Reduction of endotracheal tube biofilms using antimicrobial photodynamic therapy

Biel, Merrill A.; Sievert, Chet; Loebel, Nicolas G.; Rose, Andreas; Zimmermann, R.

doi:10.1016/j.pdpdt.2011.03.182

Cited by 14 publications

(20 citation statements)

References 18 publications

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“…Interestingly, photodynamic therapy has also been advocated as a potential method to reduce biofilm formation. 125 The high level of bacterial concentration in the inner surface of a standard ETT can play a role in the development of late-onset VAP when biofilm fragmentation occurs. This fragmentation is potentiated during saline installation and airway suctioning.…”

Section: Biofilm Preventionmentioning

confidence: 99%

Management of the Artificial AirwayDiscussion

2014

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Management of the artificial airway includes securing the tube to prevent dislodgement or migration as well as removal of secretions. Preventive measures include adequate humidification and appropriate airway suctioning. Monitoring airway patency and removing obstruction are potentially life-saving components of airway management. Cuff pressure management is important for preventing aspiration and mucosal damage as well as assuring adequate ventilation. A number of new monitoring techniques have been introduced, and automated cuff pressure control is becoming more common. The respiratory therapist should be adept with all these devices and understand the appropriate application and management.

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Section: Biofilm Preventionmentioning

confidence: 99%

Management of the Artificial AirwayDiscussion

2014

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“…A signi�cant decrease in CFU/mL (>6 log 10 units) was achieved when 300 g/mL MB and a light dose of 60 J/cm 2 (diode laser, 664 nm) were used. e reduction was >7 log 10 units when 500 g/mL MB and two light doses of 55 J/cm 2 separated by a 5-minute break were used [64,65]. Meire et al observed a statistically signi�cant 1.9 log 10 reduction in the viable counts of E. faecalis bio�lms treated with 10 mg/mL MB and exposed to a so laser of an output power of 75 mW (660 nm) for 2 min [66].…”

Section: �� Bio�lm Culture Of �Icroorganismsmentioning

confidence: 99%

“…e non-Candida pathogens T. mucoides and K. ohmeri were inactivated by APDT, with reductions of 0.85 log 10 and 0.84 log 10 , respectively [63]. Biel et al demonstrated that MB-mediated APDT is highly effective in the photoeradication of multispecies bacterial bio�lms (multidrug-resistant P. aeruginosa and MRSA) [64,65]. A signi�cant decrease in CFU/mL (>6 log 10 units) was achieved when 300 g/mL MB and a light dose of 60 J/cm 2 (diode laser, 664 nm) were used.…”

Section: �� Bio�lm Culture Of �Icroorganismsmentioning

confidence: 99%

Antimicrobial, Antimycobacterial and Antibiofi lm Properties of Couroupita guianensis Aubl. Fruit Extract

Sayen¹

2014

Biofilm Control and Antimicrobial Agents

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We review the recent literature concerning the efficiency of antimicrobial photodynamic inactivation toward various microbial species in planktonic and bio�lm cultures. e review is mainly focused on bio�lm-growing microrganisms because this form of growth poses a threat to chronically infected or immunocompromised patients and is difficult to eradicate from medical devices. We discuss the bio�lm formation process and mechanisms of its increased resistance to various antimicrobials. We present, based on data in the literature, strategies for overcoming the problem of bio�lm resistance. �actors that have potential for use in increasing the efficiency of the killing of bio�lm-forming bacteria include plant extracts, enzymes that disturb the bio�lm structure, and other nonenzymatic molecules. We propose combining antimicrobial photodynamic therapy with various antimicrobial and antibio�lm approaches to obtain a synergistic effect to permit efficient microbial growth control at low photosensitizer doses.

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“…41,49,50 Recently, an in vitro model evaluated the role of antimicrobial photodynamic therapy in the reduction of ETT biofi lm. 51 This photodynamic therapy consists of spraying a small amount of photosensitizer solution (methylene blue) into the ETT lumen, which is exposed to light (664 nm) through a small optical fi ber located within it. This study demonstrated a reduction in the polymicrobial biofi lm ( .…”

Section: Cuff Pressurementioning

confidence: 99%

“…99.9%, P , .05) after a single treatment. 51 However, more data are needed before implementing antimicrobial photodynamic therapy in clinical practice. Silver-coated ETTs have emerged as a viable alternative, after the success shown in other materials and tubes, such as urinary catheters.…”

Section: Cuff Pressurementioning

confidence: 99%

Technologic Advances in Endotracheal Tubes for Prevention of Ventilator-Associated Pneumonia

Fernandez

Levine

Restrepo

2012

Chest

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231V entilator-associated pneumonia (VAP) is a common complication in patients on mechanical ventilation (MV). Depending on the surveillance methods used for the diagnosis of VAP, the risk of this complication ranges from 1.2 to 8.5 cases per 1,000 ventilatordays (0.6%-4%). 1 VAP is associated with increased hospital length of stay, mortality, infections due to multidrug-resistant pathogens, and an attributable hospital cost of approximately $10,000 to $25,000. 2,3 Therefore, preventive measures that could impact the incidence of VAP in the ICU setting must be considered a priority, because they could improve the safety of patients in the ICU. Multiple interventions are used to prevent VAP; however, there is a growing interest in those interventions related to the endotracheal tube (ETT) as one of the main targets linked to VAP. 2,4 An ETT tube is considered one of the major risk factors for VAP, acting both as a reservoir for potential infecting microorganisms and as a bridge between the oropharyngeal environment and the sterile bronchoalveolar space by bypassing host defenses. 5,6 Moreover, the ETT alters the ability of the host to clear secretions by coughing, and keeps the epiglottis open, allowing the passage of secretions and fluids into the airways.The two most important mechanisms implicated in the development of VAP are microaspiration and biofi lm formation. Microaspiration occurs when there is distal migration of microorganisms present in the secretions accumulated above the ETT cuff. 7 Biofi lm

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Reduction of endotracheal tube biofilms using antimicrobial photodynamic therapy

Cited by 14 publications

References 18 publications

Management of the Artificial AirwayDiscussion

Management of the Artificial AirwayDiscussion

Antimicrobial, Antimycobacterial and Antibiofi lm Properties of Couroupita guianensis Aubl. Fruit Extract

Technologic Advances in Endotracheal Tubes for Prevention of Ventilator-Associated Pneumonia

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