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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.
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Shukla SK, Sharma AK, Gupta V, Kalonia A, Shaw P. Challenges with Wound Infection Models in Drug Development. Curr Drug Targets 2021; 21:1301-1312. [PMID: 32116189 DOI: 10.2174/1389450121666200302093312] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/06/2020] [Accepted: 02/06/2020] [Indexed: 01/05/2023]
Abstract
Wound research is an evolving science trying to unfold the complex untold mechanisms behind the wound healing cascade. In particular, interest is growing regarding the role of microorganisms in both acute and chronic wound healing. Microbial burden plays an important role in the persistence of chronic wounds, ultimately resulting in delayed wound healing. It is therefore important for clinicians to understand the evolution of infection science and its various etiologies. Therefore, to understand the role of bacterial biofilm in chronic wound pathogenesis, various in vitro and in vivo models are required to investigate biofilms in wound-like settings. Infection models should be refined comprising an important signet of biofilms. These models are eminent for translational research to obtain data for designing an improved wound care formulation. However, all the existing models possess limitations and do not fit properly in the model frame for developing wound care agents. Among various impediments, one of the major drawbacks of such models is that the wound they possess does not mimic the wound a human develops. Therefore, a novel wound infection model is required which can imitate the human wounds. This review article mainly discusses various in vitro and in vivo models showing microbial colonization, their advantages and challenges. Apart from these models, there are also present ex vivo wound infection models, but this review mainly focused on various in vitro and in vivo models available for studying wound infection in controlled conditions. This information might be useful in designing an ideal wound infection model for developing an effective wound healing formulation.
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Affiliation(s)
- Sandeep K Shukla
- Institute of Nuclear Medicine & Allied Sciences, Defence Research and Development Organization, SK Mazumdar Marg, Timarpur, Delhi-110054, India
| | - Ajay K Sharma
- Institute of Nuclear Medicine & Allied Sciences, Defence Research and Development Organization, SK Mazumdar Marg, Timarpur, Delhi-110054, India
| | - Vanya Gupta
- Graphic Era deemed to be University, Dehradun, India
| | - Aman Kalonia
- Institute of Nuclear Medicine & Allied Sciences, Defence Research and Development Organization, SK Mazumdar Marg, Timarpur, Delhi-110054, India
| | - Priyanka Shaw
- Institute of Nuclear Medicine & Allied Sciences, Defence Research and Development Organization, SK Mazumdar Marg, Timarpur, Delhi-110054, India
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3
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Khayyat AN, Hegazy WAH, Shaldam MA, Mosbah R, Almalki AJ, Ibrahim TS, Khayat MT, Khafagy ES, Soliman WE, Abbas HA. Xylitol Inhibits Growth and Blocks Virulence in Serratia marcescens. Microorganisms 2021; 9:microorganisms9051083. [PMID: 34070043 PMCID: PMC8158113 DOI: 10.3390/microorganisms9051083] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/09/2021] [Accepted: 05/12/2021] [Indexed: 12/15/2022] Open
Abstract
Serratia marcescens is an opportunistic nosocomial pathogen and causes wound and burn infections. It shows high resistance to antibiotics and its pathogenicity is mediated by an arsenal of virulence factors. Another therapeutic option to such infections is targeting quorum sensing (QS), which controls the expression of different S. marcescens virulence factors. Prevention of QS can deprive S. marcescens from its bacterial virulence without applying stress on the bacterial growth and facilitates the eradication of the bacteria by immunity. The objective of the current study is to explore the antimicrobial and antivirulence activities of xylitol against S. marcescens. Xylitol could inhibit the growth of S. marcescens. Sub-inhibitory concentrations of xylitol could inhibit biofilm formation, reduce prodigiosin production, and completely block protease activity. Moreover, xylitol decreased swimming motility, swarming motility and increased the sensitivity to hydrogen peroxide. The expression of rsmA, pigP, flhC, flhD fimA, fimC, shlA bsmB, and rssB genes that regulate virulence factor production was significantly downregulated by xylitol. In silico study showed that xylitol could bind with the SmaR receptor by hydrophobic interaction and hydrogen bonding, and interfere with the binding of the natural ligand with SmaR receptor. An in vivo mice survival test confirmed the ability of xylitol to protect mice against the virulence of S. marcescens. In conclusion, xylitol is a growth and virulence inhibitor in S. marcescens and can be employed for the treatment of S. marcescens wound and burn infections.
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Affiliation(s)
- Ahdab N. Khayyat
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (A.N.K.); (A.J.A.); (T.S.I.); (M.T.K.)
| | - Wael A. H. Hegazy
- Department of Microbiology and Immunology, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt;
- Correspondence: ; Tel.: +20-1101188800
| | - Moataz A. Shaldam
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Kafrelsheikh University, Kafr El-Sheikh 33516, Egypt;
| | - Rasha Mosbah
- Infection control Unit, Zagazig University Hospitals, Zagazig University, Zagazig 44519, Egypt;
- Faculty of Oral and Dental medicine, Ahram Canadian University, Giza Governorate 12573, Egypt
| | - Ahmad J. Almalki
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (A.N.K.); (A.J.A.); (T.S.I.); (M.T.K.)
| | - Tarek S. Ibrahim
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (A.N.K.); (A.J.A.); (T.S.I.); (M.T.K.)
- Department of Pharmaceutical Organic Chemistry, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt
| | - Maan T. Khayat
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (A.N.K.); (A.J.A.); (T.S.I.); (M.T.K.)
| | - El-Sayed Khafagy
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-kharj 11942, Saudi Arabia;
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Suez Canal University, Ismailia 41552, Egypt
| | - Wafaa E. Soliman
- Department of Biomedical science, Faculty of Clinical Pharmacy, King Faisal University, Alhofuf, Al-Ahsa 36362, Saudi Arabia;
- Department of Microbiology and Biotechnology, Faculty of Pharmacy, Delta University for Science and Technology, Mansoura 11152, Egypt
| | - Hisham A. Abbas
- Department of Microbiology and Immunology, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt;
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4
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Castelo-Branco DDSCM, Amando BR, Ocadaque CJ, Aguiar LD, Paiva DDDQ, Diógenes EM, Guedes GMDM, Costa CL, Santos-Filho ASP, Andrade ARCD, Cordeiro RDA, Rocha MFG, Sidrim JJC. Mini-review: from in vitro to ex vivo studies: an overview of alternative methods for the study of medical biofilms. BIOFOULING 2020; 36:1129-1148. [PMID: 33349038 DOI: 10.1080/08927014.2020.1859499] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/23/2020] [Accepted: 11/29/2020] [Indexed: 06/12/2023]
Abstract
Microbial biofilms are a natural adaptation of microorganisms, typically composed of multiple microbial species, exhibiting complex community organization and cooperation. Biofilm dynamics and their complex architecture are challenging for basic analyses, including the number of viable cells, biomass accumulation, biofilm morphology, among others. The methods used to study biofilms range from in vitro techniques to complex in vivo models. However, animal welfare has become a major concern, not only in society, but also in the academic and scientific field. Thus, the pursuit for alternatives to in vivo biofilm analyses presenting characteristics that mimic in vivo conditions has become essential. In this context, the present review proposes to provide an overview of strategies to study biofilms of medical interest, with emphasis on alternatives that approximate experimental conditions to host-associated environments, such as the use of medical devices as substrata for biofilm formation, microcosm and ex vivo models.
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Affiliation(s)
- Débora de Souza Collares Maia Castelo-Branco
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Brazil
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Brazil
| | - Bruno Rocha Amando
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Brazil
| | - Crister José Ocadaque
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Brazil
| | - Lara de Aguiar
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Brazil
- Postgraduate Program in Veterinary Sciences, College of Veterinary, State University of Ceará, Fortaleza, Brazil
| | - Débora Damásio de Queiroz Paiva
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Brazil
| | - Expedito Maia Diógenes
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Brazil
| | - Glaucia Morgana de Melo Guedes
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Brazil
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Brazil
| | - Cecília Leite Costa
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Brazil
| | - Anísio Silvestre Pinheiro Santos-Filho
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Brazil
| | - Ana Raquel Colares de Andrade
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Brazil
| | - Rossana de Aguiar Cordeiro
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Brazil
| | - Marcos Fábio Gadelha Rocha
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Brazil
- Postgraduate Program in Veterinary Sciences, College of Veterinary, State University of Ceará, Fortaleza, Brazil
| | - José Júlio Costa Sidrim
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Brazil
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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
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Das S, Czuni L, Báló V, Papp G, Gazdag Z, Papp N, Kőszegi T. Cytotoxic Action of Artemisinin and Scopoletin on Planktonic Forms and on Biofilms of Candida Species. Molecules 2020; 25:E476. [PMID: 31979177 PMCID: PMC7038054 DOI: 10.3390/molecules25030476] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/08/2020] [Accepted: 01/20/2020] [Indexed: 12/12/2022] Open
Abstract
We investigated the antifungal activities of purified plant metabolites artemisinin (Ar) and scopoletin (Sc) including inhibition, effects on metabolic activities, viability, and oxidative stress on planktonic forms and on preformed biofilms of seven Candida species. The characteristic minimum inhibitory concentration (MIC90) of Ar and Sc against Candida species ranged from 21.83-142.1 µg/mL and 67.22-119.4 µg/mL, respectively. Drug concentrations causing ≈10% CFU decrease within 60 minutes of treatments were also determined (minimum effective concentration, MEC10) using 100-fold higher CFUs than in the case of MIC90 studies. Cytotoxic effects on planktonic and on mature biofilms of Candida species at MEC10 concentrations were further evaluated with fluorescent live/dead discrimination techniques. Candida glabrata, Candida guilliermondii, and Candida parapsilosis were the species most sensitive to Ar and Sc. Ar and Sc were also found to promote the accumulation of intracellular reactive oxygen species (ROS) by increasing oxidative stress at their respective MEC10 concentrations against the tested planktonic Candida species. Ar and Sc possess dose-dependent antifungal action but the underlying mechanism type (fungistatic and fungicidal) is not clear yet. Our data suggest that Ar and Sc found in herbal plants might have potential usage in the fight against Candida biofilms.
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Affiliation(s)
- Sourav Das
- Department of Laboratory Medicine, University of Pécs, Medical School, 7624 Pécs, Ifjúság u. 13., Hungary;
- János Szentágothai Research Center, University of Pécs, 7624 Pécs, Ifjúság u. 20., Hungary
| | - Lilla Czuni
- Department of General and Environmental Microbiology, Institute of Biology, University of Pécs, 7624 Pécs, Ifjúság u. 6., Hungary; (L.C.); (V.B.); (G.P.); (Z.G.)
- Microbial Biotechnology Research Group, János Szentágothai Research Center, University of Pécs, 7624 Pécs, Ifjúság u. 20., Hungary
| | - Viktória Báló
- Department of General and Environmental Microbiology, Institute of Biology, University of Pécs, 7624 Pécs, Ifjúság u. 6., Hungary; (L.C.); (V.B.); (G.P.); (Z.G.)
| | - Gábor Papp
- Department of General and Environmental Microbiology, Institute of Biology, University of Pécs, 7624 Pécs, Ifjúság u. 6., Hungary; (L.C.); (V.B.); (G.P.); (Z.G.)
- Microbial Biotechnology Research Group, János Szentágothai Research Center, University of Pécs, 7624 Pécs, Ifjúság u. 20., Hungary
| | - Zoltán Gazdag
- Department of General and Environmental Microbiology, Institute of Biology, University of Pécs, 7624 Pécs, Ifjúság u. 6., Hungary; (L.C.); (V.B.); (G.P.); (Z.G.)
- Microbial Biotechnology Research Group, János Szentágothai Research Center, University of Pécs, 7624 Pécs, Ifjúság u. 20., Hungary
| | - Nóra Papp
- Department of Pharmacognosy, University of Pécs, Faculty of Pharmacy, 7624 Pécs, Rókus u. 2, Hungary
| | - Tamás Kőszegi
- Department of Laboratory Medicine, University of Pécs, Medical School, 7624 Pécs, Ifjúság u. 13., Hungary;
- János Szentágothai Research Center, University of Pécs, 7624 Pécs, Ifjúság u. 20., Hungary
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7
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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.
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Affiliation(s)
- Snehal Kadam
- Institute of Bioinformatics and Biotechnology, Savitribai Phule Pune University, Pune, India
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8
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Zhou G, Peng H, Wang YS, Huang XM, Xie XB, Shi QS. Enhanced synergistic effects of xylitol and isothiazolones for inhibition of initial biofilm formation by Pseudomonas aeruginosa ATCC 9027 and Staphylococcus aureus ATCC 6538. J Oral Sci 2019; 61:255-263. [PMID: 31217374 DOI: 10.2334/josnusd.18-0102] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Bacterial biofilms, formed on biotic or abiotic surfaces, can lead to serious environmental or medical problems. Therefore, it is necessary to find novel antimicrobial agents to combat biofilms, or more effective combinations of existing biocides. In this study, initial biofilms of Pseudomonas aeruginosa ATCC 9027 and Staphylococcus aureus ATCC 6538 in the presence of xylitol or xylitol and isothiazolones were determined using crystal violet staining in 96-well microplates and confocal laser scanning microscopy. Xylitol and isothiazolones exhibited enhanced synergistic inhibition of initial biofilm formation, and also the structure and production of extracellular polymeric substances by P. aeruginosa ATCC 9027 and S. aureus ATCC 6538 in a dose-dependent manner. In addition, xylitol and isothiazolones inhibited and restored the swimming motility of P. aeruginosa ATCC 9027, respectively. These findings show that a combination of xylitol and isothiazolones exerts pronounced antimicrobial activity against P. aeruginosa and S. aureus biofilms and may be applicable for preventing or reducing bacterial biofilms in vitro.
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Affiliation(s)
- Gang Zhou
- Guangdong Institute of Microbiology.,State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology.,Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Institute of Microbiology.,Guangdong Open Laboratory of Applied Microbiology, Guangdong Institute of Microbiology
| | - Hong Peng
- Guangdong Institute of Microbiology.,State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology.,Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Institute of Microbiology.,Guangdong Open Laboratory of Applied Microbiology, Guangdong Institute of Microbiology
| | - Ying-Si Wang
- Guangdong Institute of Microbiology.,State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology.,Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Institute of Microbiology.,Guangdong Open Laboratory of Applied Microbiology, Guangdong Institute of Microbiology
| | - Xiao-Mo Huang
- Guangdong Institute of Microbiology.,State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology.,Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Institute of Microbiology.,Guangdong Open Laboratory of Applied Microbiology, Guangdong Institute of Microbiology
| | - Xiao-Bao Xie
- Guangdong Institute of Microbiology.,State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology.,Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Institute of Microbiology.,Guangdong Open Laboratory of Applied Microbiology, Guangdong Institute of Microbiology
| | - Qing-Shan Shi
- Guangdong Institute of Microbiology.,State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology.,Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Institute of Microbiology.,Guangdong Open Laboratory of Applied Microbiology, Guangdong Institute of Microbiology
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9
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Salli K, Lehtinen MJ, Tiihonen K, Ouwehand AC. Xylitol's Health Benefits beyond Dental Health: A Comprehensive Review. Nutrients 2019; 11:nu11081813. [PMID: 31390800 PMCID: PMC6723878 DOI: 10.3390/nu11081813] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 07/28/2019] [Accepted: 07/31/2019] [Indexed: 12/16/2022] Open
Abstract
Xylitol has been widely documented to have dental health benefits, such as reducing the risk for dental caries. Here we report on other health benefits that have been investigated for xylitol. In skin, xylitol has been reported to improve barrier function and suppress the growth of potential skin pathogens. As a non-digestible carbohydrate, xylitol enters the colon where it is fermented by members of the colonic microbiota; species of the genus Anaerostipes have been reported to ferment xylitol and produce butyrate. The most common Lactobacillus and Bifidobacterium species do not appear to be able to grow on xylitol. The non-digestible but fermentable nature of xylitol also contributes to a constipation relieving effect and improved bone mineral density. Xylitol also modulates the immune system, which, together with its antimicrobial activity contribute to a reduced respiratory tract infection, sinusitis, and otitis media risk. As a low caloric sweetener, xylitol may contribute to weight management. It has been suggested that xylitol also increases satiety, but these results are not convincing yet. The benefit of xylitol on metabolic health, in addition to the benefit of the mere replacement of sucrose, remains to be determined in humans. Additional health benefits of xylitol have thus been reported and indicate further opportunities but need to be confirmed in human studies.
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Affiliation(s)
- Krista Salli
- Global Health & Nutrition Sciences, DuPont Nutrition & Biosciences, 02460 Kantvik, Finland
| | - Markus J Lehtinen
- Global Health & Nutrition Sciences, DuPont Nutrition & Biosciences, 02460 Kantvik, Finland
| | - Kirsti Tiihonen
- Global Health & Nutrition Sciences, DuPont Nutrition & Biosciences, 02460 Kantvik, Finland
| | - Arthur C Ouwehand
- Global Health & Nutrition Sciences, DuPont Nutrition & Biosciences, 02460 Kantvik, Finland.
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10
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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.
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11
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Páyer E, Szabó-Papp J, Ambrus L, Szöllősi AG, Andrási M, Dikstein S, Kemény L, Juhász I, Szegedi A, Bíró T, Oláh A. Beyond the physico-chemical barrier: Glycerol and xylitol markedly yet differentially alter gene expression profiles and modify signalling pathways in human epidermal keratinocytes. Exp Dermatol 2019. [PMID: 29520873 DOI: 10.1111/exd.13493] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Polyols (e.g. glycerol, xylitol) are implicated as moisturizers of the skin and other epithelial tissues. However, we lack information about their exact cellular mechanisms and their effects on the gene expression profiles. Therefore, in this study, we aimed at investigating the effects of glycerol and xylitol on human epidermal keratinocytes. The polyols (identical osmolarities; xylitol: 0.0045%-0.45%; glycerol: 0.0027%-0.27%) did not alter cellular viability or intracellular calcium concentration. However, they exerted differential effects on the expression of certain genes and signalling pathways. Indeed, both polyols up-regulated the expression of filaggrin, loricrin, involucrin and occludin; yet, xylitol exerted somewhat more profound effects. Moreover, while both polyols stimulated the MAPK pathway, only xylitol induced the activation-dependent translocation of protein kinase Cδ, a key promoter of epidermal differentiation. Finally, in various keratinocyte inflammation models, both polyols (albeit with different efficacies) exerted anti-inflammatory effects. Taken together, these data strongly suggest that glycerol and xylitol differentially modulate expressions of multiple genes and activities of signalling pathways in epidermal keratinocytes. Thus, our findings invite clinical trials to explore the applicability and the impact of a combined glycerol-xylitol therapy in the management of various skin conditions.
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Affiliation(s)
- Edit Páyer
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Judit Szabó-Papp
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Lídia Ambrus
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Attila Gábor Szöllősi
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Mónika Andrási
- Department of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | | | - Lajos Kemény
- MTA-SZTE Dermatological Research Group, Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - István Juhász
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Andrea Szegedi
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Tamás Bíró
- Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Attila Oláh
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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12
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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.
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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;
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13
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Tran PL, Li J, Lungaro L, Ramesh S, Ivanov IN, Moon JW, Graham DE, Hamood A, Wang J, Elfick AP, Rivero IV. Cryomilled zinc sulfide: A prophylactic for Staphylococcus aureus-infected wounds. J Biomater Appl 2018; 33:82-93. [PMID: 29683016 DOI: 10.1177/0885328218770530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Bacterial pathogens that colonize wounds form biofilms, which protect the bacteria from the effect of host immune response and antibiotics. This study examined the effectiveness of newly synthesized zinc sulfide in inhibiting biofilm development by Staphylococcus aureus ( S. aureus) strains. Zinc sulfide (ZnS) was anaerobically biosynthesized to produce CompA, which was further processed by cryomilling to maximize the antibacterial properties to produce CompB. The effect of the two compounds on the S. aureus strain AH133 was compared using zone of inhibition assay. The compounds were formulated in a polyethylene glycol cream. We compared the effect of the two compounds on biofilm development by AH133 and two methicillin-resistant S. aureus clinical isolates using the in vitro model of wound infection. Zone of inhibition assay revealed that CompB is more effective than CompA. At 15 mg/application, the formulated cream of either compound inhibited biofilm development by AH133, which was confirmed using confocal laser scanning microscopy. At 20 mg/application, CompB inhibited biofilm development by the two methicillin-resistant S. aureus clinical isolates. To further validate the effectiveness of CompB, mice were treated using the murine model of wound infection. Colony forming cell assay and in vivo live imaging results strongly suggested the inhibition of S. aureus growth.
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Affiliation(s)
- Phat L Tran
- 1 Department of Ophthalmology and Visual Sciences, Texas Tech University Health Sciences Center, School of Medicine, Lubbock, Texas, USA
| | - Jianqiang Li
- 2 Department of Industrial and Manufacturing Systems Engineering, Iowa State University, Ames IA, USA
| | - Lisa Lungaro
- 3 Institute for Bioengineering, University of Edinburgh, Edinburgh, Scotland, UK
| | - Srikanthan Ramesh
- 2 Department of Industrial and Manufacturing Systems Engineering, Iowa State University, Ames IA, USA
| | - Ilia N Ivanov
- 4 Center for Nanophase Materials Science, Oak Ridge National Laboratory, Oak Ridge TN, USA
| | - Ji-Won Moon
- 5 Biosciences Division, Oak Ridge National Laboratory, Oak Ridge TN, USA
| | - David E Graham
- 5 Biosciences Division, Oak Ridge National Laboratory, Oak Ridge TN, USA
| | - Abdul Hamood
- 6 Department of Molecular Microbiology and Immunology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.,7 Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - James Wang
- 8 School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Alistair Pd Elfick
- 3 Institute for Bioengineering, University of Edinburgh, Edinburgh, Scotland, UK
| | - Iris V Rivero
- 2 Department of Industrial and Manufacturing Systems Engineering, Iowa State University, Ames IA, USA.,7 Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
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14
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Smith MK, Nicholson CL, Parks-Miller A, Hamzavi IH. Hidradenitis suppurativa: an update on connecting the tracts. F1000Res 2017; 6:1272. [PMID: 28794864 PMCID: PMC5538037 DOI: 10.12688/f1000research.11337.1] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2017] [Indexed: 12/18/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a devastating disease involving abscesses, sinus tracts, and inflammation classically affecting the axilla, groin, and/or anogenital region. Although the disease pathogenesis is not fully understood, recent advances suggest that HS pathology runs much deeper than the cutaneous manifestations. It is now believed that HS is a systemic inflammatory disease that gives rise to the characteristic cutaneous manifestations. This disease is problematic for both patients and physicians to manage because of a variety of diagnostic and management difficulties. This article seeks to provide updates on the current understanding of HS to increase awareness and improve management.
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15
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Tan CH, Lee KWK, Burmølle M, Kjelleberg S, Rice SA. All together now: experimental multispecies biofilm model systems. Environ Microbiol 2017; 19:42-53. [DOI: 10.1111/1462-2920.13594] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Chuan Hao Tan
- The Singapore Centre for Environmental Life Sciences EngineeringNanyang Technological University Singapore
| | - Kai Wei Kelvin Lee
- The Singapore Centre for Environmental Life Sciences EngineeringNanyang Technological University Singapore
| | - Mette Burmølle
- Section of Microbiology, Department of BiologyUniversity of CopenhagenCopenhagen Denmark
| | - Staffan Kjelleberg
- The Singapore Centre for Environmental Life Sciences EngineeringNanyang Technological University Singapore
- The School of Biological SciencesNanyang Technological University Singapore
| | - Scott A. Rice
- The Singapore Centre for Environmental Life Sciences EngineeringNanyang Technological University Singapore
- The School of Biological SciencesNanyang Technological University Singapore
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16
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Nair S, Desai S, Poonacha N, Vipra A, Sharma U. Antibiofilm Activity and Synergistic Inhibition of Staphylococcus aureus Biofilms by Bactericidal Protein P128 in Combination with Antibiotics. Antimicrob Agents Chemother 2016; 60:7280-7289. [PMID: 27671070 PMCID: PMC5119008 DOI: 10.1128/aac.01118-16] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 09/18/2016] [Indexed: 12/29/2022] Open
Abstract
P128 is an antistaphylococcal protein, comprising a cell wall-degrading enzymatic region and a Staphylococcus-specific binding region, which possesses specific and potent bactericidal activity against sensitive and drug-resistant strains of Staphylococcus aureus To explore P128's ability to kill S. aureus in a range of environments relevant to clinical infection, we investigated the anti-S. aureus activity of P128 alone and in combination with standard-of-care antibiotics on planktonic and biofilm-embedded cells. P128 was found to have potent antibiofilm activity on preformed S. aureus biofilms as detected by CFU reduction and a colorimetric minimum biofilm inhibitory concentration (MBIC) assay. Scanning electron microscopic images of biofilms formed on the surfaces of microtiter plates and on catheters showed that P128 at low concentrations could destroy the biofilm structure and lyse the cells. When it was tested in combination with antibiotics which are known to be poor inhibitors of S. aureus in biofilms, such as vancomycin, gentamicin, ciprofloxacin, linezolid, and daptomycin, P128 showed highly synergistic antibiofilm activity that resulted in much reduced MBIC values for P128 and the individual antibiotics. The synergistic effect was seen for both sensitive and resistant isolates of S. aureus Additionally, in an in vitro mixed-biofilm model mimicking the wound infection environment, P128 was able to prevent biofilm formation by virtue of its anti-Staphylococcus activity. The potent S. aureus biofilm-inhibiting activity of P128 both alone and in combination with antibiotics is an encouraging sign for the development of P128 for treatment of complicated S. aureus infections involving biofilms.
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Affiliation(s)
- Sandhya Nair
- GangaGen Biotechnologies Pvt. Ltd., Yeshwantpur, Bangalore, India
| | - Srividya Desai
- GangaGen Biotechnologies Pvt. Ltd., Yeshwantpur, Bangalore, India
| | | | - Aradhana Vipra
- GangaGen Biotechnologies Pvt. Ltd., Yeshwantpur, Bangalore, India
| | - Umender Sharma
- GangaGen Biotechnologies Pvt. Ltd., Yeshwantpur, Bangalore, India
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17
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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.
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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
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18
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Townsend EM, Sherry L, Rajendran R, Hansom D, Butcher J, Mackay WG, Williams C, Ramage G. Development and characterisation of a novel three-dimensional inter-kingdom wound biofilm model. BIOFOULING 2016; 32:1259-1270. [PMID: 27841027 DOI: 10.1080/08927014.2016.1252337] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 10/19/2016] [Indexed: 06/06/2023]
Abstract
Chronic diabetic foot ulcers are frequently colonised and infected by polymicrobial biofilms that ultimately prevent healing. This study aimed to create a novel in vitro inter-kingdom wound biofilm model on complex hydrogel-based cellulose substrata to test commonly used topical wound treatments. Inter-kingdom triadic biofilms composed of Candida albicans, Pseudomonas aeruginosa, and Staphylococcus aureus were shown to be quantitatively greater in this model compared to a simple substratum when assessed by conventional culture, metabolic dye and live dead qPCR. These biofilms were both structurally complex and compositionally dynamic in response to topical therapy, so when treated with either chlorhexidine or povidone iodine, principal component analysis revealed that the 3-D cellulose model was minimally impacted compared to the simple substratum model. This study highlights the importance of biofilm substratum and inclusion of relevant polymicrobial and inter-kingdom components, as these impact penetration and efficacy of topical antiseptics.
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Affiliation(s)
- Eleanor M Townsend
- a Oral Sciences Research Group, Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences , University of Glasgow , Glasgow , UK
- b Institute of Healthcare Policy and Practice , University of West of Scotland , Paisley , UK
| | - Leighann Sherry
- a Oral Sciences Research Group, Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences , University of Glasgow , Glasgow , UK
- b Institute of Healthcare Policy and Practice , University of West of Scotland , Paisley , UK
| | - Ranjith Rajendran
- a Oral Sciences Research Group, Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences , University of Glasgow , Glasgow , UK
| | - Donald Hansom
- a Oral Sciences Research Group, Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences , University of Glasgow , Glasgow , UK
| | - John Butcher
- b Institute of Healthcare Policy and Practice , University of West of Scotland , Paisley , UK
| | - William G Mackay
- b Institute of Healthcare Policy and Practice , University of West of Scotland , Paisley , UK
| | - Craig Williams
- b Institute of Healthcare Policy and Practice , University of West of Scotland , Paisley , UK
| | - Gordon Ramage
- a Oral Sciences Research Group, Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences , University of Glasgow , Glasgow , UK
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19
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Anghel EL, DeFazio MV, Barker JC, Janis JE, Attinger CE. Current Concepts in Debridement. Plast Reconstr Surg 2016; 138:82S-93S. [DOI: 10.1097/prs.0000000000002651] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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20
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Bandara HMHN, Herpin MJ, Kolacny D, Harb A, Romanovicz D, Smyth HDC. Incorporation of Farnesol Significantly Increases the Efficacy of Liposomal Ciprofloxacin against Pseudomonas aeruginosa Biofilms in Vitro. Mol Pharm 2016; 13:2760-70. [PMID: 27383205 DOI: 10.1021/acs.molpharmaceut.6b00360] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The challenge of eliminating Pseudomonas aeruginosa infections, such as in cystic fibrosis lungs, remains unchanged due to the rapid development of antibiotic resistance. Poor drug penetration into dense P. aeruginosa biofilms plays a vital role in ineffective clearance of the infection. Thus, the current antibiotic therapy against P. aeruginosa biofilms need to be revisited and alternative antibiofilm strategies need to be invented. Fungal quorum sensing molecule (QSM), farnesol, appears to have detrimental effects on P. aeruginosa. Thus, this study aimed to codeliver naturally occurring QSM farnesol, with the antibiotic ciprofloxacin as a liposomal formulation to eradicate P. aeruginosa biofilms. Four different liposomes (with ciprofloxacin and farnesol, Lcip+far; with ciprofloxacin, Lcip; with farnesol, Lfar; control, Lcon) were prepared using dehydration-rehydration method and characterized. Drug entrapment and release were evaluated by spectrometry and high performance liquid chromatography (HPLC). The efficacy of liposomes was assessed using standard biofilm assay. Liposome-treated 24 h P. aeruginosa biofilms were quantitatively assessed by XTT reduction assay and crystal violet assay, and qualitatively by confocal laser scanning microscopy (CLSM) and transmission electron microscopy (TEM). Ciprofloxacin release from liposomes was higher when encapsulated with farnesol (Lcip+far) compared to Lcip (3.06% vs 1.48%), whereas farnesol release was lower when encapsulated with ciprofloxacin (Lcip+far) compared to Lfar (1.81% vs 4.75%). The biofilm metabolism was significantly lower when treated with Lcip+far or Lcip compared to free ciprofloxacin (XTT, P < 0.05). When administered as Lcip+far, the ciprofloxacin concentration required to achieve similar biofilm inhibition was 125-fold or 10-fold lower compared to free ciprofloxacin or Lcip, respectively (P < 0.05). CLSM and TEM confirmed predominant biofilm disruption, greater dead cell ratio, and increased depth of biofilm killing when treated with Lcip+far compared to other liposomal preparations. Thus, codelivery of farnesol and ciprofloxacin is likely to be a promising approach to battle antibiotic resistant P. aeruginosa biofilms by enhancing biofilm killing at significantly lower antibiotic doses.
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Affiliation(s)
- H M H N Bandara
- Division of Pharmaceutics, College of Pharmacy, The University of Texas at Austin , Austin, Texas 78712, United States
| | - M J Herpin
- Division of Pharmaceutics, College of Pharmacy, The University of Texas at Austin , Austin, Texas 78712, United States
| | - D Kolacny
- Division of Pharmaceutics, College of Pharmacy, The University of Texas at Austin , Austin, Texas 78712, United States
| | - A Harb
- Division of Pharmaceutics, College of Pharmacy, The University of Texas at Austin , Austin, Texas 78712, United States
| | - D Romanovicz
- Institute of Cellular and Molecular Biology, College of Natural Sciences, The University of Texas at Austin , Austin, Texas 78712, United States
| | - H D C Smyth
- Division of Pharmaceutics, College of Pharmacy, The University of Texas at Austin , Austin, Texas 78712, United States
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21
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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.
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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
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22
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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.
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23
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Kucera J, Sojka M, Pavlik V, Szuszkiewicz K, Velebny V, Klein P. Multispecies biofilm in an artificial wound bed—A novel model for in vitro assessment of solid antimicrobial dressings. J Microbiol Methods 2014; 103:18-24. [DOI: 10.1016/j.mimet.2014.05.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 05/04/2014] [Accepted: 05/05/2014] [Indexed: 01/30/2023]
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24
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Next science wound gel technology, a novel agent that inhibits biofilm development by gram-positive and gram-negative wound pathogens. Antimicrob Agents Chemother 2014; 58:3060-72. [PMID: 24637684 DOI: 10.1128/aac.00108-14] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Loss of the skin barrier facilitates the colonization of underlying tissues with various bacteria, where they form biofilms that protect them from antibiotics and host responses. Such wounds then become chronically infected. Topical antimicrobials are a major component of chronic wound therapy, yet currently available topical antimicrobials vary in their effectiveness on biofilm-forming pathogens. In this study, we evaluated the efficacy of Next Science wound gel technology (NxtSc), a novel topical agent designed to kill planktonic bacteria, penetrate biofilms, and kill the bacteria within. In vitro quantitative analysis, using strains isolated from wounds, showed that NxtSc inhibited biofilm development by Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae by inhibiting bacterial growth. The gel formulation NxtSc-G5, when applied to biofilms preformed by these pathogens, reduced the numbers of bacteria present by 7 to 8 log10 CFU/disc or CFU/g. In vivo, NxtSc-G5 prevented biofilm formation for 72 h when applied at the time of wounding and infection and eliminated biofilm infection when applied 24 h after wounding and infection. Storage of NxtSc-G5 at room temperature for 9 months did not diminish its efficacy. These results establish that NxtSc is efficacious in vitro and in vivo in preventing infection and biofilm development by different wound pathogens when applied immediately and in eliminating biofilm infection already established by these pathogens. This novel antimicrobial agent, which is nontoxic and has a usefully long shelf life, shows promise as an effective agent for the prevention and treatment of biofilm-related infections.
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Abstract
Chronic wounds are typically halted in the inflammatory stage of wound healing secondary to a prolonged inflammatory response of the body to bacterial colonization, as planktonic bacteria and biofilm and senescent cells present at the wound's edges. Surgical debridement of these wounds is a critical step taken by the treating physician to attain complete healing. In order for debridement to successfully reset the stages of wound healing, residual biofilm and senescent cells must be removed. Despite the importance of complete and thorough debridement, few methods exist, and even fewer articles have been written describing techniques to ensure that all portions of a wound are equally addressed with each procedure. Using methylene blue dye to color the wound allows the surgeon to address and debride all portions of the wound adequately. In addition, the surgeon must be very familiar with what the normal tissue colors are following removal of the methylene blue-dyed tissue. Getting to tissue with those colors provides an end point to the debridement and helps prevent removal of excess healthy tissue. This article describes the primary author's technique for staining tissues with methylene blue dye prior to wound debridement, as well as the colors to look for to signal completion of surgery. In addition, a review of biofilm and senescent cells is presented as both are targeted but frequently missed when wounds are incompletely debrided.
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26
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Duplantier AJ, van Hoek ML. The Human Cathelicidin Antimicrobial Peptide LL-37 as a Potential Treatment for Polymicrobial Infected Wounds. Front Immunol 2013; 4:143. [PMID: 23840194 PMCID: PMC3699762 DOI: 10.3389/fimmu.2013.00143] [Citation(s) in RCA: 158] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 05/28/2013] [Indexed: 12/30/2022] Open
Abstract
Diabetic patients often have ulcers on their lower-limbs that are infected by multiple biofilm-forming genera of bacteria, and the elimination of the biofilm has proven highly successful in resolving such wounds in patients. To that end, antimicrobial peptides have shown potential as a new anti-biofilm approach. The single human cathelicidin peptide LL-37 has been shown to have antimicrobial and anti-biofilm activity against multiple Gram-positive and Gram-negative human pathogens, and have wound-healing effects on the host. The combination of the anti-biofilm effect and wound-healing properties of LL-37 may make it highly effective in resolving polymicrobially infected wounds when topically applied. Such a peptide or its derivatives could be a platform from which to develop new therapeutic strategies to treat biofilm-mediated infections of wounds. This review summarizes known mechanisms that regulate the endogenous levels of LL-37 and discusses the anti-biofilm, antibacterial, and immunological effects of deficient vs. excessive concentrations of LL-37 within the wound environment. Here, we review recent advances in understanding the therapeutic potential of this peptide and other clinically advanced peptides as a potential topical treatment for polymicrobial infected wounds.
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Affiliation(s)
- Allen J Duplantier
- National Center for Biodefense and Infectious Diseases, George Mason University , Manassas, VA , USA
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Brackman G, De Meyer L, Nelis HJ, Coenye T. Biofilm inhibitory and eradicating activity of wound care products against Staphylococcus aureus and Staphylococcus epidermidis biofilms in an in vitro chronic wound model. J Appl Microbiol 2013; 114:1833-42. [PMID: 23490006 DOI: 10.1111/jam.12191] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 03/07/2013] [Accepted: 03/07/2013] [Indexed: 01/20/2023]
Abstract
AIMS Although several factors contribute to wound healing, bacterial infections and the presence of biofilm can significantly affect healing. Despite that this clearly indicates that therapies should address biofilm in wounds, only few wound care products have been evaluated for their antibiofilm effect. For this reason, we developed a rapid quantification approach to investigate the efficacy of wound care products on wounds infected with Staphylococcus spp. METHODS AND RESULTS An in vitro chronic wound infection model was used in which a fluorescent Staph. aureus strain was used to allow the rapid quantification of the bacterial burden after treatment. A good correlation was observed between the fluorescence signal and the bacterial counts. When evaluated in this model, several commonly used wound dressings and wound care products inhibited biofilm formation resulting in a decrease between one and seven log CFU per biofilm compared with biofilm formed in the absence of products. In contrast, most dressings only moderately affected mature biofilms. CONCLUSION Our model allowed the rapid quantification of the bacterial burden after treatment. However, the efficacy of treatment varied between the different types of dressings and/or wound care products. SIGNIFICANCE AND IMPACT OF THE STUDY Our model can be used to compare the efficacy of wound care products to inhibit biofilm formation and/or eradicate mature biofilms. In addition, the results indicate that treatment of infected wounds should be started as soon as possible and that novel products with more potent antibiofilm activity are needed.
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Affiliation(s)
- G Brackman
- Laboratory of Pharmaceutical Microbiology, Ghent University, Ghent, Belgium
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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
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Comparison of culture and molecular identification of bacteria in chronic wounds. Int J Mol Sci 2012; 13:2535-2550. [PMID: 22489109 PMCID: PMC3317672 DOI: 10.3390/ijms13032535] [Citation(s) in RCA: 129] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Revised: 01/30/2012] [Accepted: 02/13/2012] [Indexed: 12/12/2022] Open
Abstract
Clinical diagnostics of chronic polymicrobial infections, such as those found in chronic wounds, represent a diagnostic challenge for both culture and molecular methods. In the current retrospective study, the results of aerobic bacterial cultures and culture-free bacterial identification using DNA analyses were compared. A total of 168 chronic wounds were studied. The majority of bacteria identified with culture testing were also identified with molecular testing, but the majority of bacteria identified with the molecular testing were not identified with culture testing. Seventeen (17) different bacterial taxa were identified with culture, and 338 different bacterial taxa were identified with molecular testing. This study demonstrates the increased sensitivity that molecular microbial identification can have over culture methodologies, and previous studies suggest that molecular bacterial identification can improve the clinical outcomes of patients with chronic wounds.
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Shah J. Ace your certification exam: biofilm-based wound care. J Am Coll Clin Wound Spec 2011; 3:97-8. [PMID: 24527371 PMCID: PMC3921234 DOI: 10.1016/j.jcws.2012.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Dr Jayesh Shah authors this quarterly column, consisting of 5 questions with explanations, to help you practice for your exam. In this issue, the column focuses on questions about biofilm-based wound care.
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Dowd SE, Wolcott RD, Kennedy J, Jones C, Cox SB. Molecular diagnostics and personalised medicine in wound care: assessment of outcomes. J Wound Care 2011; 20:232, 234-9. [PMID: 21647068 DOI: 10.12968/jowc.2011.20.5.232] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE This large, level A, retrospective cohort study set out to compare healing outcomes in three large cohorts of wound patients managed universally for bioburden: standard of care group, who were prescribed systemic antibiotics on the basis of empiric and traditional culture-based methodologies; treatment group 1, who were prescribed an improved selection of systemic antibiotics based on the results of molecular diagnostics; treatment group 2 who received personalised topical therapeutics (including antibiotics) based on the results of molecular diagnostics. METHOD Apart from the differences in diagnostic methods and antibiotic treatments described above, all three cohorts were subjected to the same biofilm-based wound care protocol, which included evaluation of the host and bioburden, frequent sharp debridement, use of wound dressings and comprehensive standard care (reperfusion therapy, nutritional support, offloading, compression and management of comorbidities). RESULTS In all, 1378 patients were recruited into the study. In the standard of care group 48.5% of patients (244/503) healed completely during the 7-month study period. This increased to 62.4% (298/479) in treatment group 1 and 90.4% (358/396) in treatment group 2. Cox proportional hazards analysis revealed the time to complete closure decreased by 26% in treatment group 1 (p<0.001) and 45.9% in treatment group 2 (p<0.001) compared with the standard of care group. Patients in treatment group 2 had >200% better odds of healing at any given time point compared with the other cohorts. CONCLUSION Implementation of personalised topical therapeutics guided by molecular diagnosis resulted in statistically and clinically significant improvements in outcome. The integration of molecular diagnostics and personalised medicine provides a directed and targeted approach to wound care. CONFLICT OF INTEREST SED and RDW are owners of PathoGenius Laboratories, a clinical diagnostic laboratory. SED and RDW are owners of Research and Testing Laboratory, which develops molecular diagnostics. CJ and JK are clinical advisors for PathoGenius. CJ and JK are owners of Southeastern Medical Compounding, Savannah, GA and Southeastern Medical Technologies, Savannah, GA.
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Affiliation(s)
- S E Dowd
- Research and Testing Laboratory and Pathogenius Diagnostics, Lubbock, TX, USA.
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Mäkinen KK. Sugar alcohol sweeteners as alternatives to sugar with special consideration of xylitol. Med Princ Pract 2011; 20:303-20. [PMID: 21576989 DOI: 10.1159/000324534] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Accepted: 12/26/2010] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Dental caries is a diet-associated disease which continues to be a serious health problem in most industrialized and developing countries. Strategies to maximize caries prevention should automatically consider the use of sugar substitutes. It is important that public health authorities are made cognizant of the availability of new polyol-type sugar substitutes. REVIEW SUMMARY Clinical studies have shown that xylitol, a natural, physiologic sugar alcohol of the pentitol type, can be used as a safe and effective caries-limiting sweetener. Habitual use of xylitol-containing food and oral hygiene adjuvants has been shown to reduce the growth of dental plaque, to interfere with the growth of caries-associated bacteria, to decrease the incidence of dental caries, and to be associated with remineralization of caries lesions. Numerous public regulatory bodies have endorsed the use of xylitol as a caries-limiting agent. Other sugar alcohols that have been successfully used as sugar substitutes include D-glucitol (sorbitol), which, however, owing to its hexitol nature, normally has no strong effect on the mass and adhesiveness of bacterial plaque and on the growth of mutans streptococci. A tetritol-type alditol, erythritol, has shown potential as a non-cariogenic sugar substitute. Combinations of xylitol and erythritol may reduce the incidence of caries more effectively than either alditol alone. CONCLUSIONS Partial sugar substitution with polyols is an important dietary tool in the prevention of dental caries that should be used to enhance existing fluoride-based caries prevention programmes. The most effective method of conveying this information to the public is through a proper health claim for these alditols in food labelling. The present review summarizes clinical and biochemical aspects of the above three dietary polyols and emphasizes the role of sugar substitution as a potential health-promoting strategy.
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Affiliation(s)
- Kauko K Mäkinen
- Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, Turku, Finland.
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