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Li R, Rouse M, Pace BT, Grey SF, Mclaughlin K, Schobel SA, Simons MP. Host CD3 + T-cells can significantly modulate phage treatment effects on bacterial bioburden in mouse models. Front Microbiol 2023; 14:1240176. [PMID: 37766890 PMCID: PMC10520710 DOI: 10.3389/fmicb.2023.1240176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/03/2023] [Indexed: 09/29/2023] Open
Abstract
Wound healing is a complex system including such key players as host, microbe, and treatments. However, little is known about their dynamic interactions. Here we explored the interplay between: (1) bacterial bioburden and host immune responses, (2) bacterial bioburden and wound size, and (3) treatments and wound size, using murine models and various treatment modalities: Phosphate buffer saline (PBS or vehicle, negative control), doxycycline, and two doses of A. baumannii phage mixtures. We uncovered that the interplay between bacterial bioburden and host immune system may be bidirectional, and that there is an interaction between host CD3+ T-cells and phage dosage, which significantly impacts bacterial bioburden. Furthermore, the bacterial bioburden and wound size association is significantly modulated by the host CD3+ T-cells. When the host CD3+ T-cells (x on log10 scale) are in the appropriate range (1.35 < x < = 1.5), we observed a strong association between colony forming units (CFU) and wound size, indicating a hallmark of wound healing. On the basis of the findings and our previous work, we proposed an integrated parallel systems biology model.
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Affiliation(s)
- Renhua Li
- Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- Surgical Critical Care Initiative (SC2i), Uniformed Services University (USU), Bethesda, MD, United States
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD, United States
| | - Michael Rouse
- Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- Surgical Critical Care Initiative (SC2i), Uniformed Services University (USU), Bethesda, MD, United States
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD, United States
- Walter Reed National Military Medical Center, Bethesda, MD, United States
| | - Brendon T. Pace
- Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- Eastern Virginia Medical School, Norfolk, VA, United States
| | - Scott F. Grey
- Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- Surgical Critical Care Initiative (SC2i), Uniformed Services University (USU), Bethesda, MD, United States
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD, United States
| | - Kimberly Mclaughlin
- Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- Surgical Critical Care Initiative (SC2i), Uniformed Services University (USU), Bethesda, MD, United States
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD, United States
| | - Seth A. Schobel
- Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- Surgical Critical Care Initiative (SC2i), Uniformed Services University (USU), Bethesda, MD, United States
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD, United States
| | - Mark P. Simons
- Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- Naval Medical Research Center, Silver Spring, MD, United States
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Blunt KM, Bentkowski BN, Milliron E, Cavendish P, Qin C, Magnussen RA, Stoodley P, Flanigan DC. Influence of Staphylococcus epidermidis on Collagen Crimp Patterns of Soft Tissue Allograft. Am J Sports Med 2023:3635465231181649. [PMID: 37449681 DOI: 10.1177/03635465231181649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
BACKGROUND Postoperative infections, commonly from Staphylococcus epidermidis, may result in anterior cruciate ligament graft failure and necessitate revision surgery. In biomechanical studies, S. epidermidis has been shown to establish biofilms on tendons and reduce graft strength. PURPOSE/HYPOTHESIS The goal of this study was to determine the effect of bacterial bioburden on the collagen structure of tendon. It was hypothesized that an increase in S. epidermidis biofilm would compromise tendon crimp, a pattern necessary for mechanical integrity, of soft tissue allografts. STUDY DESIGN Controlled laboratory study. METHODS Cultures of S. epidermidis were used to inoculate tibialis anterior cadaveric tendons. Conditions assessed included 5 × 105 colony-forming units or concentrated spent media from culture (no living bacteria). Incubation times of 30 minutes, 3 hours, 6 hours, and 24 hours were utilized. Second-harmonic generation imaging allowed for visualization of collagen autofluorescence. Crimp lengths were determined using ImageJ and compared based on incubation time. RESULTS Incubation time positively correlated with increasing S. epidermidis bioburden. Both fine and coarse crimp patterns lengthened with increasing incubation time. Significant coarse crimp changes were observed after only 30-minute incubations (P < .029), whereas significant fine crimp lengthening occurred after 6 hours (P < .0001). No changes in crimp length were identified after incubation in media lacking living bacteria. CONCLUSION The results of this study demonstrate that exposure to S. epidermidis negatively affects collagen crimp structure. Structural alterations at the collagen fiber level occur within 30 minutes of exposure to media containing S. epidermidis. CLINICAL RELEVANCE Our study highlights the need for antimicrobial precautions to prevent graft colonization and maximize graft mechanical strength.
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Affiliation(s)
- Koral M Blunt
- The Ohio State University College of Medicine, Columbus, Ohio, USA
| | | | - Eric Milliron
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Parker Cavendish
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Charles Qin
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Robert A Magnussen
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- The Ohio State University Sports Medicine Research Institute, Columbus, Ohio, USA
| | - Paul Stoodley
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, Ohio, USA
| | - David C Flanigan
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- The Ohio State University Sports Medicine Research Institute, Columbus, Ohio, USA
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Weiying Lu, Amit Rao, Alisha Oropallo, Scott Gawlik, John Haight. Use of Copper Nanoparticles to Reduce Bioburden in the Treatment of Diabetic Foot Ulcers. Eplasty 2022; 22:QA4. [PMID: 36793619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
What percentage of persons living with diabetes will experience a diabetic foot ulcer (DFU)?How are copper nanoparticles effective in the treatment of DFUs?What are common adjunct therapies in the treatment of DFUs?What pathogens commonly colonize DFUs, and how are they approached?
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Moog P, Jensch M, Betzl J, Bauer AT, Cerny MK, Schmauss D, Kükrek H, Erne H, Machens HG, Megerle K. Bacterial bioburden of wounds: influence of debridement and negative-pressure wound therapy (NPWT). J Wound Care 2021; 30:604-611. [PMID: 34382852 DOI: 10.12968/jowc.2021.30.8.604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To clarify the role of microbiological swabs in surgical decision-making, we investigated the effect of negative-pressure wound therapy (NPWT) and serial surgical debridement on bacterial bioburden in hard-to-heal wounds and ultimately correlated them with the success of surgical closure. METHOD All patients were treated with surgical debridement, jet lavage and NPWT before their wounds were finally closed. The treatment effect was assessed by correlating microbiological swabs obtained immediately after intervention with those obtained after removal of the dressings during the following surgical procedures. The result of the last microbiological swab taken before definitive surgical closure was correlated with the requirement for revision surgery. RESULTS We included the results of 704 microbiological swabs from 97 patients in 110 wound localisations in this monocentric, retrospective study. NPWT did not improve bacterial bioburden in 77% of cases and the duration of NPWT did not affect the result. Furthermore, no significant effect of NPWT could be found for either anaerobic (p=0.96) or aerobic bacteria (p=0.43). In contrast, surgical debridement decreased bacterial load in approximately 60% of cases. If sterile wound swabs could be obtained at all, it was during the first four surgical debridements in 60% of patients; after that only 10% became sterile. CONCLUSIONS Sterile microbiological wound swabs before surgical closure were associated with lower rates of revision surgery, while low or medium bacterial loads did not increase revision rates.
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Affiliation(s)
- Philipp Moog
- Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, D-81675, Munich, Germany
| | - Maryna Jensch
- Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, D-81675, Munich, Germany
| | - Julia Betzl
- Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, D-81675, Munich, Germany
| | - Anna-Theresa Bauer
- Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, D-81675, Munich, Germany
| | - Michael K Cerny
- Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, D-81675, Munich, Germany
| | - Daniel Schmauss
- Department for Plastic, Reconstructive and Aesthetic Surgery, Ospedale Regionale di Lugano, Lugano, Switzerland
| | - Haydar Kükrek
- Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, D-81675, Munich, Germany
| | - Holger Erne
- Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, D-81675, Munich, Germany
| | - Hans-Günther Machens
- Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, D-81675, Munich, Germany
| | - Kai Megerle
- Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, D-81675, Munich, Germany
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