1
|
Detection of Oxacillin/Cefoxitin Resistance in Staphylococcus aureus Present in Recurrent Tonsillitis. Microorganisms 2023; 11:microorganisms11030615. [PMID: 36985189 PMCID: PMC10055619 DOI: 10.3390/microorganisms11030615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/16/2023] [Accepted: 02/23/2023] [Indexed: 03/06/2023] Open
Abstract
Background: Recurrent tonsillitis is one of the most common diseases in childhood, caused many times by ß-lactam-resistant S. aureus. The objective of this study was to investigate an alternative method to identify resistance to oxacillin/cefoxitin in S. aureus from hospitalized children with recurrent tonsillitis. Methods: The samples of S. aureus came from patients with recurrent tonsillitis and were used in 16S rRNA sequencing and an antibiogram test for identification and verifying resistance, after which HSI methodology were applied for separation of S. aureus resistances. Results: The S. aureus isolated showed sensitivity to oxacillin/cefoxitin and the diagnostic images show a visual description of the resistance different groups formed, that may be related to sensitivity and resistance to oxacillin/cefoxitin, characterizing the MRSA S. aureus. Conclusions: Samples that showed phenotypic resistance to oxacillin/cefoxitin were clearly separated from samples that did not show this resistance. A PLS-DA model predicted the presence of resistance to oxacillin/cefoxitin in S. aureus samples and it was possible to observe the pixels classified as MRSA. The HSI was able to successfully discriminate samples in replicas that were sensitive and resistant, based on the calibration model it received.
Collapse
|
2
|
Biofilms in Chronic Wound Infections: Innovative Antimicrobial Approaches Using the In Vitro Lubbock Chronic Wound Biofilm Model. Int J Mol Sci 2023; 24:ijms24021004. [PMID: 36674518 PMCID: PMC9862456 DOI: 10.3390/ijms24021004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 01/06/2023] Open
Abstract
Chronic wounds have harmful effects on both patients and healthcare systems. Wound chronicity is attributed to an impaired healing process due to several host and local factors that affect healing pathways. The resulting ulcers contain a wide variety of microorganisms that are mostly resistant to antimicrobials and possess the ability to form mono/poly-microbial biofilms. The search for new, effective and safe compounds to handle chronic wounds has come a long way throughout the history of medicine, which has included several studies and trials of conventional treatments. Treatments focus on fighting the microbial colonization that develops in the wound by multidrug resistant pathogens. The development of molecular medicine, especially in antibacterial agents, needs an in vitro model similar to the in vivo chronic wound environment to evaluate the efficacy of antimicrobial agents. The Lubbock chronic wound biofilm (LCWB) model is an in vitro model developed to mimic the pathogen colonization and the biofilm formation of a real chronic wound, and it is suitable to screen the antibacterial activity of innovative compounds. In this review, we focused on the characteristics of chronic wound biofilms and the contribution of the LCWB model both to the study of wound poly-microbial biofilms and as a model for novel treatment strategies.
Collapse
|
3
|
Choudhary MI, Römling U, Nadeem F, Bilal HM, Zafar M, Jahan H, ur-Rahman A. Innovative Strategies to Overcome Antimicrobial Resistance and Tolerance. Microorganisms 2022; 11:microorganisms11010016. [PMID: 36677308 PMCID: PMC9863313 DOI: 10.3390/microorganisms11010016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Antimicrobial resistance and tolerance are natural phenomena that arose due to evolutionary adaptation of microorganisms against various xenobiotic agents. These adaptation mechanisms make the current treatment options challenging as it is increasingly difficult to treat a broad range of infections, associated biofilm formation, intracellular and host adapted microbes, as well as persister cells and microbes in protected niches. Therefore, novel strategies are needed to identify the most promising drug targets to overcome the existing hurdles in the treatment of infectious diseases. Furthermore, discovery of novel drug candidates is also much needed, as few novel antimicrobial drugs have been introduced in the last two decades. In this review, we focus on the strategies that may help in the development of innovative small molecules which can interfere with microbial resistance mechanisms. We also highlight the recent advances in optimization of growth media which mimic host conditions and genome scale molecular analyses of microbial response against antimicrobial agents. Furthermore, we discuss the identification of antibiofilm molecules and their mechanisms of action in the light of the distinct physiology and metabolism of biofilm cells. This review thus provides the most recent advances in host mimicking growth media for effective drug discovery and development of antimicrobial and antibiofilm agents.
Collapse
Affiliation(s)
- M. Iqbal Choudhary
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Pakistan
- H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Pakistan
| | - Ute Römling
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, 171 65 Stockholm, Sweden
- Correspondence: (U.R.); (H.J.); Tel.: +46-8-5248-7319 (U.R.); +92-21-111-232-292 (ext. 301) (H.J.)
| | - Faiza Nadeem
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Pakistan
| | - Hafiz Muhammad Bilal
- H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Pakistan
| | - Munirah Zafar
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Pakistan
| | - Humera Jahan
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Pakistan
- Correspondence: (U.R.); (H.J.); Tel.: +46-8-5248-7319 (U.R.); +92-21-111-232-292 (ext. 301) (H.J.)
| | - Atta ur-Rahman
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Pakistan
- H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Pakistan
| |
Collapse
|
4
|
Anju VT, Busi S, Imchen M, Kumavath R, Mohan MS, Salim SA, Subhaswaraj P, Dyavaiah M. Polymicrobial Infections and Biofilms: Clinical Significance and Eradication Strategies. Antibiotics (Basel) 2022; 11:antibiotics11121731. [PMID: 36551388 PMCID: PMC9774821 DOI: 10.3390/antibiotics11121731] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/21/2022] [Accepted: 11/24/2022] [Indexed: 12/03/2022] Open
Abstract
Biofilms are population of cells growing in a coordinated manner and exhibiting resistance towards hostile environments. The infections associated with biofilms are difficult to control owing to the chronicity of infections and the emergence of antibiotic resistance. Most microbial infections are contributed by polymicrobial or mixed species interactions, such as those observed in chronic wound infections, otitis media, dental caries, and cystic fibrosis. This review focuses on the polymicrobial interactions among bacterial-bacterial, bacterial-fungal, and fungal-fungal aggregations based on in vitro and in vivo models and different therapeutic interventions available for polymicrobial biofilms. Deciphering the mechanisms of polymicrobial interactions and microbial diversity in chronic infections is very helpful in anti-microbial research. Together, we have discussed the role of metagenomic approaches in studying polymicrobial biofilms. The outstanding progress made in polymicrobial research, especially the model systems and application of metagenomics for detecting, preventing, and controlling infections, are reviewed.
Collapse
Affiliation(s)
- V T Anju
- Department of Biochemistry and Molecular Biology, School of Life Sciences, Pondicherry University, Puducherry 605014, India
| | - Siddhardha Busi
- Department of Microbiology, School of Life Sciences, Pondicherry University, Puducherry 605014, India
- Correspondence:
| | - Madangchanok Imchen
- Department of Microbiology, School of Life Sciences, Pondicherry University, Puducherry 605014, India
| | - Ranjith Kumavath
- Department of Genomic Science, School of Biological Sciences, Central University of Kerala, Kerala 671316, India
- Department of Biotechnology, School of Life Sciences, Pondicherry University, Puducherry 605014, India
| | - Mahima S. Mohan
- Department of Microbiology, School of Life Sciences, Pondicherry University, Puducherry 605014, India
| | - Simi Asma Salim
- Department of Microbiology, School of Life Sciences, Pondicherry University, Puducherry 605014, India
| | - Pattnaik Subhaswaraj
- Department of Biotechnology and Bioinformatics, Sambalpur University, Burla, Sambalpur 768019, India
| | - Madhu Dyavaiah
- Department of Biochemistry and Molecular Biology, School of Life Sciences, Pondicherry University, Puducherry 605014, India
| |
Collapse
|
5
|
Reversal of Polymicrobial Biofilm Tolerance to Ciprofloxacin by Blue Light plus Carvacrol. Microorganisms 2021; 9:microorganisms9102074. [PMID: 34683395 PMCID: PMC8539106 DOI: 10.3390/microorganisms9102074] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 11/17/2022] Open
Abstract
Chronic wound infections are often caused by multi-species biofilms and these biofilm-embedded bacteria exhibit remarkable tolerance to existing antibiotics, which presents huge challenges to control such infections in the wounds. In this investigation, we established a polymicrobial biofilm composed of P. aeruginosa, S. aureus, K. pneumoniae, and A. baumannii. We tested a cocktail therapy comprising 405-nm blue light (BL), carvacrol (Ca), and antibiotics on the multispecies biofilm. Despite the fact that all strains used to form the biofilm were susceptible to ciprofloxacin (CIP) in planktonic cultures, the biofilm was found to withstand ciprofloxacin as well as BL-Ca dual treatment, mainly because K. pneumoniae outgrew and became dominant in the biofilm after each treatment. Strikingly, when ciprofloxacin was combined with BL-Ca, the multispecies biofilms succumbed substantially and were eradicated at an efficacy of 99.9%. Mechanistically, BL-Ca treatment increased membrane permeability and potentiated the anti-biofilm activity of ciprofloxacin, probably by facilitating ciprofloxacin’s entrance of the bacteria, which is particularly significant for K. pneumoniae, a species that is refractory to either ciprofloxacin or BL-Ca dual treatment. The results suggest that bacterial membrane damage can be one of the pivotal strategies to subvert biofilm tolerance and combat the recalcitrant multispecies biofilms.
Collapse
|
6
|
Cheong JZA, Johnson CJ, Wan H, Liu A, Kernien JF, Gibson ALF, Nett JE, Kalan LR. Priority effects dictate community structure and alter virulence of fungal-bacterial biofilms. THE ISME JOURNAL 2021; 15:2012-2027. [PMID: 33558690 PMCID: PMC8245565 DOI: 10.1038/s41396-021-00901-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/21/2020] [Accepted: 01/18/2021] [Indexed: 02/06/2023]
Abstract
Polymicrobial biofilms are a hallmark of chronic wound infection. The forces governing assembly and maturation of these microbial ecosystems are largely unexplored but the consequences on host response and clinical outcome can be significant. In the context of wound healing, formation of a biofilm and a stable microbial community structure is associated with impaired tissue repair resulting in a non-healing chronic wound. These types of wounds can persist for years simmering below the threshold of classically defined clinical infection (which includes heat, pain, redness, and swelling) and cycling through phases of recurrent infection. In the most severe outcome, amputation of lower extremities may occur if spreading infection ensues. Here we take an ecological perspective to study priority effects and competitive exclusion on overall biofilm community structure in a three-membered community comprised of strains of Staphylococcus aureus, Citrobacter freundii, and Candida albicans derived from a chronic wound. We show that both priority effects and inter-bacterial competition for binding to C. albicans biofilms significantly shape community structure on both abiotic and biotic substrates, such as ex vivo human skin wounds. We further show attachment of C. freundii to C. albicans is mediated by mannose-binding lectins. Co-cultures of C. freundii and C. albicans trigger the yeast-to-hyphae transition, resulting in a significant increase in neutrophil death and inflammation compared to either species alone. Collectively, the results presented here facilitate our understanding of fungal-bacterial interactions and their effects on host-microbe interactions, pathogenesis, and ultimately, wound healing.
Collapse
Affiliation(s)
- J Z Alex Cheong
- Department of Medical Microbiology and Immunology, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA
| | - Chad J Johnson
- Department of Medicine, Division of Infectious Disease, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA
| | - Hanxiao Wan
- Department of Medical Microbiology and Immunology, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA
| | - Aiping Liu
- Department of Surgery, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA
| | - John F Kernien
- Department of Medicine, Division of Infectious Disease, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA
| | - Angela L F Gibson
- Department of Surgery, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA
| | - Jeniel E Nett
- Department of Medical Microbiology and Immunology, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA
- Department of Medicine, Division of Infectious Disease, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA
| | - Lindsay R Kalan
- Department of Medical Microbiology and Immunology, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA.
- Department of Medicine, Division of Infectious Disease, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA.
| |
Collapse
|
7
|
Brown HL, Clayton A, Stephens P. The role of bacterial extracellular vesicles in chronic wound infections: Current knowledge and future challenges. Wound Repair Regen 2021; 29:864-880. [PMID: 34132443 DOI: 10.1111/wrr.12949] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 05/14/2021] [Accepted: 05/26/2021] [Indexed: 12/16/2022]
Abstract
Chronic wounds are a significant global problem with an increasing economic and patient welfare impact. How wounds move from an acute to chronic, non-healing, state is not well understood although it is likely that it is driven by a poorly regulated local inflammatory state. Opportunistic pathogens such as Staphylococcus aureus and Pseudomonas aeruginosa are well known to stimulate a pro-inflammatory response and so their presence may further drive chronicity. Studies have demonstrated that host cell extracellular vesicles (hEVs), in particular exosomes, have multiple roles in both increasing and decreasing chronicity within wounds; however, the role of bacterial extracellular vesicles (bEVs) is still poorly understood. The aim of this review is to evaluate bEV biogenesis and function within chronic wound relevant bacterial species to determine what, if any, role bEVs may have in driving wound chronicity. We determine that bEVs drive chronicity by both increasing persistence of key pathogens such as Staphylococcus aureus and Pseudomonas aeruginosa and stimulating a pro-inflammatory response by the host. Data also suggest that both bEVs and hEVs show therapeutic promise, providing vaccine candidates, decoy targets for bacterial toxins or modulating the bacterial species within chronic wound biofilms. Caution should, however, be used when interpreting findings to date as the bEV field is still in its infancy and as such lacks consistency in bEV isolation and characterization. It is of primary importance that this is addressed, allowing meaningful conclusions to be drawn and increasing reproducibility within the field.
Collapse
Affiliation(s)
- Helen L Brown
- School of Dentistry, Cardiff University, Cardiff, UK
| | - Aled Clayton
- Division of Cancer & Genetics, School of Medicine, Cardiff, UK
| | - Phil Stephens
- School of Dentistry, Cardiff University, Cardiff, UK
| |
Collapse
|
8
|
Thaarup IC, Bjarnsholt T. Current In Vitro Biofilm-Infected Chronic Wound Models for Developing New Treatment Possibilities. Adv Wound Care (New Rochelle) 2021; 10:91-102. [PMID: 32496982 DOI: 10.1089/wound.2020.1176] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Significance: The prevalence of chronic wounds is increasing worldwide. The most recent estimates suggest that up to 2% of the population in the industrialized countries is affected. Recent Advances: During the past few decades, bacterial biofilms have been elucidated as one of the primary reasons why chronic wounds fail to heal. Critical Issues: There is a lack of direct causation and evidence of the role that biofilms play in persistent wounds, which complicates research on new treatment options, since it is still unknown which factors dominate. For this reason, several different in vitro wound models that mimic the biofilm infections observed in chronic wounds and other chronic infections have been created. These different models are, among other purposes, used to test a variety of wound care products. However, chronic wounds are highly complex, and several different factors must be taken into consideration along with the infection, including physiochemical and human-supplemented factors. Furthermore, the limitations of using in vitro models, such as the lack of a responsive immune system should always be given due consideration. Future Directions: Present understandings of all the elements and interactions that take place within chronic wounds are incomplete. As our insight of in vivo chronic wounds continues to expand, so too must the in vitro models used to mimic these infections evolve and adapt to new knowledge.
Collapse
Affiliation(s)
- Ida C. Thaarup
- Department of Immunology and Microbiology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Bjarnsholt
- Department of Immunology and Microbiology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Microbiology, Copenhagen University Hospital, Copenhagen, Denmark
| |
Collapse
|
9
|
Redman WK, Welch GS, Rumbaugh KP. Differential Efficacy of Glycoside Hydrolases to Disperse Biofilms. Front Cell Infect Microbiol 2020; 10:379. [PMID: 32793516 PMCID: PMC7393775 DOI: 10.3389/fcimb.2020.00379] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 06/19/2020] [Indexed: 01/04/2023] Open
Abstract
Chronic wounds will impact 2% of the United States population at some point in their life. These wounds are often associated with a reoccurring, chronic infection caused by a community of microorganisms encased in an extracellular polymeric substance (EPS), or a biofilm. Biofilm-associated microbes can exhibit tolerance to antibiotics, which has prompted researchers to investigate therapeutics that improve antibiotic efficacy. Glycoside hydrolases (GHs), enzymes that target the polysaccharide linkages within the EPS, are one potential adjunctive therapy. In order to develop GH-based therapeutics, it is imperative that we understand whether the composition of biofilm EPS changes based on the environment and/or presence of other microbes. Here, we utilized α-amylase and cellulase to target the polysaccharides within the EPS of mono- and dual-species Pseudomonas aeruginosa and Staphylococcus aureus biofilms in three different models that vary in clinical relevancy. We show that biofilms established in an in vitro well-plate model are not strongly adhered to the polystyrene surface and do not accurately reflect the GH efficacy seen with biofilms grown in vivo. However, dispersal efficacy in an in vitro wound microcosm model was more reflective of that seen in a murine wound model. We also saw a striking loss of efficacy for cellulase to disperse S. aureus in both mono- and dual species biofilms grown in the wound models, suggesting that EPS constituents may be altered depending on the environment.
Collapse
Affiliation(s)
- Whitni K Redman
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, United States.,Immunology and Molecular Microbiology, Texas Tech University Health Sciences Center, Lubbock, TX, United States
| | - Garrett S Welch
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, United States.,TTUHSC Surgery Burn Center of Research Excellence, Texas Tech University Health Sciences Center, Lubbock, TX, United States
| | - Kendra P Rumbaugh
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, United States.,Immunology and Molecular Microbiology, Texas Tech University Health Sciences Center, Lubbock, TX, United States.,TTUHSC Surgery Burn Center of Research Excellence, Texas Tech University Health Sciences Center, Lubbock, TX, United States
| |
Collapse
|
10
|
Kadam S, Nadkarni S, Lele J, Sakhalkar S, Mokashi P, Kaushik KS. Corrigendum: Bioengineered Platforms for Chronic Wound Infection Studies: How Can We Make Them More Human-Relevant? Front Bioeng Biotechnol 2020; 7:449. [PMID: 32117902 PMCID: PMC7011166 DOI: 10.3389/fbioe.2019.00449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 11/15/2022] Open
Affiliation(s)
- Snehal Kadam
- Institute of Bioinformatics and Biotechnology, Savitribai Phule Pune University, Pune, India
| | | | | | | | | | - Karishma Surendra Kaushik
- Institute of Bioinformatics and Biotechnology, Savitribai Phule Pune University, Pune, India
- *Correspondence: Karishma Surendra Kaushik
| |
Collapse
|
11
|
Kadam S, Nadkarni S, Lele J, Sakhalkar S, Mokashi P, Kaushik KS. Bioengineered Platforms for Chronic Wound Infection Studies: How Can We Make Them More Human-Relevant? Front Bioeng Biotechnol 2019; 7:418. [PMID: 31921821 PMCID: PMC6923179 DOI: 10.3389/fbioe.2019.00418] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 11/29/2019] [Indexed: 12/19/2022] Open
Abstract
Chronic wound infections are an important cause of delayed wound healing, posing a significant healthcare burden with consequences that include hospitalization, amputation, and death. These infections most often take the form of three-dimensional biofilm communities, which are notoriously recalcitrant to antibiotics and immune clearance, contributing to the chronic wound state. In the chronic wound microenvironment, microbial biofilms interact closely with other key components, including host cellular and matrix elements, immune cells, inflammatory factors, signaling components, and mechanical cues. Intricate relationships between these contributing factors not only orchestrate the development and progression of wound infections but also influence the therapeutic outcome. Current medical treatment for chronic wound infections relies heavily on long-term usage of antibiotics; however, their efficacy and reasons for failure remain uncertain. To develop effective therapeutic approaches, it is essential to better understand the complex pathophysiology of the chronic wound infection microenvironment, including dynamic interactions between various key factors. For this, it is critical to develop bioengineered platforms or model systems that not only include key components of the chronic wound infection microenvironment but also recapitulate interactions between these factors, thereby simulating the infection state. In doing so, these platforms will enable the testing of novel therapeutics, alone and in combinations, providing insights toward composite treatment strategies. In the first section of this review, we discuss the key components and interactions in the chronic wound infection microenvironment, which would be critical to recapitulate in a bioengineered platform. In the next section, we summarize the key features and relevance of current bioengineered chronic wound infection platforms. These are categorized and discussed based on the microenvironmental components included and their ability to recapitulate the architecture, interactions, and outcomes of the infection microenvironment. While these platforms have advanced our understanding of the underlying pathophysiology of chronic wound infections and provided insights into therapeutics, they possess certain insufficiencies that limit their clinical relevance. In the final section, we propose approaches that can be incorporated into these existing model systems or developed into future platforms developed, thus enhancing their biomimetic and translational capabilities, and thereby their human-relevance.
Collapse
Affiliation(s)
- Snehal Kadam
- Institute of Bioinformatics and Biotechnology, Savitribai Phule Pune University, Pune, India
| | | | | | | | | | | |
Collapse
|
12
|
Viviana Serna González C, Thum M, de Oliveira Ramalho A, Beloto Silva O, Franco Coelho M, Medeiros da Silva Queiroz W, Maria Sebba Tosta de Souza D, Cristina Nogueira P, Lúcia Conceição Gouveia Santos V. Análise da “1a Recomendação Brasileira para o Gerenciamento do Biofilme em Feridas Crônicas e Complexas”. ESTIMA 2019. [DOI: 10.30886/estima.v17.783_pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objetivos: Analisar criticamente a “1ª Recomendação brasileira para o gerenciamento de biofilme em feridas crônicas e complexas”. Método: Realizou-se revisão da literatura atual às informações nele contidas. Resultados: Observou-se que a publicação carece de metodologia compatível com o título, existem lacunas nas recomendações quanto à classificação das evidências e com ausência de fundamentação a partir de importantes consensos internacionais para o tratamento das feridas complexas com suspeita de biofilme, publicados nos últimos três anos. Conclusão: Conclui-se que o manuscrito não deve ser usado como guia de recomendações clínicas, mas como revisão bibliográfica sobre o tema.
Collapse
|
13
|
Viviana Serna González C, Thum M, de Oliveira Ramalho A, Beloto Silva O, Franco Coelho M, Medeiros da Silva Queiroz W, Maria Sebba Tosta de Souza D, Cristina Nogueira P, Lúcia Conceição Gouveia Santos V. Analysis of “1st Brazilian Recommendation for Biofilm Management in Chronic and Complex Wounds”. ESTIMA 2019. [DOI: 10.30886/estima.v17.783_in] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objectives: Analyze critically the “1st Brazilian Recommendation for Biofilm Management in Chronic and Complex Wounds” (from Portuguese, “1a Recomendação Brasileira para o Gerenciamento de Biofilme em Feridas Crônicas e Complexas”). Method: Reviewing information contained in said document according to current literature. Results: The publication was showed to lack methodology compatible with its title; gaps in the recommendations were perceived regarding evidence classification, as well as an absence of grounding from important international consensus, published in the last three years, about treatment of complex wounds with suspected biofilm. Conclusion: The document was concluded to be inadequate for use as a clinical guideline, being considered only a bibliographic review about the theme.
Collapse
|
14
|
Tipton CD, Sanford NE, Everett JA, Gabrilska RA, Wolcott RD, Rumbaugh KP, Phillips CD. Chronic wound microbiome colonization on mouse model following cryogenic preservation. PLoS One 2019; 14:e0221565. [PMID: 31442275 PMCID: PMC6707584 DOI: 10.1371/journal.pone.0221565] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 08/10/2019] [Indexed: 01/06/2023] Open
Abstract
Chronic wound infections are increasingly recognized to be dynamic and polymicrobial in nature, necessitating the development of wound models which reflect the complexities of infection in a non-healing wound. Wound slough isolated from human chronic wounds and transferred to mice was recently shown to create polymicrobial infection in mice, and there is potential this tool may be improved by cryogenic preservation. The purpose of this study was to investigate the application of cryogenic preservation to transferring polymicrobial communities, specifically by quantifying the effects of cryopreservation and wound microbiome transplantation. Slough from an established murine polymicrobial surgical excision model and five patients were subjected to three preservation strategies: refrigeration until infection, freezing in liquid nitrogen, or freezing in liquid nitrogen with glycerol solution prior to infection in individual mice. Four days following inoculation onto mice, wound microbiota were quantified using either culture isolation or by 16s rRNA gene community profiling and quantitative PCR. Cryogenic preservation did not significantly reduce bacterial viability. Reestablished microbial communities were significantly associated with patient of origin as well as host context (i.e., originally preserved from a patient versus mouse infection). Whereas preservation treatment did not significantly shape community composition, the transfers of microbiomes from human to mouse were characterized by reduced diversity and compositional changes. These findings indicated that changes should be expected to occur to community structure after colonization, and that compositional change is likely due to the rapid change in infection context as opposed to preservation strategy. Furthermore, species that were present in higher relative abundance in wound inoculate were more likely to colonize subsequent wounds, and wound inoculate with higher bacterial load established wound communities that were more compositionally similar. Results inform expectations for the complementation of chronic wound in vivo modeling with cryogenic preservation archives.
Collapse
Affiliation(s)
- Craig D. Tipton
- Department of Biological Sciences, Texas Tech University, Lubbock, Texas, United States of America
- RTL Genomics, Research and Testing Laboratories, Lubbock, Texas, United States of America
- * E-mail:
| | - Nicholas E. Sanford
- Southwest Regional Wound Care Center, Lubbock, Texas, United States of America
| | - Jake A. Everett
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, United States of America
| | - Rebecca A. Gabrilska
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, United States of America
| | - Randall D. Wolcott
- Southwest Regional Wound Care Center, Lubbock, Texas, United States of America
| | - Kendra P. Rumbaugh
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, United States of America
| | - Caleb D. Phillips
- Department of Biological Sciences, Texas Tech University, Lubbock, Texas, United States of America
- Natural Science Research Laboratory, Texas Tech University, Lubbock, Texas, United States of America
| |
Collapse
|
15
|
Bewick S, Gurarie E, Weissman JL, Beattie J, Davati C, Flint R, Thielen P, Breitwieser F, Karig D, Fagan WF. Trait-based analysis of the human skin microbiome. MICROBIOME 2019; 7:101. [PMID: 31277701 PMCID: PMC6612184 DOI: 10.1186/s40168-019-0698-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 05/19/2019] [Indexed: 05/04/2023]
Abstract
BACKGROUND The past decade of microbiome research has concentrated on cataloging the diversity of taxa in different environments. The next decade is poised to focus on microbial traits and function. Most existing methods for doing this perform pathway analysis using reference databases. This has both benefits and drawbacks. Function can go undetected if reference databases are coarse-grained or incomplete. Likewise, detection of a pathway does not guarantee expression of the associated function. Finally, function cannot be connected to specific microbial constituents, making it difficult to ascertain the types of organisms exhibiting particular traits-something that is important for understanding microbial success in specific environments. A complementary approach to pathway analysis is to use the wealth of microbial trait information collected over years of lab-based, culture experiments. METHODS Here, we use journal articles and Bergey's Manual of Systematic Bacteriology to develop a trait-based database for 971 human skin bacterial taxa. We then use this database to examine functional traits that are over/underrepresented among skin taxa. Specifically, we focus on three trait classes-binary, categorical, and quantitative-and compare trait values among skin taxa and microbial taxa more broadly. We compare binary traits using a Chi-square test, categorical traits using randomization trials, and quantitative traits using a nonparametric relative effects test based on global rankings using Tukey contrasts. RESULTS We find a number of traits that are over/underrepresented within the human skin microbiome. For example, spore formation, acid phosphatase, alkaline phosphatase, pigment production, catalase, and oxidase are all less common among skin taxa. As well, skin bacteria are less likely to be aerobic, favoring, instead, a facultative strategy. They are also less likely to exhibit gliding motility, less likely to be spirillum or rod-shaped, and less likely to grow in chains. Finally, skin bacteria have more difficulty at high pH, prefer warmer temperatures, and are much less resilient to hypotonic conditions. CONCLUSIONS Our analysis shows how an approach that relies on information from culture experiments can both support findings from pathway analysis, and also generate new insights into the structuring principles of microbial communities.
Collapse
Affiliation(s)
- Sharon Bewick
- Department of Biological Sciences, Clemson University, Clemson, SC 29631 USA
| | - Eliezer Gurarie
- Department of Biology, University of Maryland, College Park, MD 20742 USA
| | - JL Weissman
- Department of Biology, University of Maryland, College Park, MD 20742 USA
| | - Jess Beattie
- Department of Biology, University of Maryland, College Park, MD 20742 USA
| | - Cyrus Davati
- Department of Biology, University of Maryland, College Park, MD 20742 USA
| | - Rachel Flint
- Department of Biology, University of Maryland, College Park, MD 20742 USA
| | - Peter Thielen
- Research and Exploratory Development Department, Johns Hopkins Applied Physics Laboratory, Laurel, MD 20723 USA
| | - Florian Breitwieser
- Center for Computational Biology, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205 USA
| | - David Karig
- Research and Exploratory Development Department, Johns Hopkins Applied Physics Laboratory, Laurel, MD 20723 USA
- Department of Bioengineering, Clemson University, Clemson, SC 29631 USA
| | - William F. Fagan
- Department of Biology, University of Maryland, College Park, MD 20742 USA
| |
Collapse
|
16
|
Current Status of In Vitro Models and Assays for Susceptibility Testing for Wound Biofilm Infections. Biomedicines 2019; 7:biomedicines7020034. [PMID: 31052271 PMCID: PMC6630351 DOI: 10.3390/biomedicines7020034] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 04/20/2019] [Accepted: 04/26/2019] [Indexed: 12/17/2022] Open
Abstract
Biofilm infections have gained recognition as an important therapeutic challenge in the last several decades due to their relationship with the chronicity of infectious diseases. Studies of novel therapeutic treatments targeting infections require the development and use of models to mimic the formation and characteristics of biofilms within host tissues. Due to the diversity of reported in vitro models and lack of consensus, this review aims to provide a summary of in vitro models currently used in research. In particular, we review the various reported in vitro models of Pseudomonas aeruginosa biofilms due to its high clinical impact in chronic wounds and in other chronic infections. We assess advances in in vitro models that incorporate relevant multispecies biofilms found in infected wounds, such as P. aeruginosa with Staphylococcus aureus, and additional elements such as mammalian cells, simulating fluids, and tissue explants in an attempt to better represent the physiological conditions found at an infection site. It is hoped this review will aid researchers in the field to make appropriate choices in their proposed studies with regards to in vitro models and methods.
Collapse
|
17
|
Abstract
Silver is added to an array of commercially available healthcare products including wound dressings. However, overuse of silver is being raised as a potential health concern due to the possible selection of tolerant or resistant bacteria and as a factor that may induce cross resistance to antibiotics. To date, there are only a limited number of studies that have documented evidence of silver resistance in bacteria isolated from medical situations. These studies have indicated low levels of silver resistance in bacteria. However, in comparison to antibiotics, only a small number of studies have been undertaken to investigate silver resistance. It is clear that more studies are required to confirm the most effective therapeutic levels of silver that are needed to kill microbes. In addition, it is probable that sub-therapeutic levels of silver may potentially select for enhanced microbial tolerance. Nevertheless, to date, there still remains very little evidence that silver resistance is a growing health concern in wound care; more studies are clearly needed to substantiate this concern, which has not been observed clinically to any major degree. The issue of biofilm tolerance to silver is more complicated and data on the effect of silver on biofilms is sparse at present.
Collapse
Affiliation(s)
- Steven L Percival
- a R&D Department, Centre of Excellence in Biofilm Science (CEBS) , 5D Health Protection Group Ltd , Liverpool Bio-Innovation Hub , Liverpool , UK
| | - Anne-Marie Salisbury
- a R&D Department, Centre of Excellence in Biofilm Science (CEBS) , 5D Health Protection Group Ltd , Liverpool Bio-Innovation Hub , Liverpool , UK
| | - Rui Chen
- a R&D Department, Centre of Excellence in Biofilm Science (CEBS) , 5D Health Protection Group Ltd , Liverpool Bio-Innovation Hub , Liverpool , UK
| |
Collapse
|
18
|
Trivedi U, Madsen JS, Everett J, Fell C, Russel J, Haaber J, Crosby HA, Horswill AR, Burmølle M, Rumbaugh KP, Sørensen SJ. Staphylococcus aureus coagulases are exploitable yet stable public goods in clinically relevant conditions. Proc Natl Acad Sci U S A 2018; 115:E11771-E11779. [PMID: 30463950 PMCID: PMC6294911 DOI: 10.1073/pnas.1804850115] [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] [Indexed: 01/25/2023] Open
Abstract
Coagulation is an innate defense mechanism intended to limit blood loss and trap invading pathogens during infection. However, Staphylococcus aureus has the ability to hijack the coagulation cascade and generate clots via secretion of coagulases. Although many S. aureus have this characteristic, some do not. The population dynamics regarding this defining trait have yet to be explored. We report here that coagulases are public goods that confer protection against antimicrobials and immune factors within a local population or community, thus promoting growth and virulence. By utilizing variants of a methicillin-resistant S. aureus we infer that the secretion of coagulases is a cooperative trait, which is subject to exploitation by invading mutants that do not produce the public goods themselves. However, overexploitation, "tragedy of the commons," does not occur at clinically relevant conditions. Our micrographs indicate this is due to spatial segregation and population viscosity. These findings emphasize the critical role of coagulases in a social evolution context and provide a possible explanation as to why the secretion of these public goods is maintained in mixed S. aureus communities.
Collapse
Affiliation(s)
- Urvish Trivedi
- Section of Microbiology, Department of Biology, Faculty of Science, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Jonas S Madsen
- Section of Microbiology, Department of Biology, Faculty of Science, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Jake Everett
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX 79430
| | - Cody Fell
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX 79430
| | - Jakob Russel
- Section of Microbiology, Department of Biology, Faculty of Science, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Jakob Haaber
- Department of Veterinary and Animal Sciences, Faculty of Health & Medical Sciences, University of Copenhagen, 1870 Copenhagen, Denmark
| | - Heidi A Crosby
- Department of Immunology and Microbiology, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045
| | - Alexander R Horswill
- Department of Immunology and Microbiology, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045
| | - Mette Burmølle
- Section of Microbiology, Department of Biology, Faculty of Science, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Kendra P Rumbaugh
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX 79430
| | - Søren J Sørensen
- Section of Microbiology, Department of Biology, Faculty of Science, University of Copenhagen, 2100 Copenhagen, Denmark;
| |
Collapse
|
19
|
Percival SL, Malone M, Mayer D, Salisbury AM, Schultz G. Role of anaerobes in polymicrobial communities and biofilms complicating diabetic foot ulcers. Int Wound J 2018; 15:776-782. [PMID: 29863794 DOI: 10.1111/iwj.12926] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 02/28/2018] [Indexed: 11/29/2022] Open
Abstract
Infected tissues in the feet of people with diabetes in the form of a diabetic foot ulcer (DFU) present a complex pathology for clinicians to manage. This is partly attributed to the multi-factorial nature of the disease, which may include; altered foot architecture leading to excessive plantar pressures and frictional forces peripheral arterial disease and loss of protective sensation. In addition, to the above co-morbid variables, it is understood that a delayed wound healing state may be perpetuated by the presence of microorganisms residing in the wound tissue. The microbiology of chronic DFUs has often been reported as being polymicrobial. Of growing interest is the presence and potential role of anaerobic microorganisms in the pathology of DFUs and how they may contribute to the infective process or delayed healing. The presence of anaerobes in DFUs has been greatly underestimated, largely due to the limitations of conventional culture methods in identifying them from samples. Advancements in molecular and microscopy techniques have extended our view of the wound microbiome in addition to observing the growth and behaviour (planktonic or biofilm) of microorganisms in situ. This review paper will reflect on the evidence for the role and significance of anaerobes in DFUs and infection. A focus of this review will be to explore recent advancements in molecular genomics and microscopy techniques in order to better assess the roles of anaerobic bacteria in chronic DFUs and in biofilm-based wound care.
Collapse
Affiliation(s)
- Steven L Percival
- 5D Health Protection Group Ltd, Centre of Excellence in Biofilm Science and Technologies (CEBST), Liverpool Bio-Innovation Hub, Liverpool, UK
| | - Matthew Malone
- Infectious Disease and Microbiology, School of Medicine, Western Sydney University, Sydney, Australia.,High Risk Foot Service, Liverpool Hospital South Western Sydney LHD, Sydney, New South Wales, Australia
| | - Dieter Mayer
- Department of Surgery, HFR Fribourg - Cantonal Hospital, Fribourg, Switzerland
| | - Anne-Marie Salisbury
- 5D Health Protection Group Ltd, Centre of Excellence in Biofilm Science and Technologies (CEBST), Liverpool Bio-Innovation Hub, Liverpool, UK
| | - Gregory Schultz
- Institute for Wound Research, Department Obstetrics & Gynaecology, University of Florida, Gainesville, Florida
| |
Collapse
|
20
|
Trivedi U, Madsen JS, Rumbaugh KP, Wolcott RD, Burmølle M, Sørensen SJ. A post-planktonic era of in vitro infectious models: issues and changes addressed by a clinically relevant wound like media. Crit Rev Microbiol 2016; 43:453-465. [PMID: 27869519 DOI: 10.1080/1040841x.2016.1252312] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Medical science is pitted against an ever-increasing rise in antibiotic tolerant microorganisms. Concurrently, during the past decade, biofilms have garnered much attention within research and clinical practice. Although the significance of clinical biofilms is becoming very apparent, current methods for diagnostics and direction of therapy plans in many hospitals do not reflect this knowledge; with many of the present tools proving to be inadequate for accurately mimicking the biofilm phenomenon. Based on current findings, we address some of the fundamental issues overlooked by clinical labs: the paradigm shifts that need to occur in assessing chronic wounds; better simulation of physiological conditions in vitro; and the importance of incorporating polymicrobial populations into biofilm models. In addition, this review considers using a biofilm relevant in vitro model for cultivating and determining the antibiotic tolerance and susceptibility of microorganisms associated with chronic wounds. This model presents itself as a highly rapid and functional tool that can be utilized by hospitals in an aim to improve bedside treatments.
Collapse
Affiliation(s)
- Urvish Trivedi
- a Department of Biology, Faculty of Science , Section of Microbiology, University of Copenhagen , Copenhagen , Denmark
| | - Jonas S Madsen
- a Department of Biology, Faculty of Science , Section of Microbiology, University of Copenhagen , Copenhagen , Denmark
| | - Kendra P Rumbaugh
- b Department of Surgery , Texas Tech University Health Sciences Center , Lubbock , TX , USA
| | | | - Mette Burmølle
- a Department of Biology, Faculty of Science , Section of Microbiology, University of Copenhagen , Copenhagen , Denmark
| | - Søren J Sørensen
- a Department of Biology, Faculty of Science , Section of Microbiology, University of Copenhagen , Copenhagen , Denmark
| |
Collapse
|
21
|
Smith K, Collier A, Townsend EM, O’Donnell LE, Bal AM, Butcher J, Mackay WG, Ramage G, Williams C. One step closer to understanding the role of bacteria in diabetic foot ulcers: characterising the microbiome of ulcers. BMC Microbiol 2016; 16:54. [PMID: 27005417 PMCID: PMC4804642 DOI: 10.1186/s12866-016-0665-z] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 03/07/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The aim of this study was to characterise the microbiome of new and recurrent diabetic foot ulcers using 16S amplicon sequencing (16S AS), allowing the identification of a wider range of bacterial species that may be important in the development of chronicity in these debilitating wounds. Twenty patients not receiving antibiotics for the past three months were selected, with swabs taken from each individual for culture and 16S AS. DNA was isolated using a combination of bead beating and kit extraction. Samples were sequenced on the Illumina Hiseq 2500 platform. RESULTS Conventional laboratory culture showed positive growth from only 55 % of the patients, whereas 16S AS was positive for 75 % of the patients (41 unique genera, representing 82 different operational taxonomic units (OTU's). S. aureus was isolated in 72 % of culture-positive samples, whereas the most commonly detected bacteria in all ulcers were Peptoniphilus spp., Anaerococcus spp. and Corynebacterium spp., with the addition of Staphylococcus spp. in new ulcers. The majority of OTU's residing in both new and recurrent ulcers (over 67 %) were identified as facultative or strict anaerobic Gram-positive organisms. Principal component analysis (PCA) showed no difference in clustering between the two groups (new and recurrent ulcers). CONCLUSIONS The abundance of anaerobic bacteria has important implications for treatment as it suggests that the microbiome of each ulcer "starts afresh" and that, although diverse, are not distinctly different from one another with respect to new or recurrent ulcers. Therefore, when considering antibiotic therapy the duration of current ulceration may be a more important consideration than a history of healed ulcer.
Collapse
Affiliation(s)
- Karen Smith
- />School of Health, Nursing and Midwifery, Institute of Healthcare Associated Infection, University of the West of Scotland, Barbour Building, Paisley Campus, Paisley, PA1 2BE UK
| | - Andrew Collier
- />NHS Ayrshire and Arran, University Hospital Ayr, Ayr, UK
| | - Eleanor M. Townsend
- />School of Health, Nursing and Midwifery, Institute of Healthcare Associated Infection, University of the West of Scotland, Barbour Building, Paisley Campus, Paisley, PA1 2BE UK
- />Infection and Immunity Research Group, Glasgow Dental School, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Lindsay E. O’Donnell
- />Infection and Immunity Research Group, Glasgow Dental School, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Abhijit M. Bal
- />NHS Ayrshire and Arran, University Hospital Ayr, Ayr, UK
| | - John Butcher
- />School of Health, Nursing and Midwifery, Institute of Healthcare Associated Infection, University of the West of Scotland, Barbour Building, Paisley Campus, Paisley, PA1 2BE UK
| | - William G. Mackay
- />School of Health, Nursing and Midwifery, Institute of Healthcare Associated Infection, University of the West of Scotland, Barbour Building, Paisley Campus, Paisley, PA1 2BE UK
| | - Gordon Ramage
- />Infection and Immunity Research Group, Glasgow Dental School, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Craig Williams
- />School of Health, Nursing and Midwifery, Institute of Healthcare Associated Infection, University of the West of Scotland, Barbour Building, Paisley Campus, Paisley, PA1 2BE UK
| |
Collapse
|
22
|
Ganesh K, Sinha M, Mathew-Steiner SS, Das A, Roy S, Sen CK. Chronic Wound Biofilm Model. Adv Wound Care (New Rochelle) 2015; 4:382-388. [PMID: 26155380 DOI: 10.1089/wound.2014.0587] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 09/05/2014] [Indexed: 12/27/2022] Open
Abstract
Significance: Multispecies microbial biofilms may contribute to wound chronicity by derailing the inherent reparative process of the host tissue. In the biofilm form, bacteria are encased within an extracellular polymeric substance and become recalcitrant to antimicrobials and host defenses. For biofilms of relevance to human health, there are two primary contributing factors: the microbial species involved and host response which, in turn, shapes microbial processes over time. This progressive interaction between microbial species and the host is an iterative process that helps evolve an acute-phase infection to a pathogenic chronic biofilm. Thus, long-term wound infection studies are needed to understand the longitudinal cascade of events that culminate into a pathogenic wound biofilm. Recent Advances: Our laboratory has recently published the first long-term (2 month) study of polymicrobial wound biofilm infection in a translationally valuable porcine wound model. Critical Issues: It is widely recognized that the porcine system represents the most translationally valuable approach to experimentally model human skin wounds. A meaningful experimental biofilm model must be in vivo, include mixed species of clinically relevant microbes, and be studied longitudinally long term. Cross-validation of such experimental findings with findings from biofilm-infected patient wounds is critically important. Future Directions: Additional value may be added to the experimental system described above by studying pigs with underlying health complications (e.g., metabolic syndrome), as is typically seen in patient populations.
Collapse
Affiliation(s)
- Kasturi Ganesh
- Department of Surgery, Comprehensive Wound Center, Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio
| | - Mithun Sinha
- Department of Surgery, Comprehensive Wound Center, Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio
| | - Shomita S. Mathew-Steiner
- Department of Surgery, Comprehensive Wound Center, Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio
| | - Amitava Das
- Department of Surgery, Comprehensive Wound Center, Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio
| | - Sashwati Roy
- Department of Surgery, Comprehensive Wound Center, Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio
| | - Chandan K. Sen
- Department of Surgery, Comprehensive Wound Center, Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio
| |
Collapse
|
23
|
Kelesidis T. Origin of de novo daptomycin non susceptible enterococci. World J Clin Infect Dis 2015; 5:30-36. [DOI: 10.5495/wjcid.v5.i2.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 04/01/2015] [Accepted: 04/20/2015] [Indexed: 02/06/2023] Open
Abstract
The emergence of daptomycin non-susceptible enterococci (DNSE) poses both treatment and infection control challenges. Clinicians should be vigilant that DNSE may be isolated from patients with or without (de novo DNSE) prior use of daptomycin. Recent epidemiological data suggest the presence of a community reservoir for DNSE which may be associated with environmental, foodborne and agricultural exposures. The mechanisms of nonsusceptibility to daptomycin have not been well characterized and may not parallel those for Staphylococcus aureus. The identification of daptomycin resistance genes in anaerobes, in farm animals and in an ecosystem that has been isolated for million years, suggest that the environmental reservoir for de novo DNSE may be larger than previously thought. Herein, the limited available scientific evidence regarding the possible origin of de novo DNSE is discussed. The current existing evidence is not sufficient to draw firm conclusions on the origin of DNSE. Further studies to determine the mechanisms of de novo daptomycin nonsusceptibility among enterococci are needed.
Collapse
|
24
|
Brackman G, Coenye T. In Vitro and In Vivo Biofilm Wound Models and Their Application. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 897:15-32. [DOI: 10.1007/5584_2015_5002] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
25
|
Synergistic interactions of Pseudomonas aeruginosa and Staphylococcus aureus in an in vitro wound model. Infect Immun 2014; 82:4718-28. [PMID: 25156721 DOI: 10.1128/iai.02198-14] [Citation(s) in RCA: 245] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
In individuals with polymicrobial infections, microbes often display synergistic interactions that can enhance their colonization, virulence, or persistence. One of the most prevalent types of polymicrobial infection occurs in chronic wounds, where Pseudomonas aeruginosa and Staphylococcus aureus are the two most common causes. Although they are the most commonly associated microbial species in wound infections, very little is known about their interspecies relationship. Evidence suggests that P. aeruginosa-S. aureus coinfections are more virulent than monoculture infection with either species; however, difficulties in growing these two pathogens together in vitro have hampered attempts to uncover the mechanisms involved. Here we describe a simple and clinically relevant in vitro wound model that supported concomitant growth of P. aeruginosa and S. aureus. We observed that the ability of P. aeruginosa and S. aureus to survive antibiotic treatment increased when they were grown together in planktonic cocultures and that antibiotic tolerance was further enhanced when they were grown together in the wound model. We attributed this enhanced tolerance to both the "host-derived" and "bacterium-derived" matrix components. Taken together, our data indicate that P. aeruginosa and S. aureus may benefit each other by coinfecting wounds and that the host-derived matrix may serve as important a role as the bacterium-derived matrix in protecting bacteria from some antibiotics.
Collapse
|
26
|
Uppalapati SR, Kingston JJ, Murali HS, Batra HV. Heterologous protection against alpha toxins of Clostridium perfringens and Staphylococcus aureus induced by binding domain recombinant chimeric protein. Vaccine 2014; 32:3075-81. [DOI: 10.1016/j.vaccine.2014.03.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 03/03/2014] [Accepted: 03/05/2014] [Indexed: 11/16/2022]
|
27
|
Wolcott R, Costerton J, Raoult D, Cutler S. The polymicrobial nature of biofilm infection. Clin Microbiol Infect 2013; 19:107-12. [DOI: 10.1111/j.1469-0691.2012.04001.x] [Citation(s) in RCA: 197] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
28
|
Ramakrishna US, Kingston JJ, Harishchandra Sripathi M, Batra HV. Taguchi optimization of duplex PCR for simultaneous identification of Staphylococcus aureus and Clostridium perfringens alpha toxins. FEMS Microbiol Lett 2013; 340:93-100. [PMID: 23278425 DOI: 10.1111/1574-6968.12070] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 11/12/2012] [Accepted: 12/18/2012] [Indexed: 01/01/2023] Open
Abstract
Staphylococcus aureus and Clostridium perfringens are two major bacteria that infect open wounds and delay the healing process. The rapid and progressive deterioration of soft tissue during S. aureus and C. perfringens coinfections is due to analogous necrotic alpha toxins produced by the two organisms. The aim of this study was to determine the alpha toxins of S. aureus and C. perfringens by duplex PCR. The PCR assay employed two sets of primers: hlaf/r to amplify staphylococcal alpha toxin gene hla (274 bp) and cpaf/r to amplify clostridial alpha toxin gene cpa (398 bp) along with a competitive internal amplification control (608 bp), simultaneously. Optimization of the duplex PCR assay was achieved by a modified Taguchi method, an engineering optimization process, in a nine-tube combinatorial array. The detection level of the duplex PCR was found to be 10 pg of purified DNA or 10(3 ) CFU mL(-1) of S. aureus and 100 pg of purified DNA or 10(4) CFU mL(-1) of C. perfringens. Other bacteria routinely found in tissue infections were tested for cross-reactivity and the duplex PCR turned out to be highly specific. This duplex PCR assay provides a rapid, robust and reliable alternative to the existing conventional techniques in establishing the aetiology of S. aureus and C. perfringens in soft tissue infections.
Collapse
|
29
|
Kim PJ, Steinberg JS. Wound care: biofilm and its impact on the latest treatment modalities for ulcerations of the diabetic foot. Semin Vasc Surg 2012; 25:70-4. [PMID: 22817855 DOI: 10.1053/j.semvascsurg.2012.04.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Biofilm is an increasingly important topic of discussion in the care of the chronic diabetic foot wound. Treatment modalities have focused on biofilm reduction or eradication through debridement techniques, topical therapies, negative pressure therapy, and ultrasound. In addition, advanced wound healing modalities, such as bioengineered alternative tissues, require optimal wound bed preparation with specific consideration of biofilm reduction before their application. Although fundamental principles of diabetic wound care still apply, critical thought must be given to biofilm before implementing a treatment plan for the closure of these complex wounds.
Collapse
Affiliation(s)
- Paul J Kim
- Center for Wound Healing and Hyperbaric Medicine, MedStar Georgetown University Hospital, Washington, DC 20007, USA.
| | | |
Collapse
|
30
|
Percival SL, Hill KE, Williams DW, Hooper SJ, Thomas DW, Costerton JW. A review of the scientific evidence for biofilms in wounds. Wound Repair Regen 2012; 20:647-57. [DOI: 10.1111/j.1524-475x.2012.00836.x] [Citation(s) in RCA: 317] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
| | - Katja E. Hill
- School of Dentistry; Cardiff University; Cardiff; United Kingdom
| | | | - Samuel J. Hooper
- School of Dentistry; Cardiff University; Cardiff; United Kingdom
| | - Dave W. Thomas
- School of Dentistry; Cardiff University; Cardiff; United Kingdom
| | - John W. Costerton
- Center for Genomic Sciences; Allegheny-Singer Research Institute; Pittsburgh; Pennsylvania
| |
Collapse
|
31
|
Abstract
The integrity of human skin is central to the prevention of infection. Acute and chronic wounds can develop when the integrity of skin as a barrier to infection is disrupted. As a multi-functional organ, skin possesses important biochemical and physical properties that influence its microbiology. These properties include a slightly acidic pH, a low moisture content, a high lipid content (which results in increased hydrophobicity) and the presence of antimicrobial peptides. Such factors have a role to play in preventing exogenous microbial colonisation and subsequent infection. In addition, the properties of skin both select for and enhance colonisation and biofilm formation by certain 'beneficial' micro-organisms. These beneficial micro-organisms can provide further protection against colonisation by potential pathogens, a process known as colonisation resistance. The aim of this paper is to summarise the microflora of skin and wounds, highlighting the role of certain micro-organisms and biofilms in associated infections.
Collapse
Affiliation(s)
- Steven L Percival
- SL Percival, Department of Pathology, Medical School, West Virginia University, Morgantown, West Virginia, WV 26506-9203, USA.
| | | | | | | |
Collapse
|
32
|
Case-control study comparing de novo and daptomycin-exposed daptomycin-nonsusceptible Enterococcus infections. Antimicrob Agents Chemother 2012; 56:2150-2. [PMID: 22252808 DOI: 10.1128/aac.05918-11] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Understanding factors associated with de novo daptomycin-nonsusceptible Enterococcus (DNSE) infections will aid in better understanding the mechanisms of daptomycin nonsusceptibility. We conducted a case-control study to compare patients with DNSE infections who were daptomycin treatment naïve (n = 9) and those with DNSE infections who had exposure to daptomycin (n = 13). Less frequent exposure to antimicrobials, increased susceptibility to nitrofurantoin and gentamicin, and shorter duration of hospitalization were associated with de novo DNSE infection, suggesting a potential community reservoir.
Collapse
|
33
|
Malic S, Hill K, Playle R, Thomas D, Williams D. In vitro interaction of chronic wound bacteria in biofilms. J Wound Care 2011; 20:569-70, 572, 574-7. [DOI: 10.12968/jowc.2011.20.12.569] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- S. Malic
- Tissue Engineering and Reparative Dentistry, School of Dentistry, Cardiff University, UK
| | - K.E. Hill
- Tissue Engineering and Reparative Dentistry, School of Dentistry, Cardiff University, UK
| | - R. Playle
- Applied Clinical Research and Public Health, School of Dentistry, Cardiff University, UK
| | - D.W. Thomas
- Tissue Engineering and Reparative Dentistry, School of Dentistry, Cardiff University, UK
| | - D.W. Williams
- Tissue Engineering and Reparative Dentistry, School of Dentistry, Cardiff University, UK
| |
Collapse
|
34
|
Dalton T, Dowd SE, Wolcott RD, Sun Y, Watters C, Griswold JA, Rumbaugh KP. An in vivo polymicrobial biofilm wound infection model to study interspecies interactions. PLoS One 2011; 6:e27317. [PMID: 22076151 PMCID: PMC3208625 DOI: 10.1371/journal.pone.0027317] [Citation(s) in RCA: 239] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 10/14/2011] [Indexed: 12/20/2022] Open
Abstract
Chronic wound infections are typically polymicrobial; however, most in vivo studies have focused on monospecies infections. This project was designed to develop an in vivo, polymicrobial, biofilm-related, infected wound model in order to study multispecies biofilm dynamics and in relation to wound chronicity. Multispecies biofilms consisting of both Gram negative and Gram positive strains, as well as aerobes and anaerobes, were grown in vitro and then transplanted onto the wounds of mice. These in vitro-to-in vivo multi-species biofilm transplants generated polymicrobial wound infections, which remained heterogeneous with four bacterial species throughout the experiment. We observed that wounded mice given multispecies biofilm infections displayed a wound healing impairment over mice infected with a single-species of bacteria. In addition, the bacteria in the polymicrobial wound infections displayed increased antimicrobial tolerance in comparison to those in single species infections. These data suggest that synergistic interactions between different bacterial species in wounds may contribute to healing delays and/or antibiotic tolerance.
Collapse
Affiliation(s)
- Trevor Dalton
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, United States of America
- Department of Microbiology and Immunology, Texas Tech University Health Sciences Center, Lubbock, Texas, United States of America
| | - Scot E. Dowd
- Research and Testing Laboratory, Lubbock, Texas, United States of America
| | - Randall D. Wolcott
- Research and Testing Laboratory, Lubbock, Texas, United States of America
| | - Yan Sun
- Research and Testing Laboratory, Lubbock, Texas, United States of America
| | - Chase Watters
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, United States of America
- Department of Microbiology and Immunology, Texas Tech University Health Sciences Center, Lubbock, Texas, United States of America
| | - John A. Griswold
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, United States of America
| | - Kendra P. Rumbaugh
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, United States of America
- Department of Microbiology and Immunology, Texas Tech University Health Sciences Center, Lubbock, Texas, United States of America
- * E-mail:
| |
Collapse
|
35
|
Hammond AA, Miller KG, Kruczek CJ, Dertien J, Colmer-Hamood JA, Griswold JA, Horswill AR, Hamood AN. An in vitro biofilm model to examine the effect of antibiotic ointments on biofilms produced by burn wound bacterial isolates. Burns 2010; 37:312-21. [PMID: 21130579 DOI: 10.1016/j.burns.2010.09.017] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Revised: 09/20/2010] [Accepted: 09/26/2010] [Indexed: 01/17/2023]
Abstract
PURPOSE Topical treatment of burn wounds is essential as reduced blood supply in the burned tissues restricts the effect of systemic antibiotics. On the burn surface, microorganisms exist within a complex structure termed a biofilm, which enhances bacterial resistance to antimicrobial agents significantly. Since bacteria differ in their ability to develop biofilms, the susceptibility of these biofilms to topically applied antibiotics varies, making it essential to identify which topical antibiotics efficiently disrupt or prevent biofilms produced by these pathogens. Yet, a simple in vitro assay to compare the susceptibility of biofilms produced by burn wound isolates to different topical antibiotics has not been reported. METHODS Biofilms were developed by inoculating cellulose disks on agar plates with burn wound isolates and incubating for 24h. The biofilms were then covered for 24h with untreated gauze or gauze coated with antibiotic ointment and remaining microorganisms were quantified and visualized microscopically. RESULTS Mupirocin and triple antibiotic ointments significantly reduced biofilms produced by the Staphylococcus aureus and Pseudomonas aeruginosa burn wound isolates tested, as did gentamicin ointment, with the exception of one P. aeruginosa clinical isolate. CONCLUSIONS The described assay is a practical and reproducible approach to identify topical antibiotics most effective in eliminating biofilms produced by burn wound isolates.
Collapse
Affiliation(s)
- Adrienne A Hammond
- Department of Surgery, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | | | | | | | | | | | | | | |
Collapse
|
36
|
Coenye T, Nelis HJ. In vitro and in vivo model systems to study microbial biofilm formation. J Microbiol Methods 2010; 83:89-105. [DOI: 10.1016/j.mimet.2010.08.018] [Citation(s) in RCA: 251] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2010] [Revised: 08/19/2010] [Accepted: 08/23/2010] [Indexed: 12/23/2022]
|
37
|
Hill KE, Malic S, McKee R, Rennison T, Harding KG, Williams DW, Thomas DW. An in vitro model of chronic wound biofilms to test wound dressings and assess antimicrobial susceptibilities. J Antimicrob Chemother 2010; 65:1195-206. [DOI: 10.1093/jac/dkq105] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
|