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Guo J, Cao G, Wang X, Tang W, Diwu W, Yan M, Yang M, Bi L, Han Y. Coating CoCrMo Alloy with Graphene Oxide and ε-Poly-L-Lysine Enhances Its Antibacterial and Antibiofilm Properties. Int J Nanomedicine 2021; 16:7249-7268. [PMID: 34737563 PMCID: PMC8560011 DOI: 10.2147/ijn.s321800] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 10/04/2021] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION With increases in implant infections, the search for antibacterial and biofilm coatings has become a new interest for orthopaedists and dentists. In recent years, graphene oxide (GO) has been extensively studied for its superior antibacterial properties. However, most of these studies have focused on solutions and there are few antibacterial studies on metal surfaces, especially the surfaces of cobalt-chromium-molybdenum (CoCrMo) alloys. ε-Poly-L-lysine (ε-PLL), as a novel food preservative, has a spectrum of antimicrobial activity; however, its antimicrobial activity after coating an implant surface is not clear. METHODS In this study, for the first time, a two-step electrodeposition method was used to coat GO and ε-PLL on the surface of a CoCrMo alloy. Its antibacterial and antibiofilm properties against S. aureus and E. coli were then studied. RESULTS The results show that the formation of bacteria and biofilms on the coating surface was significantly inhibited, GO and ε-PLL composite coatings had the best antibacterial and antibiofilm effects, followed by ε-PLL and GO coatings. In terms of classification, the coatings are anti-adhesive and contact-killing/inhibitory surfaces. In addition to oxidative stress, physical damage to GO and electrostatic osmosis of ε-PLL are the main antibacterial and antibiofilm mechanisms. DISCUSSION This is the first study that GO and ε-PLL coatings were successfully prepared on the surface of CoCrMo alloy by electrodeposition. It provides a promising new approach to the problem of implant infection in orthopedics and stomatology.
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Affiliation(s)
- Jianbin Guo
- Department of Orthopedics, The First Affiliated Hospital of Air Force Military Medical University, Xi’an, People’s Republic of China
- Department of Joint Surgery, Hong-Hui Hospital, Xi’an Jiaotong University College of Medicine, Xi’an, People’s Republic of China
| | - Guihua Cao
- Department of Geriatrics, The First Affiliated Hospital of Air Force Military Medical University, Xi’an, People’s Republic of China
| | - Xing Wang
- Department of Orthopedics, The First Affiliated Hospital of Air Force Military Medical University, Xi’an, People’s Republic of China
| | - Wenhao Tang
- Department of Orthopedics, The First Affiliated Hospital of Air Force Military Medical University, Xi’an, People’s Republic of China
| | - Weilong Diwu
- Department of Orthopedics, The First Affiliated Hospital of Air Force Military Medical University, Xi’an, People’s Republic of China
| | - Ming Yan
- Department of Orthopedics, The First Affiliated Hospital of Air Force Military Medical University, Xi’an, People’s Republic of China
| | - Min Yang
- Department of Orthopedics, The First Affiliated Hospital of Air Force Military Medical University, Xi’an, People’s Republic of China
| | - Long Bi
- Department of Orthopedics, The First Affiliated Hospital of Air Force Military Medical University, Xi’an, People’s Republic of China
| | - Yisheng Han
- Department of Orthopedics, The First Affiliated Hospital of Air Force Military Medical University, Xi’an, People’s Republic of China
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Antibacterial and antibiofilm properties of graphene and its derivatives. Colloids Surf B Biointerfaces 2021; 200:111588. [PMID: 33529928 DOI: 10.1016/j.colsurfb.2021.111588] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 01/17/2021] [Accepted: 01/20/2021] [Indexed: 12/22/2022]
Abstract
Infections resulting from bacteria and biofilms have become a huge problem threatening human health. In recent years, the antibacterial and antibiofilm effects of graphene and its derivatives have been extensively studied. However, there continues to be some controversy over whether graphene and its derivatives can resist infection and biofilms. Moreover, the antibacterial mechanism and cytotoxicity of graphene and its derivatives are unclear. In the present review, antibacterial and antibiofilm abilities of graphene and its derivatives in solution, on the surface are reviewed, and their toxicity and possible mechanisms are also reviewed. Furthermore, we propose possible future development directions for graphene and its derivatives in antibacterial and antibiofilm applications.
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Baman JR, Medhekar AN, Jain SK, Knight BP, Harrison LH, Smith B, Saba S. Management of systemic fungal infections in the presence of a cardiac implantable electronic device: A systematic review. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2020; 44:159-166. [PMID: 33052591 DOI: 10.1111/pace.14090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/26/2020] [Accepted: 10/11/2020] [Indexed: 12/16/2022]
Abstract
Evidence to inform the management of systemic fungal infections in the setting of a cardiac implantable electronic devices (CIED), such as a permanent pacemaker or implantable cardioverter-defibrillator, is scant and limited to case reports and series. The available literature suggests high morbidity and mortality. To better characterize the shared experience of these cases and their outcomes, we performed a systematic review. We investigated all published reports of systemic fungal infections-fungemia and fungal vegetative disease-in the context of CIED, drawing from PubMed, EMBASE, and the Cochrane database of systematic reviews, inclusive of patients who received treatment between January 2000 and May 2020. Exclusion criteria included presence of ventricular assist device and concurrent bacteremia, bacterial endocarditis, bacterial vegetative infection, or viremia. Among 6261 screened articles, 48 cases from 41 individual studies were identified. Candida and Aspergillus species were the most commonly isolated fungi. There was significant heterogeneity in antifungal medication selection and duration. CIED extraction-either transvenous or surgical-was associated with increased survival to hospital discharge (92%) and clinical recovery at latest follow-up (81%), compared to cases where CIED extraction was deferred (56% and 40%, respectively). Importantly, there were no prospective data, and the data were limited to individual case reports and one small case series. In summary, CIED extraction is associated with improved fungal clearance and patient survival. Reported antifungal regimens are heterogeneous and nonuniform. Prospective studies are needed to verify these results and define optimal antifungal regimens.
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Affiliation(s)
- Jayson R Baman
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Ankit N Medhekar
- Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Sandeep K Jain
- Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Bradley P Knight
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Lee H Harrison
- Infectious Diseases Epidemiology Research Unit, School of Medicine and Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Brandon Smith
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Samir Saba
- Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Candidemia in patients with cardiovascular implantable electronic devices. J Interv Card Electrophysiol 2020; 60:69-75. [PMID: 32048116 DOI: 10.1007/s10840-020-00706-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 02/02/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE Current guidelines recommend complete extraction of cardiovascular implantable electronic devices (CIEDs) in the case of persistent or recurrent fungemia without other identifiable sources, though supporting evidence is lacking. We sought to evaluate the prognosis of patients with candidemia and CIEDs. METHODS Twelve consecutive patients (54 ± 12 years, 8 male) with CIED and concurrent candidemia were reviewed. RESULTS At the time of diagnosis with candidemia, seven patients were immunocompromised, six were on long-term antibacterial therapy, two were intravenous drug users, four were on chronic hemodialysis, and six had a central venous catheter. Four patients were confirmed as definite CIED infection as vegetation was visible on lead by echocardiogram. The other 8 patients were considered possible CIED infection with candidemia of unknown focus. All patients with visible vegetation underwent CIED removal without complications, and other patients were initially managed non-operatively. After 1 year of follow-up, 7 patients had died and at extended follow-up, all patients without lead removal died while 3 of 4 patients with lead extraction survived. Of note, 50% of deaths in the patients without lead removal were associated with fungal sepsis. CONCLUSIONS Candida fungemia is associated with a high mortality. CIED removal should be an early consideration in these patients even if lead vegetations are not seen.
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Candida tropicalis defibrillator endocarditis: A case report and review of current literature. Med Mycol Case Rep 2019; 25:1-9. [PMID: 31245269 PMCID: PMC6582067 DOI: 10.1016/j.mmcr.2019.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 04/29/2019] [Accepted: 06/07/2019] [Indexed: 11/20/2022] Open
Abstract
We provide a review of current literature and report on a case of electronic device infective endocarditis with C. tropicalis. A 64-year-old man presented for revision of his implantable cardioverter defibrillator. Echocardiography revealed extensive vegetations attached to the Eustachian valve and in the right ventricular apex. Microbiological findings presented C. tropicalis on the explanted material. The patient refused additional surgical intervention. We successfully treated the patient with liposomal Amphotericin B and Flucytosine for 8 weeks.
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Agarwalla SV, Ellepola K, Costa MCFD, Fechine GJM, Morin JLP, Castro Neto AH, Seneviratne CJ, Rosa V. Hydrophobicity of graphene as a driving force for inhibiting biofilm formation of pathogenic bacteria and fungi. Dent Mater 2019; 35:403-413. [PMID: 30679015 DOI: 10.1016/j.dental.2018.09.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 09/18/2018] [Accepted: 09/26/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To evaluate the surface and wettability characteristics and the microbial biofilm interaction of graphene coating on titanium. METHODS Graphene was deposited on titanium (Control) via a liquid-free technique. The transfer was performed once (TiGS), repeated two (TiGD) and five times (TiGV) and characterized by AFM (n=10), Raman spectroscopy (n=10), contact angle and SFE (n=5). Biofilm formation (n=3) to Streptococcus mutans, Enterococcus faecalis, Pseudomonas aeruginosa and Candida albicans was evaluated after 24h by CV assay, CFU, XTT and confocal microscopy. Statistics were performed by one-way Anova, Tukey's tests and Pearson's correlation analysis at a pre-set significance level of 5 %. RESULTS Raman mappings revealed coverage yield of 82 % for TiGS and ≥99 % for TiGD and TiGV. Both TiGD and TiGV presented FWHM>44cm-1 and ID/IG ratio<0.12, indicating multiple graphene layers and occlusion of defects. The contact angle was significantly higher for TiGD and TiGV (110° and 117°) comparing to the Control (70°). The SFE was lower for TiGD (13.8mN/m) and TiGV (12.1mN/m) comparing to Control (38.3mN/m). TiGD was selected for biofilm assays and exhibited significant reduction in biofilm formation for all microorganisms compared to Control. There were statistical correlations between the high contact angle and low SFE of TiGD and decreased biofilm formation. SIGNIFICANCE TiGD presented high quality and coverage and decreased biofilm formation for all species. The increased hydrophobicity of graphene films was correlated with the decreased biofilm formation for various species.
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Affiliation(s)
| | - Kassapa Ellepola
- Faculty of Dentistry, National University of Singapore, Singapore
| | | | | | - Julien Luc Paul Morin
- Centre for Advanced 2D Materials and Graphene Research Centre, National University of Singapore, Singapore
| | - A H Castro Neto
- Centre for Advanced 2D Materials and Graphene Research Centre, National University of Singapore, Singapore
| | | | - Vinicius Rosa
- Faculty of Dentistry, National University of Singapore, Singapore; Centre for Advanced 2D Materials and Graphene Research Centre, National University of Singapore, Singapore.
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Carneiro H, Rasalingam R. Fungal prosthetic aortic valve endocarditis and endarteritis: An unusual cause of aortic root vegetations. Echocardiography 2018; 36:401-405. [PMID: 30592783 DOI: 10.1111/echo.14233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 11/23/2018] [Accepted: 11/27/2018] [Indexed: 11/28/2022] Open
Abstract
Fungal endocarditis is a relatively rare occurrence with high morbidity and mortality. Patients may have an indolent and non-specific course requiring a high index of suspicion to make a diagnosis. Here, we present the case of a 33-year-old patient who presented with fevers and acute lower limb ischemia requiring a 4-compartment fasciotomy caused by septic emboli from Candida albicans endocarditis. The patient had a large vegetation in the ascending aorta associated with a mycotic aneurysm, which is an exceedingly rare location for a vegetation. We also review the literature and summarize the typical echocardiographic appearance and vegetation locations in fungal endocarditis.
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Affiliation(s)
- Herman Carneiro
- Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.,Department of Cardiology, VA Boston Healthcare System, West Roxbury, Massachusetts
| | - Ravi Rasalingam
- Department of Cardiology, VA Boston Healthcare System, West Roxbury, Massachusetts
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Risk Factors and Outcomes of Endocarditis Due to Non-HACEK Gram-Negative Bacilli: Data from the Prospective Multicenter Italian Endocarditis Study Cohort. Antimicrob Agents Chemother 2018; 62:AAC.02208-17. [PMID: 29378721 DOI: 10.1128/aac.02208-17] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 01/04/2018] [Indexed: 11/20/2022] Open
Abstract
The objective of this study was to investigate predisposing factors and outcomes of infective endocarditis (IE) caused by non-HACEK Gram-negative bacilli (GNB) in a contemporary multicenter cohort. Patients with IE due to GNB, prospectively observed in 26 Italian centers from 2004 to 2011, were analyzed. Using a case-control design, each case was compared to three age- and sex-matched controls with IE due to other etiologies. Logistic regression was performed to identify risk factors for IE due to GNB. Factors associated with early and late mortality were assessed by Cox regression analysis. The study group comprised 58 patients with IE due to GNB. We found that Escherichia coli was the most common pathogen, followed by Pseudomonas aeruginosa and Klebsiella pneumoniae The genitourinary tract as a source of infection (odds ratio [OR], 13.59; 95% confidence interval [CI], 4.63 to 39.93; P < 0.001), immunosuppression (OR, 5.16; 95% CI, 1.60 to 16.24; P = 0.006), and the presence of a cardiac implantable electronic device (CIED) (OR, 3.57; 95% CI, 1.55 to 8.20; P = 0.003) were factors independently associated with IE due to GNB. In-hospital mortality was 13.8%, and mortality rose to 30.6% at 1 year. A multidrug-resistant (MDR) etiology was associated with in-hospital mortality (hazard ratio [HR], 21.849; 95% CI, 2.672 to 178.683; P = 0.004) and 1-year mortality (HR, 4.408; 95% CI, 1.581 to 12.287; P = 0.005). We conclude that the presence of a genitourinary focus, immunosuppressive therapy, and an indwelling CIED are factors associated with IE due to GNB. MDR etiology is the major determinant of in-hospital and long-term mortality.
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Jones BM, Wazni O, Rehm SJ, Shishehbor MH. Fighting fungus with a laser and a hose: Management of a giant Candida albicans
implantable cardioverter-defibrillator lead vegetation with simultaneous AngioVac aspiration and laser sheath lead extraction. Catheter Cardiovasc Interv 2017; 91:318-321. [DOI: 10.1002/ccd.27153] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 04/04/2017] [Accepted: 04/29/2017] [Indexed: 01/05/2023]
Affiliation(s)
| | - Oussama Wazni
- Heart and Vascular Institute, Cleveland Clinic; Cleveland Ohio
| | - Susan J. Rehm
- Department of Infectious Disease; Cleveland Clinic; Cleveland Ohio
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