Abstract

BackgroundInfections of the ears, paranasal sinuses, nose and throat are very common and represent a serious issue for the healthcare system. Bacterial biofilms have been linked to upper respiratory tract infections and antibiotic resistance, raising serious concerns regarding the therapeutic management of such infections. In this context, novel strategies able to fight biofilms may be therapeutically beneficial and offer a valid alternative to conventional antimicrobials. Biofilms consist of mixed microbial communities, which interact with other species in the surroundings and communicate through signaling molecules. These interactions may result in antagonistic effects, which can be exploited in the fight against infections in a sort of “bacteria therapy”. Streptococcus salivarius and Streptococcus oralis are α-hemolytic streptococci isolated from the human pharynx of healthy individuals. Several studies on otitis-prone children demonstrated that their intranasal administration is safe and well tolerated and is able to reduce the risk of acute otitis media. The aim of this research is to assess S. salivarius 24SMB and S. oralis 89a for the ability to interfere with biofilm of typical upper respiratory tract pathogens.MethodsTo investigate if soluble substances secreted by the two streptococci could inhibit biofilm development of the selected pathogenic strains, co-cultures were performed with the use of transwell inserts. Mixed-species biofilms were also produced, in order to evaluate if the inhibition of biofilm formation might require direct contact. Biofilm production was investigated by means of a spectrophotometric assay and by confocal laser scanning microscopy.ResultsWe observed that S. salivarius 24SMB and S. oralis 89a are able to inhibit the biofilm formation capacity of selected pathogens and even to disperse their pre-formed biofilms. Diffusible molecules secreted by the two streptococci and lowered pH of the medium revealed to be implied in the mechanisms of anti-biofilm activity.ConclusionsS. salivarius 24SMB and S. oralis 89a possess desirable characteristics as probiotic for the treatment and prevention of infections of the upper airways. However, the nature of the inhibition appear to be multifactorial and additional studies are required to get further insights.

Highlights

  • Infections of the ears, paranasal sinuses, nose and throat are very common and represent a serious issue for the healthcare system

  • Interaction between S. salivarius 24SMB and S. oralis 89a The reciprocal interaction between the two probiotic strains led to an increase in biofilm production of both S. salivarius (21%) and S. oralis (24%), compared to biofilm produced when cultured separately (Fig. 1a and b)

  • Interference on biofilm formation Generally, the mixture of S. salivarius and S. oralis displayed an inhibitory activity against biofilm development of all tested bacteria, except for S. pyogenes whose biofilm formation was not significantly influenced by presence of the probiotic strains (Fig. 2)

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Summary

Introduction

Infections of the ears, paranasal sinuses, nose and throat are very common and represent a serious issue for the healthcare system. Bacterial biofilms have been linked to upper respiratory tract infections and antibiotic resistance, raising serious concerns regarding the therapeutic management of such infections. In this context, novel strategies able to fight biofilms may be therapeutically beneficial and offer a valid alternative to conventional antimicrobials. Biofilms consist of mixed microbial communities, which interact with other species in the surroundings and communicate through signaling molecules These interactions may result in antagonistic effects, which can be exploited in the fight against infections in a sort of “bacteria therapy”. Despite the presence of mechanical barriers and host immune defenses, the upper respiratory tract offers an easy access to pathogens involved in acute and chronic infections of ears, paranasal sinuses, nose and throat. The microbial biofilm makes infections persistent and more refractory to treatments

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