Coraça-Huber Débora C, Steixner Stephan, Wurm Alexander, Nogler Michael
Research Laboratory for Biofilms and Implant Associated Infections (BIOFILM LAB), Experimental Orthopedics, University Hospital for Orthopedics and Traumatology, Medical University of Innsbruck, Peter-Mayr-Strasse 4b, Room 204, 6020 Innsbruck, Austria.
University Hospital for Orthopedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
Biomedicines. 2021 Mar 26;9(4):334. doi: 10.3390/biomedicines9040334.
Implantable medical devices, such as prosthetics, catheters, and several other devices, have revolutionized medicine, but they increase the infection risk. In previous decades, commercially available antibiotics lost their activity against coagulase-negative (CoNS) and several other microorganisms. Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are the two major omega-3 polyunsaturated fatty acids (ω-3 PUFAs) with antimicrobial properties. In this study, we tested the EPA and the DHA for its antibacterial and anti-biofilm activity in vitro against , , and different CoNS as reference strains and isolated from patients undergoing orthopedic treatment for implant infections. The tests were carried out with the strains in planktonic and biofilm form. Cytotoxicity assay was carried out with EPA and DHA using human gingival fibroblasts HGF-1. The highest concentration of EPA and DHA promoted the complete killing of 1457 and ATCC 25923 in planktonic form. The fatty acids showed low activity against . EPA and DHA completely killed or significantly reduced the count of planktonic bacteria of the patient isolated strains. When incubated with media enriched with EPA and DHA, the biofilm formation was significantly reduced on 1457 and not present on ATCC 25923. The reduction or complete killing were also observed with the clinical isolates. The pre-formed biofilms showed reduction of the cell counting after treatment with EPA and DHA. In this study, the ω-3 PUFAs EPA and DHA showed antimicrobial and anti-biofilm activity in vitro against , , and , as well as against multi-drug resistant and CoNS strains isolated from patients undergoing periprosthetic joint infections (PJI) treatment. Higher concentrations of the fatty acids showed killing activity on planktonic cells and inhibitory activity of biofilm formation. Although both substances showed antimicrobial activity, EPA showed better results in comparison with DHA. In addition, when applied on human gingival fibroblasts in vitro, EPA and DHA showed a possible protective effect on cells cultured in medium enriched with ethanol. Further studies are required to confirm the antimicrobial activity of EPA and DHA against multi-drug resistant strains and pan-drug resistant strains.
可植入式医疗设备，如假肢、导管和其他一些设备，彻底改变了医学，但它们增加了感染风险。在过去几十年里，市售抗生素对凝固酶阴性（CoNS）及其他几种微生物失去了活性。二十二碳六烯酸（DHA）和二十碳五烯酸（EPA）是两种具有抗菌特性的主要ω-3多不饱和脂肪酸（ω-3 PUFAs）。在本研究中，我们测试了EPA和DHA对金黄色葡萄球菌、大肠杆菌以及不同CoNS作为参考菌株和从接受植入物感染骨科治疗的患者中分离出的菌株的体外抗菌和抗生物膜活性。测试针对浮游形式和生物膜形式的菌株进行。使用人牙龈成纤维细胞HGF-1对EPA和DHA进行细胞毒性测定。EPA和DHA的最高浓度促进了浮游形式的金黄色葡萄球菌1457和大肠杆菌ATCC 25923的完全杀灭。脂肪酸对表皮葡萄球菌显示出低活性。EPA和DHA完全杀灭或显著减少了患者分离菌株的浮游细菌数量。当与富含EPA和DHA的培养基一起孵育时，金黄色葡萄球菌1457上的生物膜形成显著减少，而在大肠杆菌ATCC 25923上则不存在。临床分离株也观察到减少或完全杀灭。预先形成的生物膜在用EPA和DHA处理后显示细胞计数减少。在本研究中，ω-3 PUFAs EPA和DHA在体外对金黄色葡萄球菌、大肠杆菌、表皮葡萄球菌以及从接受人工关节感染（PJI）治疗的患者中分离出的耐多药金黄色葡萄球菌和CoNS菌株显示出抗菌和抗生物膜活性。较高浓度的脂肪酸对浮游细胞显示出杀灭活性和生物膜形成抑制活性。虽然两种物质都显示出抗菌活性，但与DHA相比，EPA显示出更好的结果。此外，当在体外应用于人牙龈成纤维细胞时，EPA和DHA对在富含乙醇的培养基中培养的细胞显示出可能的保护作用。需要进一步研究来证实EPA和DHA对耐多药菌株和泛耐药菌株的抗菌活性。
