Successful treatment of biofilm infections using shock waves combined with antibiotic therapy

Abstract

Many bacteria secrete a highly hydrated framework of extracellular polymer matrix on suitable substrates and embed within the matrix to form a biofilm. Bacterial biofilms are observed on many medical devices, endocarditis, periodontitis and lung infections in cystic fibrosis patients. Bacteria in biofilm are protected from antibiotics and >1,000 times of the minimum inhibitory concentration may be required to treat biofilm infections. Here, we demonstrated that shock waves could be used to remove Salmonella, Pseudomonas and Staphylococcus biofilms in urinary catheters. The studies were extended to a Pseudomonas chronic pneumonia lung infection and Staphylococcus skin suture infection model in mice. The biofilm infections in mice, treated with shock waves became susceptible to antibiotics, unlike untreated biofilms. Mice exposed to shock waves responded to ciprofloxacin treatment, while ciprofloxacin alone was ineffective in treating the infection. These results demonstrate for the first time that, shock waves, combined with antibiotic treatment can be used to treat biofilm infection on medical devices as well as in situ infections.

Optimization and integration of nanosilver on polycaprolactone nanofibrous mesh for bacterial inhibition and wound healing in vitro and in vivo

“…30,31 In vitro cytotoxicity test Green fluorescent protein (GFP) transgenic neonatal mice (1-3 days) were obtained from the Experimental Animal Department of the Third Military Medical University, and the experimental protocol was approved by the Institutional Animal Care and Use Committee of the Third Military Medical University. The fibroblasts were isolated from the neonatal mice according to the previous study.…”

Shockwave Therapy Efficiently Cures Multispecies Chronic Periodontitis in a Humanized Rat Model

“…The recent medical reports of use of shock waves (SW) for various therapeutic purposes have opened new vistas to be explored for dental applications (Datey et al, 2016). Anti-bacterial effects of shock waves have shown promising results in some studies (Gnanadhas et al, 2015), however there is a lack of substantial research and cumulative evidence about this in the available dental literature. With this background the present in-vitro study was designed with an aim to assess the effect of shock waves on multispecies oral biofilm and its adjunctive effect on the antibacterial efficacy of four different antimicrobial agents commonly used in periodontal therapy as a novel approach.…”

Urodynamic and molecular characteristics of detrusor underactivity in a rat cryoinjury model and effects of low energy shock wave therapy

“…Shock wave (SW) has been shown to have various interactions and effects on biological systems. 15 High-energy extracorporeal SW therapy has been used to disintegrate urolithiasis for 30 years. 16 At lower energy levels, however, SW enhanced expression of VEGF, eNOS, PCNA, chemoattractant factors, and recruitment of progenitor cells, and improved tissue regeneration.…”