Abstract
Patients receiving lipid emulsions are at increased risk of contracting catheter-related bloodstream infections (CRBSIs) in the clinic. More than 15% of CRBSIs are polymicrobial. The objective of this study was to explore the effects of lipid emulsions on the formation of Escherichia coli (E. coli)–Candida albicans (C. albicans) mixed-species biofilms (BFs) on polyvinyl chloride (PVC) surfaces and the underlying mechanism. Mixed-species BFs were produced by coculturing E. coli and C. albicans with PVC in various concentrations of lipid emulsions. Crystal violet staining and XTT assays were performed to test the mixed-species BF biomass and the viability of microbes in the BFs. The microstructures of the BFs were observed by an approach that combined confocal laser scanning microscopy, fluorescence in situ hybridization, and scanning electron microscopy. The study found that lipid emulsions could promote the formation of E. coli–C. albicans mixed-species BFs, especially with 10% lipid emulsions. The mechanism by which lipid emulsions promote mixed-species BF formation may involve significant upregulation of the expression of the flhDC, iha, HTA1, and HWP1 genes, which are associated with bacterial motility, adhesion, and BF formation. The results derived from this study necessitate strict aseptic precautions when handling lipid emulsions and avoiding the use of high concentrations of lipid emulsions for as long as possible.
Highlights
Patients receiving lipid emulsions are at increased risk of contracting catheter-related bloodstream infections (CRBSIs) in the clinic
We aimed to determine whether the formation of E. coli–C. albicans mixedspecies BFs was significantly altered by clinical lipid emulsions
The results showed that the lipid emulsions with various concentrations exhibited greater microbial adhesion and mixed-species BF biomass than those in the control group, which was treated with tryptic soy broth (TSB) medium alone at each time point (P < 0.05)
Summary
Patients receiving lipid emulsions are at increased risk of contracting catheter-related bloodstream infections (CRBSIs) in the clinic. The objective of this study was to explore the effects of lipid emulsions on the formation of Escherichia coli (E. coli)– Candida albicans (C. albicans) mixed-species biofilms (BFs) on polyvinyl chloride (PVC) surfaces and the underlying mechanism. The risk of catheter-related bloodstream infections (CRBSIs) for patients receiving a long period of PN through CVCs is relatively high due to the presence of lipid emulsions, an indispensable component of PN, which provide vital energy and fatty acids for patients and favour the growth of various microbes, including bacteria and fungi[3,4]. These studies were limited to studying infections caused by monospecies BFs15–17. The effects of lipid emulsions on the formation of E. coli–C. albicans mixed-species BFs on medical catheters are still unknown
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