safety of automated titanium fastener compared with hand-tied knots for prosthesis fixation in infective endocarditis. Methods Between January 2016 and December 2022, a total of 220 patients requiring surgery for infective endocarditis were included in this retrospective analysis. The primary study endpoint was re-endocarditis during follow-up. The secondary study endpoints included stroke onset, all-cause mortality, and a composite outcome of either re-endocarditis, stroke, or all-cause mortality during follow-up. Results Suture-securing with an automated titanium fastener was performed in 114 (51.8%) patients, whereas the conventional technique of hand knot-tying was used in 106 (48.2%) patients. The risk of re-endocarditis was significantly lower in the automated titanium fastener group, as shown in a multivariable proportional competing risk regression model (adjusted sub-hazard ratio 0.33, 95% confidence interval 0.11-0.99, p = 0.048). The multivariable Cox proportional hazards regression analysis showed that the automated titanium fastener group was not associated with an increased risk of stroke-onset or attaining the composite outcome, respectively, (adjusted hazard ratio 0.54, 95% confidence interval 0.27-1.08, p = 0.082), (adjusted hazard ratio 0.65, 95% confidence interval 0.42-1.02, p = 0.061). Also, this group was not associated with an increased risk of all-cause mortality, as demonstrated in the multivariable Poisson regression analysis (adjusted incidence-rate ratio 1.42, 95% confidence interval 0.83-2.42, p = 0.202). Conclusions The use of automated titanium fastener device seems to be safe for infective endocarditis. Analyses of larger cohorts are required.
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Affiliation(s)
- Amila Kahrovic
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Philipp Angleitner
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Harald Herkner
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Paul Werner
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Thomas Poschner
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Leila Alajbegovic
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Alfred Kocher
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Marek Ehrlich
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Günther Laufer
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Martin Andreas
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
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3
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Maisat W, Yuki K. Volatile anesthetic isoflurane exposure facilitates Enterococcus biofilm infection. FASEB J 2023; 37:e23186. [PMID: 37665578 PMCID: PMC10495085 DOI: 10.1096/fj.202301128r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 09/05/2023]
Abstract
Enterococcus faecalis (E. faecalis) is one of the major pathogenic bacteria responsible for surgical site infections. Biofilm infections are major hospital-acquired infections. Previous studies suggested that ions could regulate biofilm formation in microbes. Volatile anesthetics, frequently administered in surgical setting, target ion channels. Here, we investigated the role of ion channels/transporters and volatile anesthetics in the biofilm formation by E. faecalis MMH594 strain and its ion transporter mutants. We found that a chloride transporter mutant significantly reduced biofilm formation compared to the parental strain. Downregulation of teichoic acid biosynthesis in the chloride transporter mutant impaired biofilm matrix formation and cellular adhesion, leading to mitigated biofilm formation. Among anesthetics, isoflurane exposure enhanced biofilm formation in vitro and in vivo. The upregulation of de novo purine biosynthesis pathway by isoflurane exposure potentially enhanced biofilm formation, an essential process for DNA, RNA, and ATP synthesis. We also demonstrated that isoflurane exposure to E. faecalis increased cyclic-di-AMP and extracellular DNA production, consistent with the increased purine biosynthesis. We further showed that isoflurane enhanced the enzymatic activity of phosphoribosyl pyrophosphate synthetase (PRPP-S). With the hypothesis that isoflurane directly bound to PRPP-S, we predicted isoflurane binding site on it using rigid docking. Our study provides a better understanding of the underlying mechanisms of E. faecalis biofilm formation and highlights the potential impact of an ion transporter and volatile anesthetic on this process. These findings may lead to the development of novel strategies for preventing E. faecalis biofilm formation and improving patient outcomes in clinical settings.
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Affiliation(s)
- Wiriya Maisat
- Department of Anesthesiology, Critical Care and Pain Medicine, Cardiac Anesthesia Division, Boston Children’s Hospital, Boston, MA, USA
- Department of Anaesthesia, Harvard Medical School, Boston, MA, USA
- Department of Immunology, Harvard Medical School, Boston, MA, USA
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Koichi Yuki
- Department of Anesthesiology, Critical Care and Pain Medicine, Cardiac Anesthesia Division, Boston Children’s Hospital, Boston, MA, USA
- Department of Anaesthesia, Harvard Medical School, Boston, MA, USA
- Department of Immunology, Harvard Medical School, Boston, MA, USA
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
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van Schaik TJA, van Meer MPA, de Jong LD, Goosen JHM, Somford MP, van Susante JLC. No difference in bacterial contamination of hip capsule sutures and control sutures in hip arthroplasty surgery. Antimicrob Resist Infect Control 2023; 12:101. [PMID: 37710282 PMCID: PMC10503031 DOI: 10.1186/s13756-023-01305-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 09/05/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Perioperative preventive measures are important to further reduce the rate of periprosthetic joint infections (PJI) in patients undergoing total hip arthroplasty (THA). During THA surgery, joint capsule sutures are commonly placed to optimize exposure and reinsertion of the capsule. Bacterial contamination of these sutures during the procedure poses a potential risk for postoperative infection. In this exploratory study, we assessed the contamination rate of capsule sutures compared to the contamination of the remains of exchanged control sutures at the time of closure. METHODS In 100 consecutive patients undergoing primary THA capsule sutures were exchanged by sterile sutures at the time of capsule closure. Both the original sutures and the remainder of the newly placed (control) sutures were retrieved, collected and cultured for ten days. Types of bacterial growth and contamination rates of both sutures were assessed. RESULTS Sutures from 98 patients were successfully collected and analyzed. Bacterial growth was observed in 7/98 (7.1%) of the capsule sutures versus 6/98 (6.1%) of the control sutures, with a difference of 1% [CI -6-8]. There was no clear pattern in differences in subtypes of bacteria between groups. CONCLUSIONS This study showed that around 7% of capsule sutures used in primary THA were contaminated with bacteria and as such exchange by new sutures at the time of capsule closure could be an appealing PJI preventive measure. However, since similar contamination rates were encountered with mainly non-virulent bacteria for both suture groups, the PJI preventive effect of this measure appears to be minimal.
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Affiliation(s)
- Thomas J A van Schaik
- Department of Orthopedic Surgery, Rijnstate Hospital, Arnhem, The Netherlands
- Department of Orthopedic Surgery, Radboudumc, Nijmegen, The Netherlands
| | - Maurits P A van Meer
- Department of Medical Microbiology and Immunology, Rijnstate Hospital, Arnhem, The Netherlands
| | - Lex D de Jong
- Department of Orthopedic Surgery, Rijnstate Hospital, Arnhem, The Netherlands
| | - Jon H M Goosen
- Department of Orthopedic Surgery, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Matthijs P Somford
- Department of Orthopedic Surgery, Rijnstate Hospital, Arnhem, The Netherlands
| | - Job L C van Susante
- Department of Orthopedic Surgery, Rijnstate Hospital, Arnhem, The Netherlands.
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Fontana-Escartín A, Hauadi KE, Lanzalaco S, Pérez-Madrigal MM, Armelin E, Turon P, Alemán C. Smart Design of Sensor-Coated Surgical Sutures for Bacterial Infection Monitoring. Macromol Biosci 2023; 23:e2300024. [PMID: 37119469 DOI: 10.1002/mabi.202300024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/21/2023] [Indexed: 05/01/2023]
Abstract
Virtually, all implantable medical devices are susceptible to infection. As the main healthcare issue concerning implantable devices is the elevated risk of infection, different strategies based on the coating or functionalization of biomedical devices with antiseptic agents or antibiotics are proposed. In this work, an alternative approach is presented, which consists of the functionalization of implantable medical devices with sensors capable of detecting infection at very early stages through continuous monitoring of the bacteria metabolism. This approach, which is implemented in surgical sutures as a representative case of implantable devices susceptible to bacteria colonization, is expected to minimize the risk of worsening the patient's clinical condition. More specifically, non-absorbable polypropylene/polyethylene (PP/PE) surgical sutures are functionalized with conducting polymers using a combination of low-pressure oxygen plasma, chemical oxidative polymerization, and anodic polymerization, to detect metabolites coming from bacteria respiration. Functionalized suture yarns are used for real-time monitoring of bacteria growth, demonstrating the potential of this strategy to fight against infections.
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Affiliation(s)
- Adrián Fontana-Escartín
- Departament d'Enginyeria Química and Barcelona Research Center for Multiscale Science and Engineering, EEBE, Universitat Politècnica de Catalunya (UPC), C/ Eduard Maristany, 10-14, Barcelona, 08019, Spain
| | - Karima El Hauadi
- Departament d'Enginyeria Química and Barcelona Research Center for Multiscale Science and Engineering, EEBE, Universitat Politècnica de Catalunya (UPC), C/ Eduard Maristany, 10-14, Barcelona, 08019, Spain
| | - Sonia Lanzalaco
- Departament d'Enginyeria Química and Barcelona Research Center for Multiscale Science and Engineering, EEBE, Universitat Politècnica de Catalunya (UPC), C/ Eduard Maristany, 10-14, Barcelona, 08019, Spain
| | - Maria M Pérez-Madrigal
- Departament d'Enginyeria Química and Barcelona Research Center for Multiscale Science and Engineering, EEBE, Universitat Politècnica de Catalunya (UPC), C/ Eduard Maristany, 10-14, Barcelona, 08019, Spain
| | - Elaine Armelin
- Departament d'Enginyeria Química and Barcelona Research Center for Multiscale Science and Engineering, EEBE, Universitat Politècnica de Catalunya (UPC), C/ Eduard Maristany, 10-14, Barcelona, 08019, Spain
| | - Pau Turon
- B. Braun Surgical, S.A.U. Carretera de Terrasa 121, Rubí, 08191, Spain
| | - Carlos Alemán
- Departament d'Enginyeria Química and Barcelona Research Center for Multiscale Science and Engineering, EEBE, Universitat Politècnica de Catalunya (UPC), C/ Eduard Maristany, 10-14, Barcelona, 08019, Spain
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology, Baldiri Reixac 10-12, Barcelona, 08028, Spain
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Corcoll F, Pérez-Prieto D, Karbysheva S, Trampuz A, Fariñas O, Monllau JC. Are Hamstring Grafts a Predisposing Factor to Infection in R-ACL Surgery? A Comparative In Vitro Study. Pathogens 2023; 12:761. [PMID: 37375451 DOI: 10.3390/pathogens12060761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The objective of the present study was to evaluate the formation of biofilms in bone patellar tendon bone grafts (BPTB grafts), and to compare it to the formation of biofilm formation in quadrupled hamstring anterior cruciate ligament grafts (4×Ht graft). METHODS A descriptive in vitro study was conducted. One 4×Ht graft and one BPTB graft were prepared. They were then contaminated with a strain of S. epidermidis. Later, a quantitative analysis was conducted by means of microcalorimetry and sonication with plating. Additionally, a qualitative analysis was conducted by means of electron microscopy. RESULTS No significant differences were found between the bacterial growth profiles of the 4×Ht graft and the BPTB graft in microcalorimetry and colony counting. In the samples analyzed with electron microscopy, no specific biofilm growth pattern was identified upon comparing the BPTB graft to the 4×Ht graft. CONCLUSIONS There were no significant differences found at either the quantitative or qualitative level when comparing bacterial growth in the BPTB graft to that in the 4×Ht graft. Therefore, the presence of sutures in the 4×Ht graft cannot be established as a predisposing factor for increased biofilm growth in this in vitro study.
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Affiliation(s)
- Ferran Corcoll
- Department of Traumatology and Orthopaedic Surgery, Hospital del Mar-Universitat Autònoma de Barcelona (UAB), 08003 Barcelona, Spain
| | - Daniel Pérez-Prieto
- Department of Traumatology and Orthopaedic Surgery, Hospital del Mar-Universitat Autònoma de Barcelona (UAB), 08003 Barcelona, Spain
| | - Svetlana Karbysheva
- Center for Musculoskeletal Surgery, Charite'-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, 10117 Berlin, Germany
| | - Andrej Trampuz
- Center for Musculoskeletal Surgery, Charite'-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, 10117 Berlin, Germany
| | - Oscar Fariñas
- Banc de Sang i Teixits de Catalunya, Barcelona (BST), 08005 Barcelona, Spain
| | - Juan Carles Monllau
- Department of Traumatology and Orthopaedic Surgery, Hospital del Mar-Universitat Autònoma de Barcelona (UAB), 08003 Barcelona, Spain
- Departament de Ciències Morfològiques, Edifici M Facultat de Medicina Avinguda Can Domènech S/N Campus de la Universitat Autònoma de Barcelona (UAB) Bellaterra (Cerdanyola del Vallès), 08193 Barcelona, Spain
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Schaffer SD, Hutchison CA, Rouchon CN, Mdluli NV, Weinstein AJ, McDaniel D, Frank KL. Diverse Enterococcus faecalis strains show heterogeneity in biofilm properties. Res Microbiol 2023; 174:103986. [PMID: 35995340 PMCID: PMC9825631 DOI: 10.1016/j.resmic.2022.103986] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 01/11/2023]
Abstract
Biofilm formation is important for Enterococcus faecalis to cause healthcare-associated infections. It is unclear how E. faecalis biofilms vary in parameters such as development and composition. To test the hypothesis that differences in biofilms exist among E. faecalis strains, we evaluated in vitro biofilm formation and matrix characteristics of five genetically diverse E. faecalis lab-adapted strains and clinical isolates (OG1RF, V583, DS16, MMH594, and VA1128). Biofilm formation of all strains was repressed in TSB+10% FBS. However, DMEM+10% FBS enhanced biofilm formation of clinical isolate VA1128. Crystal violet staining and fluorescence microscopy of biofilms grown on Aclar membranes demonstrated differences between OG1RF and VA1128 in biofilm development over a 48-h time course. None of the biofilms were dispersed by single treatments of sodium (meta)periodate, DNase, or Proteinase K alone, but the biofilm biomass of both OG1RF and DS16 was partially removed by a sequential treatment of sodium (meta)periodate and DNase. Reversing the treatment order was not effective, suggesting that the extracellular DNA targeted by DNase was obscured by carbohydrates that are susceptible to sodium (meta)periodate degradation. Fluorescent staining of biofilm matrix components further demonstrated that more carbohydrates bound by wheat germ agglutinin comprise OG1RF biofilms compared to VA1128 biofilms. This study highlights the existence of heterogeneity in biofilm properties among diverse E. faecalis strains, which may have implications for the design of novel anti-biofilm treatment strategies.
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Affiliation(s)
- Scott D Schaffer
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, MD, USA
| | - Carissa A Hutchison
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, MD, USA
| | - Candace N Rouchon
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, MD, USA
| | - Nontokozo V Mdluli
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, MD, USA
| | - Arielle J Weinstein
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, MD, USA
| | - Dennis McDaniel
- Biomedical Instrumentation Center, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Kristi L Frank
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
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New In Situ-Generated Polymer-Iodine Complexes with Broad-Spectrum Antimicrobial Activity. Microbiol Spectr 2022; 10:e0055022. [PMID: 36125311 PMCID: PMC9603132 DOI: 10.1128/spectrum.00550-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Iodine-containing systems show broad antiseptic properties that can be an invaluable tool in controlling infections in humans and animals. Here, we describe the first proof-of-concept studies on biocidal active polyamide- and polyurethane-iodine complexes that are produced in situ directly during the fabrication and/or polymerization process at laboratory and commercially relevant scales. These polymer-iodine materials are active against a broad range of microorganisms, including bacteria and fungi. It is suggested that the ease of manufacture and subsequent commercialization make said systems especially suited for applications as base materials for medical devices to reduce infection risks and control the spread of pathogens. IMPORTANCE Infectious diseases are of mounting medical and public concern. A major contributor to this trend is the proliferation of medical implants, which are inherently vulnerable to microbial contamination and the subsequent onset of hospital-acquired infections. Moreover, implant-associated infections in humans are often difficult to diagnose and treat and are associated with substantial health care costs. Here, we present the development of biocidal active polyamide- and polyurethane-iodine complexes that are generated in situ during fabrication. We show that the excellent antiseptic properties of water-soluble povidone-iodine can be similarly realized in water-insoluble engineering plastics, specifically polyamide- and polyurethane-iodine. These complexes have inherent biocidal activity against major pathogenic bacteria and fungi.
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Kwak J, Lee DC, Jang JH. Subconjunctival Abscess Formation with Periorbital Cellulitis Following Scleral Buckling. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2022. [DOI: 10.3341/jkos.2022.63.9.802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: We present a case of a subconjunctival abscess formation with periorbital cellulitis following scleral buckling (SB) and pars planar vitrectomy (PPV).Case summary: A 51-year-old female patient came to our hospital with complaints of ocular pain and discharge in the right eye. The patient underwent SB and several times of PPV for multiple rhegmatogenous retinal detachment due to acute retinal necrosis. The onset of symptoms was 9 months after the last vitrectomy. A subconjunctival abscess was seen at 8 o'clock position on slit lamp, and periorbital cellulitis was observed on computed tomography image, the patient underwent an incision and drainage (I&D) surgery. Another 9 months later, a subconjunctival abscess was newly found at 4 o'clock position. Since the abscess site and the position of the stitch which sutured the buckle sponge was exactly same, the cause of infection was thought to be the sponge suture materials. Along with I&D surgery, the suture at the end of the sponge was removed. After then, conjunctival and periorbital inflammation got improved and the patient is still in the process of examination to date.Conclusions: Subconjunctival abscess or periorbital cellulitis is a rare complication of SB, caused by the use of an exogenous materials such as silicon sponge or suture stitches. Therefore, when ocular pain or inflammation is observed in SB patients, early detection and active treatment is required for suspected periorbital cellulitis.
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Bhouri N, Debbabi F, Lassoued MA, Abderrahmen M, Ben Abdessalem S. Wound infections preventing using antibacterial chitosan/Laurus nobilis essential oil emulsion on PET braided surgical sutures. Colloids Surf A Physicochem Eng Asp 2022. [DOI: 10.1016/j.colsurfa.2022.128678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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The Cationic Antimicrobial Peptide Activity of Lysozyme Reduces Viable Enterococcus faecalis Cells in Biofilms. Antimicrob Agents Chemother 2022; 66:e0233921. [PMID: 35446133 DOI: 10.1128/aac.02339-21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Enterococcus faecalis, a leading cause of health care-associated infections, forms biofilms and is resistant to many antimicrobial agents. Planktonic-phase E. faecalis is resistant to high concentrations of the enzyme lysozyme, which catalyzes the hydrolysis of N-acetylmuramic acid and N-acetylglucosamine linkages in peptidoglycan and is also a cationic antimicrobial peptide (CAMP). E. faecalis lysozyme resistance in planktonic cells is stimulated upon activation of the extracytoplasmic function sigma factor SigV via cleavage of the anti-sigma factor RsiV by the transmembrane protease Eep. Planktonically grown E. faecalis lacking eep is more sensitive than wild-type strains to growth inhibition by lysozyme. This study was initiated to determine whether E. faecalis OG1RFΔeep biofilms would be protected from lysozyme. Serendipitously, we discovered that exposure of both E. faecalis OG1RF and OG1RFΔeep biofilms to chicken egg white lysozyme resulted in decreases in biofilm cell viability of 3.7 and 3.8 log10 CFU/mL, respectively. Treatment of biofilms of both strains with recombinant purified human lysozyme was associated with reductions in cell viability of >99.9% for both strains. Lysozyme-treated OG1RF and OG1RFΔeep biofilms contained a higher percentage of dead cells by Live/Dead staining and were associated with more extracellular DNA. Heat-inactivated human lysozyme, which was devoid of muramidase activity, as well as the lysozyme-derived CAMP LP9 and the CAMP polymyxin B, decreased biofilm cell viability. These results are consistent with a model in which the CAMP activity, rather than the muramidase activity, of lysozyme causes lysis of E. faecalis biofilm cells despite them having an intact lysozyme resistance-inducing signaling pathway. Finally, lysozyme was also effective in reducing viable biofilm cells of several other E. faecalis strains, including the vancomycin-resistant strain V583 and multidrug-resistant strain MMH594. This study demonstrates the potential for lysozyme to be developed as a novel antibiofilm therapeutic.
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Surgical Applications of Materials Engineered with Antimicrobial Properties. Bioengineering (Basel) 2022; 9:bioengineering9040138. [PMID: 35447700 PMCID: PMC9030825 DOI: 10.3390/bioengineering9040138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/17/2022] [Accepted: 03/24/2022] [Indexed: 02/06/2023] Open
Abstract
The infection of surgically placed implants is a problem that is both large in magnitude and that broadly affects nearly all surgical specialties. Implant-associated infections deleteriously affect patient quality-of-life and can lead to greater morbidity, mortality, and cost to the health care system. The impact of this problem has prompted extensive pre-clinical and clinical investigation into decreasing implant infection rates. More recently, antimicrobial approaches that modify or treat the implant directly have been of great interest. These approaches include antibacterial implant coatings (antifouling materials, antibiotics, metal ions, and antimicrobial peptides), antibacterial nanostructured implant surfaces, and antibiotic-releasing implants. This review provides a compendium of these approaches and the clinical applications and outcomes. In general, implant-specific modalities for reducing infections have been effective; however, most applications remain in the preclinical or early clinical stages.
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Wang X, Liu P, Wu Q, Zheng Z, Xie M, Chen G, Yu J, Wang X, Li G, Kaplan D. Sustainable Antibacterial and Anti-Inflammatory Silk Suture with Surface Modification of Combined-Therapy Drugs for Surgical Site Infection. ACS APPLIED MATERIALS & INTERFACES 2022; 14:11177-11191. [PMID: 35192338 DOI: 10.1021/acsami.2c00106] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Silk sutures with antibacterial and anti-inflammatory functions were developed for sustained dual-drug delivery to prevent surgical site infections (SSIs). The silk sutures were prepared with core-shell structures braided from degummed silk filaments and then coated with a silk fibroin (SF) layer loaded with berberine (BB) and artemisinin (ART). Both the rapid release of drugs to prevent initial biofilm formation and the following sustained release to maintain effective concentrations for more than 42 days were demonstrated. In vitro assays using human fibroblasts (Hs 865.Sk) demonstrated cell proliferation on the materials, and hemolysis was 2.4 ± 0.8%, lower than that required by ISO 10993-4 standard. The sutures inhibited platelet adhesion and promoted collagen deposition and blood vessel formation. In vivo assessments using Sprague-Dawley (SD) rats indicated that the coating reduced the expression of pro-inflammatory cytokines interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α), shortening the inflammatory period and promoting angiogenesis. The results demonstrated that these new sutures exhibited stable structures, favorable biocompatibility, and sustainable antibacterial and anti-inflammatory functions with potential for surgical applications.
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Affiliation(s)
- Xuchen Wang
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, China
| | - Peixin Liu
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Orthopedic Institute, Soochow University, Suzhou 215006, China
| | - Qinting Wu
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, China
| | - Zhaozhu Zheng
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, China
| | - Maobin Xie
- Department of Biomedical Engineering, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou 511436, China
| | - Guoqiang Chen
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, China
| | - Jia Yu
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Orthopedic Institute, Soochow University, Suzhou 215006, China
| | - Xiaoqin Wang
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, China
| | - Gang Li
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, China
| | - David Kaplan
- Department of Biomedical Engineering, Tufts University, 4 Colby Street, Medford, Massachusetts 02155, United States
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14
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Garcia DR, Vishwanath N, Allu S, Dockery DM, Berns EM, Spake CSL, Li T, Barrett C, Antoci V, Born CT. Synergistic Effects of Silver Carboxylate and Chlorhexidine Gluconate for Wound Care and Prevention of Surgical Site Inflections by Cutibacterium acnes and Methicillin-Resistant Staphylococcus aureus. Surg Infect (Larchmt) 2022; 23:254-261. [PMID: 35085476 DOI: 10.1089/sur.2021.237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: This study presents the effectiveness of a combined silver carboxylate (AgCar) and chlorohexidine gluconate (AgCar:CHG) chemistry assessed against two commonly encountered nosocomial pathogens, Methicillin-resistant Staphylococcus aureus (MRSA) and Cutibacterium acnes, within the context of surgical antisepsis and wound care. Methods: Through an Institutional Review Board- and Institutional Animal Care and Use Committee (IACUC)-approved protocol, AgCar:CHG was applied to live Yucatan porcine skin and visualized by fast red and green staining to assess level of skin penetration. Dose response curves for Cutibacterium acnes and MRSA were generated to determine the optimal therapeutic ratio of AgCar to CHG. Coatings were applied to two different clinically available sutures and antimicrobial efficacy was evaluated at 24-hour intervals using Kirby-Bauer (KB) assays. Graphite furnace atomic absorption spectroscopy was used to measure AgCar elution from sutures over time. Results: Synergistic application of AgCar:CHG demonstrated deep pilosebaceous gland penetration on Yucatan pig skin. The therapeutic concentration range of AgCar was determined to be between 120 × -150 × and 30 × -60 × dopage for MRSA and Cutibacterium acnes, respectively. A 1:1 therapeutic ratio of AgCar to CHG was found to have 100% bactericidal activity against both pathogens. Sutures coated with AgCar:CHG showed sustained antimicrobial activity against MRSA and Cutibacterium acnes, and were significantly more efficacious than antimicrobial sutures over the three- to four-day period (p < 0.01). Conclusions: This AgCar:CHG chemistry demonstrates deep skin penetration, extended elution, and broad-spectrum antimicrobial activity compared with commercially available options. This chemistry shows promise as an additional tool for the prophylaxis of surgical site infections.
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Affiliation(s)
- Dioscaris R Garcia
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA.,Brown University, Providence, Rhode Island, USA.,Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Neel Vishwanath
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Sai Allu
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Dominique M Dockery
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Ellis M Berns
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Carole S L Spake
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Troy Li
- Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA.,Brown University, Providence, Rhode Island, USA
| | - Caitlin Barrett
- Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA.,Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Valentin Antoci
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA.,Brown University, Providence, Rhode Island, USA.,Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Christopher T Born
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA.,Brown University, Providence, Rhode Island, USA.,Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
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15
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Engineering surgical stitches to prevent bacterial infection. Sci Rep 2022; 12:834. [PMID: 35039588 PMCID: PMC8764053 DOI: 10.1038/s41598-022-04925-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 12/14/2021] [Indexed: 12/30/2022] Open
Abstract
Surgical site infections (SSIs) account for a massive economic, physiological, and psychological burden on patients and health care providers. Sutures provide a surface to which bacteria can adhere, proliferate, and promote SSIs. Current methods for fighting SSIs involve the use of sutures coated with common antibiotics (triclosan). Unfortunately, these antibiotics have been rendered ineffective due to the increasing rate of antibiotic resistance. A promising new avenue involves the use of metallic nanoparticles (MNPs). MNPs exhibit low cytotoxicity and a strong propensity for killing bacteria while evading the typical antibiotic resistance mechanisms. In this work, we developed a novel MNPs dip-coating method for PDS-II sutures and explored the capabilities of a variety of MNPs in killing bacteria while retaining the cytocompatibility. Our findings indicated that our technique provided a homogeneous coating for PDS-II sutures, maintaining the strength, structural integrity, and degradability. The MNP coatings possess strong in vitro antibacterial properties against P aeruginosa and S. aureus—varying the %of dead bacteria from ~ 40% (for MgO NPs) to ~ 90% (for Fe2O3) compared to ~ 15% for uncoated PDS-II suture, after 7 days. All sutures demonstrated minimal cytotoxicity (cell viability > 70%) reinforcing the movement towards the use MNPs as a viable antibacterial technology.
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16
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Bustamante Montalvo M, Cainzos M, Prieto Carreiras L, Castiñeira Piñeiro A, García Iglesias A, Fernandez Novo A, González Gómez LM, Flores A, Diz Gil R, Fernández Baltar C. Evaluation of the effect of triclosan coated sutures in the prevention of surgical site infections in a Spanish hospital setting: A prospective, observational study. Infect Prev Pract 2021; 3:100154. [PMID: 34430841 PMCID: PMC8365457 DOI: 10.1016/j.infpip.2021.100154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 06/01/2021] [Indexed: 01/27/2023] Open
Abstract
Background Surgical site infections (SSIs) are one of the most frequently reported types of hospital-acquired infection and are associated with substantial clinical and economic burden. Aim To assess the incidence of SSIs and analyze contributing risk factors in a real-world Spanish hospital setting before and after the implementation of triclosan-coated sutures (TCS). Methods A prospective, observational study was conducted at Hospital Clínico Universitario de Santiago de Compostela, Spain. Enrolled patients underwent surgery in the following specialties: general surgery, urology, neurosurgery, gynaecology, and traumatology. The primary outcome of the study was SSI incidence, assessed at a 30-day follow-up. Secondary outcomes were length of hospital stay, and readmission, reintervention, and mortality rates, also at 30 days. Findings 5,081 patients were included in the study, of which 2,591 were treated using non-coated sutures (NCS) and 2,490 using TCS. After adjusting for potential confounders, TCS significantly reduced SSI rate by 36%, compared with NCS (odds ratio [OR]: 0.64; 95% confidence interval [CI]: 0.48-0.85; P<0.003). When stratified by wound classification, a statistically significant reduction in SSI incidence, in favour of TCS use, was observed for Class IV (dirty) wounds (35.6% versus 22.7% for NCS and TCS, respectively; OR: 0.53; 95% CI: 0.31-0.90). Conclusion The use of TCS reduced SSI risk when compared with NCS. This reduction was significant for Class IV wounds, providing evidence that supports the use of TCS for this type of wound.
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Affiliation(s)
- Manuel Bustamante Montalvo
- Servicio de Cirugía General y Digestiva, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Miguel Cainzos
- Servicio de Cirugía General y Digestiva, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Luis Prieto Carreiras
- Servicio de Cirugía General y Digestiva, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Andrea Castiñeira Piñeiro
- Servicio de Cirugía General y Digestiva, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Adrián García Iglesias
- Servicio de Traumatología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Ana Fernandez Novo
- Servicio de Ginecología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Lara María González Gómez
- Servicio de Neurocirugía, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Ana Flores
- Servicio de Neurocirugía, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Rita Diz Gil
- Servicio de Urología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Carlos Fernández Baltar
- Servicio de Urología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
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17
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Browne KL, Crowley JD, Tan CJ, O'Sullivan CB, Walsh WR. Effect of ultraviolet-C light on the environmental bacterial bioburden in various veterinary facilities. Am J Vet Res 2021; 82:582-588. [PMID: 34166087 DOI: 10.2460/ajvr.82.7.582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the effect of a mobile UV-C disinfection device on the environmental bacterial bioburden in veterinary facilities. SAMPLES 40 swab samples of surfaces from the operating theaters of 3 veterinary hospitals and 1 necropsy laboratory. PROCEDURES Various surfaces were swabbed, and collected material was eluted from the swabs in PBSS. Then, an aliquot of the sample fluid was processed with a bacteria-specific rapid metabolic assay to quantify bacterial bioburden. Each site was then treated with UV-C light with an automated disinfection device for approximately 45 minutes. The same surfaces were swabbed following UV-C treatment, and bioburden was quantified. The bioburden at additional time points, including after a second UV-C treatment, was determined for the small animal operating theater. RESULTS All surfaces at all sites had a persistent viable bacterial population following manual cleaning. Disinfection with UV-C achieved a mean bioburden reduction of 94% (SD, 5.2%; range, 91% to 95%) for all surfaces, compared with manual disinfection alone. Repeated UV-C treatment of the small animal operating theater reduced mean bioburden by 99% (SD, 0.8%), including no detectable bacteria on 4 of 10 surfaces. CONCLUSIONS AND CLINICAL RELEVANCE Disinfection with UV-C light may be a beneficial adjunct method for terminal disinfection of veterinary operating theaters to reduce environmental bioburden. (Am J Vet Res 2021;82:582-588).
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Affiliation(s)
- Katrina L Browne
- From the Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- From the School of Chemistry, University of New South Wales, Sydney, NSW 2052, Australia
| | - James D Crowley
- From the Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Sydney Veterinary Emergency and Specialists, Rosebery, NSW 2018, Australia
| | - Christopher J Tan
- From the Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Sydney Veterinary Emergency and Specialists, Rosebery, NSW 2018, Australia
| | | | - William R Walsh
- From the Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
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18
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Deng X, Qasim M, Ali A. Engineering and polymeric composition of drug-eluting suture: A review. J Biomed Mater Res A 2021; 109:2065-2081. [PMID: 33830631 DOI: 10.1002/jbm.a.37194] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 12/14/2020] [Accepted: 03/24/2021] [Indexed: 12/12/2022]
Abstract
Sutures are the most popular surgical implants in the global surgical equipment market. They are used for holding tissues together to achieve wound closure. However, controlling the body's immune response to these "foreign bodies" at site of infection is challenging. Natural polymers such as collagen, silk, nylon, and cotton, and synthetic polymers such as polycaprolactone, poly(lactic-co-glycolic acid), poly(p-dioxanone) and so forth, contribute the robust foundation for the engineering of drug-eluting sutures. The incorporation of active pharmaceutical ingredients (APIs) with polymeric composition of suture materials is an efficient way to reduce inflammatory reaction in the wound site as well as to control bacterial growth, while allowing wound healing. The incorporation of polymeric composition in surgical sutures has been found to add high flexibility as well as excellent physical and mechanical properties. Fabrication processes and polymer materials allow control over drug-eluting profiles to effectively address wound healing requirements. This review outlines and discusses (a) polymer materials and APIs used in suture applications, including absorbable and nonabsorbable sutures; (b) suture structures, such as monofilament, multifilament, barded and smart sutures; and (c) the existing manufacturing techniques for drug-eluting suture production, including electrospinning, melt-extrusion and coating.
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Affiliation(s)
- Xiaoxuan Deng
- Centre for Bioengineering and Nanomedicine (Dunedin), Faculty of Dentistry, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Muhammad Qasim
- Centre for Bioengineering and Nanomedicine (Dunedin), Faculty of Dentistry, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Azam Ali
- Centre for Bioengineering and Nanomedicine (Dunedin), Faculty of Dentistry, Division of Health Sciences, University of Otago, Dunedin, New Zealand
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19
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Yamakado K. Hydrogen Peroxide Does Not Significantly Reduce Cutibacterium acnes Suture Contamination in Arthroscopic Rotator Cuff Repair. Arthroscopy 2021; 37:1134-1140. [PMID: 33340680 DOI: 10.1016/j.arthro.2020.12.186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 11/29/2020] [Accepted: 12/01/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate the efficacy of application of the 3% hydrogen peroxide (HP)-soaked gauze as an addition to the standard preoperative sterile skin preparation for Cutibacterium acnes suture contamination in arthroscopic rotator cuff repairs. METHODS A prospective randomized study was undertaken to evaluate 151 consecutive patients undergoing arthroscopic rotator cuff repair. Each shoulder was prepared with 1 of the 2 randomly selected protocols: chlorhexidine alcohol (1% chlorhexidine gluconate in 70% isopropyl alcohol)(control group) and chlorhexidine alcohol with 3% HP (HP-treated group). In the HP-treated group, the 3% HP-soaked gauze was applied over the shoulder for 5 minutes before the application of the chlorhexidine-alcohol. The first cut-tails of the anchor suture after cuff fixation were submitted to aerobic and anaerobic cultures. Patients were clinically evaluated for infection 10 days, 28 days, 3 months, 6 months, and 12 months after surgery. RESULTS The rate of C acnes-positive cultures was 13.0% (10 of 77 cases) in the control group and 6.8% (5 of 74 cases) in the HP-treated group. The HP-treated group showed a trend of lower C acnes-positive culture rate, which did not reach statistical significance (relative risk, 0.52; 95% confidence interval, 0.19 and 1.45; number needed to treat, 16.1; P = .20). One case of coagulase-negative Staphylococcus (Staphylococcus intermedius) was isolated in the HP-treated group (1 of 74 cases, 1.3%). No other bacteria were isolated. No infections occurred in any of the patients treated in this study during the minimum 3-month follow-up period. One patient in the HP-treated group complained of skin irritation. CONCLUSIONS The use of a 3% HP-soaked gauze as an addition to the standard preoperative sterile skin preparation for arthroscopic rotator cuff repairs showed only a marginal effect (statistically insignificant) in reducing the C acnes suture contamination rate in the arthroscopic rotator cuff repair patients. LEVEL OF EVIDENCE I, prospective, randomized trial.
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Affiliation(s)
- Kotaro Yamakado
- Department of Orthopaedics, Fukui General Hospital, Fukui, Japan.
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20
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Callahan B, Baumann P. Managing Complications of Patellar Fracture Hardware Removal. Cureus 2020; 12:e12364. [PMID: 33520556 PMCID: PMC7839801 DOI: 10.7759/cureus.12364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A simple surgical procedure is not without the risk of complications and when removing hardware from the bone, such as a previous patella fracture hardware, the surgeon must be well aware of this potential. Here we present the case of a 71-year-old male who presented for removal of retained hardware of united right patella fracture with overlying skin complications. Surgical intervention was uneventful. On post-operative day 1, the patient suffered a fall while using the restroom unassisted with a subsequent large amount of bleeding from the incision site. X-rays demonstrated a new displaced inferior pole patellar fracture. The patient returned to the operating room for debridement and repair of this new patellar fracture with primary closure. Intraoperative cultures of initial operative site were positive for Corynebacterium and Staphylococcus epidermidis. The patient was then started on intravenous Vancomycin based on culture sensitivities. The patella fixation/repair was protected with a knee immobilizer as there was increased risk of falls due to his age/underlying medical condition. This case discusses recommendations and guidelines for preventing and managing these various postoperative complications.
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Affiliation(s)
- Blake Callahan
- Orthopaedic Surgery, University of Central Florida (UCF) College of Medicine, Orlando, USA
| | - Patricia Baumann
- Orthopaedic Surgery, C.W. Bill Young Department of Veterans Affairs Medical Center, Saint Petersburg, USA
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21
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Matos RS, Pinheiro BS, Souza IS, Paes de Castro RR, Ramos GQ, Pinto EP, Silva RS, da Fonseca Filho HD. 3D micromorphology evaluation of kefir microbial films loaded with extract of Amazon rainforest fruit Cupuaçu. Micron 2020; 142:102996. [PMID: 33360436 DOI: 10.1016/j.micron.2020.102996] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/27/2020] [Accepted: 12/07/2020] [Indexed: 02/07/2023]
Abstract
We performed qualitative and quantitative analysis of surfaces of kefir biofilms loaded with Amazon rainforest fruit extract. Scanning electron microscopy and atomic force microscopy were used to evaluate the micromorphology of the biofilms. The films surface displayed a lower density of microorganisms (∼ 0.061 microorganisms/μm2) for the lowest concentration of fruit extract, however, a greater density (∼0.220 microorganisms/μm2) was observed for the higher concentration. Height stereometric parameters revealed that the biofilms with the highest concentration presented the highest roughness. However, almost all the stereometric parameters related to texture showed no significant difference. Furthermore, the Hurst coefficients of the average power spectrum density were similar for all biofilms. Fractal parameters confirmed that higher concentrations of fruit extract induced a superior topographic irregularity. However, fractal lacunarity does not show any significant difference confirming the similarity of the microtextures. Moreover, fractal succolarity and surface entropy exhibited values that suggested ideal percolation and strong topographic uniformity, respectively, indicating that these films can uniformly adhere to other surfaces. Our results confirm that the stereometric and fractal parameters can be relevant for the surface characterization of microbial films, which can be of great importance to the biomedical field.
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Affiliation(s)
- Robert S Matos
- Federal University of Sergipe-UFS, Postgraduate Program in Materials Science and Engineering, São Cristóvão, Sergipe, Brazil; Federal University of Amapá-UNIFAP, Amazonian Materials Group, Physics Department, Macapá, Amapá, Brazil
| | - Bianca S Pinheiro
- Federal University of Sergipe-UFS, Postgraduate Program in Materials Science and Engineering, São Cristóvão, Sergipe, Brazil
| | - Izabella S Souza
- Federal University of Amapá-UNIFAP, Amazonian Materials Group, Physics Department, Macapá, Amapá, Brazil
| | - Ruy R Paes de Castro
- Federal University of Amazonas-UFAM, Laboratory of Synthesis of Nanomaterials and Nanoscopy, Physics Department, Manaus, Amazonas, Brazil
| | - Glenda Q Ramos
- Postgraduate Program in Tropical Medicine, Fundação de Medicina Tropical, State University of Amazonas, 69040-000, Manaus, AM, Brazil
| | - Erveton P Pinto
- Federal University of Amapá-UNIFAP, Amazonian Materials Group, Physics Department, Macapá, Amapá, Brazil
| | - Romualdo S Silva
- Federal University of Sergipe-UFS, Postgraduate Program in Physics, São Cristóvão, Sergipe, Brazil
| | - Henrique D da Fonseca Filho
- Federal University of Amazonas-UFAM, Laboratory of Synthesis of Nanomaterials and Nanoscopy, Physics Department, Manaus, Amazonas, Brazil.
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22
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da Silva MRP, Matos RS, Estevam CS, Santos SB, da Silva FMA, de Sousa IGPP, da Fonseca Filho HD, Almeida LE. Structural evaluation of polymeric microbial films grown on kefir loaded with Maytenus rigida extract. Microsc Res Tech 2020; 84:627-638. [PMID: 33078519 DOI: 10.1002/jemt.23621] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 10/08/2020] [Indexed: 01/01/2023]
Abstract
Kefir is a probiotic that has several health promising properties. Its grains can form microbial films on different types of substrates. In the present work, the surface characteristics of kefir biofilms associated with Maytenus rigida Mart. extract were minutely studied. Three different concentrations of plant extract were included in the biofilm forming solutions, where fresh grains of kefir were inoculated. The results showed that the plant extract was successfully incorporated into the exopolysaccharide matrix of the biofilm. The main chemical components found linked to the plant extract were triterpenes. The crystallinity of biofilms increased with the addition of the plant extract. The morphology revealed that at low concentrations of the extract there was a prevalence of lactobacilli, while at high concentrations yeasts were more observed. Adhesion and wettability were higher for biofilm with less extract. These results revealed that a combination of plant extract and kefir's exopolysaccharide could form biofilms with chemical and topographic properties of great interest in regenerative medicine.
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Affiliation(s)
- Mário R P da Silva
- Postgraduate Program in Materials Science and Engineering, Federal University of Sergipe-UFS, São Cristovão, Sergipe, Brazil
| | - Robert S Matos
- Postgraduate Program in Materials Science and Engineering, Federal University of Sergipe-UFS, São Cristovão, Sergipe, Brazil.,Amazonian Materials Group, Department of Physics, Federal University of Amapá-UNIFAP, Macapá, Amapá, Brazil
| | - Charles S Estevam
- Postgraduate Program in Physiological Sciences, Federal University of Sergipe-UFS, São Cristovão, Sergipe, Brazil
| | - Samuel B Santos
- Postgraduate Program in Physiological Sciences, Federal University of Sergipe-UFS, São Cristovão, Sergipe, Brazil
| | - Felipe M A da Silva
- Chemical Department, Federal University of Amazonas-UFAM, Manaus, Amazonas, Brazil
| | | | | | - Luís E Almeida
- Postgraduate Program in Materials Science and Engineering, Federal University of Sergipe-UFS, São Cristovão, Sergipe, Brazil
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23
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Kaushik S, Thungon PD, Goswami P. Silk Fibroin: An Emerging Biocompatible Material for Application of Enzymes and Whole Cells in Bioelectronics and Bioanalytical Sciences. ACS Biomater Sci Eng 2020; 6:4337-4355. [PMID: 33455178 DOI: 10.1021/acsbiomaterials.9b01971] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Enzymes and whole cells serve as the active biological entities in a myriad of applications including bioprocesses, bioanalytics, and bioelectronics. Conserving the natural activity of these functional biological entities during their prolonged use is one of the major goals for validating their practical applications. Silk fibroin (SF) has emerged as a biocompatible material to interface with enzymes as well as whole cells. These biomaterials can be tailored both physically and chemically to create excellent scaffolds of different forms such as fibers, films, and powder for immobilization and stabilization of enzymes. The secondary structures of the SF-protein can be attuned to generate hydrophobic/hydrophilic pockets suitable to create the biocompatible microenvironments. The fibrous nature of the SF protein with a dominant hydrophobic property may also serve as an excellent support for promoting cellular adhesion and growth. This review compiles and discusses the recent literature on the application of SF as a biocompatible material at the interface of enzymes and cells in various fields, including the emerging area of bioelectronics and bioanalytical sciences.
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Affiliation(s)
- Sharbani Kaushik
- Department of Chemistry and Biochemistry, The Ohio State University, Columbus, Ohio 43201, United States
| | - Phurpa Dema Thungon
- Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati 781039, Assam, India
| | - Pranab Goswami
- Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati 781039, Assam, India
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Solis-Velazquez OA, Gutiérrez-Lomelí M, Guerreo-Medina PJ, Rosas-García MDL, Iñiguez-Moreno M, Avila-Novoa MG. Nosocomial pathogen biofilms on biomaterials: Different growth medium conditions and components of biofilms produced in vitro. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2020; 54:1038-1047. [PMID: 32680693 DOI: 10.1016/j.jmii.2020.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 06/04/2020] [Accepted: 07/06/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND/PURPOSE (S) Nosocomial pathogens can develop biofilms on hospital surfaces and medical devices; however, few studies have focused on the evaluation of mono-and dual-species biofilms developed by nosocomial pathogens under different growth conditions. METHODS This study investigated biofilm development by nosocomial pathogens (Acinetobacter baumannii, Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa) on biomaterials in different culture media and their components of the extracellular matrix biofilm. RESULTS The mono-species biofilms showed cell densities from 7.50 to 9.27 Log10 CFU/cm2 on natural rubber latex type I (NLTI) and from 7.58 to 8.79 Log10 CFU/cm2 on stainless steel (SS). Dual-species biofilms consisted of S. aureus + P. aeruginosa (7.87-8.27 Log10 CFU/cm2 in TSBP and TSBME onto SS; p < 0.05), E. coli + P. aeruginosa (8.32-8.86 Log10 CFU/cm2 in TSBME onto SS and TSBP onto NLTI; p < 0.05), and S. aureus + E. coli (7.82 Log10 CFU/cm2 in TSBME onto SS; p < 0.05). Furthermore, biofilm detachment after proteinase K treatment was 5.54-32.81% compared to 7.95-24.15% after DNase I treatment in the mono-dual species biofilm matrix. Epifluorescence microscopy and scanning electron microscopy (SEM) enabled visualizing the bacteria and extracellular polymeric substances of biofilms on SS and NLTI. CONCLUSION Nosocomial pathogens can develop biofilms on biomaterials. Mono-species biofilms of Gram-negative bacteria showed lower densities than dual-species biofilms in TSBME and TSBP. Additionally, dual-species biofilms showed a higher concentration of proteins and eDNA in the extracellular matrix.
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Affiliation(s)
- Oscar Alberto Solis-Velazquez
- Laboratorio de Microbiología, Departamento de Ciencias Médicas y de la Vida, Centro Universitario de la Ciénega, Universidad de Guadalajara, Jalisco, Mexico
| | - Melesio Gutiérrez-Lomelí
- Laboratorio de Alimentos, Departamento de Ciencias Médicas y de la Vida, Centro Universitario de la Ciénega, Universidad de Guadalajara, Jalisco, Mexico
| | - Pedro Javier Guerreo-Medina
- Laboratorio de Alimentos, Departamento de Ciencias Médicas y de la Vida, Centro Universitario de la Ciénega, Universidad de Guadalajara, Jalisco, Mexico
| | - María de Lourdes Rosas-García
- Laboratorio de Microbiología, Departamento de Ciencias Médicas y de la Vida, Centro Universitario de la Ciénega, Universidad de Guadalajara, Jalisco, Mexico
| | | | - María Guadalupe Avila-Novoa
- Laboratorio de Microbiología, Departamento de Ciencias Médicas y de la Vida, Centro Universitario de la Ciénega, Universidad de Guadalajara, Jalisco, Mexico.
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The Role of Bacterial Colonization of the Suture Thread in Early Identification and Targeted Antibiotic Treatment of Surgical Site Infections: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124416. [PMID: 32575528 PMCID: PMC7345290 DOI: 10.3390/ijerph17124416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 06/15/2020] [Indexed: 11/16/2022]
Abstract
Background: The aim of the present study is to investigate the role of the colonization of suture thread to identify patients at risk of developing a surgical site infection (SSI) after clean surgical procedures. Methods: Patients who underwent elective clean surgery procedures at the Surgery Unit of the AOU-University of Campania Luigi Vanvitelli in a 21-month period were prospectively enrolled. For each patient, a synthetic absorbable thread in Lactomer 9-1 was inserted into the surgical site at the end of surgery and microbiologically evaluated after 48 h. Antibiotic prophylaxis was chosen according to international guidelines. Results: A total of 238 patients were enrolled; 208 (87.4%) of them were subjected to clean procedures without the placement of prosthesis, and 30 (12.6%) with prosthesis. Of the 238 patients, 117 (49.2%) underwent an antimicrobial prophylaxis. Overall, 79 (33.2%) patients showed a bacterial colonization of the thread: among the 208 without the implantation of prosthesis, 19 (21.8%) of the 87 with antibiotic prophylaxis and in 58 (47.9%) of the 121 without it; among the 30 patients with the implantation of prosthesis, only two patients showed a colonized thread. The patients with antibiotic prophylaxis developed a colonization of the thread less frequently than those without it (17.9% vs. 47.9%, p < 0.001). SSI was observed in six (2.5%) patients, all of them showing a colonized thread (7.6% vs. 0%, p < 0.001). The bacteria identified in colonized threads were the same as those found in SSIs. Conclusions: Our study presents a new method that is able to precociously assess patients who have undergone clean procedures who may develop SSI, and identify the microorganism involved.
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Caputo L, Smeriglio A, Trombetta D, Cornara L, Trevena G, Valussi M, Fratianni F, De Feo V, Nazzaro F. Chemical Composition and Biological Activities of the Essential Oils of Leptospermum petersonii and Eucalyptus gunnii. Front Microbiol 2020; 11:409. [PMID: 32351456 PMCID: PMC7174609 DOI: 10.3389/fmicb.2020.00409] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 02/27/2020] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to characterize the chemical composition and to evaluate the antimicrobial and phytotoxic properties of the essential oils (EOs) obtained from leaves of Leptospermum petersonii chemotype "Variety B" and Eucalyptus gunnii, native to Australia. Geranyl acetate, γ-terpinene, geraniol, terpinolene, α-pinene, p-cimene, and linalool were the main components in L. petersonii EO, confirming also the existence of several chemotypes in such taxa; on the other hand, 1,8-cineole, trans-sabinene hydrate acetate, globulol, longicyclene, terpinolene, and camphene were present in major amounts in the E. gunnii EO. Chemical analysis of L. petersonii revealed that it belongs to the variety "B." E. gunnii EO showed good antibacterial activity, with an MIC of 0.5 and 2 μg/mL against Staphylococcus aureus, and Pectobacterium carotovorum, respectively. The activity of E. gunnii EO was stronger than L. petersonii EO, whose maximum MIC reached 5 μg/mL. E. gunnii and L. petersonii EOs were particularly effective in inhibiting the biofilm formation by S. aureus, already at a concentration of 0.01 μg/mL. The other strains were resistant to both EOs up to a dose of 0.05 μg/mL. The maximum inhibition on biofilm formed by P. carotovorum was recorded for E. gunnii EO, reaching a value of 93.12% at 1.0 μg/mL. This is the first manuscript which studies the biofilm inhibition by EOs and evaluates their effects on biofilm metabolism. Both EOs were more effective against P. carotovorum. In addition, even though L. petersonii EO 0.1 μg/mL was unable to inhibit biofilm formation by Escherichia coli, it decreased the metabolic activity of the biofilm to 78.55% compared to control; furthermore, despite it inducing a relatively low inhibition (66.67%) on biofilm formation, it markedly affected metabolic activity, which decreased to 16.09% with respect to the control. On the contrary, L. petersonii EO 0.5 μg/mL induced a 79.88% inhibition of S. aureus biofilm, maintaining a high metabolic activity (90.89%) compared to the control. Moreover, this EO showed inhibitory activity against radical elongation of Solanum lycopersicum and the germination of radish. On the contrary, E. gunnii EO showed no phytotoxic activity.
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Affiliation(s)
- Lucia Caputo
- Department of Pharmacy, University of Salerno, Fisciano, Italy
| | - Antonella Smeriglio
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Domenico Trombetta
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Laura Cornara
- Department for the Earth, Environment and Life Sciences, School of Mathematical, Physical and Natural Sciences, University of Genoa, Genoa, Italy
| | - Greg Trevena
- Essentially Australia, Byron Bay, NSW, Australia
| | - Marco Valussi
- European Herbal and Traditional Medicine Practitioners Association, Norwich, United Kingdom
| | - Florinda Fratianni
- Institute of Food Sciences, CNR-ISA, Italian National Research Council, Avellino, Italy
| | - Vincenzo De Feo
- Department of Pharmacy, University of Salerno, Fisciano, Italy
| | - Filomena Nazzaro
- Institute of Food Sciences, CNR-ISA, Italian National Research Council, Avellino, Italy
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Armijo LM, Wawrzyniec SJ, Kopciuch M, Brandt YI, Rivera AC, Withers NJ, Cook NC, Huber DL, Monson TC, Smyth HDC, Osiński M. Antibacterial activity of iron oxide, iron nitride, and tobramycin conjugated nanoparticles against Pseudomonas aeruginosa biofilms. J Nanobiotechnology 2020; 18:35. [PMID: 32070354 PMCID: PMC7029462 DOI: 10.1186/s12951-020-0588-6] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 01/29/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Novel methods are necessary to reduce morbidity and mortality of patients suffering from infections with Pseudomonas aeruginosa. Being the most common infectious species of the Pseudomonas genus, P. aeruginosa is the primary Gram-negative etiology responsible for nosocomial infections. Due to the ubiquity and high adaptability of this species, an effective universal treatment method for P. aeruginosa infection still eludes investigators, despite the extensive research in this area. RESULTS We report bacterial inhibition by iron-oxide (nominally magnetite) nanoparticles (NPs) alone, having a mean hydrodynamic diameter of ~ 16 nm, as well as alginate-capped iron-oxide NPs. Alginate capping increased the average hydrodynamic diameter to ~ 230 nm. We also investigated alginate-capped iron-oxide NP-drug conjugates, with a practically unchanged hydrodynamic diameter of ~ 232 nm. Susceptibility and minimum inhibitory concentration (MIC) of the NPs, NP-tobramycin conjugates, and tobramycin alone were determined in the PAO1 bacterial colonies. Investigations into susceptibility using the disk diffusion method were done after 3 days of biofilm growth and after 60 days of growth. MIC of all compounds of interest was determined after 60-days of growth, to ensure thorough establishment of biofilm colonies. CONCLUSIONS Positive inhibition is reported for uncapped and alginate-capped iron-oxide NPs, and the corresponding MICs are presented. We report zero susceptibility to iron-oxide NPs capped with polyethylene glycol, suggesting that the capping agent plays a major role in enabling bactericidal ability in of the nanocomposite. Our findings suggest that the alginate-coated nanocomposites investigated in this study have the potential to overcome the bacterial biofilm barrier. Magnetic field application increases the action, likely via enhanced diffusion of the iron-oxide NPs and NP-drug conjugates through mucin and alginate barriers, which are characteristic of cystic-fibrosis respiratory infections. We demonstrate that iron-oxide NPs coated with alginate, as well as alginate-coated magnetite-tobramycin conjugates inhibit P. aeruginosa growth and biofilm formation in established colonies. We have also determined that susceptibility to tobramycin decreases for longer culture times. However, susceptibility to the iron-oxide NP compounds did not demonstrate any comparable decrease with increasing culture time. These findings imply that iron-oxide NPs are promising lower-cost alternatives to silver NPs in antibacterial coatings, solutions, and drugs, as well as other applications in which microbial abolition or infestation prevention is sought.
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Affiliation(s)
- Leisha M. Armijo
- Center for High Technology Materials, University of New Mexico, 1313 Goddard Street SE, Albuquerque, NM 87106-4343 USA
| | - Stephen J. Wawrzyniec
- Center for High Technology Materials, University of New Mexico, 1313 Goddard Street SE, Albuquerque, NM 87106-4343 USA
| | - Michael Kopciuch
- Center for High Technology Materials, University of New Mexico, 1313 Goddard Street SE, Albuquerque, NM 87106-4343 USA
| | - Yekaterina I. Brandt
- Center for High Technology Materials, University of New Mexico, 1313 Goddard Street SE, Albuquerque, NM 87106-4343 USA
| | - Antonio C. Rivera
- Center for High Technology Materials, University of New Mexico, 1313 Goddard Street SE, Albuquerque, NM 87106-4343 USA
| | - Nathan J. Withers
- Center for High Technology Materials, University of New Mexico, 1313 Goddard Street SE, Albuquerque, NM 87106-4343 USA
| | - Nathaniel C. Cook
- Center for High Technology Materials, University of New Mexico, 1313 Goddard Street SE, Albuquerque, NM 87106-4343 USA
| | - Dale L. Huber
- Center for Integrated Nanotechnologies, Sandia National Laboratories, 1000 Eubank SE, Albuquerque, NM 87123 USA
| | - Todd C. Monson
- Sandia National Laboratories, Nanomaterials Sciences, P.O. Box 5800, MS 1415, Albuquerque, NM 87185 USA
| | - Hugh D. C. Smyth
- College of Pharmacy, The University of Texas at Austin, 2409 University Avenue, Stop A1900, Austin, TX 78712 USA
| | - Marek Osiński
- Center for High Technology Materials, University of New Mexico, 1313 Goddard Street SE, Albuquerque, NM 87106-4343 USA
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Mahesh L, Kumar VR, Jain A, Shukla S, Aragoneses JM, Martínez González JM, Fernández-Domínguez M, Calvo-Guirado JL. Bacterial Adherence Around Sutures of Different Material at Grafted Site: A Microbiological Analysis. MATERIALS 2019; 12:ma12182848. [PMID: 31487852 PMCID: PMC6765980 DOI: 10.3390/ma12182848] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 08/21/2019] [Accepted: 08/31/2019] [Indexed: 01/08/2023]
Abstract
Closure of the surgical incision has been the primary function of sutures since their introduction. However, whatever the type, they are known to carry bacteria, which can be a source of infection. Five types of surgical sutures, Gut, Silk, Vicryl, PTFE, and Polyamide, were selected and tested on their ability to carry aerobic and anaerobic bacteria and were rated on the basis of forming colony-forming units (CFUs). Aerobic bacteria grown around gut sutures showed minimum CFUs (≈30 × 104/suture). Though very less anaerobic bacteria growth was seen among all tested suture materials, it was maximum around Vicryl and polyamide sutures. Every suture material is capable, albeit not equally, of holding bacterial biofilm formation, which can be a source of surgical site infection.
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Affiliation(s)
| | | | - Anshi Jain
- Department of Oral Pathology, ITS Dental College, Ghaziabad 201009, Uttar Pradesh, India
| | - Sagrika Shukla
- Private Practice in Periodontology, New Delhi 110001, India
| | - Juan Manuel Aragoneses
- Department of Dental Research in Universidad Federico Henríquez y Carvajal (UFHEC), Santo Domingo 10107, Dominican Republic
| | | | - Manuel Fernández-Domínguez
- Department of Oral Surgery and Implantology and Director of Research in Dentistry in the Doctoral Program of Translational Medicine, CEU San Pablo University, 28223 Madrid, Spain
| | - José Luis Calvo-Guirado
- Department of Oral Surgery and Implant Dentistry, Faculty of Health Sciences, Universidad Católica de Murcia, UCAM, 30107 Murcia, Spain.
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Prasad K, Zhou R, Zhou R, Schuessler D, Ostrikov KK, Bazaka K. Cosmetic reconstruction in breast cancer patients: Opportunities for nanocomposite materials. Acta Biomater 2019; 86:41-65. [PMID: 30576863 DOI: 10.1016/j.actbio.2018.12.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 12/08/2018] [Accepted: 12/17/2018] [Indexed: 12/23/2022]
Abstract
The most common malignancy in women, breast cancer remains a major medical challenge that affects the life of thousands of patients every year. With recognized benefits to body image and self-esteem, the use of synthetic mammary implants for elective cosmetic augmentation and post-mastectomy reconstruction continues to increase. Higher breast implant use leads to an increased occurrence of implant-related complications associated with implant leakage and rupture, capsular contracture, necrosis and infections, which include delayed healing, pain, poor aesthetic outcomes and the need for revision surgeries. Along with the health status of the implant recipient and the skill of the surgeon, the properties of the implant determine the likelihood of implant-related complications and, in doing so, specific patient outcomes. This paper will review the challenges associated with the use of silicone, saline and "gummy bear" implants in view of their application in patients recovering from breast cancer-related mastectomy, and investigate the opportunities presented by advanced functional nanomaterials in meeting these challenges and potentially opening new dimensions for breast reconstruction. STATEMENT OF SIGNIFICANCE: Breast cancer is a significant cause of morbidity and mortality in women worldwide, which is difficult to prevent or predict, and its treatment carries long-term physiological and psychological consequences. Post-mastectomy breast reconstruction addresses the cosmetic aspect of cancer treatment. Yet, drawbacks of current implants contribute to the development of implant-associated complications, which may lead to prolonged patient care, pain and loss of function. Nanomaterials can help resolve the intrinsic biomechanical mismatch between implant and tissues, enhance mechanical properties of soft implantable materials, and provide an alternative avenue for controlled drug delivery. Here, we explore advances in the use of functionalized nanomaterials to enhance the properties of breast implants, with representative examples that highlight the utility of nanomaterials in addressing key challenges associated with breast reconstruction.
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Affiliation(s)
- Karthika Prasad
- School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, Brisbane, QLD 4000, Australia; CSIRO-QUT Joint Sustainable Processes and Devices Laboratory, Commonwealth Scientific and Industrial Research Organisation, P.O. Box 218, Lindfield, NSW 2070, Australia
| | - Renwu Zhou
- School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, Brisbane, QLD 4000, Australia; CSIRO-QUT Joint Sustainable Processes and Devices Laboratory, Commonwealth Scientific and Industrial Research Organisation, P.O. Box 218, Lindfield, NSW 2070, Australia
| | - Rusen Zhou
- School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, Brisbane, QLD 4000, Australia; CSIRO-QUT Joint Sustainable Processes and Devices Laboratory, Commonwealth Scientific and Industrial Research Organisation, P.O. Box 218, Lindfield, NSW 2070, Australia
| | - David Schuessler
- Product Development, Allergan, 2525 Dupont Drive, Irvine, CA 92612, United States
| | - Kostya Ken Ostrikov
- School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, Brisbane, QLD 4000, Australia; CSIRO-QUT Joint Sustainable Processes and Devices Laboratory, Commonwealth Scientific and Industrial Research Organisation, P.O. Box 218, Lindfield, NSW 2070, Australia
| | - Kateryna Bazaka
- School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, Brisbane, QLD 4000, Australia; CSIRO-QUT Joint Sustainable Processes and Devices Laboratory, Commonwealth Scientific and Industrial Research Organisation, P.O. Box 218, Lindfield, NSW 2070, Australia.
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Eldeen MS, Elfeky EH, Hashish AET, Hassan A. Comparison of inhibitory effect between DL–tryptophan and lactoferrin on Pseudomonas aeruginosa biofilm formation in wound dressing. JOURNAL OF ACUTE DISEASE 2019. [DOI: 10.4103/2221-6189.263707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Lin J, Ni B, Liu G. Percutaneous Endoscopic Necrosectomy (PEN) Combined with Percutaneous Catheter Drainage (PCD) and Irrigation for the Treatment of Clinically Relevant Pancreatic Fistula after Pancreatoduodenectomy. J INVEST SURG 2018; 33:317-324. [PMID: 30587050 DOI: 10.1080/08941939.2018.1511014] [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] [Indexed: 01/08/2023]
Abstract
Purpose: This study aimed to evaluate the efficacy of percutaneous endoscopic necrosectomy (PEN) combined with percutaneous catheter drainage (PCD) and irrigation versus PCD for the treatment of clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreatoduodenectomy (PD). Materials and Methods: A total of 34 consecutive patients who suffered from CR-POPF after PD were enrolled in this retrospective cohort study. 12 patients received PEN combined with PCD and irrigation, and 22 patients received PCD. The complications and outcomes of the treatments were compared. Results: No patients suffered from severe PCD- or PEN-related complications. Compared with those treated with PCD, the patients treated with PEN combined with PCD and irrigation had a lower incidence of postoperative delayed severe intraabdominal hemorrhage (31.8% vs. 0%; p = 0.04). During the follow-up period, no patients in either group suffered from collection recurrence or external pancreatic fistula requiring surgical intervention.Conclusions: PEN combined with PCD and irrigation was safe and effective for reducing postoperative delayed severe intraabdominal hemorrhage in patients with CR-POPF after PD.
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Affiliation(s)
- Jian Lin
- Department of Hepatopancreatobiliary Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, PR China
| | - Biqing Ni
- Department of Hepatopancreatobiliary Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, PR China
| | - Guozhong Liu
- Department of Hepatopancreatobiliary Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, PR China
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Everhart JS, DiBartola AC, Dusane DH, Magnussen RA, Kaeding CC, Stoodley P, Flanigan DC. Bacterial Deoxyribonucleic Acid Is Often Present in Failed Revision Anterior Cruciate Ligament Reconstructions. Arthroscopy 2018; 34:3046-3052. [PMID: 30301629 DOI: 10.1016/j.arthro.2018.06.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 06/04/2018] [Accepted: 06/06/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine whether bacterial DNA will be detectable by polymerase chain reaction (PCR) in torn graft tissue at the time of revision anterior cruciate ligament reconstruction (ACLR). METHODS A total of 31 consecutive revision ACLR cases from 1 center from 2014-2016 were recruited. No patients had clinical signs of infection on presentation. Torn graft tissue was obtained in revision cases and subjected to clinical culture and PCR analysis with a universal bacterial primer. Fluorescence microscopy was used to confirm the presence of a biofilm. We obtained negative control samples of water open to air on the field and excess primary ACLR graft tissue, as well as torn native ligament, to evaluate for PCR positivity due to environmental contamination. RESULTS Clinical cultures were positive (coagulase-negative Staphylococcus) in 1 revision case (3%, 1 of 31). Bacterial DNA was detectable in most revision ACLR cases (87.0%, 27 of 31), and there was a low rate of PCR positivity in negative control samples of water open to air (0%, 0 of 3), excess primary ACLR graft tissue after passage (20%, 1 of 5), or native torn ligament (20%, 1 of 5). Bacterial biofilm presence on failed graft tissue as well as monofilament suture was visually confirmed with fluorescence microscopy. CONCLUSIONS Bacterial DNA is frequently present in failed ACLR grafts, with high rates of DNA detection by PCR but low culture positivity. LEVEL OF EVIDENCE Level IV, case series.
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Affiliation(s)
- Joshua S Everhart
- Department of Orthopaedics, Wexner Medical Center, The Ohio State University, Columbus, Ohio, U.S.A
| | - Alex C DiBartola
- Department of Orthopaedics, Wexner Medical Center, The Ohio State University, Columbus, Ohio, U.S.A
| | - Devendra H Dusane
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, Ohio, U.S.A
| | - Robert A Magnussen
- Department of Orthopaedics, Wexner Medical Center, The Ohio State University, Columbus, Ohio, U.S.A.; Jameson Crane Sports Medicine Institute, Wexner Medical Center, The Ohio State University, Columbus, Ohio, U.S.A
| | - Christopher C Kaeding
- Department of Orthopaedics, Wexner Medical Center, The Ohio State University, Columbus, Ohio, U.S.A.; Jameson Crane Sports Medicine Institute, Wexner Medical Center, The Ohio State University, Columbus, Ohio, U.S.A
| | - Paul Stoodley
- Department of Orthopaedics, Wexner Medical Center, The Ohio State University, Columbus, Ohio, U.S.A.; Department of Microbial Infection and Immunity, The Ohio State University, Columbus, Ohio, U.S.A
| | - David C Flanigan
- Department of Orthopaedics, Wexner Medical Center, The Ohio State University, Columbus, Ohio, U.S.A.; Jameson Crane Sports Medicine Institute, Wexner Medical Center, The Ohio State University, Columbus, Ohio, U.S.A..
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Prevention of bacterial colonization on non-thermal atmospheric plasma treated surgical sutures for control and prevention of surgical site infections. PLoS One 2018; 13:e0202703. [PMID: 30183745 PMCID: PMC6124751 DOI: 10.1371/journal.pone.0202703] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 08/07/2018] [Indexed: 11/19/2022] Open
Abstract
Surgical site infections have a remarkable impact on morbidity, extended hospitalization and mortality. Sutures strongly contribute to development of surgical site infections as they are considered foreign material in the human body. Sutures serve as excellent surfaces for microbial adherence and subsequent colonization, biofilm formation and infection on the site of a surgery. Various antimicrobial sutures have been developed to prevent suture-mediated surgical site infection. However, depending on the site of surgery, antimicrobial sutures may remain ineffective, and antimicrobial agents on them might have drawbacks. Plasma, defined as the fourth state of matter, composed of ionized gas, reactive oxygen and nitrogen species, free radical and neutrals, draws attention for the control and prevention of hospital-acquired infections due to its excellent antimicrobial activities. In the present study, the efficacy of non-thermal atmospheric plasma treatment for prevention of surgical site infections was investigated. First, contaminated poly (glycolic-co-lactic acid), polyglycolic acid, polydioxanone and poly (glycolic acid-co-caprolactone) sutures were treated with non-thermal atmospheric plasma to eradicate contaminating bacteria like Staphylococcus aureus and Escherichia coli. Moreover, sutures were pre-treated with non-thermal atmospheric plasma and then exposed to S. aureus and E. coli. Our results revealed that non-thermal atmospheric plasma treatment effectively eradicates contaminating bacteria on sutures, and non-thermal atmospheric plasma pre-treatment effectively prevents bacterial colonization on sutures without altering their mechanical properties. Chemical characterization of sutures was performed with FT-IR and XPS and results showed that non-thermal atmospheric plasma treatment substantially increased the hydrophilicity of sutures which might be the primary mechanism for the prevention of bacterial colonization. In conclusion, plasma-treated sutures could be considered as novel alternative materials for the control and prevention of surgical site infections.
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Hong B, Winkel A, Ertl P, Stumpp SN, Schwabe K, Stiesch M, Krauss JK. Bacterial colonisation of suture material after routine neurosurgical procedures: relevance for wound infection. Acta Neurochir (Wien) 2018; 160:497-503. [PMID: 29189910 DOI: 10.1007/s00701-017-3404-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 11/13/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND Wound healing impairment is a serious problem in surgical disciplines which may be associated with chronic morbidity, increased cost and patient discomfort. Here we aimed to investigate the relevance of bacterial colonisation on suture material using polymerase chain reaction (PCR) to detect and taxonomically classify bacterial DNA in patients with and without wound healing problems after routine neurosurgical procedures. METHODS Repeat surgery was performed in 25 patients with wound healing impairment and in 38 patients with well-healed wounds. To determine the presence of bacteria, a 16S rDNA-based PCR detection method was applied. Fragments of 500 bp were amplified using universal primers which target hypervariable regions within the bacterial 16S rRNA gene. Amplicons were separated from each other by single-strand conformation polymorphism (SSCP) analysis, and finally classified using Sanger sequencing. RESULTS PCR/SSCP detected DNA of various bacteria species on suture material in 10/38 patients with well-healed wounds and in 12/25 patients with wound healing impairment including Staphylococcus aureus, Staphylococcus epidermidis, Propionibacterium acnes and Escherichia coli. Microbiological cultures showed bacterial growth in almost all patients with wound healing impairment and positive results in PCR/SSCP (10/12), while this was the case in only one patient with a well-healed wound (1/10). CONCLUSIONS Colonisation of suture material with bacteria occurs in a relevant portion of patients with and without wound healing impairment after routine neurosurgical procedures. Suture material may provide a nidus for bacteria and subsequent biofilm formation. Most likely, however, such colonisation of sutures is not a general primer for subsequent wound infection.
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Affiliation(s)
- Bujung Hong
- Department of Neurosurgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
| | - Andreas Winkel
- Department of Prosthetic Dentistry and Biomedical Material Science, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - Philipp Ertl
- Department of Neurosurgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - Sascha Nico Stumpp
- Department of Prosthetic Dentistry and Biomedical Material Science, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - Kerstin Schwabe
- Department of Neurosurgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - Meike Stiesch
- Department of Prosthetic Dentistry and Biomedical Material Science, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - Joachim K Krauss
- Department of Neurosurgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
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Obermeier A, Schneider J, Harrasser N, Tübel J, Mühlhofer H, Pförringer D, von Deimling C, Foehr P, Kiefel B, Krämer C, Stemberger A, Schieker M, Burgkart R, von Eisenhart-Rothe R. Viable adhered Staphylococcus aureus highly reduced on novel antimicrobial sutures using chlorhexidine and octenidine to avoid surgical site infection (SSI). PLoS One 2018; 13:e0190912. [PMID: 29315313 PMCID: PMC5760023 DOI: 10.1371/journal.pone.0190912] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 12/22/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Surgical sutures can promote migration of bacteria and thus start infections. Antiseptic coating of sutures may inhibit proliferation of adhered bacteria and avoid such complications. OBJECTIVES This study investigated the inhibition of viable adhering bacteria on novel antimicrobially coated surgical sutures using chlorhexidine or octenidine, a critical factor for proliferation at the onset of local infections. The medical need, a rapid eradication of bacteria in wounds, can be fulfilled by a high antimicrobial efficacy during the first days after wound closure. METHODS As a pretesting on antibacterial efficacy against relevant bacterial pathogens a zone of inhibition assay was conducted with middle ranged concentrated suture coatings (22 μg/cm). For further investigation of adhering bacteria in detail the most clinically relevant Staphylococcus aureus (ATCC®49230™) was used. Absorbable braided sutures were coated with chlorhexidine-laurate, chlorhexidine-palmitate, octenidine-laurate, and octenidine-palmitate. Each coating type resulted in 11, 22, or 33 μg/cm drug content on sutures. Scanning electron microscopy (SEM) was performed once to inspect the coating quality and twice to investigate if bacteria have colonized on sutures. Adhesion experiments were assessed by exposing coated sutures to S. aureus suspensions for 3 h at 37°C. Subsequently, sutures were sonicated and the number of viable bacteria released from the suture surface was determined. Furthermore, the number of viable planktonic bacteria was measured in suspensions containing antimicrobial sutures. Commercially available sutures without drugs (Vicryl®, PGA Resorba®, and Gunze PGA), as well as triclosan-containing Vicryl® Plus were used as control groups. RESULTS Zone of inhibition assay documented a multispecies efficacy of novel coated sutures against tested bacterial strains, comparable to most relevant S. aureus over 48 hours. SEM pictures demonstrated uniform layers on coated sutures with higher roughness for palmitate coatings and sustaining integrity of coated sutures. Adherent S. aureus were found via SEM on all types of investigated sutures. The novel antimicrobial sutures showed significantly less viable adhered S. aureus bacteria (up to 6.1 log) compared to Vicryl® Plus (0.5 log). Within 11 μg/cm drug-containing sutures, octenidine-palmitate (OL11) showed the highest number of viable adhered S. aureus (0.5 log), similar to Vicryl® Plus. Chlorhexidine-laurate (CL11) showed the lowest number of S. aureus on sutures (1.7 log), a 1.2 log greater reduction. In addition, planktonic S. aureus in suspensions were highly inhibited by CL11 (0.9 log) represents a 0.6 log greater reduction compared to Vicryl® Plus (0.3 log). CONCLUSIONS Novel antimicrobial sutures can potentially limit surgical site infections caused by multiple pathogenic bacterial species. Therefore, a potential inhibition of multispecies biofilm formation is assumed. In detail tested with S. aureus, the chlorhexidine-laurate coating (CL11) best meets the medical requirements for a fast bacterial eradication. This suture coating shows the lowest survival rate of adhering as well as planktonic bacteria, a high drug release during the first-clinically most relevant- 48 hours, as well as biocompatibility. Thus, CL11 coatings should be recommended for prophylactic antimicrobial sutures as an optimal surgical supplement to reduce wound infections. However, animal and clinical investigations are important to prove safety and efficacy for future applications.
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Affiliation(s)
- Andreas Obermeier
- Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der Technischen Universität München, München, Germany
- * E-mail:
| | - Jochen Schneider
- II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, München, Germany
| | - Norbert Harrasser
- Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der Technischen Universität München, München, Germany
| | - Jutta Tübel
- Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der Technischen Universität München, München, Germany
| | - Heinrich Mühlhofer
- Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der Technischen Universität München, München, Germany
| | - Dominik Pförringer
- Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar der Technischen Universität München, München, Germany
| | - Constantin von Deimling
- Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der Technischen Universität München, München, Germany
| | - Peter Foehr
- Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der Technischen Universität München, München, Germany
| | - Barbara Kiefel
- Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der Technischen Universität München, München, Germany
| | - Christina Krämer
- Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der Technischen Universität München, München, Germany
| | - Axel Stemberger
- Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der Technischen Universität München, München, Germany
| | - Matthias Schieker
- Klinik für Chirurgie, Experimentelle Chirurgie und Regenerative Medizin, Klinikum der Universität München, München, Germany
| | - Rainer Burgkart
- Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der Technischen Universität München, München, Germany
| | - Rüdiger von Eisenhart-Rothe
- Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der Technischen Universität München, München, Germany
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Joseph B, George A, Gopi S, Kalarikkal N, Thomas S. Polymer sutures for simultaneous wound healing and drug delivery - A review. Int J Pharm 2017; 524:454-466. [PMID: 28385650 DOI: 10.1016/j.ijpharm.2017.03.041] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 03/15/2017] [Accepted: 03/18/2017] [Indexed: 01/27/2023]
Abstract
Drug delivery using suitable polymeric devices has gathered momentum in the recent years due to their remarkable properties. The versatility of polymeric materials makes them reliable candidates for site targeted drug release. Among them biodegradable sutures has received considerable attention because they offer great promises in the realm of drug delivery. Sutures have been found to be an effective strategy for the delivery of antibacterial agents or anti-inflammatory drugs to the surgical site. Recent developments yielded sutures with improved mechanical properties, but designing sutures with all the desirable properties is still under investigation. This review is an attempt to analyze the recent developments pertaining to biologically active sutures emphasizing their potential as drug delivery vehicle.
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Affiliation(s)
- Blessy Joseph
- International and Inter University Centre for Nanoscience and Nanotechnology, Mahatma Gandhi University, Kottayam 686 560, Kerala, India
| | - Anne George
- Department of Anatomy, Kottayam Medical College, Kerala, India
| | - Sreeraj Gopi
- Plant Lipids Pvt. Ltd., Kolencherry, Cochin, India
| | - Nandakumar Kalarikkal
- International and Inter University Centre for Nanoscience and Nanotechnology, Mahatma Gandhi University, Kottayam 686 560, Kerala, India; School of Pure and Applied Physics, Mahatma Gandhi University, Kottayam 686 560, Kerala, India.
| | - Sabu Thomas
- International and Inter University Centre for Nanoscience and Nanotechnology, Mahatma Gandhi University, Kottayam 686 560, Kerala, India; School of Chemical Sciences, Mahatma Gandhi University, Kottayam 686 560, Kerala, India.
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Dhom J, Bloes DA, Peschel A, Hofmann UK. Bacterial adhesion to suture material in a contaminated wound model: Comparison of monofilament, braided, and barbed sutures. J Orthop Res 2017; 35:925-933. [PMID: 27208547 DOI: 10.1002/jor.23305] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 05/11/2016] [Indexed: 02/04/2023]
Abstract
Contaminated suture material plays an important role in the physiopathology of surgical site infections. Recently, suture material has been developed characterized by barbs projecting from a monofilament base. Claimed advantages for barbed sutures are a shortened wound closure time and reduced maximum wound tension. It has also been suggested that these sutures would be advantageous microbiologically. The aim of this study was to test the microbiological characteristics of the barbed Quill in comparison to the monofilament Ethilon II and the braided sutures Vicryl and triclosan-coated Vicryl Plus. In our study, sutures were cultivated on color-change agar with Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecium, Escherichia coli, and Pseudomonas aeruginosa and the halo size was measured. In a second study arm with longer cultivation bacterial growth was followed by antibiotic treatment. Ethilon II and Quill showed good comparable results, whereas large halos were found around Vicryl. Vicryl Plus results depended on triclosan sensitivity. After longer bacterial cultivation and antibiotic treatment, halos were up to 3.6 times smaller on Quill than on Vicryl (p < 0.001), but 1.4 times larger than on Ethilon II (p < 0.001) regarding S. aureus. Confocal microscopy analysis showed bacterial colonization between the braided filaments on Vicryl and beneath the barbs on Quill. From a microbiological perspective, barbed sutures can be recommended in aseptic surgery, but should only be used carefully in septic surgery. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:925-933, 2017.
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Affiliation(s)
- Jonas Dhom
- Medical Faculty of the University of Tübingen, D-72076 Tübingen, Germany
| | - Dominik A Bloes
- Cellular and Molecular Microbiology Division, Interfaculty Institute of Microbiology and Infection Medicine, University of Tübingen, D-72076 Tübingen, Germany
- German Center for Infection Research, Partner site Tübingen, D-72076 Tübingen, Germany
| | - Andreas Peschel
- Cellular and Molecular Microbiology Division, Interfaculty Institute of Microbiology and Infection Medicine, University of Tübingen, D-72076 Tübingen, Germany
- German Center for Infection Research, Partner site Tübingen, D-72076 Tübingen, Germany
| | - Ulf K Hofmann
- Department of Orthopaedic Surgery, University Hospital of Tübingen, D-72076 Tübingen, Germany
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de Jonge SW, Atema JJ, Solomkin JS, Boermeester MA. Meta-analysis and trial sequential analysis of triclosan-coated sutures for the prevention of surgical-site infection. Br J Surg 2017; 104:e118-e133. [PMID: 28093723 DOI: 10.1002/bjs.10445] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 09/26/2016] [Accepted: 11/03/2016] [Indexed: 01/27/2023]
Abstract
BACKGROUND Triclosan-coated sutures (TCS) were developed to reduce the risk of surgical-site infection (SSI). Level 1A evidence of effectiveness has been presented in various recent meta-analyses, yet well designed RCTs have not been able to reproduce these favourable results. The aim of this study was to evaluate all available evidence critically with comprehensive analysis to seek a more reliable answer regarding the effectiveness of TCS in the prevention of SSI. METHODS PubMed, MEDLINE, Embase and Cochrane Library databases were searched from 1990 to November 2015 for RCTs that compared TCS with sutures that were exactly the same, but uncoated, in the prevention of SSI. Pooled relative risks (RRs) with corresponding 95 per cent confidence intervals were estimated using a random-effects model. Metaregression was used to substantiate subgroup effects, trial sequential analysis was employed to assess the risk of random error, and quality of evidence was determined using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. RESULTS Twenty-one RCTs including 6462 patients were included. Risk of bias was serious. Pooled effects showed a RR of 0·72 (95 per cent c.i. 0·60 to 0·86; P < 0·001) for all publications. At a risk of 138 SSIs per 1000 procedures, the use of TCS reduced this by 39 (95 per cent c.i. 19, 55). Trial sequential analysis confirmed a RR reduction of 15 per cent for the use of TCS. CONCLUSION GRADE assessment shows moderate-quality evidence that TCS are effective in reducing SSI. Trial sequential analysis indicates that the effect was robust, and additional data are unlikely to alter the summary effect.
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Affiliation(s)
- S W de Jonge
- Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands
| | - J J Atema
- Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands
| | - J S Solomkin
- Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - M A Boermeester
- Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands
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Giusto G, Tramuta C, Caramello V, Comino F, Nebbia P, Robino P, Singer E, Grego E, Gandini M. Cleaning with a wet sterile gauze significantly reduces contamination of sutures, instruments, and surgical gloves in an ex-vivo pelvic flexure enterotomy model in horses. CANADIAN JOURNAL OF VETERINARY RESEARCH = REVUE CANADIENNE DE RECHERCHE VETERINAIRE 2017; 81:69-72. [PMID: 28154467 PMCID: PMC5220602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 07/01/2016] [Indexed: 06/06/2023]
Abstract
The objective of this study was to investigate whether cleaning surgical materials used to close pelvic flexure enterotomies with a wet sterile gauze will reduce contamination and whether the use of a full thickness appositional suture pattern (F) or a partial thickness inverting (or Cushing) suture pattern (C) would make a difference in the level of contamination. Large colon specimens were assigned to group F or C and divided into subgroups N and G. In group G, a wet sterile gauze was passed over the suture material, another over the instruments, and another over the gloves. In group N, no treatment was applied. The bacterial concentration was measured by optical density (OD) at 24 h. The OD of subgroup CG was lower than that of subgroup CN (P = 0.019). The OD of subgroup FG was lower than that of subgroup FN (P = 0.02). The OD of subgroups CG, CN, FG, and FN was lower than that of the negative control (P < 0.003, P < 0.001, P < 0.001, and P < 0.00). The use of a sterile wet gauze significantly reduced contamination of suture materials. A partial thickness inverting suture pattern did not produce less contamination than a full thickness appositional suture pattern.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Marco Gandini
- Address all correspondence to Dr. Marco Gandini; telephone: +390116708861; e-mail:
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Morrison S, Singh A, Rousseau J, Weese JS. Adherence of methicillin-resistant Staphylococcus pseudintermedius to suture materials commonly used in small animal surgery. Am J Vet Res 2016; 77:194-8. [PMID: 27027714 DOI: 10.2460/ajvr.77.2.194] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate adherence of methicillin-resistant Staphylococcus pseudintermedius (MRSP) to 5 suture materials commonly used in small animal surgery. SAMPLE 10 epidemiologically unrelated MRSP isolates (obtained from dogs with clinical infections) that had strong biofilm-forming ability and 5 types of suture. PROCEDURES The 5 types of suture evaluated were monofilament polyglecaprone 25, monofilament polydioxanone, triclosan-coated (TC)-monofilament polydioxanone, braided polyglactin 910, and barbed monofilament polydioxanone. Suture segments were incubated in standard suspensions of MRSP for 2 minutes. Segments were then placed in tryptone soy broth and incubated overnight. After incubation, segments were rinsed with PBS solution and sonicated to dislodge adherent bacteria. Resulting suspensions were used to create serial dilutions that were plated, incubated overnight, and counted the following day. Bacterial adherence to 1 segment of each suture type was assessed by use of scanning electron microscopy. RESULTS There was significantly less adherence of MSRP to TC-monofilament polydioxanone than to polyglecaprone 25, polyglactin 910, barbed monofilament polydioxanone, and monofilament polydioxanone. There was significantly less adherence of MSRP to polyglecaprone than to polyglactin 910. CONCLUSIONS AND CLINICAL RELEVANCE Barbed suture had a bacterial adherence profile comparable to that for monofilament suture. Adherence of MRSP was greatest for braided polyglactin 910. Use of TC-monofilament polydioxanone can be considered for patients that are at high risk of developing surgical site infections and for which a surgeon chooses a multifilament suture.
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Kindinger LM, Kyrgiou M, MacIntyre DA, Cacciatore S, Yulia A, Cook J, Terzidou V, Teoh TG, Bennett PR. Preterm Birth Prevention Post-Conization: A Model of Cervical Length Screening with Targeted Cerclage. PLoS One 2016; 11:e0163793. [PMID: 27812088 PMCID: PMC5094773 DOI: 10.1371/journal.pone.0163793] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 09/14/2016] [Indexed: 11/18/2022] Open
Abstract
Women with a history of excisional treatment (conization) for cervical intra-epithelial neoplasia (CIN) are at increased risk of preterm birth, perinatal morbidity and mortality in subsequent pregnancy. We aimed to develop a screening model to effectively differentiate pregnancies post-conization into low- and high-risk for preterm birth, and to evaluate the impact of suture material on the efficacy of ultrasound indicated cervical cerclage. We analysed longitudinal cervical length (CL) data from 725 pregnant women post-conization attending preterm surveillance clinics at three London university Hospitals over a ten year period (2004-2014). Rates of preterm birth <37 weeks after targeted cerclage for CL<25mm were compared with local and national background rates and expected rates for this cohort. Rates for cerclage using monofilament or braided suture material were also compared. Of 725 women post-conization 13.5% (98/725) received an ultrasound indicated cerclage and 9.7% (70/725) delivered prematurely, <37weeks; 24.5% (24/98) of these despite insertion of cerclage. The preterm birth rate was lower for those that had monofilament (9/60, 15%) versus braided (15/38, 40%) cerclage (RR 0.7, 95% CI 0.54 to 0.94, P = 0.008). Accuracy parameters of interval reduction in CL between longitudinal second trimester screenings were calculated to identify women at low risk of preterm birth, who could safely discontinue surveillance. A reduction of CL <10% between screening timepoints predicts term birth, >37weeks. Our triage model enables timely discharge of low risk women, eliminating 36% of unnecessary follow-up CL scans. We demonstrate that preterm birth in women post-conization may be reduced by targeted cervical cerclage. Cerclage efficacy is however suture material-dependant: monofilament is preferable to braided suture. The introduction of triage prediction models has the potential to reduce the number of unnecessary CL scan for women at low risk of preterm birth.
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Affiliation(s)
- Lindsay M Kindinger
- Institute of Reproductive and Developmental Biology, Department of Surgery and Cancer, Imperial College, London, United Kingdom.,Department of Obstetrics and Gynaecology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Maria Kyrgiou
- Institute of Reproductive and Developmental Biology, Department of Surgery and Cancer, Imperial College, London, United Kingdom.,Department of Obstetrics and Gynaecology, Queen Charlotte's and Chelsea-Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - David A MacIntyre
- Institute of Reproductive and Developmental Biology, Department of Surgery and Cancer, Imperial College, London, United Kingdom
| | - Stefano Cacciatore
- Institute of Reproductive and Developmental Biology, Department of Surgery and Cancer, Imperial College, London, United Kingdom
| | - Angela Yulia
- Institute of Reproductive and Developmental Biology, Department of Surgery and Cancer, Imperial College, London, United Kingdom.,Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital NHS Trust, London, United Kingdom
| | - Joanna Cook
- Institute of Reproductive and Developmental Biology, Department of Surgery and Cancer, Imperial College, London, United Kingdom
| | - Vasso Terzidou
- Institute of Reproductive and Developmental Biology, Department of Surgery and Cancer, Imperial College, London, United Kingdom.,Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital NHS Trust, London, United Kingdom
| | - T G Teoh
- Institute of Reproductive and Developmental Biology, Department of Surgery and Cancer, Imperial College, London, United Kingdom.,Department of Obstetrics and Gynaecology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Phillip R Bennett
- Institute of Reproductive and Developmental Biology, Department of Surgery and Cancer, Imperial College, London, United Kingdom.,Department of Obstetrics and Gynaecology, Queen Charlotte's and Chelsea-Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
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Abstract
BACKGROUND Robotic-assisted abdominal sacrocolpopexy (RASC) is an effective procedure for the surgical treatment of vaginal vault prolapse associated with a rare, but serious, risk of sacral osteomyelitis. CASE We report a case of Bacteroides fragilis sacral osteomyelitis after RASC that presented only as back pain. Treatment included intravenous antibiotics and abdominal exploration with removal of sacral mesh. CONCLUSIONS Sacral osteomyelitis is a rare complication following RASC and may present only as back pain without constitutional symptoms. Intravenous antibiotics and surgical excision of sacral mesh are routinely performed, but preservation of vaginal mesh is a viable option. The clinician should have a high index of suspicion for osteomyelitis in any patient who presents with back pain after RASC, regardless of absence of other presenting symptoms.
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Barnes AMT, Dale JL, Chen Y, Manias DA, Greenwood Quaintance KE, Karau MK, Kashyap PC, Patel R, Wells CL, Dunny GM. Enterococcus faecalis readily colonizes the entire gastrointestinal tract and forms biofilms in a germ-free mouse model. Virulence 2016; 8:282-296. [PMID: 27562711 DOI: 10.1080/21505594.2016.1208890] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The mammalian gastrointestinal (GI) tract is a complex organ system with a twist-a significant portion of its composition is a community of microbial symbionts. The microbiota plays an increasingly appreciated role in many clinically-relevant conditions. It is important to understand the details of biofilm development in the GI tract since bacteria in this state not only use biofilms to improve colonization, biofilm bacteria often exhibit high levels of resistance to common, clinically relevant antibacterial drugs. Here we examine the initial colonization of the germ-free murine GI tract by Enterococcus faecalis-one of the first bacterial colonizers of the naïve mammalian gut. We demonstrate strong morphological similarities to our previous in vitro E. faecalis biofilm microcolony architecture using 3 complementary imaging techniques: conventional tissue Gram stain, immunofluorescent imaging (IFM) of constitutive fluorescent protein reporter expression, and low-voltage scanning electron microscopy (LV-SEM). E. faecalis biofilm microcolonies were readily identifiable throughout the entire lower GI tract, from the duodenum to the colon. Notably, biofilm development appeared to occur as discrete microcolonies directly attached to the epithelial surface rather than confluent sheets of cells throughout the GI tract even in the presence of high (>109) fecal bacterial loads. An in vivo competition experiment using a pool of 11 select E. faecalis mutant strains containing sequence-defined transposon insertions showed the potential of this model to identify genetic factors involved in E. faecalis colonization of the murine GI tract.
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Affiliation(s)
- Aaron M T Barnes
- a Departments of Microbiology & Immunology , University of Minnesota Medical School , Minneapolis , MN , USA
| | - Jennifer L Dale
- a Departments of Microbiology & Immunology , University of Minnesota Medical School , Minneapolis , MN , USA
| | - Yuqing Chen
- a Departments of Microbiology & Immunology , University of Minnesota Medical School , Minneapolis , MN , USA
| | - Dawn A Manias
- a Departments of Microbiology & Immunology , University of Minnesota Medical School , Minneapolis , MN , USA
| | - Kerryl E Greenwood Quaintance
- b Department of Laboratory Medicine and Pathology , Division of Clinical Microbiology, Mayo Clinic , Rochester , MN , USA
| | - Melissa K Karau
- b Department of Laboratory Medicine and Pathology , Division of Clinical Microbiology, Mayo Clinic , Rochester , MN , USA
| | - Purna C Kashyap
- c Division of Gastroenterology , Department of Medicine , Mayo Clinic , Rochester , MN , USA
| | - Robin Patel
- b Department of Laboratory Medicine and Pathology , Division of Clinical Microbiology, Mayo Clinic , Rochester , MN , USA.,d Department of Medicine , Division of Infectious Disease, Mayo Clinic , Rochester , MN , USA
| | - Carol L Wells
- a Departments of Microbiology & Immunology , University of Minnesota Medical School , Minneapolis , MN , USA.,e Laboratory Medicine and Pathology , University of Minnesota Medical School , Minneapolis , MN , USA
| | - Gary M Dunny
- a Departments of Microbiology & Immunology , University of Minnesota Medical School , Minneapolis , MN , USA
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Kindinger LM, MacIntyre DA, Lee YS, Marchesi JR, Smith A, McDonald JAK, Terzidou V, Cook JR, Lees C, Israfil-Bayli F, Faiza Y, Toozs-Hobson P, Slack M, Cacciatore S, Holmes E, Nicholson JK, Teoh TG, Bennett PR. Relationship between vaginal microbial dysbiosis, inflammation, and pregnancy outcomes in cervical cerclage. Sci Transl Med 2016; 8:350ra102. [DOI: 10.1126/scitranslmed.aag1026] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 06/23/2016] [Indexed: 12/20/2022]
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Dennis C, Sethu S, Nayak S, Mohan L, Morsi YY, Manivasagam G. Suture materials - Current and emerging trends. J Biomed Mater Res A 2016; 104:1544-59. [DOI: 10.1002/jbm.a.35683] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 01/07/2016] [Accepted: 02/05/2016] [Indexed: 01/08/2023]
Affiliation(s)
- Christopher Dennis
- Centre for Biomaterials Science and Technology, School of Mechanical and Building Sciences, VIT University; Vellore Tamil Nadu 632014 India
| | - Swaminathan Sethu
- GROW Research Laboratory, Narayana Nethralaya Foundation; Bangalore Karnataka 560099 India
| | - Sunita Nayak
- Centre for Biomaterials Science and Technology, School of Mechanical and Building Sciences, VIT University; Vellore Tamil Nadu 632014 India
- School of Bio Sciences and Technology, VIT University; Vellore Tamil Nadu 632014 India
| | - Loganathan Mohan
- Surface Engineering Division; CSIR - National Aerospace Laboratories; Bangalore Karnataka 560017 India
| | - Yosry Yos Morsi
- Biomechanical and Tissue Engineering Labs, Faculty of Science, Engineering and Technology, Swinburne University of Technology; Australia
| | - Geetha Manivasagam
- Centre for Biomaterials Science and Technology, School of Mechanical and Building Sciences, VIT University; Vellore Tamil Nadu 632014 India
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Tummalapalli M, Anjum S, Kumari S, Gupta B. Antimicrobial Surgical Sutures: Recent Developments and Strategies. POLYM REV 2016. [DOI: 10.1080/15583724.2015.1119163] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Boybeyi Ö, Kaçmaz B, Günal YD, Gül S, Yörübulut S, Aslan MK. Bacterial adhesion to braided surgical sutures: an in vitro study. EUROPEAN JOURNAL OF PLASTIC SURGERY 2015. [DOI: 10.1007/s00238-015-1171-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Brandenburg KS, Calderon DF, Kierski PR, Brown AL, Shah NM, Abbott NL, Schurr MJ, Murphy CJ, McAnulty JF, Czuprynski CJ. Inhibition of Pseudomonas aeruginosa biofilm formation on wound dressings. Wound Repair Regen 2015; 23:842-54. [PMID: 26342168 DOI: 10.1111/wrr.12365] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 07/31/2015] [Accepted: 09/02/2015] [Indexed: 01/19/2023]
Abstract
Chronic nonhealing skin wounds often contain bacterial biofilms that prevent normal wound healing and closure and present challenges to the use of conventional wound dressings. We investigated inhibition of Pseudomonas aeruginosa biofilm formation, a common pathogen of chronic skin wounds, on a commercially available biological wound dressing. Building on prior reports, we examined whether the amino acid tryptophan would inhibit P. aeruginosa biofilm formation on the three-dimensional surface of the biological dressing. Bacterial biomass and biofilm polysaccharides were quantified using crystal violet staining or an enzyme linked lectin, respectively. Bacterial cells and biofilm matrix adherent to the wound dressing were visualized through scanning electron microscopy. D-/L-tryptophan inhibited P. aeruginosa biofilm formation on the wound dressing in a dose dependent manner and was not directly cytotoxic to immortalized human keratinocytes although there was some reduction in cellular metabolism or enzymatic activity. More importantly, D-/L-tryptophan did not impair wound healing in a splinted skin wound murine model. Furthermore, wound closure was improved when D-/L-tryptophan treated wound dressing with P. aeruginosa biofilms were compared with untreated dressings. These findings indicate that tryptophan may prove useful for integration into wound dressings to inhibit biofilm formation and promote wound healing.
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Affiliation(s)
- Kenneth S Brandenburg
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - Diego F Calderon
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | - Patricia R Kierski
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | - Amanda L Brown
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | - Nihar M Shah
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Nicholas L Abbott
- Department of Chemical and Biological Engineering, University of Wisconsin-Madison, Madison, Wisconsin
| | - Michael J Schurr
- Mission Trauma Services, Mission Medical Associates, Mission Memorial Hospital, Asheville, North Carolina
| | - Christopher J Murphy
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California.,Department of Ophthalmology & Vision Science, School of Medicine, University of California-Davis, Davis, California
| | - Jonathan F McAnulty
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | - Charles J Czuprynski
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, Wisconsin
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Lianhua Y, Yunchao H, Guangqiang Z, Kun Y, Xing L, Fengli G. The effect of iatrogenic Staphylococcus epidermidis intercellar adhesion operon on the formation of bacterial biofilm on polyvinyl chloride surfaces. Surg Infect (Larchmt) 2015; 15:768-73. [PMID: 25402758 DOI: 10.1089/sur.2013.129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The intercellular adhesion gene (ica) of Staphylococcus epidermidis is a key factor for bacterial aggregation. This study explored the effect of ica on the formation of bacterial biofilm on polyvinyl chloride (PVC) surfaces. METHODS Genes related to bacterial biofilm formation, including 16S rRNA, autolysin (atlE), fibrinogen binding protein gene (fbe), and ica were identified and sequenced from 112 clinical isolates of iatrogenic S. epidermidis by polymerase chain reaction (PCR) and gene sequencing. Based on the sequencing result, ica operon-positive (icaADB+/atlE+/fbe+) and ica operon-negative (icaADB-/atlE+/fbe+) strains were separated and co-cultivated with PVC material. After 6, 12, 18, 24, and 30 h of co-culture, the thickness of the bacterial biofilm and quantity of bacterial colony on the PVC surface were measured under the confocal laser scanning microscope and scanning electron microscope. RESULTS The positive rate of S. epidermidis-specific 16SrRNA in 112 iatrogenic strains was 100% (112/112). The genotype of ica-positive (icaADB+/atlE+/fbe+) strains accounted for 57.1% (64/112), and genotype of ica-negative (icaADB-/atlE+/fbe+) strains accounted for 37.5% (42/112). During 30 h of co-culture, no obvious bacterial biofilm formed on the surface of PVC in the ica-positive group, however, mature bacterial biofilm structure formed after 24 h. For all time points, thickness of bacterial biofilm and quantity of bacterial colony on PVC surfaces in the ica operon-positive group were significantly higher than those in ica operon-negative group (p<0.01). CONCLUSIONS Iatrogenic S. epidermidis can be categorized into ica operon-negative and ica operon-positive strains. The ica operon plays an important role in bacterial biofilm formation and bacterial multiplication on PVC material.
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Affiliation(s)
- Ye Lianhua
- 1 Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University , Kunming, Yunnan, China
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Hess DJ, Henry-Stanley MJ, Wells CL. The Natural Surfactant Glycerol Monolaurate Significantly Reduces Development of Staphylococcus aureus and Enterococcus faecalis Biofilms. Surg Infect (Larchmt) 2015; 16:538-42. [PMID: 26110557 DOI: 10.1089/sur.2014.162] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Bacterial biofilms are involved in a large proportion of clinical infections, including device-related infections. Unfortunately, biofilm-associated bacteria are typically less susceptible to antibiotics, and infected devices must often be removed. On the basis of a recent observation that lipid-rich biofilm matrix material is present in early biofilm formation and may protect a population of bacteria from interacting with ordinarily diffusible small molecules, we hypothesized that surfactants may be useful in preventing biofilm development. METHODS Experimental Staphylococcus aureus or Enterococcus faecalis biofilms were cultivated on surgical suture suspended in a growth medium supplemented with the natural surfactant glycerol monolaurate (GML) or with a component molecule, lauric acid. After 16 h incubation, the numbers of viable biofilm-associated bacteria were measured by standard microbiologic techniques and biofilm biomass was measured using the colorimetric crystal violet assay. RESULTS Both GML and lauric acid were effective in inhibiting biofilm development as measured by decreased numbers of viable biofilm-associated bacteria as well as decreased biofilm biomass. Compared with lauric acid on a molar basis, GML represented a more effective inhibitor of biofilms formed by either S. aureus or E. faecalis. CONCLUSIONS Because the natural surfactant GML inhibited biofilm development, resulting data were consistent with the hypothesis that lipids may play an important role in biofilm growth, implying that interfering with lipid formation may help control development of clinically relevant biofilms.
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Affiliation(s)
- Donavon J Hess
- 1 Department of Surgery, University of Minnesota , Minneapolis.,2 Department of Pediatrics, University of Minnesota , Minneapolis
| | | | - Carol L Wells
- 1 Department of Surgery, University of Minnesota , Minneapolis.,3 Laboratory Medicine and Pathology, University of Minnesota , Minneapolis
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