Microbiology and Virology Laboratories, University of Modena and Reggio Emilia, Modena, Italy.
Department of Surgery, Medicine, Dentistry and Morphological Sciences with interest in Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.
Microbiol Spectr. 2021 Dec 22;9(3):e0104721. doi: 10.1128/Spectrum.01047-21. Epub 2021 Nov 17.
Peritoneal catheter-associated biofilm infection is reported to be the main cause of refractory peritonitis in peritoneal dialysis patients. The application of antimicrobial lock therapy, based on results on central venous catheters, may be a promising option for treatment of biofilm-harboring peritoneal catheters. This study investigated the effects of two lock solutions, EDTA and taurolidine, on an model of Pseudomonas aeruginosa biofilm-related peritoneal catheter infection. Silicone peritoneal catheters were incubated for 24 h with a bioluminescent strain of P. aeruginosa. Then, serial dilutions of taurolidine and/or EDTA were applied (for 24 h) once or twice onto the contaminated catheters, and P. aeruginosa viability/persistence were evaluated in real time up to 120 h using a Fluoroskan reader. On selected supernatants, high-performance liquid chromatography mass spectrometry (HPLC-MS) analysis was performed to measure the production of autoinducers (AI), phenazines, and pyocyianines. Taurolidine alone or in combination with EDTA caused a significant decrease of bacterial load and biofilm persistence on the contaminated catheters. The treatment did not lead to the sterilization of the devices, yet it resulted in a substantial destructuration of the catheter-associated P. aeruginosa biofilm. HPLC-MS analysis showed that the treatment of biofilm-harboring catheters with taurolidine and EDTA also affected the secretory activity of the pathogen. EDTA and taurolidine affect P. aeruginosa biofilm produced on peritoneal catheters and profoundly compromise the microbial secretory profile. Future studies are needed to establish whether such lock solutions can be used to render peritoneal catheter-related infections more susceptible to antibiotic treatment. An model allows studies on the mechanisms by which the lock solutions exert their antimicrobial effects on catheter-associated biofilm, thus providing a better understanding of the management of devise-associated infections.
腹膜导管相关生物膜感染据报道是腹膜透析患者难治性腹膜炎的主要原因。基于中心静脉导管的结果，应用抗菌封管治疗可能是治疗生物膜定植腹膜导管的一种有前途的选择。本研究调查了两种封管液（EDTA 和牛磺罗定）对铜绿假单胞菌生物膜相关腹膜导管感染模型的影响。将发光的铜绿假单胞菌菌株孵育在硅酮腹膜导管上 24 h。然后，将牛磺罗定和/或 EDTA 的连续稀释液（24 h）一次或两次应用于污染的导管上，并使用 Fluoroskan 读取器实时评估直到 120 h 的铜绿假单胞菌活力/持久性。在选定的上清液中，进行高效液相色谱质谱（HPLC-MS）分析，以测量自动诱导物（AI）、吩嗪和吡咯菌素的产生。牛磺罗定单独或与 EDTA 联合使用可显著降低污染导管上的细菌负荷和生物膜持久性。该治疗不会导致器械灭菌，但会导致与导管相关的铜绿假单胞菌生物膜的结构严重破坏。HPLC-MS 分析表明，用牛磺罗定和 EDTA 处理生物膜定植的导管也会影响病原体的分泌活性。EDTA 和牛磺罗定影响腹膜导管上产生的铜绿假单胞菌生物膜，并严重损害微生物分泌谱。需要进一步的研究来确定这些封管液是否可用于使腹膜导管相关感染更容易接受抗生素治疗。 该模型允许研究封管液对导管相关生物膜发挥其抗菌作用的机制，从而更好地理解器械相关感染的管理。
