Biofilms: survival mechanisms of clinically relevant microorganisms.

Biofilms present a new challenging concept in sustaining chronic, common antibiotic-resistant ear, nose, and throat (ENT) infections. They are communities of sessile bacteria embedded in a matrix of extracellular polymeric substances of their own synthesis that adhere to a foreign body or a mucosal surface with impaired host defense. The aim of this paper is to review the literature on ENT diseases that can be attributed to biofilm formation and to discuss options for future treatment. Literature review from Medline and database sources. Electronic links and related books were also included. Controlled clinical trials, animal models, ex vivo models, laboratory studies, retrospective studies, and systematic reviews. Biofilm formation is a dynamic five-step process guided by interbacterial communicating systems. Bacteria in biofilms express different genes and have markedly different phenotypes from their planktonic counterparts. Detachment of cells, production of endotoxin, increased resistance to the host immune system, and provision of a niche for the generation of resistant organisms are biofilm processes that could initiate the infection process. Effective prevention and management strategies include interruption of quorum sensing, inhibition of related genes, disruption of the protective extrapolymer matrix, macrolides (clarithromycin and erythromycin), and mechanical debridement of the biofilm-bearing tissues. With regard to medical indwelling devices, surface treatment of fluoroplastic grommets and redesign of cochlear implants could minimize initial microbial colonization. As the role of biofilms in human infection becomes better defined, ENT surgeons should be prepared to deal with their unique and tenacious nature.

Salmonella enterica forms biofilms that are relatively resistant to chemical sanitizing treatments. Ionizing radiation has been used to inactivate Salmonella on a variety of foods and contact surfaces, but the relative efficacy of the process against biofilm-associated cells versus free-living planktonic cells is not well documented. The radiation sensitivity of planktonic or biofilm-associated cells was determined for three food-borne-illness-associated isolates of Salmonella. Biofilms were formed on sterile glass slides in a coincubation apparatus, using inoculated tryptic soy broth, incubated at 37 degrees C for 48 h. Resulting biofilms were 18 to 24 microm in height as determined by confocal scanning laser microscopy. The planktonic and biofilm cultures were gamma irradiated to doses of 0.0 (control), 0.5, 1.0, 1.5, 2.0 and 2.5 kGy. The D(10) value (the dose of radiation required to reduce a population by 1 log(10), or 90%) was calculated for each isolate-culture based on surviving populations at each radiation dose. The D(10) values of S. enterica serovar Anatum were not significantly (P < 0.05) different for biofilm-associated (0.645 kGy) and planktonic (0.677 kGy) cells. In contrast, the biofilm-associated cells of S. enterica serovar Stanley were significantly more sensitive to ionizing radiation than the respective planktonic cells, with D(10) values of 0.531 and 0.591 kGy, respectively. D(10) values of S. enterica serovar Enteritidis were similarly reduced for biofilm-associated (0.436 kGy) versus planktonic (0.535 kGy) cells. The antimicrobial efficacy of ionizing radiation is therefore preserved or enhanced in treatment of biofilm-associated bacteria.

Proper regulation of airway surface layer (ASL) is essential for effective mucociliary clearance (MCC) in healthy airways. ASL depletion due to deficient cystic fibrosis transmembrane conductance regulator (CFTR)-mediated anion/fluid secretion plays an important role in the pathogenesis of mucociliary dysfunction and chronic muco-obstructive lung disease in patients with cystic fibrosis (CF). Quantitative measurement of ASL height by confocal fluorescence microscopy following addition of fluorescent dye has contributed important insight into the (dys)regulation of ASL in health and disease. Here, we present a novel method enabling studies of ASL regulation that does not require the addition of dye by using reflected light by confocal microscopy of primary airway epithelial cultures grown at air-liquid interface (ALI). After apical volume addition to primary tracheal mouse cultures, confocal reflection microscopy yielded comparable ASL height as confocal fluorescence microscopy on cultures of wild-type mice, and was sensitive to detect ASL depletion on cultures of βENaC-Tg mice. Under unperturbed conditions, ASL determined by confocal reflection microscopy was significantly higher in wild-type and βENaC-Tg mice compared to values obtained by confocal fluorescence microscopy. Studies in normal and CF primary human airway epithelial cultures showed that confocal reflection microscopy was sensitive to detect effects of low temperature rescue and pharmacological modulation including improvement of CFTR function by VX-809 and VX-770 in cultures from CF patients with the F508del mutation. Our results support confocal reflection microscopy as a novel sensitive technique for quantitative studies of ASL regulation and response to therapeutic intervention under near-physiological conditions that may be applicable for studies of (patho)physiology and drug screens in healthy and CF airways.

The majority of prostate cancer-related deaths are associated with advanced and metastatic malignancies. Although anoikis resistance has been recognized as one of the hallmarks of metastatic prostate malignancies, the molecular events that cause anoikis resistance are poorly understood. In this study, we found that the detachment of PC-3 prostate cancer cells caused a time-dependent increase in the expression level of the leukotriene B4 receptor-2 (BLT2) and that BLT2 played a critical role in establishing anoikis resistance in these cells. Blocking BLT2 with the pharmacological inhibitor LY255283 or with RNAi knockdown clearly abolished anoikis resistance and resulted in severe apoptotic death. Additionally, we demonstrated that the activation of NADPH oxidase (NOX) and subsequent generation of reactive oxygen species (ROS) were downstream of BLT2 signaling and led to the activation of NF-κB, thus establishing anoikis resistance during cell detachment. Furthermore, we observed that the ectopic expression of BLT2 in normal prostate PWR-1E cells rendered the cells resistant to anoikis and apparently diminished apoptotic cell death following detachment. Taken together, our results suggest that BLT2-NOX-ROS-NF-κB cascade induction during detachment confers a novel mechanism of anoikis resistance in prostate cancer cells and potentially contributes to prostate cancer progression.

Biofilms are of great practical importance for beneficial technologies such as water and wastewater treatment and bioremediation of groundwater and soil. In other settings biofilms cause severe problems, for example in 65% of bacterial infections currently treated by clinicians (particularly those associated with prosthetics and implants), accelerated corrosion in industrial systems, oil souring and biofouling. Until recently, the structure and function of biofilms could only be inferred from gross measures of biomass and metabolic activity. This limitation meant that investigators involved in biofilm research and application had only a crude understanding of the microbial ecology, physical structure and chemical characteristics of biofilms. Consequently, opportunities for the exploitation and control of biofilms were very limited. The past decade has witnessed the development of several new techniques to elucidate the structure and function of biofilms. Examples include: the use of molecular probes that identify different microbes in complex communities as well as their metabolic functions; the use of microsensors that show concentration gradients of key nutrients and chemicals; the use of confocal laser scanning microscopy to describe the physical structure of biofilms and the development of a new generation of mathematical models that allow for the prediction of biofilm structure and function. However, much progress remains to be made in efforts to understand, control and exploit biofilms. This timely book will introduce its readers to the structure and function of biofilms at a fundamental level as determined during the past decade of research, including: Extracellular polymers as the biofilm matrix; Biofilm phenotype (differential gene expression, interspecies signalling); Biofilm ecology; Biofilm monitoring; Resistance of biofilms to antimicrobial agents and Biofilm abatement. Biofilms in Medicine, Industry and Environmental Technology offers a holistic and multi-disciplinary description of the topic, including biofilm formation and composition, but also biofilm monitoring, disinfection and control. All these aspects are presented from three points of views: medical, industrial and environmental biotechnological in a compact, easy to read format.

Biofilms 2003: emerging themes and challenges in studies of surface-associated microbial life.

The ability of the opportunistic pathogen, Staphylococcus aureus, to form biofilms is increasingly being viewed as an important contributor to chronic infections. In vitro methods for analyzing S. aureus biofilm formation have focused on bacterial attachment and accumulation on abiotic surfaces, such as in microtiter plate and flow cell assays. Microtiter plates provide a rapid measure of relative biomass levels, while flow cells have limited experimental throughput but are superior for confocal microscopy biofilm visualization. Although these assays have proven effective at identifying mechanisms involved in cell attachment and biofilm accumulation, the significance of these assays in vivo remains unclear. Studies have shown that when medical devices are implanted they are coated with host factors, such as matrix proteins, that facilitate S. aureus attachment and biofilm formation. To address the challenge of integrating existing biofilm assay features with a biotic surface, we have established an in vitro biofilm technique utilizing UV-sterilized coverslips coated with human plasma. The substratum more closely resembles the in vivo state and provides a platform for S. aureus to establish a robust biofilm. Importantly, these coverslips are amenable to confocal microscopy imaging to provide a visual reference of the biofilm growth stage, effectively merging the benefits of the microtiter and flow cell assays. We confirmed the approach using clinical S. aureus isolates and mutants with known biofilm phenotypes. Altogether, this new biofilm assay can be used to assess the function of S. aureus virulence factors associated with biofilm formation and for monitoring the efficacy of biofilm treatment modalities.

DualBeam instruments that combine the imaging capability of scanning electron microscopy (SEM) with the cutting and deposition capability of a focused ion beam (FIB) provide biologists with a powerful tool for investigating three-dimensional structure with nanoscale (1 nm-100 nm) resolution. Ever since Van Leeuwenhoek used the first microscope to describe bacteria more than 300 years ago, microscopy has played a central role in scientists' efforts to understand biological systems. Light microscopy is generally limited to a useful resolution of about a micrometer. More recently the use of confocal and electron microscopy has enabled investigations at higher resolution. Used with fluorescent markers, confocal microscopy can detect and localize molecular scale features, but its imaging resolution is still limited. SEM is capable of nanometer resolution, but is limited to the near surface region of the sample.

Understanding the limiting factors and mechanisms of biofilm processes requires the direct measurement of microscale gradients using the appropriate tools. Microscale measurements can provide mechanistic information that cannot be obtained from bulk-scale measurements. Among the most used and trusted tools in microscale biofilm research are microsensors. The goal of this chapter is to introduce microsensor technology along with several examples to illustrate microscale processes in biofilms that are usually absent in bulk. We define a microsensor for biofilm research as a needle-type sensor with tip diameter of a few microns and a length up to several hundred microns. Microsensors can be used noninvasively to monitor in situ biofilm processes. Both optical and electrochemical microsensors can be used for biofilm applications. Because of newly discovered biofilm processes, the design and use of microsensors require customization and carefully designed experiments. In this chapter we present several examples describing the use of microsensors (1) in environmental biofilms, (2) in medical biofilms, and (3) in biofilms for energy and bioproducts. Microsensors can be the most useful if the measured profiles are integrated into the study of overall biofilm processes.

Understanding biofilms — are we there yet?

Comparison of biofilm cell quantification methods for drinking water distribution systems

BackgroundCorynebacterium striatum (C. striatum) is a gram-positive, anaerobic bacillus found both environmentally and in human skin and nasal mucosa flora. It is reportedly the etiologic agent of community-acquired and nosocomial diseases and is significantly associated with bacteremia and medical endovascular devices. This is the rare case of mitral valve native valve endocarditis (NVE) caused by C. striatum occurring in a young adult without underlying structural heart disease or indwelling cardiovascular medical devices successfully treated with multidisciplinary therapy.Case presentationThe patient was a 28-year-old female with no medical history. She was transferred our hospital due to sudden onset of vertigo and vomit. A computed tomography on day 2 revealed the hydrocephalus due to the cerebellar infarction, and she underwent posterior fossa decompression for cerebellar infarction. An angiography on day 8 revealed a left vertebral artery dissection, which was suspected be the etiology. Afterwards, a sudden fever of 39 degrees developed on day 38. She was diagnosed with aspiration pneumonia and treated with ampicillin/sulbactam but was still febrile at the time of transfer for rehabilitation. Treatment continued with levofloxacin, the patient had no fever decline, and she was readmitted to our hospital. Readmission blood cultures (3/3 sets) revealed C. striatum, and an echocardiogram revealed an 11 mm long mitral valve vegetation, leading to NVE diagnosis. On the sixth illness day, cardiac failure symptoms manifested. Echocardiography revealed mitral valve rupture. She was transferred again on the 11th day of illness, during which time her mitral valve was replaced. C. striatum was detected in the vegetation. Following surgery, she returned to our hospital, and vancomycin administration continued. The patient was discharged after 31 total days of postoperative antimicrobial therapy. The patient experienced no exacerbations thereafter.ConclusionsWe report the rare case of C. striatum mitral valve NVE in a young adult without structural heart disease or indwelling cardiovascular devices.Clinical trial numberNot applicable.

The mechanism by which cAMP stimulates cystic fibrosis transmembrane conductance regulator (CFTR)-mediated chloride (Cl-) secretion is cell type-specific. By using Madin-Darby canine kidney (MDCK) type I epithelial cells as a model, we tested the hypothesis that cAMP stimulates Cl- secretion by stimulating CFTR Cl- channel trafficking from an intracellular pool to the apical plasma membrane. To this end, we generated a green fluorescent protein (GFP)-CFTR expression vector in which GFP was linked to the N terminus of CFTR. GFP did not alter CFTR function in whole cell patch-clamp or planar lipid bilayer experiments. In stably transfected MDCK type I cells, GFP-CFTR localization was substratum-dependent. In cells grown on glass coverslips, GFP-CFTR was polarized to the basolateral membrane, whereas in cells grown on permeable supports, GFP-CFTR was polarized to the apical membrane. Quantitative confocal fluorescence microscopy and surface biotinylation experiments demonstrated that cAMP did not stimulate detectable GFP-CFTR translocation from an intracellular pool to the apical membrane or regulate GFP-CFTR endocytosis. Disruption of the microtubular cytoskeleton with colchicine did not affect cAMP-stimulated Cl- secretion or GFP-CFTR expression in the apical membrane. We conclude that cAMP stimulates CFTR-mediated Cl- secretion in MDCK type I cells by activating channels resident in the apical plasma membrane.

Microstructures of fried lotus root slices were observed using confocal laser scanning microscopy (CLSM) in fluorescent modes. The three-dimensional (3D) cell structure and morphology of samples were analyzed, for the first time, using 3D reconstructed fluorescent images to determine the cell morphology, oil location and content. Results show that oil was mainly located in the intercellular spaces, broken cells and voids created by the cutting operation, as well as in the wrinkles and distortions caused by the water leakage after frying, cell detachment, starch swelling and rapid dehydration of the first cell layer. Besides, the image stacks obtained by CLSM were processed independently to determine the oil-volume measurements using objective threshold selection. The 3D image data were used for quantitative characterization of oil content by calculating the oil volume. A good correlation between the CLSM results and normal analysis is obtained with the correlation coefficients of 0.892 and 0.875 in calibration and predication, respectively. This study demonstrated that CLSM could determine the oil location and content in fried snacks. Practical Application One of the most important quality parameters for the oil uptake of vacuum fried (VF) and atmospheric fried (AF) lotus root slices were determined and compared under the same frying condition. Microstructures of fried root slices of lotus (Nelumbo nucifera Gaertn.) were observed using CLSM in fluorescent modes. The three-dimensional (3D) cell structure and morphology of samples were analyzed, for the first time, using 3D reconstructed fluorescent images to determine the cell morphology, oil location and content. This optimal way of fried and fired condition was selected by the analytical results of CLSM.

Rotifers are some of the smallest known invertebrates and have been described from all aquatic (marine, estuarine, freshwater) and some semi-terrestrial (soils, mosses) environments. They were the first ‘animalcules’, described by Antonie van Leeuwenhoek in the seventeenth century, and since then, have been the subject of countless investigations that have resulted in over 2000 described species. Studies of the rotifer nervous system began in the eighteenth century, with classical histological techniques that revealed several unique features that remain true to this day, including the eutelic nature of the rotifer brain, the gross morphology of sensory receptors, and the general topography of their nerve cords. With the advent of electron microscopy, confocal laser scanning microscopy, and neuropharmacological techniques in the twentieth century, the details of the rotifer nervous system have become more apparent. The brain consists of a cortex of somata without glial cells and surrounding a fibrous neuropil. Brain somata can be categorized based on several ultrastructural details, as well as differences in neurotransmitter phenotype, which include populations of cells containing catecholamines, serotonin, and neuropeptides. The cerebral neuropil and neurites that innervate the nerve cords, mastax, and sensory receptors also display a variety of neurotransmitter phenotypes. These sensory receptors include putative chemo-, mechano-, and photosensitive organs that function in locomotion, feeding, and reproduction, and appear to respond to a wide variety of exogenous neurotransmitters and neurohormones. While details on neurogenesis remain largely unexplored, early results based on gene expression studies hold promise for future developments in rotifer neurobiology.