Abstract

Bacterial wound infections are a common problem associated with surgical interventions. In particular, biofilm-forming bacteria are hard to eradicate, and alternative methods of treatment based on covering wounds with vascularized flaps of tissue are being developed. The greater omentum is a complex organ covering the intestines in the abdomen, which support wound recovery following surgical procedures and exhibit natural antimicrobial activity that could improve biofilm eradication. We investigated changes in rats’ metabolome following Klebsiella pneumoniae infections, as well as the greater omentum’s ability for Klebsiella pneumoniae biofilm eradication. Rats received either sterile implants or implants covered with Klebsiella pneumoniae biofilm (placed in the peritoneum or greater omentum). Metabolic profiles were monitored at days 0, 2, and 5 after surgery using combined proton nuclear magnetic resonance (1H NMR) and high performance liquid chromatography quadrupole time-of-flight tandem mass spectrometry (LC–QTOF-MS) measurements of urine samples followed by chemometric analysis. Obtained results indicated that grafting of the sterile implant to the greater omentum did not cause major disturbances in rats’ metabolism, whereas the sterile implant located in the peritoneum triggered metabolic perturbations related to tricarboxylic acid (TCA) cycle, as well as choline, tryptophan, and hippurate metabolism. Presence of implants colonized with Klebsiella pneumoniae biofilm resulted in similar levels of metabolic perturbations in both locations. Our findings confirmed that surgical procedures utilizing the greater omentum may have a practical use in wound healing and tissue regeneration in the future.

Highlights

  • Klebsiella pneumoniae belongs to the Enterobacteriaceae family and is a Gram-negative, non-motile, encapsulated bacteria found in the normal microbiome of the mouth, skin, and intestines [1]

  • PriorPrior to to metabolomics analysis we evaluated whether treatments were successful biofilm eradication metabolomics analysis we evaluated whether treatments were successful in in biofilm eradication byby quantifying number bacteria implants

  • Our study was focused onon the initial metabolic changes triggered by Klebsiella pneumoniae infection towere

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Summary

Introduction

Klebsiella pneumoniae belongs to the Enterobacteriaceae family and is a Gram-negative, non-motile, encapsulated bacteria found in the normal microbiome of the mouth, skin, and intestines [1]. In Europe, 8.9 million patients suffered from nosocomial infections in 2016 [6], and it was estimated that every year close to 91,130 of deaths occur as a direct consequence of these infections [7]. Metal or silicone implants used for tissue or bone reconstruction serve as a perfect scaffold for microbial biofilm establishment [8]. Such biofilm infections are hard to eradicate due to their inherent tolerance to antibiotics and physical cleansing methods leading to chronic wound infections [9]. Effective alternative approaches for prevention and biofilm eradication related to chronic and device-associated infections are critically needed. The greater omentum is one of the most promising candidates for flaps with angiogenic and antibacterial potential [12]

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