Abstract

Staphylococcus aureus is a common pathogen isolated from burn patients that can form biofilms on burn wounds and implanted deep vein catheters, which often leads to refractory infections or even biofilm-related sepsis. As biofilm formation is usually regulated by environmental conditions, we hypothesized that serum composition may be altered after burn injury, potentially affecting the ability of infecting bacteria to form biofilms. As predicted, we observed that serum from burn-injured rats increases biofilm formation by S. aureus and also induces bacterial aggregation and adherence to human fibronectin and fibrinogen. Analysis of potential regulatory factors revealed that exposure to burn serum decreases expression of the quorum-sensing agr system and increases mRNA levels of some biofilm inducers such as sarA and icaA. In addition, we also observed that burn serum imposes oxidative stress and increases expression of key oxidoreductase genes (sodA, sodM, katA, and ahpC) in S. aureus. Importantly, the ability of burn serum to enhance biofilm formation and bacterial cell aggregation can be abrogated by treatment with an antioxidant. Taken together, these findings indicate that burn serum increases S. aureus biofilm formation via elevated oxidative stress, and may lead to novel strategies to control biofilm formation and infection in burn patients.

Highlights

  • Infections are the leading cause of morbidity and mortality in burn patients (Rafla and Tredget, 2011)

  • Because biofilm formation is often regulated by environmental stimuli, we hypothesized that burn injuries may alter serum chemistry in a way that affects the ability of infecting bacteria to form biofilms

  • We demonstrated that serum from burn-injured rats enhances biofilm formation by S. aureus, one of the most common pathogens that infects burn patients

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Summary

INTRODUCTION

Infections are the leading cause of morbidity and mortality in burn patients (Rafla and Tredget, 2011). Because infecting microbes often inhabit the wounds or implanted catheters of burn patients, they are exposed to this modified environment Whether these changes impact bacteria is not known. Biofilm formation of S. aureus is often regulated by some stress conditions, such as temperature, sodium chloride, glucose, and oxidative stress (Rode et al, 2007) These stimuli further affect the complicated pathways involved in biofilm formation including both ica-dependent and ica-independent mechanisms. Treatment with antioxidant abrogates the ability of burn serum to increase S. aureus biofilm formation and cell aggregation. Together, these observations suggest that enhanced biofilm formation by S. aureus in burn serum is due to elevated oxidative stress. These findings may provide a foundation for novel strategies to control biofilms and infections in burn patients

MATERIALS AND METHODS
Burn Procedure and Burn Serum Isolation
Ethics Statement
RESULTS
DISCUSSION
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