Antibiotics Enhance Prevention and Eradication Efficacy of Cathodic-Voltage-Controlled Electrical Stimulation against Titanium-Associated Methicillin-Resistant <named-content content-type="genus-species">Staphylococcus aureus</named-content> and <named-content content-type="genus-species">Pseudomonas aeruginosa</named-content> Biofilms

ABSTRACT Periprosthetic joint infection (PJI) develops clinically, even with antibiotic treatment, and methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa are predominant causes of these infections. Due to biofilm formation, antibiotic treatment for patients with PJI can pe...

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Autores principales:	Mary K. Canty, Lisa A. Hansen, Menachem Tobias, Sandy Spencer, Terry Henry, Nicole R. Luke-Marshall, Anthony A. Campagnari, Mark T. Ehrensberger
Formato:	article
Lenguaje:	EN
Publicado:	American Society for Microbiology 2019
Materias:	orthopedic infection treatment prevention bacteria biofilms Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/fffba7fb76d341a7a44a1885b00a4a12
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spelling	oai:doaj.org-article:fffba7fb76d341a7a44a1885b00a4a122021-11-15T15:22:20ZAntibiotics Enhance Prevention and Eradication Efficacy of Cathodic-Voltage-Controlled Electrical Stimulation against Titanium-Associated Methicillin-Resistant <named-content content-type="genus-species">Staphylococcus aureus</named-content> and <named-content content-type="genus-species">Pseudomonas aeruginosa</named-content> Biofilms10.1128/mSphere.00178-192379-5042https://doaj.org/article/fffba7fb76d341a7a44a1885b00a4a122019-06-01T00:00:00Zhttps://journals.asm.org/doi/10.1128/mSphere.00178-19https://doaj.org/toc/2379-5042ABSTRACT Periprosthetic joint infection (PJI) develops clinically, even with antibiotic treatment, and methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa are predominant causes of these infections. Due to biofilm formation, antibiotic treatment for patients with PJI can perpetuate resistance, further complicating the use of noninvasive treatments. This study evaluated cathodic-voltage-controlled electrical stimulation (CVCES) of titanium, in combination with a clinically relevant antibiotic, to synergistically prevent MRSA and P. aeruginosa PJIs by inhibiting bacterial adherence or as a treatment for eradicating established biofilms. CVCES of −1.0 V, −1.5 V, or −1.8 V (versus Ag/AgCl), with or without vancomycin for MRSA or gentamicin for P. aeruginosa, was applied to sterile titanium incubated with cultures to evaluate prevention of attachment or eradication of preestablished biofilms. Treatments were 24 h long and included open-circuit potential controls, antibiotic alone, CVCES, and CVCES plus antibiotic. Biofilm-associated and planktonic CFU were enumerated. In general, CVCES at −1.8 V alone or with antibiotic completely eradicated biofilm-associated CFU for both strains, and these parameters were also highly effective against planktonic bacteria, resulting in a >6-log reduction in MRSA and no detectable planktonic P. aeruginosa. All CFU were reduced ∼3 to 5 logs from controls for prevention CVCES plus antibiotics at −1.0 V and −1.5 V against MRSA. Remarkably, there were no detectable P. aeruginosa CFU following prevention CVCES at −1.0 V or −1.5 V with gentamicin. Our results suggest that CVCES in combination with antibiotics may be an effective approach for prevention and treatment of PJI. IMPORTANCE Periprosthetic joint infections (PJIs) develop clinically in the presence of antibiotic therapies and are responsible for increased patient morbidity and rising health care costs. Many of these infections involve bacterial biofilm formation on orthopedic hardware, and it has been well established that these biofilms are refractory to most antibiotic treatments. Recent studies have focused on novel methods to prevent and eradicate infection. Cathodic-voltage-controlled electrical stimulation (CVCES) has previously been shown to be effective as a method for prevention and eradication of Gram-positive and Gram-negative infections. The present study revealed that the utility of CVCES for prevention and eradication of methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa is enhanced in the presence of clinically relevant antibiotics. The synergistic effects of CVCES and antibiotics are effective in a magnitude-dependent manner. The results of this study indicate a promising alternative method to current PJI mitigation techniques.Mary K. CantyLisa A. HansenMenachem TobiasSandy SpencerTerry HenryNicole R. Luke-MarshallAnthony A. CampagnariMark T. EhrensbergerAmerican Society for Microbiologyarticleorthopedic infectiontreatmentpreventionbacteriabiofilmsMicrobiologyQR1-502ENmSphere, Vol 4, Iss 3 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	orthopedic infection treatment prevention bacteria biofilms Microbiology QR1-502
spellingShingle	orthopedic infection treatment prevention bacteria biofilms Microbiology QR1-502 Mary K. Canty Lisa A. Hansen Menachem Tobias Sandy Spencer Terry Henry Nicole R. Luke-Marshall Anthony A. Campagnari Mark T. Ehrensberger Antibiotics Enhance Prevention and Eradication Efficacy of Cathodic-Voltage-Controlled Electrical Stimulation against Titanium-Associated Methicillin-Resistant <named-content content-type="genus-species">Staphylococcus aureus</named-content> and <named-content content-type="genus-species">Pseudomonas aeruginosa</named-content> Biofilms
description	ABSTRACT Periprosthetic joint infection (PJI) develops clinically, even with antibiotic treatment, and methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa are predominant causes of these infections. Due to biofilm formation, antibiotic treatment for patients with PJI can perpetuate resistance, further complicating the use of noninvasive treatments. This study evaluated cathodic-voltage-controlled electrical stimulation (CVCES) of titanium, in combination with a clinically relevant antibiotic, to synergistically prevent MRSA and P. aeruginosa PJIs by inhibiting bacterial adherence or as a treatment for eradicating established biofilms. CVCES of −1.0 V, −1.5 V, or −1.8 V (versus Ag/AgCl), with or without vancomycin for MRSA or gentamicin for P. aeruginosa, was applied to sterile titanium incubated with cultures to evaluate prevention of attachment or eradication of preestablished biofilms. Treatments were 24 h long and included open-circuit potential controls, antibiotic alone, CVCES, and CVCES plus antibiotic. Biofilm-associated and planktonic CFU were enumerated. In general, CVCES at −1.8 V alone or with antibiotic completely eradicated biofilm-associated CFU for both strains, and these parameters were also highly effective against planktonic bacteria, resulting in a >6-log reduction in MRSA and no detectable planktonic P. aeruginosa. All CFU were reduced ∼3 to 5 logs from controls for prevention CVCES plus antibiotics at −1.0 V and −1.5 V against MRSA. Remarkably, there were no detectable P. aeruginosa CFU following prevention CVCES at −1.0 V or −1.5 V with gentamicin. Our results suggest that CVCES in combination with antibiotics may be an effective approach for prevention and treatment of PJI. IMPORTANCE Periprosthetic joint infections (PJIs) develop clinically in the presence of antibiotic therapies and are responsible for increased patient morbidity and rising health care costs. Many of these infections involve bacterial biofilm formation on orthopedic hardware, and it has been well established that these biofilms are refractory to most antibiotic treatments. Recent studies have focused on novel methods to prevent and eradicate infection. Cathodic-voltage-controlled electrical stimulation (CVCES) has previously been shown to be effective as a method for prevention and eradication of Gram-positive and Gram-negative infections. The present study revealed that the utility of CVCES for prevention and eradication of methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa is enhanced in the presence of clinically relevant antibiotics. The synergistic effects of CVCES and antibiotics are effective in a magnitude-dependent manner. The results of this study indicate a promising alternative method to current PJI mitigation techniques.
format	article
author	Mary K. Canty Lisa A. Hansen Menachem Tobias Sandy Spencer Terry Henry Nicole R. Luke-Marshall Anthony A. Campagnari Mark T. Ehrensberger
author_facet	Mary K. Canty Lisa A. Hansen Menachem Tobias Sandy Spencer Terry Henry Nicole R. Luke-Marshall Anthony A. Campagnari Mark T. Ehrensberger
author_sort	Mary K. Canty
title	Antibiotics Enhance Prevention and Eradication Efficacy of Cathodic-Voltage-Controlled Electrical Stimulation against Titanium-Associated Methicillin-Resistant <named-content content-type="genus-species">Staphylococcus aureus</named-content> and <named-content content-type="genus-species">Pseudomonas aeruginosa</named-content> Biofilms
title_short	Antibiotics Enhance Prevention and Eradication Efficacy of Cathodic-Voltage-Controlled Electrical Stimulation against Titanium-Associated Methicillin-Resistant <named-content content-type="genus-species">Staphylococcus aureus</named-content> and <named-content content-type="genus-species">Pseudomonas aeruginosa</named-content> Biofilms
title_full	Antibiotics Enhance Prevention and Eradication Efficacy of Cathodic-Voltage-Controlled Electrical Stimulation against Titanium-Associated Methicillin-Resistant <named-content content-type="genus-species">Staphylococcus aureus</named-content> and <named-content content-type="genus-species">Pseudomonas aeruginosa</named-content> Biofilms
title_fullStr	Antibiotics Enhance Prevention and Eradication Efficacy of Cathodic-Voltage-Controlled Electrical Stimulation against Titanium-Associated Methicillin-Resistant <named-content content-type="genus-species">Staphylococcus aureus</named-content> and <named-content content-type="genus-species">Pseudomonas aeruginosa</named-content> Biofilms
title_full_unstemmed	Antibiotics Enhance Prevention and Eradication Efficacy of Cathodic-Voltage-Controlled Electrical Stimulation against Titanium-Associated Methicillin-Resistant <named-content content-type="genus-species">Staphylococcus aureus</named-content> and <named-content content-type="genus-species">Pseudomonas aeruginosa</named-content> Biofilms
title_sort	antibiotics enhance prevention and eradication efficacy of cathodic-voltage-controlled electrical stimulation against titanium-associated methicillin-resistant <named-content content-type="genus-species">staphylococcus aureus</named-content> and <named-content content-type="genus-species">pseudomonas aeruginosa</named-content> biofilms
publisher	American Society for Microbiology
publishDate	2019
url	https://doaj.org/article/fffba7fb76d341a7a44a1885b00a4a12
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