CDC Biofilm Reactor Research Articles

In vitro Tolerance of Staphylococcus haemolyticus and Candida albicans Biofilms to Dalbavancin and Anidulafungin

Background: Concerns about infections resulting from bacterial biofilm formation in invasive devices such as catheters and prostheses are becoming widespread in the public health domain. Staphylococcus haemolyticus, a coagulase-negative bacterium, and Candida albicans, a yeast, have become recurrent pathogens of these diseases because their presence in these devices enhances the likelihood of infection. It is believed that these microorganisms produce biofilms, which complicate treatment and slow the patient´s recuperation. Dalba-vancin is a semisynthetic, lipoglycopeptide-class antibiotic utilized as an anti-infective agent to break down gram-positive bacteria biofilms. Anidulafungin is an echinocandin class anti-fungal medication that works very well against resistant yeast strains and removes biofilms. Objective: This study aims to examine the anti-infective agents´ tolerance to the biofilms of Staphylococcus haemolyticus and Candida albicans. Methods: Polymicrobial biofilms were grown in a CDC Biofilm Reactor (CBR) for use in in vitro experiments. Results: When dalbavancin maintained its antibiotic activities against Staphylococcus hae-molyticus in comparison with their activity against the sessile forms, the antifungal anidula-fungin lost efficacy in eliminating Candida albicans. Conclusion: The planktonic forms of microbes are examined in relation to the tolerance to these anti-infective drugs.

Coupon position does not affect Pseudomonas aeruginosa and Staphylococcus aureus biofilm densities in the CDC biofilm reactor

The CDC Biofilm Reactor method is the standard biofilm growth protocol for the validation of US Environmental Protection Agency biofilm label claims. However, no studies have determined the effect of coupon orientation within the reactor on biofilm growth. If positional effects have a statistically significant impact on biofilm density, they should be accounted for in the experimental design. Here, we isolate and quantify biofilms from each possible coupon surface in the reactor to quantitatively determine the positional effects in the CDC Biofilm Reactor. The results showed no statistically significant differences in viable cell density across different orientations and vertical positions in the reactor. Pseudomonas aeruginosa log densities were statistically equivalent among all coupon heights and orientations. While the Staphylococcus aureus cell growth showed no statistically significant differences, the densities were not statistically equivalent among all coupon heights and orientations due to the variability in the data. Structural differences were observed between biofilms on the high-shear baffle side of the reactor compared to the lower shear glass side of the reactor. Further studies are required to determine whether biofilm susceptibility to antimicrobials differs based on structural differences attributed to orientation.

Development of an in vitro biofilm model for the study of the impact of fluoroquinolones on sewer biofilm microbiota.

Sewer biofilms are likely to constitute hotspots for selecting and accumulating antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs). This study aimed to optimize culture conditions to obtain in vitro biofilms, mimicking the biofilm collected in sewers, to study the impact of fluoroquinolones (FQs) on sewer biofilm microbiota. Biofilms were grown on coupons in CDC Biofilm Reactors®, continuously fed with nutrients and inoculum (1/100 diluted wastewater). Different culture conditions were tested: (i) initial inoculum: diluted wastewater with or without sewer biofilm, (ii) coupon material: concrete vs. polycarbonate, and (iii) time of culture: 7 versus 14 days. This study found that the biomass was highest when in vitro biofilms were formed on concrete coupons. The biofilm taxonomic diversity was not affected by adding sewer biofilm to the initial inoculum nor by the coupon material. Pseudomonadales, Burkholderiales and Enterobacterales dominated in the sewer biofilm composition, whereas in vitro biofilms were mainly composed of Enterobacterales. The relative abundance of qnrA, B, D and S genes was higher in in vitro biofilms than sewer biofilm. The resistome of sewer biofilm showed the highest Shannon diversity index compared to wastewater and in vitro biofilms. A PCoA analysis showed differentiation of samples according to the nature of the sample, and a Procrustes analysis showed that the ARG changes observed were linked to changes in the microbial community. The following growing conditions were selected for in vitro biofilms: concrete coupons, initial inoculation with sewer biofilm, and a culture duration of 14 days. Then, biofilms were established under high and low concentrations of FQs to validate our in vitro biofilm model. Fluoroquinolone exposure had no significant impact on the abundance of qnr genes, but high concentration exposure increased the proportion of mutations in gyrA (codons S83L and D87N) and parC (codon S80I). In conclusion, this study allowed the determination of the culture conditions to develop an in vitro model of sewer biofilm; and was successfully used to investigate the impact of FQs on sewer microbiota. In the future, this setup could be used to clarify the role of sewer biofilms in disseminating resistance to FQs in the environment.

Biofilm formation of the food spoiler Brochothrix thermosphacta on different industrial surface materials using a biofilm reactor

Brochothrix thermosphacta is considered as a major food spoiler bacteria. This study evaluates biofilm formation by B. thermosphacta CD337(2) – a strong biofilm producer strain – on three food industry materials (polycarbonate (PC), polystyrene (PS), and stainless steel (SS)). Biofilms were continuously grown under flow at 25 °C in BHI broth in a modified CDC biofilm reactor. Bacterial cells were enumerated by plate counting, and biofilm spatial organization was deciphered by combining confocal laser scanning microscopy and image analysis. The biofilms had the same growth kinetics on all three materials and reach 8log CFU/cm2 as maximal concentration. Highly structured biofilms were observed on PC and PS, but less structured ones on SS. This difference was confirmed by structural quantification analysis using the image analysis software tool BiofilmQ. Biofilm on SS show less roughness, density, thickness and volume. The biofilm 3D structure seemed to be related to the coupon topography and roughness.The materials used in this study do not affect biofilm growth. However, their roughness and topography affect the biofilm architecture, which could influence biofilm behaviour.

Efficacy of Pectobacterium carotovorum subsp. carotovorum inactivation using ultraviolet C light-emitting diodes: Investigation of inactivation efficacy toward planktonic and biofilm cells on the stainless steel surfaces of cutting machines

The presence of Pectobacterium carotovorum subsp. carotovorum (P. carotovorum) in kimchi cabbage (Brassica rapa L. subsp. pekinensis) negatively influences kimchi quality. Accordingly, inactivation processes to effectively control spoilage caused by plant bacteria, including P. carotovorum, are crucial for extending the shelf life of kimchi. In this regard, ultraviolet C light-emitting diode (UVC-LED) technologies are increasingly attracting attention as non-thermal and non-contact sterilization technologies and are also considered as alternatives to chemical disinfectants. In this study, we investigated the efficacy of the inactivation of P. carotovorum planktonic and biofilm cells that cause cabbage soft rot disease using the UVC-LED treatment technology as a potential disinfection method for a safe kimchi manufacturing process. A biofilm was formed on the surface of a stainless-steel cutter knife using the recommended CDC biofilm reactor system and thereafter, exposed to a range of UVC-LED intensities. Our results indicated that P. carotovorum planktonic and biofilm cells to UVC-LED irradiation at 9.0 mJ/cm2 resulted in >5.0 and >2.0 log10 inactivation, respectively. Additionally, the P. carotovorum planktonic and biofilm cell inactivation kinetics fitted the non-linear reduction curve. The UVC-LED treatment was also found to be highly efficient in eliminating planktonic cells, showing consistency with the Weibull and Weibull tailing models for planktonic cells.

Effect of florfenicol on Piscirickettsia salmonis biofilm formed in materials used in salmonid nets, nylon and high-density polyethylene.

Piscirickettsiosis is the most prevalent bacterial disease affecting seawater salmon in Chilean salmon industry. Antibiotic therapy is the first alternative to counteract infections caused by Piscirickettsia salmonis. The presence of bacterial biofilms on materials commonly used in salmon farming may be critical for understanding the bacterial persistence in the environment. In the present study, the CDC Biofilm Reactor® was used to investigate the effect of sub- and over-MIC of florfenicol on both the pre-formed biofilm and the biofilm formation by P. salmonis under the antibiotic stimuli on Nylon and high-density polyethylene (HDPE) surfaces. This study demonstrated that FLO, at sub- and over-MIC doses, decreases biofilm-embedded live bacteria in the P. salmonis isolates evaluated. However, it was shown that in the P. salmonis Ps007 strain the presence of sub-MIC of FLO reduced its biofilm formation on HDPE surfaces; however, biofilm persists on Nylon surfaces. These results demonstrated that P. salmonis isolates behave differently against FLO and also, depending on the surface materials. Therefore, it remains a challenge to find an effective strategy to control the biofilm formation of P. salmonis, and certainly other marine pathogens that affect the sustainability of the Chilean salmon industry.

An investigation into the effects of prosthesis relevant surfaces on the formation of Staphylococcus aureus biofilms

The aim of this study was to investigate the effects prosthesis relevant surfaces and finishes have on the formation of Staphylococcus aureus (S. aureus) biofilms, the leading causative pathogenic bacteria of periprosthetic joint infection (PJI). Microbiological biofilm analysis was conducted to quantify S. aureus biofilm growth on prosthesis relevant surface coatings and finishes. Through the use of a CDC Biofilm Reactor (CDC-BR), biofilms were grown under constant shear conditions on three different titanium surface finishes, including Plasma Spray (PS), Grit Blasted (GB) and an As-fabricated (AF) surface used for comparative and control purposes. Advanced metrological techniques were applied to characterise each surface. This advanced approach to surface characterisation, including functional volume parameters has been carried out to provide a detailed quantifiable description of the surface and one that better relates to the nature of growth upon a surface. Results show that the PS surface exhibits a significant increase in biofilm growth in comparison to the GB and AF surfaces, with the AF surface showing the lowest amount of biofilm growth. Additionally, the morphology of the features of the PS coating allows for the biofilm accumulation to flourish in the re-entrant features across its topography. These findings highlight the difficulties of biofilm eradication and further complicate the design process of prosthetics, where features implemented to promote osseointegration simultaneously offer favourable locations for bacterial cell attachment and subsequent biofilm development, leading potentially, to PJI. There is a general consensus throughout literature regarding an apparent trend between an increase in Sa and an increase in biofilm formation (Zheng et al 2021 Frontiers in Bioengineering and Biotechnology 9 643722; Bridgens et al 2015 Surface and Coatings Technology 284; James et al 2019 Aesthetic Plast. Surg. 43 490–497). This study has shown that whilst this may generally be the case, the location of this surface area increase within the topography may be a more important observation.

α,α-disubstituted β-amino amides eliminate Staphylococcus aureus biofilms by membrane disruption and biomass removal

Bacterial biofilms account for up to 80% of all infections and complicate successful therapies due to their intrinsic tolerance to antibiotics. Biofilms also cause serious problems in the industrial sectors, for instance due to the deterioration of metals or microbial contamination of products. Efforts are put in finding novel strategies in both avoiding and fighting biofilms. Biofilm control is achieved by killing and/or removing biofilm or preventing transition to the biofilm lifestyle. Previous research reported on the anti-biofilm potency of α,α-disubstituted β-amino amides A1, A2 and A3, which are small antimicrobial peptidomimetics with a molecular weight below 500 Da. In the current study it was investigated if these derivatives cause a fast disintegration of biofilm bacteria and removal of Staphylococcus aureus biofilms. One hour incubation of biofilms with all three derivatives resulted in reduced metabolic activity and membrane permeabilization in S. aureus (ATCC 25923) biofilms. Bactericidal properties of these derivatives were attributed to a direct effect on membranes of biofilm bacteria. The green fluorescence protein expressing Staphylococcus aureus strain AH2547 was cultivated in a CDC biofilm reactor and utilized for disinfectant efficacy testing of A3, following the single tube method (American Society for Testing and Materials designation number E2871). A3 at a concentration of 90 μM acted as fast as 100 μM chlorhexidine and was equally effective. Confocal laser scanning microscopy studies showed that chlorhexidine treatment lead to fluorescence fading indicating membrane permeabilization but did not cause biomass removal. In contrast, A3 treatment caused a simultaneous biofilm fluorescence loss and biomass removal. These dual anti-biofilm properties make α,α-disubstituted β-amino amides promising scaffolds in finding new control strategies against recalcitrant biofilms.

Effectiveness of a polyhexamethylene biguanide-containing wound cleansing solution using experimental biofilm models.

Antiseptics are widely used in wound management to prevent or treat wound infections, and have been shown to have antibiofilm efficacy. The objective of this study was to assess the effectiveness of a polyhexamethylene biguanide (PHMB)-containing wound cleansing and irrigation solution on model biofilm of pathogens known to cause wound infections compared with a number of other antimicrobial wound cleansing and irrigation solutions. Staphylococcus aureus and Pseudomonas aeruginosa single-species biofilms were cultured using microtitre plate and Centers for Disease Control and Prevention (CDC) biofilm reactor methods. Following a 24-hour incubation period, the biofilms were rinsed to remove planktonic microorganisms and then challenged with wound cleansing and irrigation solutions. Following incubation of the biofilms with a variety of concentrations of the test solutions (50%, 75% or 100%) for 20, 30, 40, 50 or 60 minutes, remaining viable organisms from the treated biofilms were quantified. The six antimicrobial wound cleansing and irrigation solutions used were all effective in eradicating Staphylococcus aureus biofilm bacteria in both test models. However, the results were more variable for the more tolerant Pseudomonas aeruginosa biofilm. Only one of the six solutions (sea salt and oxychlorite/NaOCl-containing solution) was able to eradicate Pseudomonas aeruginosa biofilm using the microtitre plate assay. Of the six solutions, three (a solution containing PHMB and poloxamer 188 surfactant, a solution containing hypochlorous acid (HOCl) and a solution containing NaOCl/HOCl) showed increasing levels of eradication of Pseudomonas aeruginosa biofilm microorganisms with increasing concentration and exposure time. Using the CDC biofilm reactor model, all six cleansing and irrigation solutions, except for the solution containing HOCl, were able to eradicate Pseudomonas aeruginosa biofilms such that no viable microorganisms were recovered. This study demonstrated that a PHMB-containing wound cleansing and irrigation solution was as effective as other antimicrobial wound irrigation solutions for antibiofilm efficacy. Together with the low toxicity, good safety profile and absence of any reported acquisition of bacterial resistance to PHMB, the antibiofilm effectiveness data support the alignment of this cleansing and irrigation solution with antimicrobial stewardship (AMS) strategies.

Evaluation of Omadacycline Alone and in Combination with Rifampin against Staphylococcus aureus and Staphylococcus epidermidis in an In Vitro Pharmacokinetic/Pharmacodynamic Biofilm Model.

Biofilm-associated infections lead to substantial morbidity. Omadacycline (OMC) is a novel aminomethylcycline with potent in vitro activity against Staphylococcus aureus and Staphylococcus epidermidis, but data surrounding its use in biofilm-associated infections are lacking. We investigated the activity of OMC alone and in combination with rifampin (RIF) against 20 clinical strains of staphylococci in multiple in vitro biofilm analyses, including an in vitro pharmacokinetic/pharmacodynamic (PK/PD) CDC biofilm reactor (CBR) model (simulating human exposures). The observed MICs for OMC demonstrated potent activity against the evaluated strains (0.125 to 1 mg/L), with an increase of MICs generally observed in the presence of biofilm (0.25 to >64 mg/L). Furthermore, RIF was shown to reduce OMC biofilm MICs (bMICs) in 90% of strains, and OMC plus RIF combination in biofilm time-kill analyses (TKAs) exhibited synergistic activity in most of the strains. Within the PK/PD CBR model, OMC monotherapy primarily displayed bacteriostatic activity, while RIF monotherapy generally exhibited initial bacterial eradication, followed by rapid regrowth likely due to the emergence of RIF resistance (RIF bMIC, >64 mg/L). However, the combination of OMC plus RIF produced rapid and sustained bactericidal activity in nearly all the strains (3.76 to 4.03 log10 CFU/cm2 reductions from starting inoculum in strains in which bactericidal activity was reached). Furthermore, OMC was shown to prevent the emergence of RIF resistance. Our data provide preliminary evidence that OMC in combination with RIF could be a viable option for biofilm-associated infections with S. aureus and S. epidermidis. Further research involving OMC in biofilm-associated infections is warranted.

Efficacy of meropenem extended infusion vs intermittent bolus monotherapy and in combination with colistin against Pseudomonas aeruginosa biofilm

Device-related infections are difficult-to-treat due to biofilms. In this setting, optimizing the antibiotic efficacy is difficult since most PK/PD studies have been performed on planktonic cells, and therapies are limited when multidrug-resistant bacteria are involved. We aimed to analyze the PK/PD indices of meropenem predicting anti-biofilm efficacy againstmeropenem-susceptible and -resistantP. aeruginosastrains. Pharmacodynamics of meropenem dosages mimicking those of clinical practice (intermittent bolus of 2g every 8h; extended infusion of 2g over 4h every 8h), with and without colistin, were evaluated with the CDC Biofilm Reactor in vitro model for susceptible (PAO1) and extensively drug resistant (XDR-HUB3) P. aeruginosa. Efficacy was correlated with the pharmacokinetic/pharmacodynamic indices for meropenem. Concerning PAO1, both meropenem regimens were bactericidal, with higher killing for the extended infusion (∆log10 CFU/mL 54-0h=-4.66±0.93 and ∆log10 CFU/mL 54-0h=-3.4±0.41 for intermittent bolus; p<0.001). Concerning XDR-HUB3, meropenem by intermittent bolus was non-active whereas it showed bactericidal effect by extended infusion (∆log10 CFU/mL 54-0h=-3.65±0.29; p<0.001). Time above minimum inhibitory concentration (f%T>MIC) had the best correlation with efficacy for both strains. Adding colistin always improved meropenem activity and resistant-strains did not emerge. Thef%T>MIC was the PK/PD index that best correlated with the anti-biofilm efficacy of meropenem; it was better optimized when using extended infusion, allowing to recover bactericidal activity in monotherapy also against meropenem-resistantP. aeruginosa.Combining meropenemby extended infusionwith colistin offered the most effective therapy for both strains. Optimizing meropenem dosing by extended infusion should be encouraged when treating biofilm-related infections.

Evaluation of Listeria monocytogenes biofilms attachment and formation on different surfaces using a CDC biofilm reactor

Listeria monocytogenes can adapt, persist, and form biofilms on food premises surfaces, representing a challenge for food safety, since they led to disease transmission, food contamination and spoilage during production. Physical interventions (scrubbing and wiping) can help controlling formation, nevertheless when biofilms are formed, they are usually very resistant to current control strategies used in the food industry. Biofilm attachment and formation is influenced by environment characteristics, substrate properties and microbial motility. The purpose of this study was to evaluate the ability of L. monocytogenes to attach and form biofilms on different surfaces (wood, nylon, and polycarbonate) representative of the materials used during produce harvesting and storage. Multi-strain L. monocytogenes biofilms were grown in a CDC Biofilm reactor at 20 ± 2 °C up to 96-h and characterized for: a) attachment strength by enumerating cells after rinsing; b) hydrophobicity and interfacial tension by contact angle measurements; c) biofilm architecture by Laser Scanning Confocal Microscopy. All experiments were done in triplicate. Material, incubation, and solvent significantly affected the hydrophobicity and wetting properties of L. monocytogenes biofilms (P < 0.05). The type of material and incubation time significantly influenced hydrophobicity and wetting properties of L. monocytogenes biofilms (P < 0.05). Highest contact angle and lowest interfacial tension were observed on polycarbonate coupons. The data presented contributes to understanding Listeria biofilms grow on different surfaces commonly used in produce harvesting and storage. The data obtained in this study can be used when evaluating intervention strategies to control this pathogen in food premises.

A NOVEL WEIGHT-BEARING SILORANE-BASED BONE CEMENT OFFERS POTENTIAL FOR GREATER LOCAL ANTIBACTERIAL DELIVERY COMPARED WITH PMMA AND INHIBITS BACTERIAL ATTACHMENT

We developed a novel silorane-based biomaterial (SBB) for use as an orthopedic cement. SBB is comprised of non-toxic silicon-based monomers, undergoes non-exothermic polymerization, and has weight-bearing strength required of orthopedic cements. We sought to compare the antibiotic release kinetics of this new cement to that of commercially available PMMA bone cement. We also evaluated each material's inherent propensity to support the attachment of bacteria under both static and dynamic conditions.One gram of either rifampin or vancomycin was added to 40g batches of PMMA and SBB. Pellets were individually soaked in PBS. Eluate was collected and tested daily for 14 days using HPLC. Compressive strength and modulus were tested over 21 days. Bioassays were used to confirm the bioactivity of the antibiotics eluted.We measured the growth and maturation of staphylococcus aureus (SA) biofilm on the surface of both PMMA and SBB disks over the course of 72 hours in a static well plate and in a dynamic biofilm reactor (CDC Biofilm Reactor). N=4 at 24, 48, and 72 hours. A luminescent strain of SA (Xen 29) was employed allowing imaging of bacteria on the discs.SBB eluted higher concentrations of vancomycin than did PMMA over the course of 14 days (p&lt;0.001). A significant 55.1% greater day 1 elution was observed from SBB. Silorane cement was able to deliver rifampin in clinically favorable concentrations over 14 days. On the contrary, PMMA was unable to deliver rifampin past day 1. The incorporation of rifampin into PMMA severely reduced its mechanical strength (p&lt;0.001) and modulus (p&lt;0.001).Surface bacterial radiance of PMMA specimens was significantly greater than that of SBB specimens at all time points (p&lt;0.05).The novel silorane-based cement demonstrated superior antibiotic release and, even without antibiotic incorporation, demonstrated an innate inhabitation to bacterial attachment and biofilm.

Influence of Different Stainless Steel Finishes on Biofilm Formation by Listeria monocytogenes

Biofilm formation of Listeria monocytogenes on stainless steel, a widely used abiotic surface in the food processing industry, was investigated by focusing on the attachment tendency and behavior of L. monocytogenes 08-5578 on eight different stainless steel surfaces: glass bead blasted (rough and fine), deburred (Timesaver), drum deburred, pickled, pickled and drum polished, electrolytic polished, and cold rolled (untreated control). The aim was to see whether there are finishes with significantly lower bacterial attachment. Surface roughness data (measured via four roughness parameters), determined by interferometry, was also compared with the number of adhering cells to detect possible correlations. Cultivation of L. monocytogenes biofilms was carried out using a CDC biofilm reactor with 1% tryptic soy broth set at 20°C for 4, 8, and 24 h. In addition, a cultivation trial was run with continuous nutrient flow (1% tryptic soy broth, 6.2 mL/min) for 24 h. Eight-hour results showed a significant difference (P < 0.05) in biofilm cell counts in biofilms between the glass bead-blasted surfaces (3.23 and 3.26 log CFU/cm2 for the fine and rough, respectively) and deburred (Timesaver) surface (2.57 log CFU/cm2), between drum deburred and deburred (Timesaver) surface (3.41 versus 2.57 log CFU/cm2), and between drum deburred and pickled surface (3.41 versus 2.77 log CFU/cm2). Data gained after 4-h, 24-h, and 24-h plus an additional 24-h continuous flow cultivation showed no significant difference in attachment among surfaces. No correlation between roughness data and attachment was found after all four incubation times, suggesting that roughness values, at these ranges, are insufficient in determining the surfaces' affinity to bacteria. Overall, this study suggests that roughness values cannot be used to predict the degree of L. monocytogenes attachment to a specific stainless steel surface.

One Step Forward with Dry Surface Biofilm (DSB) of Staphylococcus aureus: TMT-Based Quantitative Proteomic Analysis Reveals Proteomic Shifts between DSB and Hydrated Biofilm.

The Gram-positive bacterium Staphylococcus aureus is responsible for serious acute and chronic infections worldwide and is well-known for its biofilm formation ability. Recent findings of biofilms on dry hospital surfaces emphasise the failures in current cleaning practices and disinfection and the difficulty in removing these dry surface biofilms (DSBs). Many aspects of the formation of complex DSB biology on environmental surfaces in healthcare settings remains limited. In the present study, we aimed to determine how the protein component varied between DSBs and traditional hydrated biofilm. To do this, biofilms were grown in tryptic soy broth (TSB) on removable polycarbonate coupons in the CDC biofilm reactor over 12 days. Hydrated biofilm (50% TSB for 48 h, the media was then changed every 48 h with 20% TSB, at 37 °C with 130 rpm). DSB biofilm was produced in 5% TSB for 48 h at 35 °C followed by extended periods of dehydration (48, 66, 42 and 66 h at room temperature) interspersed with 6 h of 5% TSB at 35 °C. Then, we constructed a comprehensive reference map of 12-day DSB and 12-day hydrated biofilm associated proteins of S. aureus using a high-throughput tandem mass tag (TMT)-based mass spectrometry. Further pathway analysis of significantly differentially expressed identified proteins revealed that proteins significantly upregulated in 12-day DSB include PTS glucose transporter subunit IIBC (PtaA), UDP-N-acetylmuramate-L-alanine ligase (MurC) and UDP-N-acetylenolpyruvoylglucosamine (MurB) compared to 12-day hydrated biofilm. These three proteins are all linked with peptidoglycan biosynthesis pathway and are responsible for cell-wall formation and thicker EPS matrix deposition. Increased cell-wall formation may contribute to the persistence of DSB on dry surfaces. In contrast, proteins associated with energy metabolisms such as phosphoribosyl transferase (PyrR), glucosamine--fructose-6-phosphate aminotransferase (GlmS), galactose-6-phosphate isomerase (LacA), and argininosuccinate synthase (ArgG) were significantly upregulated whereas ribosomal and ABC transporters were significantly downregulated in the 12-day hydrated biofilm compared to DSB. However, validation by qPCR analysis showed that the levels of gene expression identified were only partially in line with our TMT-MS quantitation analysis. For the first time, a TMT-based proteomics study with DSB has shed novel insights and provided a basis for the identification and study of significant pathways vital for biofilm biology in this reference microorganism.

Disrupting Biofilms From Titanium with a CHG Antimicrobial Irrigation System

Category: Other Introduction/Purpose: Orthopedic device-related infections can be difficult to treat and decrease the success of surgical interventions. The implant provides a surface for bacterial attachment and biofilm formation, which decreases antimicrobial efficacy. This study was conducted to assess the ability of the Chlorhexidine Gluconate (CHG) Antimicrobial Irrigation System to disrupt biofilms from titanium coupons using an adapted ASTM E2871-19 method, 'Standard Test Method for Determining Disinfectant Efficacy Against Biofilm Grown in the CDC Biofilm Reactor Using the Single Tube Method.' Methods: CDC Biofilm Reactor was inoculated with Staphylococcus epidermidis (ATCC 14990TM), methicillin-resistant Staphylococcus aureus (ATCC 43300TM), Pseudomonas aeruginosa (ATCC 15442TM), or Escherichia coli (ATCC 25922TM). The reactors were run in a batch phase for 24 h, followed by continuous flow phase for an additional 24 h to produce single-species biofilms on titanium coupons. After coupons were washed with PBS to remove planktonic bacteria, growth control coupons were placed into standard sampling solution with 1% Tamol (SST) (neutralizer) or treated with CHG Antimicrobial Irrigation System according to Instructions for Use (IFU) followed by a 60 sec dwell or no dwell. Coupons were rinsed with normal saline following treatment and placed in SST. Then coupons were sonicated and vortexed to release bacteria and plated for enumeration. A coupon from each group was fixed for SEM imaging. Results: The CHG Antimicrobial Irrigation System disrupted biofilms of all organisms from titanium coupons with the greatest log reduction per coupon in the 60 sec dwell treatment group (log10 reduction 2.02 to 4.56 CFU/coupon from controls) (Table). Overall, S. epidermidis and E. coli biofilms had the greatest reductions in bacterial densities. SEM images confirmed biofilm disruption from the titanium surface. Conclusion: his study determined that the CHG Antimicrobial Irrigation System disrupted biofilms from titanium coupons when used according to the instructions for use.

Strain-to-strain variability among Staphylococcus aureus causing prosthetic joint infection drives heterogeneity in response to levofloxacin and rifampicin.

Levofloxacin and rifampicin are the preferred treatment for prosthetic joint infection (PJI) caused by Staphylococcus aureus, especially when managed with implant retention (DAIR). However, a significant variability of success has been reported, which could be related to intrinsic characteristics of the microorganism. Our aim was to evaluate the variability in the anti-biofilm response to levofloxacin and rifampicin in a clinical collection of S. aureus. Eleven levofloxacin- and rifampicin-susceptible S. aureus isolates causing PJI managed with DAIR were included. Levofloxacin, rifampicin and levofloxacin + rifampicin were tested in an in vitro static biofilm model in microtitre plates, where 48 h biofilms were challenged with antimicrobials during 24 h. Additionally, two genetically similar strains were tested in the CDC Biofilm Reactor, where 48 h biofilms were treated during 56 h. Antimicrobial activity was assessed by viable biofilm-embedded cells recount, and by crystal violet staining. All antimicrobial regimens showed significant anti-biofilm activity, but a notable scattering in the response was observed across all strains (inter-strain coefficient of variation for levofloxacin, rifampicin and levofloxacin + rifampicin of 22.8%, 35.8% and 34.5%, respectively). This variability was tempered with the combination regimen when tested in the biofilm reactor. No correlation was observed between the minimal biofilm eradicative concentration and the antimicrobial activity. Recurrent S. aureus isolates exhibited higher biofilm-forming ability compared with strains from resolved infections (7.6 log10 cfu/cm2±0.50 versus 9.0 log10 cfu±0.07). Significant variability may be expected in response to levofloxacin and rifampicin among biofilm-embedded S. aureus. A response in the lower range, together with other factors of bad prognosis, could be responsible of treatment failure.

Multispecies biofilm removal by a multisonic irrigation system in mandibular molars.

The aim of the study was to assess biofilm removal efficacy of GentleWave System and passive ultrasonic irrigation (PUI). Twenty-two human mandibular molars with Vertucci's type II configuration in the mesial root were selected. Teeth were autoclaved, inoculated with dental plaque and incubated in a CDC biofilm reactor for two weeks. The mesial roots were instrumented up to 20.06 file (V-Taper) for the GentleWave group and up to 35.04 file (Vortex Blue) for PUI group. Irrigation was performed using GentleWave and PUI irrigation protocols (n=11). Dentine debris on paper points samples were obtained for quantitative real-time polymerase chain reaction (qPCR) and 16S ribosomal RNA gene sequencing (next-generation aequencing-NGS). For qPCR, a non-parametric test (α=0.05) was used. Next-generation sequencing data were analysed using mothur, with alpha diversity calculated as the Shannon and Chao1 indices and Bray-Curtis dissimilarities were used for beta diversity. Differences in alpha diversity and abundances of genera were evaluated using Kruskal-Wallis test. Differences in community composition were evaluated using analysis of similarity with Bonferroni correction for multiple comparisons. Quantitative real-time polymerase chain reaction results showed that the reduction estimated in percentages for both groups was equivalent (p > .05). NGS analysis showed that both techniques promoted a significant reduction in reads and OTUs number (p < .05). Shannon alpha diversity and Chao1 index showed no differences between pre- or post-treatment samples for both groups (p > .05). Additionally, pre-treatment communities differed from post-treatment samples in both groups regarding bacterial taxa reduction (ANOSIM R=0.50 and 0.55, p< .001). Bacterial reduction in mesial roots of mandibular molars prepared to 35.04 with PUI was similar to those prepared to 20.06 with a multisonic irrigant activation system.

Comparative efficacy of dalbavancin alone and with rifampicin against in vitro biofilms in a pharmacodynamic model with methicillin-resistant Staphylococcus aureus

The anti-biofilm efficacy of dalbavancin (DAL) has been evaluated in static models. The comparative activity of DAL alone and with rifampicin (RIF) against biofilm-embedded methicillin-resistant Staphylococcus aureus (MRSA) was evaluated using an in vitro pharmacokinetic/pharmacodynamic (PK/PD) model. Two MRSA strains (HUB-4, HUB-5) were evaluated with the Calgary Device System and the dynamic CDC-Biofilm Reactor over 144 h. Dosage regimens simulated the human PK of DAL (1500 mg, single dose), vancomycin (VAN) (1000 mg/12 h) and linezolid (LZD) (600 mg/12 h), alone and with RIF (600 mg/24 h). Efficacy was evaluated by assessing log10CFU/mL changes (ΔlogCFU/mL) and screening for resistance was conducted. The minimal biofilm inhibitory/eradication concentrations of DAL were 0.25/16 mg/L (HUB-4) and 0.25/8 mg/L (HUB-5). In the PK/PD analysis, DAL alone showed limited efficacy but no development of resistance. Adding RIF improved the activities of DAL, VAN, and LZD, but RIF-resistant strains appeared over time in all cases. DAL-RIF was bactericidal against HUB-4 in the absence of resistance at 72 h and 144 h (ΔlogCFU/mL: -3.54±0.83, -4.32±0.12, respectively), an effect that was only achieved by LZD-RIF at 144 h (-3.33 ± 0.66). DAL-RIF activity against HUB-5 was impaired by RIF resistance to a greater extent than other combinations and this combination had no bactericidal effect. The anti-biofilm efficacy of DAL was improved significantly by adding RIF. Although DAL resistance did not occur, RIF resistance appeared in all combination therapies and decreased their efficacy over time. DAL-RIF in vitro treatment appears to be a promising anti-biofilm therapy, but further studies are needed to evaluate the efficacy and risk of resistance in vivo.

Comparative Study of Different Sampling Methods of Biofilm Formed on Stainless-Steel Surfaces in a CDC Biofilm Reactor.

The formation of biofilms in dairy processing plants can reduce equipment efficiency, contribute to surface deterioration, and contaminate dairy products by releasing the microorganisms they contain, which may cause spoilage or disease. However, a more representative identification of microbial communities and physico-chemical characterization requires to detach and recover adequately the entire biofilm from the surface. The aim of this study is to develop an efficient technique for in-plant biofilm sampling by growing a strain of Pseudomonas azotoformans PFl1A on stainless-steel surface in a dynamic CDC biofilm reactor system using tryptic soy broth (TSB) and milk as growth media. Different techniques, namely, swabbing, scraping, sonic brushing, synthetic sponge, and sonicating synthetic sponge were used and the results were compared to a standard ASTM International method using ultrasonication. Their efficiencies were evaluated by cells enumeration and scanning electron microscopy. The maximum total viable counts of 8.65 ± 0.06, 8.75 ± 0.08, and 8.71 ± 0.09 log CFU/cm2 were obtained in TSB medium using scraping, synthetic sponge, and sonicating synthetic sponge, respectively, which showed no statistically significant differences with the standard method, ultrasonication (8.74 ± 0.02 log CFU/cm2). However, a significantly (p < 0.05) lower cell recovery of 8.57 ± 0.10 and 8.60 ± 0.00 log CFU/cm2 compared to ultrasonication were achieved for swabbing and sonic brushing, respectively. Furthermore, scanning electron microscopy showed an effective removal of biofilms by sonic brushing, synthetic sponge, and sonicating synthetic sponge; However, only the latter two methods guaranteed a superior release of bacterial biofilm into suspension. Nevertheless, a combination of sonication and synthetic sponge ensured dislodging of sessile cells from surface crevices. The results suggest that a sonicating synthetic sponge could be a promising method for biofilm recovery in processing plants, which can be practically used in the dairy industries as an alternative to ultrasonication.