Quorum sensing (QS), the process of autoinducer-mediated cell-cell signaling among bacteria, facilitates biofilm formation, virulence, and many other multicellular phenotypes. QS inhibitors are being investigated as antimicrobials because of their potential to reduce symptoms of infectious disease while slowing the emergence of resistant strains. Autoinducer-2 (AI-2) analogs have been shown to inhibit genotypic QS responses among many bacteria. We demonstrate for the first time, the ability of C1-alkyl AI-2 analog, isobutyl-DPD, to significantly inhibit the maturation of Escherichia coli biofilms grown in vitro. Using a novel microfluidic device that incorporates dynamic, real-time measurements of biofilm density, we also show that a combinatorial approach wherein isobutyl-DPD ((S)-4,5-dihydroxy-2,3-pentanedione) is used with the antibiotic gentamicin is quite effective in rendering near complete clearance of pre-existing E. coli biofilms. Similarly, another AI-2 analog, phenyl-DPD, also used in combination with near MIC levels of gentamicin, resulted in clearance of preformed Pseudomonas aeruginosa biofilms. Clearance of pre-existing biofilms has remained a significant health care challenge; these results warrant consideration of a new approach based on the combination of "quenching" QS signal transduction processes with traditional antibiotic treatment.

Background/Objectives:The use of electric fields in combination with small doses of antibiotics for enhanced treatment of biofilms is termed the ‘bioelectric effect’ (BE). Different mechanisms of action for the AC and DC fields have been reported in the literature over the last two decades. In this work, we conduct the first study on the correlation between the electrical energy and the treatment efficacy of the bioelectric effect on Escherichia coli K-12 W3110 biofilms.Methods:A thorough study was performed through the application of alternating (AC), direct (DC) and superimposed (SP) potentials of different amplitudes on mature E. coli biofilms. The electric fields were applied in combination with the antibiotic gentamicin (10 μg/ml) over a course of 24 h, after the biofilms had matured for 24 h. The biofilms were analysed using the crystal violet assay, the colony-forming unit method and fluorescence microscopy.Results:Results show that there is no statistical difference in treatment efficacy between the DC-, AC- and SP-based BE treatment of equivalent energies (analysis of variance (ANOVA) P>0.05) for voltages <1 V. We also demonstrate that the efficacy of the BE treatment as measured by the crystal violet staining method and colony-forming unit assay is proportional to the electrical energy applied (ANOVA P<0.05). We further verify that the treatment efficacy varies linearly with the energy of the BE treatment (r2 =0.984). Our results thus suggest that the energy of the electrical signal is the primary factor in determining the efficacy of the BE treatment, at potentials less than the media electrolysis voltage.Conclusions:Our results demonstrate that the energy of the electrical signal, and not the type of electrical signal (AC or DC or SP), is the key to determine the efficacy of the BE treatment. We anticipate that this observation will pave the way for further understanding of the mechanism of action of the BE treatment method and may open new doors to the use of electric fields in the treatment of bacterial biofilms.

We present the design, fabrication, and verification of a microfluidic platform for optical monitoring of bacterial biofilms. Biofilm formation characterizes the majority of infections caused by bacteria that are developing increased resistance to traditional antibiotic treatment, necessitating the development of reliable tools not only for study of biofilm growth, but also for in situ examination of the response to applied stimuli. The presented platform was used to continuously and non-invasively observe the dependence of Escherichia coli biofilm formation on bacterial signaling by monitoring the change in biofilm optical density over the growth period. Results were corroborated by measurement of biofilm morphological properties via confocal microscopy, and statistical analysis was applied to verify the repeatability of observed optical and morphological differences in the biofilms formed. The presented platform will be used to characterize biofilm formation and response in drug discovery applications.

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Bacterial biofilms have an extensive impact on quality of life, ranging from severe infections in the clinical field to water facility contamination in environmental science. Biofilms are comprised of diverse bacteria that produce an extracellular matrix which prevents drug diffusion through them. Hence traditional antibiotic therapies require 500-5000 times the concentration used to eliminate non-biofilmassociated infections. Early biofilm detection is critical for effective eradication. Moreover, developing an alternative biofilm treatment method that utilizes low doses of antibiotics is desired. In this paper, a realtime microsystem is shown to detect growth of biofilms as well as their removal through integrated treatment. Detection of biofilms is achieved using a surface acoustic wave (SAW) sensor that monitors the total biomass by measuring the resonant frequency of the system. Biofilm treatment is based on the bioelectric effect (BE), a combination of low-dose antibiotics with application of both alternating and direct current signals. The detection limit of the SAW system is approximately 166 pg, corresponding to a bacterial population on the order of hundreds of bacteria. The system is used to observe an 80% reduction of total biomass when treated by the BE as compared to traditional antibiotics. Through system integration of the BE with the SAW sensor, simultaneous biofilm detection and treatment is achieved. The system consumes 194 µW of power, with the sensor and treatment consuming 100 µW and 94 µW, respectively. The integrated sensing and treatment capabilities of this system advance the development of an innovative biofilm control method.

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Bacterial biofilms constitute in excess of 65% of clinical microbial infections, with the antibiotic treatment of biofilm infections posing a unique challenge due to their high antibiotic tolerance. Recent studies performed in our group have demonstrated that a bioelectric effect featuring low-intensity electric signals combined with antibiotics can significantly improve the efficacy of biofilm treatment. In this work, we demonstrate the bioelectric effect using sub-micron thick planar electrodes in a microfluidic device. This is critical in efforts to develop microsystems for clinical biofilm infection management, including both in vivo and in vitro applications. Adaptation of the method to the microscale, for example, can enable the development of localized biofilm infection treatment using microfabricated medical devices, while augmenting existing capabilities to perform biofilm management beyond the clinical realm. Furthermore, due to scale-down of the system, the voltage requirement for inducing the electric field is reduced further below the media electrolysis threshold. Enhanced biofilm treatment using the bioelectric effect in the developed microfluidic device elicited a 56% greater reduction in viable cell density and 26% further decrease in biomass growth compared to traditional antibiotic therapy. This biofilm treatment efficacy, demonstrated in a micro-scale device and utilizing biocompatible voltage ranges, encourages the use of this method for future clinical biofilm treatment applications.

We present the first demonstration of a novel bacterial biofilm treatment technique showing a 56% average decrease in bacterial cell viability compared to traditional antibiotic treatments in a Micro-BOAT platform. Integrated linear array charge-coupled devices achieve spatially realized optical density monitoring, correlating to both average biomass and localized biofilm morphology. For on-chip demonstration of biofilm treatment, a unique bioelectric effect using a superpositioned direct and alternating current electric field is applied in the presence of antibiotics. Use of the platform demonstrated successful real-time monitoring of biofilm treatment and validated an on-chip bioelectric effect showing a decrease in both bacterial cell viability and overall biomass.