Le Tong, Psaltis Alkis, Tan Lor Wai, Wormald Peter-John
Department of Surgery-Otolaryngology Head and Neck Surgery, University of Adelaide, Adelaide, Australia.
Am J Rhinol. 2008 Nov-Dec;22(6):560-7. doi: 10.2500/ajr.2008.22.3232.
Biofilms have been shown to be resistant to conventional antibiotic treatment. This study uses a sheep biofilm model developed by our department to investigate several novel topical anti-biofilm treatments.
Staphylococcal biofilms were grown in 54 sheep frontal sinuses over 8 days: Each sinus was randomized to (1) no intervention, (2) single mupirocin flush, (3) regular 12-hourly mupirocin flushes for 5 days, (4) Citric Acid Zwitterionic Surfactant (CAZS) via hydrodebrider, (5) gallium nitrate, (6) CAZS with gallium nitrate, (7) CAZS with mupirocin, and (8) saline regular flushes. Sheep were sacrificed and the sinus mucosa harvested 1 or 8 days after treatment to assess treatment and any biofilm regrowth. Confocal scanning laser microscopy was used to confirm the presence or absence of biofilms, and the extent of biofilm reduction was quantitated using fluorescent in situ hybridization and colony forming unit counts.
In the control sheep biofilm coverage averaged 31.7%. Saline and mupirocin b.d. washes for 5 days had 23% and 0.84% coverage, respectively, when harvested on day 8. A single mupirocin and gallium wash had 7.7% and 16.2% on day 1 and 5.88% and 16.0% on day 8. CAZS with hydrodebrider had 6.66% on day 1 but 21.95% on day 8 whereas CAZS with hydodebrider and gallium had 13.3% on day 8.
This study shows that regular treatment with mupirocin produced the most marked reduction in biofilm surface area coverage (0.84% and 1.25%) with sustained effects over the 8-day follow-up period.
生物膜已被证明对传统抗生素治疗具有抗性。本研究使用我们科室建立的绵羊生物膜模型来研究几种新型局部抗生物膜治疗方法。
在54只绵羊的额窦中培养葡萄球菌生物膜，持续8天：每个鼻窦随机分为（1）不干预，（2）单次莫匹罗星冲洗，（3）每12小时定期冲洗莫匹罗星5天，（4）通过水清创器使用柠檬酸两性离子表面活性剂（CAZS），（5）硝酸镓，（6）CAZS与硝酸镓，（7）CAZS与莫匹罗星，以及（8）生理盐水定期冲洗。在治疗后1天或8天处死绵羊并采集鼻窦黏膜，以评估治疗效果和任何生物膜再生长情况。使用共聚焦扫描激光显微镜确认生物膜的存在与否，并使用荧光原位杂交和菌落形成单位计数来定量生物膜减少的程度。
在对照绵羊中，生物膜覆盖率平均为31.7%。在第8天采集时，生理盐水冲洗和每天两次莫匹罗星冲洗5天的生物膜覆盖率分别为23%和0.84%。单次莫匹罗星和硝酸镓冲洗在第1天的覆盖率分别为7.7%和16.2%，在第8天分别为5.88%和16.0%。通过水清创器使用CAZS在第1天的覆盖率为6.66%，但在第8天为21.95%，而通过水清创器使用CAZS和硝酸镓在第8天的覆盖率为13.3%。
本研究表明，定期使用莫匹罗星治疗可使生物膜表面积覆盖率显著降低（0.84%和1.25%），并在8天的随访期内产生持续效果。
