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Biofilms and Device-Associated Infections

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A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Biofilm".

Deadline for manuscript submissions: closed (30 April 2022) | Viewed by 35542

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Special Issue Editor

Dr. Llinos G. Harris

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Guest Editor

Microbiology and Infectious Diseases, Swansea University Medical School, Swansea SA2 8PP, UK
Interests: biofilms; microbial pathogenesis; Staphylococci; medical device infections, ODRIs antimicrobial resistance

Special Issue Information

Dear Colleagues,

Medical device-associated infections (DAIs) are a major clinical problem as they cause clinical failure and impaired functionality, as well as reduce the lifetime of medical devices, resulting in huge increases in hospital and socioeconomic costs. DAIs are associated with contamination of a device by bacteria such as Staphylococcal spp., Escherichia coli, and Pseudomonas aeruginosa, as well as fungi such as Candida spp. These microbes are known to cause chronic persistent DAIs due to their ability to form biofilms, which protects them from the host’s immune system and antibiotics. Bacteria and fungi living in a biofilm tend to be resistant to antibiotics and thus require higher doses, and their failure often necessitates the removal of the infected device—hence, the increasing interest in understanding biofilm formation and persistence in association with medical devices.

With this Special Issue, we encourage researchers and clinicians to submit research articles, review articles, and short communications that address the various aspects of biofilm formation and persistence in association with DAIs, such as the biofilm matrix, epidemiology, imaging, microbial–host interactions, therapy, and prevention.

Dr. Llinos G. Harris
Guest Editor

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Keywords

Biofilm
Device-associated infection
Staphylococci
Candida
Coatings
Adhesion molecules
Polysaccharide
Accumulation proteins.

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Published Papers (9 papers)

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Research

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14 pages, 1669 KiB

Open AccessArticle

Easy, Flexible and Standardizable Anti-Nascent Biofilm Activity Assay to Assess Implant Materials

by Jérome Vanheuverzwijn, Eloise-Eliane Maillard, Amal Mahat, Lee Fowler, Daniel Monteyne, Leïla Bonnaud, Nicolas Landercy, Axel Hemberg, Ana Janković, Franck Meyer, Vesna Mišković-Stanković, Milena Stevanović, Codruta Mirica, David Pérez-Morga, Reto Luginbuehl, Christèle Combes, Gabriel Furtos and Véronique Fontaine

Microorganisms 2023, 11(4), 1023; https://doi.org/10.3390/microorganisms11041023 - 14 Apr 2023

Cited by 1 | Viewed by 1754

Abstract

Medical implants have improved the quality of life of many patients. However, surgical intervention may eventually lead to implant microbial contamination. The aims of this research were to develop an easy, robust, quantitative assay to assess surface antimicrobial activities, especially the anti-nascent biofilm activity, and to identify control surfaces, allowing for international comparisons. Using new antimicrobial assays to assess the inhibition of nascent biofilm during persistent contact or after transient contact with bacteria, we show that the 5 cent Euro coin or other metal-based antibacterial coins can be used as positive controls, as more than 4 log reduction on bacterial survival was observed when using either S. aureus or P. aeruginosa as targets. The methods and controls described here could be useful to develop an easy, flexible and standardizable assay to assess relevant antimicrobial activities of new implant materials developed by industries and academics. Full article

(This article belongs to the Special Issue Biofilms and Device-Associated Infections)

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14 pages, 1760 KiB

Open AccessArticle

Retardation of Bacterial Biofilm Formation by Coating Urinary Catheters with Metal Nanoparticle-Stabilized Polymers

by Osamah Al Rugaie, Ahmed A. H. Abdellatif, Mohamed A. El-Mokhtar, Marwa A. Sabet, Ahmed Abdelfattah, Mansour Alsharidah, Musaed Aldubaib, Hassan Barakat, Suha Mujahed Abudoleh, Khalid A. Al-Regaiey and Hesham M. Tawfeek

Microorganisms 2022, 10(7), 1297; https://doi.org/10.3390/microorganisms10071297 - 27 Jun 2022

Cited by 16 | Viewed by 2847

Abstract

Urinary catheter infections remain an issue for many patients and can complicate their health status, especially for individuals who require long-term catheterization. Catheters can be colonized by biofilm-forming bacteria resistant to the administered antibiotics. Therefore, this study aimed to investigate the efficacy of silver nanoparticles (AgNPs) stabilized with different polymeric materials generated via a one-step simple coating technique for their ability to inhibit biofilm formation on urinary catheters. AgNPs were prepared and characterized to confirm their formation and determine their size, charge, morphology, and physical stability. Screening of the antimicrobial activity of nanoparticle formulations and determining minimal inhibitory concentration (MIC) and their cytotoxicity against PC3 cells were performed. Moreover, the antibiofilm activity and efficacy of the AgNPs coated on the urinary catheters under static and flowing conditions were examined against a clinical isolate of Escherichia coli. The results showed that the investigated polymers could form physically stable AgNPs, especially those prepared using polyvinyl pyrrolidone (PVP) and ethyl cellulose (EC). Preliminary screening and MIC determinations suggested that the AgNPs-EC and AgNPs-PVP had superior antibacterial effects against E. coli. AgNPs-EC and AgNPs-PVP inhibited biofilm formation to 58.2% and 50.8% compared with AgNPs-PEG, silver nitrate solution and control samples. In addition, coating urinary catheters with AgNPs-EC and AgNPs-PVP at concentrations lower than the determined IC50 values significantly (p < 0.05; t-test) inhibited bacterial biofilm formation compared with noncoated catheters under both static and static and flowing conditions using two different types of commercial Foley urinary catheters. The data obtained in this study provide evidence that AgNP-coated EC and PVP could be useful as potential antibacterial and antibiofilm catheter coating agents to prevent the development of urinary tract infections caused by E. coli. Full article

(This article belongs to the Special Issue Biofilms and Device-Associated Infections)

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15 pages, 1518 KiB

Open AccessArticle

Enhanced Antibiotic Tolerance of an In Vitro Multispecies Uropathogen Biofilm Model, Useful for Studies of Catheter-Associated Urinary Tract Infections

by Jiapeng Hou, Lutian Wang, Martin Alm, Peter Thomsen, Tor Monsen, Madeleine Ramstedt and Mette Burmølle

Microorganisms 2022, 10(6), 1207; https://doi.org/10.3390/microorganisms10061207 - 13 Jun 2022

Cited by 8 | Viewed by 3063

Abstract

Catheter-associated urinary tract infections (CAUTI) are a common clinical concern as they can lead to severe, persistent infections or bacteremia in long-term catheterized patients. This type of CAUTI is difficult to eradicate, as they are caused by multispecies biofilms that may have reduced susceptibility to antibiotics. Many new strategies to tackle CAUTI have been proposed in the past decade, including antibiotic combination treatments, surface modification and probiotic usage. However, those strategies were mainly assessed on mono- or dual-species biofilms that hardly represent the long-term CAUTI cases where, normally, 2–4 or even more species can be involved. We developed a four-species in vitro biofilm model on catheters involving clinical strains of Escherichia coli, Pseudomonas aeruginosa, Klebsiella oxytoca and Proteus mirabilis isolated from indwelling catheters. Interspecies interactions and responses to antibiotics were quantitatively assessed. Collaborative as well as competitive interactions were found among members in our model biofilm and those interactions affected the individual species’ abundances upon exposure to antibiotics as mono-, dual- or multispecies biofilms. Our study shows complex interactions between species during the assessment of CAUTI control strategies for biofilms and highlights the necessity of evaluating treatment and control regimes in a multispecies setting. Full article

(This article belongs to the Special Issue Biofilms and Device-Associated Infections)

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16 pages, 987 KiB

Open AccessArticle

Virulence Characteristics of Biofilm-Forming Acinetobacter baumannii in Clinical Isolates Using a Galleria mellonella Model

by Mahmoud A. F. Khalil, Fatma A. Ahmed, Ahmed F. Elkhateeb, Eman E. Mahmoud, Mona I. Ahmed, Randa I. Ahmed, Amal Hosni, Saad Alghamdi, Ahmed Kabrah, Anas S. Dablool, Helal F. Hetta, Sawsan S. Moawad and Enas Mamdouh Hefzy

Microorganisms 2021, 9(11), 2365; https://doi.org/10.3390/microorganisms9112365 - 16 Nov 2021

Cited by 26 | Viewed by 3096

Abstract

Acinetobacter baumannii is a Gram-negative coccobacillus responsible for severe hospital-acquired infections, particularly in intensive care units (ICUs). The current study was designed to characterize the virulence traits of biofilm-forming carbapenem-resistant A. baumannii causing pneumonia in ICU patients using a Galleria mellonella model. Two hundred and thirty patients with hospital-acquired or ventilator-associated pneumonia were included in our study. Among the total isolates, A. baumannii was the most frequently isolated etiological agent in ICU patients with pneumonia (54/165, 32.7%). All A. baumannii isolates were subjected to antimicrobial susceptibility testing by the Kirby–Bauer disk diffusion method, while the minimum inhibitory concentrations of imipenem and colistin were estimated using the broth microdilution technique. The biofilm formation activity of the isolates was tested using the microtiter plate technique. Biofilm quantification showed that 61.1% (33/54) of the isolates were strong biofilm producers, while 27.7% (15/54) and 11.1% (6/54) showed moderate or weak biofilm production. By studying the prevalence of carbapenemases-encoding genes among isolates, bla_OXA-23-_like was positive in 88.9% of the isolates (48/54). The Bla_NDM gene was found in 27.7% of the isolates (15/54 isolates). Bla_OXA-23-_like and bla_NDM genes coexisted in 25.9% (14/54 isolates). Bap and bla_PER-1 genes, the biofilm-associated genes, coexisted in 5.6% (3/54) of the isolates. For in vivo assessment of A. baumannii pathogenicity, a Galleria mellonella survival assay was used. G. mellonella survival was statistically different between moderate and poor biofilm producers (p < 0.0001). The killing effect of the strong biofilm-producing group was significantly higher than that of the moderate and poor biofilm producers (p < 0.0001 for each comparison). These findings highlight the role of biofilm formation as a powerful virulence factor for carbapenem-resistant A. baumannii that causes pneumonia in the ICU. Full article

(This article belongs to the Special Issue Biofilms and Device-Associated Infections)

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8 pages, 1766 KiB

Open AccessCommunication

Comparison of Two Cutibacterium acnes Biofilm Models

by Jennifer Varin-Simon, Fabien Lamret, Marius Colin, Sophie C. Gangloff, Céline Mongaret and Fany Reffuveille

Microorganisms 2021, 9(10), 2035; https://doi.org/10.3390/microorganisms9102035 - 26 Sep 2021

Cited by 5 | Viewed by 2030

Abstract

The study of biofilms in vitro is complex and often limited by technical problems due to simplified models. Here, we compared C. acnes biofilm formation, from species involved in bone and prosthesis infection, in a static model with a dynamic model. Using similar parameters, the percentage of live bacteria within the biofilm was higher in dynamic than in static approach. In both models, bacterial internalization in osteoblast-like cells, playing the role of stress factor, affected this proportion but in opposite ways: increase of live bacteria proportion in the static model (×2.04 ± 0.53) and of dead bacteria proportion (×3.5 ± 1.03) in the dynamic model. This work highlights the huge importance in the selection of a relevant biofilm model in accordance with the environmental or clinical context to effectively improve the understanding of biofilms and the development of better antibiofilm strategies. Full article

(This article belongs to the Special Issue Biofilms and Device-Associated Infections)

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16 pages, 7989 KiB

Open AccessArticle

Titanium Wear Particles Exacerbate S. epidermidis-Induced Implant-Related Osteolysis and Decrease Efficacy of Antibiotic Therapy

by Claudia Siverino, Linda Freitag, Daniel Arens, Ursula Styger, R. Geoff Richards, T. Fintan Moriarty, Vincent A. Stadelmann and Keith Thompson

Microorganisms 2021, 9(9), 1945; https://doi.org/10.3390/microorganisms9091945 - 13 Sep 2021

Cited by 3 | Viewed by 2503

Abstract

Total joint arthroplasty (TJA) surgeries are common orthopedic procedures, but bacterial infection remains a concern. The aim of this study was to assess interactions between wear particles (WPs) and immune cells in vitro and to investigate if WPs affect the severity, or response to antibiotic therapy, of a Staphylococcus epidermidis orthopedic device-related infection (ODRI) in a rodent model. Biofilms grown on WPs were challenged with rifampin and cefazolin (100 µg/mL) to determine antibiotic efficacy. Neutrophils or peripheral blood mononuclear cells (PBMCs) were incubated with or without S. epidermidis and WPs, and myeloperoxidase (MPO) and cytokine release were analyzed, respectively. In the ODRI rodent model, rats (n = 36) had a sterile or S. epidermidis-inoculated screw implanted in the presence or absence of WPs, and a subgroup was treated with antibiotics. Bone changes were monitored using microCT scanning. The presence of WPs decreased antibiotic efficacy against biofilm-resident bacteria and promoted MPO and pro-inflammatory cytokine production in vitro. WPs exacerbated osteolytic responses to S. epidermidis infection and markedly reduced antibiotic efficacy in vivo. Overall, this work shows that the presence of titanium WPs reduces antibiotic efficacy in vitro and in vivo, induces proinflammatory cytokine release, and exacerbates S. epidermidis-induced osteolysis. Full article

(This article belongs to the Special Issue Biofilms and Device-Associated Infections)

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Review

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23 pages, 797 KiB

Open AccessReview

Impact of Healthcare-Associated Infections Connected to Medical Devices—An Update

by Nitin Chandra Teja Dadi, Barbora Radochová, Jarmila Vargová and Helena Bujdáková

Microorganisms 2021, 9(11), 2332; https://doi.org/10.3390/microorganisms9112332 - 11 Nov 2021

Cited by 59 | Viewed by 8488

Abstract

Healthcare-associated infections (HAIs) are caused by nosocomial pathogens. HAIs have an immense impact not only on developing countries but also on highly developed parts of world. They are predominantly device-associated infections that are caused by the planktonic form of microorganisms as well as those organized in biofilms. This review elucidates the impact of HAIs, focusing on device-associated infections such as central line-associated bloodstream infection including catheter infection, catheter-associated urinary tract infection, ventilator-associated pneumonia, and surgical site infections. The most relevant microorganisms are mentioned in terms of their frequency of infection on medical devices. Standard care bundles, conventional therapy, and novel approaches against device-associated infections are briefly mentioned as well. This review concisely summarizes relevant and up-to-date information on HAIs and HAI-associated microorganisms and also provides a description of several useful approaches for tackling HAIs. Full article

(This article belongs to the Special Issue Biofilms and Device-Associated Infections)

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20 pages, 4420 KiB

Open AccessReview

Antibiofouling Activity of Graphene Materials and Graphene-Based Antimicrobial Coatings

by Anna D. Staneva, Dimitar K. Dimitrov, Dilyana N. Gospodinova and Todorka G. Vladkova

Microorganisms 2021, 9(9), 1839; https://doi.org/10.3390/microorganisms9091839 - 30 Aug 2021

Cited by 29 | Viewed by 3925

Abstract

Microbial adhesion and biofilm formation is a common, nondesirable phenomenon at any living or nonliving material surface in contact with microbial species. Despite the enormous efforts made so far, the protection of material surfaces against microbial adhesion and biofilm formation remains a significant challenge. Deposition of antimicrobial coatings is one approach to mitigate the problem. Examples of such are those based on heparin, cationic polymers, antimicrobial peptides, drug-delivering systems, and other coatings, each one with its advantages and shortcomings. The increasing microbial resistance to the conventional antimicrobial treatments leads to an increasing necessity for new antimicrobial agents, among which is a variety of carbon nanomaterials. The current review paper presents the last 5 years’ progress in the development of graphene antimicrobial materials and graphene-based antimicrobial coatings that are among the most studied. Brief information about the significance of the biofouling, as well as the general mode of development and composition of microbial biofilms, are included. Preparation, antibacterial activity, and bactericidal mechanisms of new graphene materials, deposition techniques, characterization, and parameters influencing the biological activity of graphene-based coatings are focused upon. It is expected that this review will raise some ideas for perfecting the composition, structure, antimicrobial activity, and deposition techniques of graphene materials and coatings in order to provide better antimicrobial protection of medical devices. Full article

(This article belongs to the Special Issue Biofilms and Device-Associated Infections)

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26 pages, 2167 KiB

Open AccessReview

The Use of Probiotics to Fight Biofilms in Medical Devices: A Systematic Review and Meta-Analysis

by Fábio M. Carvalho, Rita Teixeira-Santos, Filipe J. M. Mergulhão and Luciana C. Gomes

Microorganisms 2021, 9(1), 27; https://doi.org/10.3390/microorganisms9010027 - 23 Dec 2020

Cited by 33 | Viewed by 6209

Abstract

Medical device-associated infections (MDAI) are a critical problem due to the increasing usage of medical devices in the aging population. The inhibition of biofilm formation through the use of probiotics has received attention from the medical field in the last years. However, this sparse knowledge has not been properly reviewed, so that successful strategies for biofilm management can be developed. This study aims to summarize the relevant literature about the effect of probiotics and their metabolites on biofilm formation in medical devices using a PRISMA-oriented (Preferred Reporting Items for Systematic reviews and Meta-Analyses) systematic search and meta-analysis. This approach revealed that the use of probiotics and their products is a promising strategy to hinder biofilm growth by a broad spectrum of pathogenic microorganisms. The meta-analysis showed a pooled effect estimate for the proportion of biofilm reduction of 70% for biosurfactants, 76% for cell-free supernatants (CFS), 77% for probiotic cells and 88% for exopolysaccharides (EPS). This review also highlights the need to properly analyze and report data, as well as the importance of standardizing the in vitro culture conditions to facilitate the comparison between studies. This is essential to increase the predictive value of the studies and translate their findings into clinical applications. Full article

(This article belongs to the Special Issue Biofilms and Device-Associated Infections)

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