Abstract

BackgroundDespite of medical advances, the number of patients suffering on non-healing chronic wounds is still increasing. This fact is attended by physical and emotional distress and an economic load. The majority of chronic wounds are infected of harmful microbials in a protecting extracellular matrix. These biofilms inhibit wound healing. Biofilm-growing bacteria developed unique survival properties, which still challenge the appropriate wound therapy. The present in-vitro biofilm models are not suitable for translational research. By means of a novel in-vivo like human plasma biofilm model (hpBIOM), this study systematically analysed the influence of 3 probiotics on the survival of five clinically relevant pathogenic microorganisms.MethodsHuman plasma was used to produce the innovate biofilm. Pathogenic microorganisms were administered to the plasma. By stimulating the production of a fibrin scaffold, stable coagula-like discs with integrated pathogens were produced. The five clinically relevant pathogens P. aeruginosa, S. aureus, S. epidermidis, E. faecium and C. albicans were challenged to the probiotics L. plantarum, B. lactis and S. cerevisiae. The probiotics were administered on top of the biofilm and the survival was quantified after 4 h and 24 h of incubation. For statistics, two-way ANOVA with post-hoc Tukey’s HSD test was applied. P-value > 0.05 was considered to be significant.ResultsSEM micrographs depicted the pathogens on the surface of the fibrin scaffold, arranged in close proximity and produced the glycocalyx. The application of probiotics induced different growth-reducing capacities towards the pathogens. B. lactis and S. cerevisiae showed slight bacteria-reducing properties. The survival of C. albicans was not affected at all. The most antimicrobial activity was detected after the treatment with L. plantarum.ConclusionsThis study successfully reproduced a novel human biofilm model, which provides a human wound milieu and individual immune competence. The success of bacteriotherapy is dependent on the strain combination, the number of probiotics and the activity of the immune cells. The eradicating effect of L. plantarum on P. aeruginosa should be emphasized.

Highlights

  • Despite of medical advances, the number of patients suffering on non-healing chronic wounds is still increasing

  • The demographic change is attended by an increased incidence of the development of chronic wounds leading to a significant socio-economic burden

  • If a wound displays no signs of healing after 4 weeks, despite of appropriate wound management, it is defined to be a chronic wound

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Summary

Introduction

The number of patients suffering on non-healing chronic wounds is still increasing. This fact is attended by physical and emotional distress and an economic load. The majority of chronic wounds are infected of harmful microbials in a protecting extracellular matrix Most patients with chronic wounds suffer from basic diseases that inhibit the perfusion of the tissue, e.g. diabetes, immobility or peripheral vascular insufficiencies. The surrounding milieu will be re-organized to a protecting extracellular polymeric substance (EPS) by the microorganisms It is postulated, that 60–80% of non-healing wounds are challenged to these biofilms [4,5,6]. 6% of acute wounds are affected by biofilms [4]

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