Taurolidine Acts on Bacterial Virulence Factors and Does Not Induce Resistance in Periodontitis-Associated Bacteria—An In-Vitro Study

Abstract

The aims of the present study were: (a) to determine the mechanism of action of taurolidine against bacterial species associated with periodontal disease, and (b) to evaluate the potential development of resistance against taurolidine as compared with minocycline. After visualizing the mode of action of taurolidine by transmission electron micrographs, the interaction with most important virulence factors (lipopolysaccharide (LPS), Porphyromonas gingivalis gingipains, Aggregatibacter actinomycetemcomitans leukotoxin), was analyzed. Then, 14 clinical isolates from subgingival biofilm samples were transferred on agar plates containing subinhibitory concentrations of taurolidine or minocycline up to 50 passages. Before and after each 10 passages, minimal inhibitory concentrations (MICs) were determined. Increasing MICs were screened for efflux mechanism. Taurolidine inhibited in a concentration-dependent manner the activities of LPS and of the arginine-specific gingipains; however, an effect on A. actinomycetemcomitans leukotoxin was not detected. One P. gingivalis strain developed a resistance against taurolidine, which was probably linked with efflux mechanisms. An increase of MIC values of minocycline occurred in five of the 14 included strains after exposure to subinhibitory concentrations of the antibiotic. The present results indicate that: (a) taurolidine interacts with LPS and gingipains, and (b) development of resistance seems to be a rare event when using taurolidine.

Taurolidine and Heparin as Catheter Lock Solution for Central Venous Catheters in Hemodialysis

“…16,42 Following 50 passages with subinhibitory concentrations of taurolidine, the MIC of Porphyromonas gingivalis increased 4-fold. 43 However, this increase in MIC was reversed by removal of taurolidine and only represented the upper range of wild-type MICs for most bacteria. A separate study investigating development of resistance showed no resistant subpopulations or mutants using large inocula (.10 9 bacteria/ mL) for 2 strains each of E. coli, P. aeruginosa, S. aureus, E. faecalis, and E. faecium at concentrations of 2-4X MIC.…”

“…51 Furthermore, taurolidine is able to mitigate the cytokine production of white blood cells in response E. coli-derived lipopolysaccharides, S. aureus-derived toxic shock syndrome toxin-1, and heat-killed C. albicans in a dose-dependent manner. 43,52,53 The mechanism of decreasing bacterial adhesion to epithelial cells and cytokine production of white blood cells both appear to be due to taurolidine acting upon the human cells rather than bacterial constituents. Finally, taurolidine is also reported to have antineoplastic effects ranging from anti-inflammatory property, stimulation of apoptosis, inhibiting angiogenesis, and preventing tumor adhesion, among others.…”

The European TauroPace™ Registry

“…Taurolidine solutions are used during lung transplantations [20]. Taurolidine was researched for adjunct use during dental implantation, with a focus on how it affects the buccal microbiome [21,22]. It has shown good results when used during spinal fusion surgery [23].…”