Abstract
Due to the globally observed increase in antibiotic resistance of bacterial pathogens and the simultaneous decline in new antibiotic developments, the need for alternative inactivation approaches is growing. This is especially true for the treatment of infections with the problematic ESKAPE pathogens, which include Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species, and often exhibit multiple antibiotic resistances. Irradiation with visible light from the violet and blue spectral range is an inactivation approach that does not require any additional supplements. Multiple bacterial and fungal species were demonstrated to be sensitive to this disinfection technique. In the present study, pathogenic ESKAPE organisms and non-pathogenic relatives are irradiated with visible blue and violet light with wavelengths of 450 and 405 nm, respectively. The irradiation experiments are performed at 37°C to test a potential application for medical treatment. For all investigated microorganisms and both wavelengths, a decrease in colony forming units is observed with increasing irradiation dose, although there are differences between the examined bacterial species. A pronounced difference can be observed between Acinetobacter, which prove to be particularly light sensitive, and enterococci, which need higher irradiation doses for inactivation. Differences between pathogenic and non-pathogenic bacteria of one genus are comparatively small, with the tendency of non-pathogenic representatives being less susceptible. Visible light irradiation is therefore a promising approach to inactivate ESKAPE pathogens with future fields of application in prevention and therapy.
Highlights
Hospital acquired infections (HAIs) challenge the health care sector (World Health Organization, 2017) and affect millions of patients each year
Most of the ESKAPE pathogens appear on the World Health Organization (WHO) list of the most problematic microbial species resulting in an appeal to concentrate research efforts on this topic
The E. moraviensis control was reduced by 1.38 log at the end of the longer 450 nm experiment at 48 h
Summary
Hospital acquired infections (HAIs) challenge the health care sector (World Health Organization, 2017) and affect millions of patients each year. The increasing development of antibiotic resistances is worsening the situation creating an urgent need for establishing new anti-infective strategies. Most of the ESKAPE pathogens appear on the World Health Organization (WHO) list of the most problematic microbial species resulting in an appeal to concentrate research efforts on this topic. For 2007, the European Centre for Disease and Control (ECDC) estimated the death of 25,000 patients in the European Union, Norway and Iceland and an additional 900 million Euros hospital costs due to five selected antibioticresistant species (European center for disease prevention and control, 2009), completely intersecting with the ESKAPE pathogens. In 2016, HAI developed in 8.4% of patients staying in an intensive care unit for more than 2 days (European center for disease prevention and control, 2018)
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