Bacterial Biofilms and Increased Bacterial Counts Are Associated with Airway Stenosis

Mazhar, Kashif; Gunawardana, Manjula; Webster, Paul; Hochstim, Christian; Koempel, Jeffery A.; Kokot, Niels; Sinha, Uttam K.; Rice, Dale H.; Baum, Marc M.

doi:10.1177/0194599814522765

Cited by 28 publications

(23 citation statements)

References 36 publications

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“…In addition, other methods of assessing biofilms include standard microbiological techniques such as measuring colony‐forming units, 16s RNA sequencing, crystal violet staining, and metagenomic shotgun sequencing. Mazhar et al also reported in a study of 12 patients with and without LTS that bacterial biofilms were observed via SEM on samples of granulation tissue from all patients with LTS, whereas none were noted on normal tissue . The advantages of using metagenomic shotgun sequencing for bacterial quantification is that it can detect nonculturable bacteria and allows for actual bacteria counts from the substrate itself rather than having to incubate the bacteria in a nutrient broth or agar.…”

Section: Discussionmentioning

confidence: 99%

“…Mazhar et al also reported in a study of 12 patients with and without LTS that bacterial biofilms were observed via SEM on samples of granulation tissue from all patients with LTS, whereas none were noted on normal tissue. 27 The advantages of using metagenomic shotgun sequencing for bacterial quantification is that it can detect nonculturable bacteria and allows for actual bacteria counts from the substrate itself rather than having to incubate the bacteria in a nutrient broth or agar. This lends itself as a technique that can allow for earlier detection of bacterial load compared to that of standard culture techniques, resulting in earlier treatment of disease processes.…”

Section: Discussionmentioning

confidence: 99%

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Feasibility of shotgun metagenomics to assess microbial ecology of pediatric tracheostomy tubes

Wang¹,

Bergeron

Andersen³

et al. 2018

The Laryngoscope

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Objective Biofilm formation on medical devices such as tracheostomy tubes (TTs) is a serious problem. The clinical impact of biofilms on the airway is still unclear. Biofilms may play a role in granulation tissue development, recurrent airway infections, and failure of laryngotracheal reconstructions. The microbial ecology on TTs has yet to be elucidated. The purpose of this study was to determine the feasibility of shotgun metagenomics to assess the biodistribution of microorganisms on TTs. Methods Four TTs were collected from pediatric patients (1.4–10.2 years) with (n = 2) and without (n = 2) granulation tissue formation. Duration of TT placement prior to retrieval from patients ranged from 5 to 365 days. DNA extraction was performed using the MO BIO UltraClean Microbial Isolation (Mo Bio Laboratories, Carlsbad, CA). Library generation using Nextera XT adapters (Illumina Inc., San Diego, CA) and metagenomic shotgun sequencing was performed using the Illumina NextSeq500 (Illumina Inc, San Diego, CA). Salinibacter ruber, a species not found in mammalian microbiome communities, was used as a DNA standard and represented 0.7% to 5.7% of the microbiome, ensuring good quality and abundance of sample DNA. Results Metagenomic shotgun sequencing was successful for all patients. In TTs associated with granuloma, Fusobacterium nucleatum, Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae were predominant, most of which are considered pathogens. From TTs without granulomas, Neisseria mucosa, Neisseria sicca, Acinetobacter baumannii, and Haemophilus parainfluenzae were identified, primarily consistent with respiratory microbiome. Conclusion This study reveals that metagenomic shotgun sequencing of biofilms formed on pediatric TTs is feasible with an apparent difference in microbiome for patients with granulation tissue. Further studies are necessary to elucidate the pathogenesis of microbial ecology and its role in airway disease in patients with TTs. Level of Evidence 2c Laryngoscope, 129:317–323, 2019

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Feasibility of shotgun metagenomics to assess microbial ecology of pediatric tracheostomy tubes

Wang¹,

Bergeron

Andersen³

et al. 2018

The Laryngoscope

View full text Add to dashboard Cite

show abstract

“…It has been reported that the presence of bacterial biofilms, bacterial counts, as well as TGF-β1 protein levels are associated with the pathogenesis of benign TS, 45 and antibiotics may help prevent TS after tracheal injury. 39 PEN is a β-lactam antibiotic with high efficiency, low toxicity, and wide clinical application.…”

Section: Discussionmentioning

confidence: 99%

“… 5 Factors that reportedly influence the incidence and development of TS include the timing and mode of mechanical ventilation after intubation, 6 mucosal injury by balloon pressure, 7 and recurrent respiratory infection. 8 …”

Section: Introductionmentioning

confidence: 99%

Erythromycin combined with corticosteroid reduced inflammation and modified trauma-induced tracheal stenosis in a rabbit model

Qin

Gan

et al. 2018

Ther Adv Respir Dis

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Background:Patients with endotracheal intubation or tracheostomy are subject to benign tracheal stenosis (TS), for which current therapies are unsatisfactory. We conducted a preliminary investigation of drugs and drug combinations for the prevention and treatment of TS in a rabbit model.Methods:Fifty-four rabbits were apportioned into nine groups according to treatment: sham-operated control; untreated TS model; amikacin; budesonide; erythromycin; penicillin; amikacin + budesonide; erythromycin + budesonide; and penicillin + budesonide. TS was induced by abrasion during surgery. The drugs were applied for 7 days before and 10 days after the surgery. Rabbits were killed on the eleventh day. Tracheal specimens were processed for determining alterations in the thicknesses of tracheal epithelium and lamina propria via hematoxylin and eosin. The tracheal mRNA (assessed by real-time quantitative polymerase chain reaction) expressions of the following fibrotic-related factors were determined: transforming growth factor-β1 (TGF- β1), collagen type I (COL1A1), collagen type III (COL3A1), and interleukin-17 (IL-17). The protein levels of TGF-β1, COL1A1, and COL3A1 were determined through immunohistochemistry and integrated optical densities.Results:Compared with all other groups, the untreated TS model had significantly thicker tracheal epithelium and lamina propria, and higher mRNA and protein levels of all targeted fibrotic factors. The mRNA and protein levels of the targeted fibrotic factors in all the drug-treated groups were lower than those of the untreated TS model, and differences were most significant in the erythromycin + budesonide group.Conclusions:Erythromycin combined with budesonide may reduce inflammation and modify fibrosis progression in TS after tracheal injury.

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“…Biofilms are ubiquitous and their ability to cause persistent bacterial loads within wound beds is well‐documented. For instance, in the head and neck alone, biofilms are at least partially implicated in the pathogenesis and persistence of chronic rhinosinusitis , chronic otitis media , laryngotracheal disease , soft tissue, and mucosal infection (often after radiation, i.e., osteoradionecrosis) , and prosthetic devices, such as tracheostomy and tympanostomy tubes . To illustrate the clinical and economic burden of chronic head and neck infections, the estimated annual national inpatient cost for odontogenic infections exceeds $200 million, with one study quoting care for a cohort of 71 patients amounting to $1.1 million , while chronic rhinosinusitis accounts for more than 20 million physician visits $4 billion in healthcare expenditures per year .…”

Section: Discussionmentioning

confidence: 99%

In‐depth analysis of antibacterial mechanisms of laser generated shockwave treatment

et al. 2018

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Taken together, LGS does not appear to have direct bacteriocidal properties, but rather by allowing for biofilm disruption and bacterial cell membrane permeabilization, both of which likely increase topical antibiotic delivery to pathogenic organisms. Insight into the mechanisms of LGS will allow for improved clinical applications and facilitate safe and effective translation of this technology. Lasers Surg. Med. © 2018 Wiley Periodicals, Inc.

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Bacterial Biofilms and Increased Bacterial Counts Are Associated with Airway Stenosis

Abstract: Bacterial biofilms, increased bacterial counts, and higher expression of TGF-β1 and SMAD3 are associated with airway stenosis.

Cited by 28 publications

References 36 publications

Feasibility of shotgun metagenomics to assess microbial ecology of pediatric tracheostomy tubes

Feasibility of shotgun metagenomics to assess microbial ecology of pediatric tracheostomy tubes

Erythromycin combined with corticosteroid reduced inflammation and modified trauma-induced tracheal stenosis in a rabbit model

In‐depth analysis of antibacterial mechanisms of laser generated shockwave treatment

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