Novel Approaches to Multidrug-Resistant Infections in Cystic Fibrosis

Murray, Thomas S.; Stanley, G.L.; Koff, Jonathan L.

doi:10.1016/j.ccm.2022.06.008

Cited by 9 publications

(5 citation statements)

References 71 publications

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“…Despite the advent of the CFTR modulator therapies, chronic respiratory infections sustained by P. aeruginosa remains a major cause of morbidity and mortality in patients with CF, driving the interest in identifying innovative antimicrobial strategies to substitute or complement antibiotic use in CF [ 22 ]. The possible use of probiotics to control respiratory infections is one of these strategies, although a definitive consensus on the clinical efficacy of this type of intervention is still lacking [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Lactobacillus Probiotic Strains Differ in Their Ability to Adhere to Human Lung Epithelial Cells and to Prevent Adhesion of Clinical Isolates of Pseudomonas aeruginosa from Cystic Fibrosis Lung

et al. 2023

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The field of probiotic applications is rapidly expanding, including their use for the control of respiratory tract infections. Nevertheless, probiotics ability to colonize the lung environment and to compete with pulmonary pathogens is still a poorly investigated research area. In this study, we aimed to evaluate the adhesion ability of a number of commercial probiotic strains to the human lung epithelial cell line A549. Furthermore, we assessed probiotic ability to prevent host cell adhesion of one of the major lung pathogens in cystic fibrosis, Pseudomonas aeruginosa, and to reduce the pathogen-induced inflammatory response of human peripheral blood mononuclear cells (PBMCs) in terms of cytokine release. Lactobacillus acidophilus displayed the highest adhesion ability to A549 cells evaluated as percent of adhered bacteria compared to the inoculum. In agreement with such an observation, L. acidophilus was the most efficient in preventing adhesion to A549 cells of a P. aeruginosa isolate from CF sputum. Three-color fluorescence labeling of A549 cells, P. aeruginosa, and L. acidophilus, and confocal microcopy image analyses revealed a likely exclusion effect played by both live and UV-killed L. acidophilus towards P. aeruginosa. Such results were confirmed by CFU count. When co-cultured with PBMCs, both live and UV-killed L. acidophilus reduced the amount of IL-1β and IL-6 in culture supernatants in a statistically significant manner. Overall, the results obtained point to L. acidophilus as an interesting candidate for further studies for a potential aerogenous administration to control P. aeruginosa infections.

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Section: Discussionmentioning

confidence: 99%

Lactobacillus Probiotic Strains Differ in Their Ability to Adhere to Human Lung Epithelial Cells and to Prevent Adhesion of Clinical Isolates of Pseudomonas aeruginosa from Cystic Fibrosis Lung

et al. 2023

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“…Probiotic administration is also proposed as a possible option for lower respiratory tract (LRT) infections. There are pathologic conditions in which patients are constantly prone to develop infections, like cystic fibrosis (CF), or are not eligible or not responsive to antibiotic treatments, which could greatly benefit from innovative antimicrobial strategies to substitute or complement antibiotic use [ 15 ]. Probiotic administration to CF patients via the oral route was able to partially restore gut dysbiosis, reduce intestinal inflammation, and lower lung through mechanisms that could be related by some studies to the gut–lung axis [ 1 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Emerging Multiscale Biofabrication Approaches for Bacteriotherapy

Rovelli,

Cecchini,

Zavagna

et al. 2024

Molecules

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Bacteriotherapy is emerging as a strategic and effective approach to treat infections by providing putatively harmless bacteria (i.e., probiotics) as antagonists to pathogens. Proper delivery of probiotics or their metabolites (i.e., post-biotics) can facilitate their availing of biomaterial encapsulation via innovative manufacturing technologies. This review paper aims to provide the most recent biomaterial-assisted strategies proposed to treat infections or dysbiosis using bacteriotherapy. We revised the encapsulation processes across multiscale biomaterial approaches, which could be ideal for targeting different tissues and suit diverse therapeutic opportunities. Hydrogels, and specifically polysaccharides, are the focus of this review, as they have been reported to better sustain the vitality of the live cells incorporated. Specifically, the approaches used for fabricating hydrogel-based devices with increasing dimensionality (D)—namely, 0D (i.e., particles), 1D (i.e., fibers), 2D (i.e., fiber meshes), and 3D (i.e., scaffolds)—endowed with probiotics, were detailed by describing their advantages and challenges, along with a future overlook in the field. Electrospinning, electrospray, and 3D bioprinting were investigated as new biofabrication methods for probiotic encapsulation within multidimensional matrices. Finally, examples of biomaterial-based systems for cell and possibly post-biotic release were reported.

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“…These two pathogens have been isolated from a wide range of nosocomial sources, and some colonization has been associated with nosocomial infections [14,15]. A wide spectrum of clinical infections has been associated with S. maltophilia and E. anophelis, and respiratory tract infections, including pneumonia, acute exacerbation of chronic obstructive pulmonary disease, and secondary bacterial infection in patients with cystic fibrosis, are the most common, especially for those who are dependent on mechanical ventilators [16,17]. Although S. maltophilia and E. anophelis are not highly virulent, these two pathogens are intrinsically resistant to many commonly used antimicrobial agents.…”

Section: Introductionmentioning

confidence: 99%

Emerging infections in vulnerable hosts: Stenotrophomonas maltophilia and Elizabethkingia anophelis

Lee,

Hsueh

2023

Current Opinion in Infectious Diseases

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Purpose of review This systematic review aimed to explore the recent trends in the epidemiology, risk factors, and antimicrobial susceptibility of two emerging opportunistic pathogens, Stenotrophomonas maltophilia and Elizabethkingia anophelis. Recent findings Since 2020, numerous outbreaks of S. maltophilia and E. anophelis have been reported worldwide. Most of these outbreaks have been associated with healthcare facilities, although one outbreak caused by E. anophelis in France was considered a community-associated infection. In terms of antimicrobial susceptibility, trimethoprim/sulfamethoxazole (TMP-SMZ), levofloxacin, and minocycline have exhibited good efficacy against S. maltophilia. Additionally, cefiderocol and a combination of aztreonam and avibactam have shown promising results in in vitro susceptibility testing. For E. anophelis, there is currently no consensus on the optimal treatment. Although some studies have reported good efficacy with rifampin, TMP-SMZ, piperacillin/tazobactam, and cefoperazone/sulbactam, minocycline had the most favourable in vitro susceptibility rates. Cefiderocol may serve as an alternative due to its low minimum inhibitory concentration (MIC) against E. anophelis. The role of vancomycin in treatment is still uncertain, although several successful cases with vancomycin treatment, even with high MIC values, have been reported. Summary Immunocompromised patients are particularly vulnerable to infections caused by S. maltophilia and E. anophelis, but the optimal treatment strategy remains inconclusive. Further research is necessary to determine the most effective use of conventional and novel antimicrobial agents in combatting these multidrug-resistant pathogens.

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Novel Approaches to Multidrug-Resistant Infections in Cystic Fibrosis

Cited by 9 publications

References 71 publications

Lactobacillus Probiotic Strains Differ in Their Ability to Adhere to Human Lung Epithelial Cells and to Prevent Adhesion of Clinical Isolates of Pseudomonas aeruginosa from Cystic Fibrosis Lung

Lactobacillus Probiotic Strains Differ in Their Ability to Adhere to Human Lung Epithelial Cells and to Prevent Adhesion of Clinical Isolates of Pseudomonas aeruginosa from Cystic Fibrosis Lung

Emerging Multiscale Biofabrication Approaches for Bacteriotherapy

Emerging infections in vulnerable hosts: Stenotrophomonas maltophilia and Elizabethkingia anophelis

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