“It Takes a Village”: Mechanisms Underlying Antimicrobial Recalcitrance of Polymicrobial Biofilms

Orazi, Giulia; O’Toole, George A.

doi:10.1128/jb.00530-19

Cited by 139 publications

(124 citation statements)

References 192 publications

(236 reference statements)

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“…The formation of a biofilm is under the control of multiple genes, including those responsible for the secretion of protective slime and installation of quorum-sensing that enables communication inside the biofilm [23]. Mature biofilm of mono/polymicrobial origin makes bacteria extremely resistant to both the host immune system and antibiotic diffusion [27]. The transition between reversible and irreversible phases of biofilm formation, coupled with phenotypic change, is the last window of opportunity for clinically reasonable preventative measures ( Figure 1).…”

Section: Key Steps Towards Pjimentioning

confidence: 99%

Prevention of Prosthetic Joint Infection: From Traditional Approaches towards Quality Improvement and Data Mining

Gallo

Nieslanikova

2020

JCM

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A projected increased use of total joint arthroplasties will naturally result in a related increase in the number of prosthetic joint infections (PJIs). Suppression of the local peri-implant immune response counters efforts to eradicate bacteria, allowing the formation of biofilms and compromising preventive measures taken in the operating room. For these reasons, the prevention of PJI should focus concurrently on the following targets: (i) identifying at-risk patients; (ii) reducing “bacterial load” perioperatively; (iii) creating an antibacterial/antibiofilm environment at the site of surgery; and (iv) stimulating the local immune response. Despite considerable recent progress made in experimental and clinical research, a large discrepancy persists between proposed and clinically implemented preventative strategies. The ultimate anti-infective strategy lies in an optimal combination of all preventative approaches into a single “clinical pack”, applied rigorously in all settings involving prosthetic joint implantation. In addition, “anti-infective” implants might be a choice in patients who have an increased risk for PJI. However, further progress in the prevention of PJI is not imaginable without a close commitment to using quality improvement tools in combination with continual data mining, reflecting the efficacy of the preventative strategy in a particular clinical setting.

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Section: Key Steps Towards Pjimentioning

confidence: 99%

Prevention of Prosthetic Joint Infection: From Traditional Approaches towards Quality Improvement and Data Mining

Gallo

Nieslanikova

2020

JCM

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“…Polymicrobial infections often lead to dramatic and unexpected outcomes in the aptitude of antibiotics to eliminate bacteria [33]. Based on the fact that we isolated pure colonies from the rst two meticulously done urine cultures, this case report apparently looks like a non-polymicrobial UTI episode which lead to a dramatic and unexpected outcome following therapy.…”

Section: Discussionmentioning

confidence: 92%

Case report on a swift shift in uropathogens from Shigella Flexneri to Escherichia Coli: a thin line between bacterial persistence and reinfection.

Tufon

Yolande

Kouanou

et al. 2020

Preprint

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Abstract Background: Urinary tract infections (UTI) are mostly caused by bacteria. Urine cultures are usually a definitive measure to select the appropriate antibiotics for the elimination of a uropathogen and subsequent recovery from the infection. However, the preferred antibiotics as determined by urine culture and sensitivity may still not eliminate the infection and would require further examination to ascertain the cause of treatment failure which could be unresolved bacteriuria, bacterial persistence, immediate reinfection with a different uropathogen or misdiagnosis.Case presentation: A 2-years 7 months-old female was admitted in the Regional hospital of Buea following persistent fever. An auto medication with amoxicillin was reported. Urinalysis was done on the first day and the sediment of the cloudy urine revealed many bacteria and few pus cells. Ceftriaxone was prescribed as empirical treatment and a request for urine and blood culture was made. Three days after admission, the temperature and CRP were 39.0°c and 96 mg/l respectively. The urine culture results (>105 CFU/ml of Shigella flexneri sensitive to ofloxacin) were presented to the doctor on the 4th day of admission. Patient was put on ofloxacin. Three days after, the temperature (38.5°c) and CRP (24mg/l) were still elevated. The blood culture result came out negative. A second urine culture was requested which came back positive (>105 CFU/ml of Escherichia coli resistant to ofloxacin and sensitive to meropenem and amikacin). Ofloxacin was discontinued and the patient put on meropenem and amikacin. The third urine culture recorded no significant growth after 48 hours of incubation. The patient was discharged looking healthy once more with a normal body temperature. Conclusion: Antibiotics tailored towards the elimination of a particular bacterial species may as well provide a favorable environment for other bacterial species that are resistant to it in the course of treating a UTI episode. This apparent treatment failure may first of all require a second urine culture for confirmation rather than considering the possibilities of a misdiagnosis.

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“…In addition, the temporary alterations in microbial neighbors contribute to enhanced mixed-species biofilm recalcitrance. A species settling down in a mixed-species biofilm can alter the physiology of neighboring species by interspecies interactions (Herschend et al, 2017), such as antibiotic resistance gene exchange, antibiotic-inactivated enzyme transfer, quorum-sensing signal-induced gene expression changes, and metabolite-mediated electron transport chain inhibition (Hansen et al, 2017;Orazi and O'Toole, 2019). For example, carbapenemase resistance gene-carried plasmid can be transferred from E. coli to either Acinetobacter baumannii or P. aeruginosa in mixed-species biofilms but is not observed in the planktonic state of these organisms (Tanner et al, 2017;Potron et al, 2011).…”

Section: Mechanisms Underpinning the Enhanced Resistance Of Mixed-spementioning

confidence: 99%

“…For example, carbapenemase resistance gene-carried plasmid can be transferred from E. coli to either Acinetobacter baumannii or P. aeruginosa in mixed-species biofilms but is not observed in the planktonic state of these organisms (Tanner et al, 2017;Potron et al, 2011). The 2-heptyl-4-hydroxyquinolone N-oxide secreted by P. aeruginosa can alter the susceptibility of S. aureus strains within mixed-species biofilms to several antibacterial agents, such as vancomycin, aminoglycosides, and chloroxylenol (Orazi and O'Toole, 2019). The fungus C. albicans can induce vancomycin resistance of S. aureus during mixed-species biofilm formation (Harriott and Noverr, 2010).…”

Section: Mechanisms Underpinning the Enhanced Resistance Of Mixed-spementioning

confidence: 99%

Fighting Mixed-Species Microbial Biofilms With Cold Atmospheric Plasma

et al. 2020

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Most biofilms in nature are formed by multiple microbial species, and such mixedspecies biofilms represent the actual lifestyles of microbes, including bacteria, fungi, viruses (phages), and/or protozoa. Microorganisms cooperate and compete in mixedspecies biofilms. Mixed-species biofilm formation and environmental resistance are major threats to water supply, food industry, and human health. The methods commonly used for microbial eradication, such as antibiotic or disinfectant treatments, are often ineffective for mixed-species biofilm consortia due to their physical matrix barrier and physiological interactions. For the last decade, an increasing number of investigations have been devoted to the usage of cold atmospheric plasma (CAP), which is produced by dielectric barrier discharges or plasma jets to prevent or eliminate microbial biofilms. Here, we summarized the production of CAP, the inactivation of microorganisms upon CAP treatment, and the microbial factors affecting the efficacy of CAP procedure. The applications of CAP as antibiotic alternative strategies for fighting mixed-species biofilms were also addressed.

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“It Takes a Village”: Mechanisms Underlying Antimicrobial Recalcitrance of Polymicrobial Biofilms

Cited by 139 publications

References 192 publications

Prevention of Prosthetic Joint Infection: From Traditional Approaches towards Quality Improvement and Data Mining

Prevention of Prosthetic Joint Infection: From Traditional Approaches towards Quality Improvement and Data Mining

Case report on a swift shift in uropathogens from Shigella Flexneri to Escherichia Coli: a thin line between bacterial persistence and reinfection.

Fighting Mixed-Species Microbial Biofilms With Cold Atmospheric Plasma

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