Removal of Staphylococcus aureus from skin using a combination antibiofilm approach

Abstract

Staphylococcus aureus (S. aureus) including methicillin resistant S. aureus (MRSA) is one of the primary microorganisms responsible for surgical site infection (SSI). Since S. aureus contamination is known to originate from the skin, eradicating it on the skin surface at surgical sites is an important intervention to reduce the chance of SSIs. Here we developed and evaluated the efficacy of a combination probiotic/brush sonication strategy for skin preparation at surgical, injection and insertion sites in medicine. A 24 h biofilm on porcine skin explants was used as a worst-case scenario for the evaluation of preparation strategies. Conventional ethanol wipes achieved 0.8~2 log reduction in viable bacteria depending on how many times wiped (x4 or x6). Brush sonication or probiotic supernatant pre-treatment alone achieved a similar reduction as ethanol wipes (1.4 and 0.7~1.4 log reduction, respectively). Notably, combining sonication and probiotic pre-treatment achieved a 4 log reduction in viable bacteria. In addition, probiotic supernatant incubation times as short as 2 h achieved the full effect of this reduction in the combined strategy. These findings suggest the promising potential of combination-format skin preparation strategies that can be developed to more effectively penetrate cracks and folds in the skin to remove biofilms.

An ex vivo model of medical device-mediated bacterial skin translocation

“…Recently, development of tissue-based biofilm models for studying wound treatments, and their use by an increasing number of contract testing organizations, has shown the potential of tissue-based preclinical models for testing biofilms. In this work, we leveraged experience with porcine skin models for injection 30 and skin preparation 29 to develop and characterize a model for indwelling medical devices. Skin preparation is an essential first step in ex vivo models to maximize the useful test time, as well as minimize response variability due to contamination.…”

“…Ex vivo microbiological tissue models have been developed to reduce animal testing, such as a human lung tissue model for pneumonia 26 and a genital mucosal model for HIV infection 27 . Biofilm on ex vivo tissue is more challenging to eradicate [28][29][30][31] and may better reflect pathogenic processes found in vivo than plastic plates or flow cells. For indwelling medical devices, the use of an ex vivo model also has unique potential to simulate the initial stages of bacterial skin translocation, which is not addressed by existing in vitro models.…”

Transcriptional Analysis and Target Genes Discovery of Pseudomonas Aeruginosa Biofilm Developed Ex Vivo Chronic Wound Model

“…Although the tissue-based model employed here did not have any immune response to chronic wounds, the model could better mimic skin tissue than any other in vitro models, such as plastic microtiter plate, CDC, and ow-cell. While the bio lms developed on porcine skin may not identical to that found clinically, it presents a tradeoff necessary to achieve reproducible and controllable bio lms for study on wound infections due to bio lms (Wang et al 2018).…”

“…Ex vivo wound model with the porcine skin explants was established as previously described with some modi cations (Yang et al 2013; Wang et al 2018). Brie y, frozen skin, obtained from local supermarket, was used as wound model substrate.…”

Microbial Biofilms in the Food Industry—A Comprehensive Review

“…There is still a lot to do in both fields, but it is true that CDP is practically the only implementation in the food industry. The health field has witnessed much more progress: phages [129], aerosolisation [130], sonication brush [131], and metal ion solutions (silver, copper, platinum, gold, and palladium) [132].…”