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Batista S, Fernandez-Pittol M, Nicolás LS, Martínez D, Rubio M, Garrigo M, Vila J, Tudó G, González-Martin J. In Vitro Effect of Three-Antibiotic Combinations plus Potential Antibiofilm Agents against Biofilm-Producing Mycobacterium avium and Mycobacterium intracellulare Clinical Isolates. Antibiotics (Basel) 2023; 12:1409. [PMID: 37760706 PMCID: PMC10526108 DOI: 10.3390/antibiotics12091409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Patients with chronic pulmonary diseases infected by Mycobacterium avium complex (MAC) often develop complications and suffer from treatment failure due to biofilm formation. There is a lack of correlation between in vitro susceptibility tests and the treatment of clinical isolates producing biofilm. We performed susceptibility tests of 10 different three-drug combinations, including two recommended in the guidelines, in biofilm forms of eight MAC clinical isolates. Biofilm developed in the eight isolates following incubation of the inoculum for 3 weeks. Then, the biofilm was treated with three-drug combinations with and without the addition of potential antibiofilm agents (PAAs). Biofilm bactericidal concentrations (BBCs) were determined using the Vizion lector system. All selected drug combinations showed synergistic activity, reducing BBC values compared to those treated with single drugs, but BBC values remained high enough to treat patients. However, with the addition of PAAs, the BBCs steadily decreased, achieving similar values to the combinations in planktonic forms and showing synergistic activity in all the combinations and in both species. In conclusion, three-drug combinations with PAAs showed synergistic activity in biofilm forms of MAC isolates. Our results suggest the need for clinical studies introducing PAAs combined with antibiotics for the treatment of patients with pulmonary diseases infected by MAC.
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Affiliation(s)
- Sara Batista
- Unitat de Microbiologia, Department de Fonaments Clínics, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, c/Casanova 143, 08036 Barcelona, Spain; (S.B.); (M.F.-P.); (J.V.)
- ISGlobal Barcelona, Institute for Global Health, c/Rosselló 132, 08036 Barcelona, Spain
- Servei de Microbiologia, CDB, Hospital Clínic de Barcelona, c/Villarroel 170, 08036 Barcelona, Spain; (L.S.N.); (D.M.)
| | - Mariana Fernandez-Pittol
- Unitat de Microbiologia, Department de Fonaments Clínics, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, c/Casanova 143, 08036 Barcelona, Spain; (S.B.); (M.F.-P.); (J.V.)
- ISGlobal Barcelona, Institute for Global Health, c/Rosselló 132, 08036 Barcelona, Spain
- Servei de Microbiologia, CDB, Hospital Clínic de Barcelona, c/Villarroel 170, 08036 Barcelona, Spain; (L.S.N.); (D.M.)
| | - Lorena San Nicolás
- Servei de Microbiologia, CDB, Hospital Clínic de Barcelona, c/Villarroel 170, 08036 Barcelona, Spain; (L.S.N.); (D.M.)
| | - Diego Martínez
- Servei de Microbiologia, CDB, Hospital Clínic de Barcelona, c/Villarroel 170, 08036 Barcelona, Spain; (L.S.N.); (D.M.)
| | - Marc Rubio
- Servei de Microbiologia, Fundació de Gestió de l’Hospital de la Santa Creu i Sant Pau, c/Sant Quintí 89, 08026 Barcelona, Spain; (M.R.); (M.G.)
- Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau), c/Sant Quintí, 89, 08026 Barcelona, Spain
| | - Montserrat Garrigo
- Servei de Microbiologia, Fundació de Gestió de l’Hospital de la Santa Creu i Sant Pau, c/Sant Quintí 89, 08026 Barcelona, Spain; (M.R.); (M.G.)
- Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau), c/Sant Quintí, 89, 08026 Barcelona, Spain
| | - Jordi Vila
- Unitat de Microbiologia, Department de Fonaments Clínics, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, c/Casanova 143, 08036 Barcelona, Spain; (S.B.); (M.F.-P.); (J.V.)
- ISGlobal Barcelona, Institute for Global Health, c/Rosselló 132, 08036 Barcelona, Spain
- Servei de Microbiologia, CDB, Hospital Clínic de Barcelona, c/Villarroel 170, 08036 Barcelona, Spain; (L.S.N.); (D.M.)
- CIBER of Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Griselda Tudó
- Unitat de Microbiologia, Department de Fonaments Clínics, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, c/Casanova 143, 08036 Barcelona, Spain; (S.B.); (M.F.-P.); (J.V.)
- ISGlobal Barcelona, Institute for Global Health, c/Rosselló 132, 08036 Barcelona, Spain
- Servei de Microbiologia, CDB, Hospital Clínic de Barcelona, c/Villarroel 170, 08036 Barcelona, Spain; (L.S.N.); (D.M.)
| | - Julian González-Martin
- Unitat de Microbiologia, Department de Fonaments Clínics, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, c/Casanova 143, 08036 Barcelona, Spain; (S.B.); (M.F.-P.); (J.V.)
- ISGlobal Barcelona, Institute for Global Health, c/Rosselló 132, 08036 Barcelona, Spain
- Servei de Microbiologia, CDB, Hospital Clínic de Barcelona, c/Villarroel 170, 08036 Barcelona, Spain; (L.S.N.); (D.M.)
- CIBER of Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Mycobacterial Adhesion: From Hydrophobic to Receptor-Ligand Interactions. Microorganisms 2022; 10:microorganisms10020454. [PMID: 35208908 PMCID: PMC8875947 DOI: 10.3390/microorganisms10020454] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/07/2022] [Accepted: 02/12/2022] [Indexed: 11/24/2022] Open
Abstract
Adhesion is crucial for the infective lifestyles of bacterial pathogens. Adhesion to non-living surfaces, other microbial cells, and components of the biofilm extracellular matrix are crucial for biofilm formation and integrity, plus adherence to host factors constitutes a first step leading to an infection. Adhesion is, therefore, at the core of pathogens’ ability to contaminate, transmit, establish residency within a host, and cause an infection. Several mycobacterial species cause diseases in humans and animals with diverse clinical manifestations. Mycobacterium tuberculosis, which enters through the respiratory tract, first adheres to alveolar macrophages and epithelial cells leading up to transmigration across the alveolar epithelium and containment within granulomas. Later, when dissemination occurs, the bacilli need to adhere to extracellular matrix components to infect extrapulmonary sites. Mycobacteria causing zoonotic infections and emerging nontuberculous mycobacterial pathogens follow divergent routes of infection that probably require adapted adhesion mechanisms. New evidence also points to the occurrence of mycobacterial biofilms during infection, emphasizing a need to better understand the adhesive factors required for their formation. Herein, we review the literature on tuberculous and nontuberculous mycobacterial adhesion to living and non-living surfaces, to themselves, to host cells, and to components of the extracellular matrix.
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Lam JTW, Lam SC, Kwok TYT, Yuen HKL. Atypical mycobacterium infection following upper eyelid Müller's muscle-conjunctival resection - case report. Orbit 2022:1-4. [PMID: 35073223 DOI: 10.1080/01676830.2022.2025856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Periorbital non-tuberculous mycobacterium (NTM) infections are uncommon. To the best of our knowledge, NTM infection as a complication following Müller's muscle-conjunctival resection (MMCR) surgery has not been reported before. We report a case of left upper lid M. Chelonae infection following MMCR surgery. A 61-year-old lady presented with left upper lid swelling and nodular mass 4 weeks after bilateral MMCR surgery for aponeurotic ptosis. Past medical and ocular history include systemic lupus erythematosus (SLE), chronic hepatitis B infection, bilateral cataract operation done 14 years ago and right eye Fuch's dystrophy with Descemet stripping automated endothelial keratoplasty done 3 years ago. She was initially treated with topical and oral antibiotics, as well as repeated incision and curettage and intralesional steroid injection with limited improvement. Seven months post-MMCR, repeated biopsy and nodule debulking were performed. Biopsy revealed granulomatous inflammation with mycobacterial infection and PCR identified M. Chelonae. A total of 6 months course of combination systemic antibiotics were given, with good response. Limited blepharoplasty with repeat nodular excision was performed 15 months after the initial MMCR surgery, and biopsy culture and PCR were both negative. No relapse of symptoms was noted and good lid height was maintained at 30 months of follow-up. Management of periorbital NTM infections can be challenging. Clinicians should consider early diagnostic workup with mycobacterial culture and PCR in suspicious cases, followed by prompt initiation of empiric treatment with systemic macrolides. A combination of surgical excision of nodules and prolonged systemic antimicrobial treatment is needed for complete organism eradication.
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Affiliation(s)
- Julia T W Lam
- Department of Ophthalmology, Hong Kong Eye Hospital, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Stacey C Lam
- Department of Ophthalmology, Hong Kong Eye Hospital, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Tracy Y T Kwok
- Department of Ophthalmology, Hong Kong Eye Hospital, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Hunter K L Yuen
- Department of Ophthalmology, Hong Kong Eye Hospital, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
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Sharma A, Vashistt J, Shrivastava R. Response surface modeling integrated microtiter plate assay for Mycobacterium fortuitum biofilm quantification. BIOFOULING 2021; 37:830-843. [PMID: 34503352 DOI: 10.1080/08927014.2021.1974846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 06/13/2023]
Abstract
In this study, the effects of agitation, temperature, and pH on biofilm formation by Mycobacterium fortuitum were studied and quantified through response surface modeling. The microtiter plate assay was optimized to achieve conditions favoring maximum mycobacterial biofilm quantification. Optical density (OD) measurement using a crystal violet assay was performed to estimate the amount of biofilm formed. Response surface methodology (RSM) results revealed an R2 value of 96.18%, exhibiting a maximum OD of 2.119 (λ570 nm) at a temperature of 37 °C and pH 7.0, under a static environment. The conditions were experimentally validated. Statistically significant results showed that the maximum biofilm was produced 96 h after mycobacterial inoculation. Thus, the results provide a basis for using RSM as an efficient optimization method for M. fortuitum biofilm assays. This approach can also be incorporated into strategies for screening anti-biofilm compounds, synthetic chemicals, drugs, or inhibitors against pathogenic mycobacteria.
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Affiliation(s)
- Ayushi Sharma
- Department of Biotechnology & Bioinformatics, Jaypee University of Information Technology, Waknaghat, Solan (H.P.), India
| | - Jitendraa Vashistt
- Department of Biotechnology & Bioinformatics, Jaypee University of Information Technology, Waknaghat, Solan (H.P.), India
| | - Rahul Shrivastava
- Department of Biotechnology & Bioinformatics, Jaypee University of Information Technology, Waknaghat, Solan (H.P.), India
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Abstract
Mycobacterium avium subsp. hominissuis (MAH) is one of the most common nontuberculous mycobacterial pathogens responsible for chronic lung disease in humans. It is widely distributed in biofilms in natural and living environments. It is considered to be transmitted from the environment. Despite its importance in public health, the ultrastructure of the MAH biofilm remains largely unknown. The ultrastructure of a MAH-containing multispecies biofilm that formed naturally in a bathtub inlet was herein reported along with those of monoculture biofilms developed from microcolonies and pellicles formed in the laboratory. Scanning electron microscopy revealed an essentially multilayered bathtub biofilm that was packed with cocci and short and long rods connected by an extracellular matrix (ECM). Scattered mycobacterium-like rod-shaped cells were observed around biofilm chunks. The MAH monoculture biofilms that developed from microcolonies in vitro exhibited an assembly of flat layers covered with thin film-like ECM membranes. Numerous small bacterial cells (0.76±0.19 μm in length) were observed, but not embedded in ECM. A glycopeptidolipid-deficient strain did not develop the layered ECM membrane architecture, suggesting its essential role in the development of biofilms. The pellicle biofilm also consisted of flat layered cells covered with an ECM membrane and small cells. MAH alone generated a flat layered biofilm covered with an ECM membrane. This unique structure may be suitable for resistance to water flow and disinfectants and the exclusion of fast-growing competitors, and small cells in biofilms may contribute to the formation and transmission of bioaerosols.
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Affiliation(s)
- Yukiko Nishiuchi
- Toneyama Institute for Tuberculosis Research, Osaka City University Graduate School of Medicine
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Tan J, Karwe MV. Inactivation and removal of Enterobacter aerogenes biofilm in a model piping system using plasma-activated water (PAW). INNOV FOOD SCI EMERG 2021. [DOI: 10.1016/j.ifset.2021.102664] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sharma D, Misba L, Khan AU. Antibiotics versus biofilm: an emerging battleground in microbial communities. Antimicrob Resist Infect Control 2019; 8:76. [PMID: 31131107 PMCID: PMC6524306 DOI: 10.1186/s13756-019-0533-3] [Citation(s) in RCA: 698] [Impact Index Per Article: 139.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 04/30/2019] [Indexed: 12/25/2022] Open
Abstract
Biofilm is a complex structure of microbiome having different bacterial colonies or single type of cells in a group; adhere to the surface. These cells are embedded in extracellular polymeric substances, a matrix which is generally composed of eDNA, proteins and polysaccharides, showed high resistance to antibiotics. It is one of the major causes of infection persistence especially in nosocomial settings through indwelling devices. Quorum sensing plays an important role in regulating the biofilm formation. There are many approaches being used to control infections by suppressing its formation but CRISPR-CAS (gene editing technique) and photo dynamic therapy (PDT) are proposed to be used as therapeutic approaches to subside bacterial biofim infections, especially caused by deadly drug resistant bad bugs.
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Affiliation(s)
- Divakar Sharma
- Medical Microbiology and Molecular Biology Laboratory, Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh, 202002 India
| | - Lama Misba
- Medical Microbiology and Molecular Biology Laboratory, Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh, 202002 India
| | - Asad U. Khan
- Medical Microbiology and Molecular Biology Laboratory, Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh, 202002 India
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Operation Department: Infection Control. PREVENTION AND CONTROL OF INFECTIONS IN HOSPITALS 2019. [PMCID: PMC7122724 DOI: 10.1007/978-3-319-99921-0_35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Infection control in the operation department is the result of many single factors and routines, based on experience, documentation and expert panels through more than a hundred years. Many factors and routines in surgery are evidence-based, but most of them are still lacking evidence and can probably never be investigated because of ethical problems. Consequently, consensus and guidance are used to a great extent. Surgery opens into sterile tissues for hours, where there is massive tissue damage by knife, diathermy, clogging of vessels, pressure against and drying of tissues, decreased blood supply, impaired phagocytosis and impaired infection defence. Microbes deposited in this devitalized tissues may find a good basis for growth and proliferation if there is lack of infection control and sterility. For patients with ongoing infections and who need surgery, special routines are made to prevent the spread of infections in the operation department. This chapter is a practical description of many important preventive procedures that may protect the surgical patient against surgical site infection (SSI).
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9
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Abstract
The genus Mycobacterium includes human pathogens (Mycobacterium tuberculosis and Mycobacterium leprae) and environmental organisms known as non-tuberculous mycobacteria (NTM) that, when associated with biomaterials and chronic disease, can cause human infections. A common pathogenic factor of mycobacteria is the formation of biofilms. Various molecules are involved in this process, including glycopeptidolipids, shorter-chain mycolic acids, and GroEL1 chaperone. Nutrients, ions, and carbon sources influence bacterial behavior and have a regulatory role in biofilm formation. The ultrastructure of mycobacterial biofilms can be studied by confocal laser scanning microscopy, a technique that reveals different phenotypic characteristics. Cording is associated with NTM pathogenicity, and is also considered an important property of M. tuberculosis strains. Mycobacterial biofilms are more resistant to environmental aggressions and disinfectants than the planktonic form. Biofilm-forming mycobacteria have been reported in many environmental studies, especially in water systems. NTM cause respiratory disease in patients with underlying diseases, such as old tuberculosis scars, bronchiectasis, and cystic fibrosis. Pathogens can be either slowly growing mycobacteria, such as Mycobacterium avium complex, or rapidly growing species, such as Mycobacterium abscessus. Another important biofilm-related group of infections are those associated with biomaterials, and in this setting the most frequently isolated organisms are rapidly growing mycobacteria. M. tuberculosis can develop a biofilm which plays a role in the process of casseous necrosis and cavity formation in lung tissue. M. tuberculosis also develops biofilms on clinical biomaterials. Biofilm development is an important factor for antimicrobial resistance, as it affords protection against antibiotics that are normally active against the same bacteria in the planktonic state. This antibiotic resistance of biofilm-forming microorganisms may result in treatment failure, and biofilms have to be physically eradicated to resolve the infection. New strategies with potential antibiofilm molecules that improve treatment efficacy have been developed. A novel antibiofilm approach focuses on Methylobacterium sp. An understanding of biofilm is essential for the appropriate management of patients with many NTM diseases, while the recent discovery of M. tuberculosis biofilms opens a new research field.
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Affiliation(s)
- Jaime Esteban
- Department of Clinical Microbiology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, Madrid, Spain
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Witherel CE, Gurevich D, Collin JD, Martin P, Spiller KL. Host–Biomaterial Interactions in Zebrafish. ACS Biomater Sci Eng 2017; 4:1233-1240. [DOI: 10.1021/acsbiomaterials.6b00760] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Claire E. Witherel
- School of Biomedical Engineering, Science, and Health Systems, Drexel University, 3141 Chestnut Street, Philadelphia, Pennsylvania 19104 United States
| | | | - John D. Collin
- Bristol Royal Infirmary, University Hospitals Bristol NHS Trust, Upper Maudlin Street, Bristol BS2 8HW, United Kingdom
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Morris MR, Bergum C, Jackson N, Markel DC. Decreased Bacterial Adherence, Biofilm Formation, and Tissue Reactivity of Barbed Monofilament Suture in an In Vivo Contaminated Wound Model. J Arthroplasty 2017; 32:1272-1279. [PMID: 28065625 DOI: 10.1016/j.arth.2016.11.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 10/26/2016] [Accepted: 11/05/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Monofilament and barbed monofilament sutures have been shown in in vitro models to have less bacterial adherence than braided suture. This study evaluates bacterial adherence to suture materials and tissue reactivity with an in vivo contaminated wound mouse model. METHODS Staphylococcus aureus was used to create an in vivo contaminated wound model at 2 amounts (106 colony-forming units [CFU] and 108 CFU) using a mouse air pouch. Three types of commonly used absorbable suture were evaluated: braided, monofilament, and barbed monofilament. Bacterial suture adherence was evaluated with suture culture, a photon-capturing camera system, and scanning electron microscopy. Tissue reactivity was assessed through histology and protein expression. RESULTS The braided suture group with the high amount of S aureus exhibited frank purulence and air pouch hypertrophy in all 8 mice. A significant difference was found between suture groups inoculated with 108 CFU (P < .05) as measured by bacterial culture concentration using the optical density method. The braided suture hosted more bacteria than either monofilament (P < .005) or barbed monofilament suture (P < .005). No difference was appreciated between the monofilament and barbed monofilament groups. Kruskal-Wallis test demonstrated a significant difference between groups in regard to levels of tumor necrosis factor-α (P < .05) and interleukin-1 (P < .05). CONCLUSION Our in vivo contaminated wound model demonstrated that barbed monofilament suture performed similarly to monofilament suture and better than braided suture in terms of bacterial adherence, biofilm formation, and tissue reactivity.
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Affiliation(s)
- Michael R Morris
- Detroit Medical Center/Providence Hospital Orthopaedic Surgery Residency Program, Detroit, Michigan
| | - Christopher Bergum
- Department of Orthopaedic Surgery, Providence Hospital, Southfield, Michigan
| | - Nancy Jackson
- Department of Orthopaedic Surgery, Providence Hospital, Southfield, Michigan
| | - David C Markel
- Department of Orthopaedic Surgery, Providence Hospital, Southfield, Michigan
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Pérez-Tanoira R, Lévano-Linares C, Celdrán-Uriarte Á, Isea-Peña MC, De Molina MS, García-Vasquez C, Esteban-Moreno J. Use of an experimental model to evaluate infection resistance of meshes in abdominal wall surgery. J Surg Res 2016; 206:435-441. [PMID: 27884340 DOI: 10.1016/j.jss.2016.08.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 08/05/2016] [Accepted: 08/11/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Staphylococcal species are the most common organisms causing prosthetic mesh infections, however, infections due to rapidly growing mycobacteria are increasing. This study evaluates the resistance of biomaterial for abdominal wall prostheses against the development of postoperative infection in a rat model. MATERIAL AND METHODS In 75 rats, we intramuscularly implanted three different types of prostheses: (1) low-density polypropylene monofilament mesh (PMM), (2) high-density PMM, and (3) a composite prosthesis composed of low-density PMM and a nonporous hydrophilic film. Meshes were inoculated with a suspension containing 108 colony-forming units of Staphylococcus aureus, Staphylococcus epidermidis, Mycobacterium fortuitum, or Mycobacterium abscessus before wound closure. Animals were sacrificed on the eighth day postoperatively for clinical evaluation, and the implants were removed for bacteriologic analyses. RESULTS Prostheses infected with S aureus showed a higher bacterial viability, worse integration, and clinical outcome compared with infection by other bacteria. Composite prostheses showed a higher number of viable colonies of both M fortuitum and Staphylococcus spp., with poorer integration in host tissue. However, when the composite prosthesis was infected with M abscessus, a lower number of viable bacteria were isolated and a better integration was observed compared with infection by other bacteria. CONCLUSIONS Considering M abscessus, a smaller collagen-free contact surface shows better resistance to infection, however, depending on the type of bacteria, prostheses with a large surface, and covered with collagen shows reduced resistance to infection, worse integration, and worse clinical outcome.
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Affiliation(s)
- Ramón Pérez-Tanoira
- Department of Microbiology, IIS-Fundación Jiménez Díaz, Madrid, Spain; Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - C Lévano-Linares
- Department of General Surgery, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | - Á Celdrán-Uriarte
- Department of General Surgery, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | - M C Isea-Peña
- Department of Microbiology, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | | | - C García-Vasquez
- Department of General Surgery, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | - J Esteban-Moreno
- Department of Microbiology, IIS-Fundación Jiménez Díaz, Madrid, Spain
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Pérez-Tanoira R, Isea-Peña MC, Celdrán A, García-Vasquez C, Esteban J. Bacterial adherence to different meshes used in abdominal surgery. Surg Infect (Larchmt) 2013; 15:90-3. [PMID: 24283764 DOI: 10.1089/sur.2013.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND We studied the influence of morphology and type of material of abdominal wall prostheses in the avoidance of bacterial adhesion in acute and chronic mesh infections. METHODS Three different types of prostheses were compared: 1) High-density polypropylene monofilament mesh (PMM); 2) low-density PMM; and 3) prostheses composed of low-density polypropylene and a non-porous hydrophilic film (composite prostheses). Microbial adhesion tests were performed using reference strains of Staphylococcus aureus 15981, Staphylococcus epidermidis ATCC 35984, Mycobacterium abscessus DSM 44196, and Mycobacterium fortuitum ATCC 13756 using a protocol described previously. RESULTS Both Staphylococcus spp. and M. fortuitum strains showed lower adherence to PMM. Mycobacterium abscessus also exhibited lower adherence to composite prostheses. Both Mycobacterium spp. strains had lower adherence than Staphylococcus spp. strains for all materials except for low-density PMM. Mycobacterium fortuitum showed higher adherence to composite prostheses than M. abscessus, whereas the latter species had higher adherence to high-density PMM than M. fortuitum. CONCLUSION Depending on the type of bacteria, collagen-coated hydrophilic prostheses with a large surface increased bacterial adherence significantly. These differences should be taken into consideration when choosing a mesh graft, which limits infection in abdominal wall reconstruction.
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Fowler JR, Perkins TA, Buttaro BA, Truant AL. Bacteria adhere less to barbed monofilament than braided sutures in a contaminated wound model. Clin Orthop Relat Res 2013; 471:665-71. [PMID: 23001503 PMCID: PMC3549181 DOI: 10.1007/s11999-012-2593-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 08/28/2012] [Indexed: 01/31/2023]
Abstract
BACKGROUND Previous studies have found fewer clinical infections in wounds closed with monofilament suture compared with braided suture. Recently, barbed monofilament sutures have shown improved strength and increased timesavings over interrupted braided sutures. However, the adherence of bacteria to barbed monofilament sutures and other commonly used suture materials is unclear. QUESTIONS/PURPOSES We therefore determined: (1) the adherence of bacteria to five suture types including a barbed monofilament suture; (2) the ability to culture bacteria after gentle washing of each suture type; and (3) the pattern of bacterial adherence. METHODS We created an experimental contaminated wound model using planktonic methicillin-resistant Staphylococcus aureus (MRSA). Five types of commonly used suture material were used: Vicryl™, Vicryl™ Plus, PDS™, PDS™ Plus, and Quill™. To determine adherence, we determined the number of bacteria removed from the suture by sequential washes. Sutures were plated to determine bacterial growth. Sutures were examined under confocal microscopy to determine adherence patterns. RESULTS The barbed monofilament suture showed the least bacterial adherence of any suture material tested. Inoculated monofilament and barbed monofilament sutures placed on agar plates had less bacterial growth than braided suture, whereas antibacterial monofilament and braided sutures showed no growth. Confocal microscopy showed more adherence to braided suture than to the barbed monofilament or monofilament sutures. CONCLUSIONS Barbed monofilament suture showed similar bacterial adherence properties to standard monofilament suture. CLINICAL RELEVANCE Our findings suggest barbed monofilament suture can be substituted for monofilament suture, at the surgeon's discretion, without fear of increased risk of infection.
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Affiliation(s)
- John R. Fowler
- />Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Kaufmann Medical Building, Suite 1010, 3471 Fifth Avenue, Pittsburgh, PA 15213 USA
| | | | - Bettina A. Buttaro
- />Department of Microbiology and Immunology, Temple University School of Medicine, Philadelphia, PA USA
| | - Allan L. Truant
- />Department of Pathology and Laboratory Medicine, Microbiology and Immunology, and Internal Medicine, Temple University Hospital and School of Medicine, Philadelphia, PA USA
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Esteban J, Molina-Manso D, Gómez-Barrena E. Bacterial adherence to vitamin E UHMWPE. Considerations about in vitro studies. J Orthop Res 2012; 30:1181: author reply 1181-2. [PMID: 22170101 DOI: 10.1002/jor.22024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2011] [Accepted: 11/04/2011] [Indexed: 02/04/2023]
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Ortíz-Pérez A, Martín-de-Hijas N, Alonso-Rodríguez N, Molina-Manso D, Fernández-Roblas R, Esteban J. Importance of antibiotic penetration in the antimicrobial resistance of biofilm formed by non-pigmented rapidly growing mycobacteria against amikacin, ciprofloxacin and clarithromycin. Enferm Infecc Microbiol Clin 2011; 29:79-84. [DOI: 10.1016/j.eimc.2010.08.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2010] [Revised: 08/24/2010] [Accepted: 08/27/2010] [Indexed: 10/18/2022]
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Kinnari T, Esteban J, Zamora N, Fernandez R, López-Santos C, Yubero F, Mariscal D, Puertolas J, Gomez-Barrena E. Effect of surface roughness and sterilization on bacterial adherence to ultra-high molecular weight polyethylene. Clin Microbiol Infect 2010; 16:1036-41. [DOI: 10.1111/j.1469-0691.2009.02995.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kinnari TJ, Esteban J, Martin-de-Hijas NZ, Sánchez-Muñoz O, Sánchez-Salcedo S, Colilla M, Vallet-Regí M, Gomez-Barrena E. Influence of surface porosity and pH on bacterial adherence to hydroxyapatite and biphasic calcium phosphate bioceramics. J Med Microbiol 2009; 58:132-137. [PMID: 19074665 DOI: 10.1099/jmm.0.002758-0] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Hydroxyapatite (HA) and biphasic calcium phosphate (BCP) ceramic materials are widely employed as bone substitutes due to their porous and osteoconductive structure. Their porosity and the lowering of surrounding pH as a result of surgical trauma may, however, predispose these materials to bacterial infections. For this reason, the influence of porosity and pH on the adherence of common Gram-positive bacteria to the surfaces of these materials requires investigation. Mercury intrusion porosimetry measurements revealed that the pore size distribution of both bioceramics had, on a logarithmic scale, a sinusoidal frequency distribution ranging from 50 to 300 nm, with a mean pore diameter of 200 nm. Moreover, total porosity was 20 % for HA and 50 % for BCP. Adherence of Staphylococcus aureus and Staphylococcus epidermidis was studied at a physiological pH of 7.4 and at a pH simulating bone infection of 6.8. Moreover, the effect of pH on the zeta potential of HA, BCP and of both staphylococci was evaluated. Results showed that when pH decreased from 7.4 to 6.8, the adherence of both staphylococci to HA and BCP surfaces decreased significantly, although at the same time the negative zeta-potential values of the ceramic surfaces and both bacteria diminished. At both pH values, the number of S. aureus adhered to the HA surface appeared to be lower than that for BCP. A decrease in pH to 6.8 reduced the adherence of both bacterial species (mean 57 %). This study provides evidence that HA and BCP ceramics do not have pores sufficiently large to allow the internalization of staphylococci. Their anti-adherent properties seemed to improve when pH value decreased, suggesting that HA and BCP bioceramics are not compromised upon orthopaedic use.
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Affiliation(s)
- Teemu J Kinnari
- Department of Otolaryngology, Helsinki University Central Hospital, PO Box 220, FI-00029 HUS, Finland.,Department of Orthopaedic Surgery and Traumatology, Fundación Jiménez Díaz-UTE, Avda de Reyes Católicos 2, E-28040 Madrid, Spain.,Department of Clinical Microbiology, Fundación Jiménez Díaz-UTE, Avda de Reyes Católicos 2, E-28040 Madrid, Spain
| | - Jaime Esteban
- Department of Clinical Microbiology, Fundación Jiménez Díaz-UTE, Avda de Reyes Católicos 2, E-28040 Madrid, Spain
| | - Nieves Z Martin-de-Hijas
- Department of Clinical Microbiology, Fundación Jiménez Díaz-UTE, Avda de Reyes Católicos 2, E-28040 Madrid, Spain
| | - Orlando Sánchez-Muñoz
- Instituto de Ciencias de los Materiales, Universidad de Valencia, PO Box 22085, E-46071 Valencia, Spain.,Department of Medicine, Helsinki University Central Hospital, PO Box 700, FI-00029 HUS, Finland
| | - Sandra Sánchez-Salcedo
- Department of Inorganic and Bioinorganic Chemistry, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, E-28040 Madrid, Spain
| | - Montserrat Colilla
- Department of Inorganic and Bioinorganic Chemistry, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, E-28040 Madrid, Spain
| | - María Vallet-Regí
- Department of Inorganic and Bioinorganic Chemistry, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, E-28040 Madrid, Spain
| | - Enrique Gomez-Barrena
- Department of Orthopaedic Surgery and Traumatology, Fundación Jiménez Díaz-UTE, Avda de Reyes Católicos 2, E-28040 Madrid, Spain
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Esteban J, Martín-de-Hijas NZ, Kinnari TJ, Ayala G, Fernández-Roblas R, Gadea I. Biofilm development by potentially pathogenic non-pigmented rapidly growing mycobacteria. BMC Microbiol 2008; 8:184. [PMID: 18928544 PMCID: PMC2588597 DOI: 10.1186/1471-2180-8-184] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2008] [Accepted: 10/17/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A study to evaluate the biofilm-development ability in three different media (Middlebrook 7H9, sterile tap water and PBS-5% glucose) was performed with 19 collection strains from 15 different species on non-pigmented rapidly growing mycobacteria (NPRGM). A microtiter plate assay was developed to evaluate the percentage of covered surface of the microtiter plate wells in different days from day 1 to day 69. RESULTS All strains were able to develop biofilm in all the tested media. Middlebrook 7H9 showed the fastest growth, followed by sterile tap water and PBS-5% glucose. A sigmoid growth curve was detected in all the strains both in Middlebrook 7H9 and in sterile tap water. A difference could be detected for Mycobacterium abscessus in tap water, where it showed faster growth than all the other strains. CONCLUSION Biofilm development seems to be a property of all the species of NPRGM and it depends on the nutrients present in the medium. The microtiter plate assay described here is a useful tool to evaluate differences in biofilm development among the different species of rapidly growing mycobacteria.
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Affiliation(s)
- Jaime Esteban
- Department of Clinical Microbiology, Fundación Jiménez Díaz-UTE, Madrid, Spain.
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Surface spreading motility shown by a group of phylogenetically related, rapidly growing pigmented mycobacteria suggests that motility is a common property of mycobacterial species but is restricted to smooth colonies. J Bacteriol 2008; 190:6894-902. [PMID: 18689490 DOI: 10.1128/jb.00572-08] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Motility in mycobacteria was described for the first time in 1999. It was reported that Mycobacterium smegmatis and Mycobacterium avium could spread on the surface of solid growth medium by a sliding mechanism and that the presence of cell wall glycopeptidolipids was essential for motility. We recently reported that Mycobacterium vaccae can also spread on growth medium surfaces; however, only smooth colonies presented this property. Smooth colonies of M. vaccae do not produce glycopeptidolipids but contain a saturated polyester that is absent in rough colonies. Here, we demonstrate that Mycobacterium chubuense, Mycobacterium gilvum, Mycobacterium obuense, and Mycobacterium parafortuitum, which are phylogenetically related to M. vaccae, are also motile. Such motility is restricted to smooth colonies, since natural rough mutants are nonmotile. Thin-layer chromatography analysis of the content of cell wall lipids confirmed the absence of glycopeptidolipids. However, compounds like the above-mentioned M. vaccae polyester were detected in all the strains but only in smooth colonies. Scanning electron microscopy showed great differences in the arrangement of the cells between smooth and rough colonies. The data obtained suggest that motility is a common property of environmental mycobacteria, and this capacity correlates with the smooth colonial morphotype. The species studied in this work do not contain glycopeptidolipids, so cell wall compounds or extracellular materials other than glycopeptidolipids are implicated in mycobacterial motility. Furthermore, both smooth motile and rough nonmotile variants formed biofilms on glass and polystyrene surfaces.
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Kinnari TJ, Esteban J, Gomez-Barrena E, Zamora N, Fernandez-Roblas R, Nieto A, Doadrio JC, López-Noriega A, Ruiz-Hernández E, Arcos D, Vallet-Regí M. Bacterial adherence to SiO2-based multifunctional bioceramics. J Biomed Mater Res A 2008; 89:215-23. [PMID: 18431760 DOI: 10.1002/jbm.a.31943] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The bacterial adherence onto different multifunctional silica-based bioceramics has been evaluated. Staphylococcus aureus and Staphylococcus epidermidis were chosen, as they cause the majority of the implant-related infections in this field. Two SiO2 mesoporous materials (MCM-41, SBA-15), an ordered SiO2-CaO-P2O5 mesoporous glass (OMG), and a biphasic magnetic bioceramic (BMB), were incubated with S. aureus and S. epidermidis for 90 min, and subsequently sonicated to quantify the number of adhered bacteria on each material. It was found that S. aureus and S. epidermidis (10(8) CFU/mL) adhered significantly less to BMB samples when compared to MCM-41, SBA-15, or OMG. However, when the material pores accessible for bacteria in each material were taken into account, the lowest bacterial adherence was found in MCM-41, and the highest in SBA-15. The results show that bacterial adherence is higher on mesoporous bioceramics, although this higher microbial attachment is mainly due to the intergranular porosity and grain size morphology rather than to the mesoporous structure.
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Affiliation(s)
- Teemu J Kinnari
- Department of Clinical Microbiology, Fundación Jiménez Díaz-UTE, Avda. de Reyes Católicos 2, ES-28040 Madrid, Spain
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