Dissolution of Biofilm Secreted by Three Different Strains of Pseudomonas aeruginosa with Bromelain, N-Acetylcysteine, and Their Combinations

Carly J Carter,Thomas Jefferies,Javed Akhter,David L Morris,Ahmed H Mekkawy,Krishna Pillai,Sarah J Valle,Samina Badar

doi:10.3390/app112311388

Carly J Carter, Thomas Jefferies + Show 6 more

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https://doi.org/10.3390/app112311388

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Abstract

Bacterial infection of hernia mesh with the formation of biofilms presents a barrier to antibiotic treatment with subsequent surgical intervention and hospitalization. Hence, in the current study, we examined the effect of BromAc, a mucolytic agent, on the dissolution of biofilm formed by three different strains of Pseudomonas aeruginosa. Pseudomonas aeruginosa was carefully grown on hernia mesh and treated with various concentrations of bromelain, NAC, and their combinations at 37 °C over 4 h in vitro. Then, the biofilm dissolution activities of the agents were evaluated. Moreover, the combination index (CI) was analyzed to determine the synergy of the bromelain and NAC combination. The results indicated that biofilms were more susceptible to degradation by bromelain, whilst NAC showed growth enhancement in two of the strains. However, in combination (BromAc), the three strains were dramatically affected by the agents, with more than 80% debridement fir a suitable combination of bromelain and NAC that was also strain-specific. Hence, the current study shows that the biofilms formed by these three strains of Pseudomonas aeruginosa were adversely affected by a single treatment of BromAc, with more than 80% debridement, indicating that subsequent treatment may abolish the biofilm completely.

Highlights

With the advent of modern medicine, many implantable medical devices such as breast, dental, and gluteal implants; orthopedic devices; heart valves; stents; pacemakers; hernia mesh; and a host of others have been introduced with either cosmetic or curative intent. These implants are successful in treating several diseases, as well as enhancing cosmetic appearance, they are prone to bacterial colonization and infection, which are often treated with antibiotics [1,2,3]; chronic recurrence often leads to hospitalization with surgical removal or debridement [4,5]
[10] different individual bacteria can invade these implants, sometimes two or three different strains of the same genus may exist in a colony [11,12], with subsequent treatment failure owing to susceptibility differences to bactericides [13]
In the present study, we investigated the dissolution action of bromelain and NAC (BromAc) on biofilm formed by Pseudomonas aeruginosa using three different strains in order to study the efficacy, with variability shown within the strains

Summary

Introduction

With the advent of modern medicine, many implantable medical devices such as breast, dental, and gluteal implants; orthopedic devices; heart valves; stents; pacemakers; hernia mesh; and a host of others have been introduced with either cosmetic or curative intent. These implants are successful in treating several diseases, as well as enhancing cosmetic appearance, they are prone to bacterial colonization and infection, which are often treated with antibiotics [1,2,3]; chronic recurrence often leads to hospitalization with surgical removal or debridement [4,5]. Treatment can be difficult because the invading bacterial colony exudes a slimy secretion (biofilm) over the implanted mesh [14]

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