Schramm Sandra, Hiller Karl-Anton, Cantzler Sylvia, Weilemann Hannes, Cantzler Maximilian, Zimmermann Julia L, Cieplik Fabian, Maisch Tim
Department of Dermatology, University Hospital Regensburg, Regensburg, Germany.
Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany.
Front Microbiol. 2020 Oct 29;11:576500. doi: 10.3389/fmicb.2020.576500. eCollection 2020.
Multi-resistant microorganisms are a long-standing problem for public healthcare, as inactivating those resistant pathogens with conventional antibiotics or antiseptics often no longer achieves the expected clinical success. The aim of this study was to investigate the antibacterial efficacy of binary combinations of conventional antibacterial agents with cold atmospheric plasma (CAP), when both are applied in non-lethal concentrations. In this study, biofilms were treated with CAP in binary combinations with benzalkonium chloride (BAC), chlorhexidine (CHX), or ciprofloxacin (CIP), respectively, which were applied in different sequences. In order to evaluate effects of binary use of two different antibacterial approaches, the so-called (LTPR) was defined. For this purpose, regrowth curves of the bacteria were measured following the respective treatment combinations. LTPR is defined as the time component of the inflection point of a normalized regrowth curve and allows the rating and interpretation of single or binary treatments with different agents or approaches. Furthermore, LTPR designates the latest time point where a retreatment appears to be appropriate for preventing regrowth of the bacteria in case the first treatment was not lethal. Here in our study, the binary combination of 10 min CAP with BAC, CHX, or CIP leads to higher LTPRs as compared to single treatments for both sequences of application. Overall, the combination of two antimicrobial approaches is an effective alternative for inactivating bacteria in biofilms instead of a single treatment. Thus, LTPR provides a novel promising way to determine antibacterial effects for single or binary use of given antimicrobial approaches.
多重耐药微生物对公共卫生保健来说是一个长期存在的问题，因为使用传统抗生素或防腐剂灭活那些耐药病原体往往不再能取得预期的临床成效。本研究的目的是调查传统抗菌剂与低温大气等离子体（CAP）二元组合的抗菌效果，二者均以非致死浓度应用。在本研究中，生物膜分别用CAP与苯扎氯铵（BAC）、洗必泰（CHX）或环丙沙星（CIP）的二元组合进行处理，并采用不同的应用顺序。为了评估两种不同抗菌方法二元使用的效果，定义了所谓的（LTPR）。为此，在各自的处理组合后测量细菌的再生长曲线。LTPR被定义为归一化再生长曲线拐点的时间成分，可用于对不同药剂或方法的单一或二元处理进行评级和解释。此外，LTPR指定了在首次处理不具有致死性的情况下，再次处理似乎适合防止细菌再生长的最晚时间点。在我们的这项研究中，与两种应用顺序的单一处理相比，10分钟CAP与BAC、CHX或CIP的二元组合导致更高的LTPR。总体而言，两种抗菌方法的组合是灭活生物膜中细菌的有效替代方法，而非单一处理。因此，LTPR为确定给定抗菌方法单一或二元使用的抗菌效果提供了一种新的、有前景的方法。
