Ultrasound‐mediated therapies for the treatment of biofilms in chronic wounds: a review of present knowledge

LuTheryn, Gareth; Glynne‐Jones, Peter; Webb, Jeremy S.; Carugo, Dario

doi:10.1111/1751-7915.13471

Cited by 64 publications

(69 citation statements)

References 157 publications

(220 reference statements)

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“…Physical methods hold promise for eradication and inhibition of biofilms. This is particularly important on surfaces such as chronic wounds [ 309 , 310 ], infected prosthetics, implants, and medical devices. Good examples of these methods include nanoparticles, sonication, irradiation (ultraviolet, visible, or infrared light), or biomaterials.…”

Section: Control Of Biofilm Infectionsmentioning

confidence: 99%

Biofilms as Promoters of Bacterial Antibiotic Resistance and Tolerance

et al. 2020

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Multidrug resistant bacteria are a global threat for human and animal health. However, they are only part of the problem of antibiotic failure. Another bacterial strategy that contributes to their capacity to withstand antimicrobials is the formation of biofilms. Biofilms are associations of microorganisms embedded a self-produced extracellular matrix. They create particular environments that confer bacterial tolerance and resistance to antibiotics by different mechanisms that depend upon factors such as biofilm composition, architecture, the stage of biofilm development, and growth conditions. The biofilm structure hinders the penetration of antibiotics and may prevent the accumulation of bactericidal concentrations throughout the entire biofilm. In addition, gradients of dispersion of nutrients and oxygen within the biofilm generate different metabolic states of individual cells and favor the development of antibiotic tolerance and bacterial persistence. Furthermore, antimicrobial resistance may develop within biofilms through a variety of mechanisms. The expression of efflux pumps may be induced in various parts of the biofilm and the mutation frequency is induced, while the presence of extracellular DNA and the close contact between cells favor horizontal gene transfer. A deep understanding of the mechanisms by which biofilms cause tolerance/resistance to antibiotics helps to develop novel strategies to fight these infections.

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Section: Control Of Biofilm Infectionsmentioning

confidence: 99%

Biofilms as Promoters of Bacterial Antibiotic Resistance and Tolerance

et al. 2020

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“…Planktonic and sessile bacteria are already well equipped to develop genetic resistance to antimicrobial agents. However, a significant complication of biofilm development is that the extracellular matrix acts as a further physical barrier to antimicrobial agents and subsequently confers an enhanced tolerance to treatment [14]. Moreover, other characteristics of biofilms that provide them with enhanced survival and resistance to antimicrobials include social cooperation and localised gradients within the biofilm that provide habitat diversity [15].…”

Section: Introductionmentioning

confidence: 99%

A Microfluidic-Based Investigation of Bacterial Attachment in Ureteral Stents

et al. 2020

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Obstructions of the ureter lumen can originate from intrinsic or extrinsic factors, such as kidney stones, tumours, or strictures. These can affect the physiological flow of urine from the kidneys to the bladder, potentially causing infection, pain, and kidney failure. To overcome these complications, ureteral stents are often deployed clinically in order to temporarily re-establish urinary flow. Despite their clinical benefits, stents are prone to encrustation and biofilm formation that lead to reduced quality of life for patients; however, the mechanisms underlying the formation of crystalline biofilms in stents are not yet fully understood. In this study, we developed microfluidic-based devices replicating the urodynamic field within different configurations of an occluded and stented ureter. We employed computational fluid dynamic simulations to characterise the flow dynamic field within these models and investigated bacterial attachment (Pseudomonas fluorescens) by means of crystal violet staining and fluorescence microscopy. We identified the presence of hydrodynamic cavities in the vicinity of a ureteric occlusion, which were characterised by low levels of wall shear stress (WSS < 40 mPa), and observed that initiation of bacterial attachment occurred in these specific regions of the stented ureter. Notably, the bacterial coverage area was directly proportional to the number of cavities present in the model. Fluorescence microscopy confirmed that the number density of bacteria was greater within cavities (3 bacteria·mm−2) when compared to side-holes of the stent (1 bacterium·mm−2) or its luminal surface (0.12 bacteria·mm−2). These findings informed the design of a novel technological solution against bacterial attachment, which reduces the extent of cavity flow and increases wall shear stress over the stent’s surface.

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“…In some case, the data may be related to the way we culture bacteria and prepare biofilms. It has been reported that if this intensity frequency ultrasound is not combined with antibiotics, it is more likely to stimulate the growth of bacteria, presumably because the input of nutrients and oxygen [31][32][33]. Due to the complexity of bacterial biofilms, many mysteries remain to be solved.…”

Section: Discussionmentioning

confidence: 99%

The penetration effect of HMME-mediated low-frequency and low-intensity ultrasound against the Staphylococcus aureus bacterial biofilm

Wang

Jiang³

et al. 2020

Eur J Med Res

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Background The purpose of this study was to observe the effect of hematoporphyrin monomethyl ether (HMME)-mediated low-frequency and low-intensity ultrasound on mature and stable Staphylococcus aureus (S. aureus) biofilms under different ultrasound parameters. Methods The biofilm was formed after 48-h culture with stable concentration of bacterial solution. Different types of ultrasound and time were applied to the biofilm, and the ultrasonic type and time of our experiments were determined when the biofilm was not damaged. The penetration effects of low-frequency and low-intensity ultrasound were decided by the amount of HMME that penetrated into the biofilm which was determined by fluorescence spectrometry. Results The destruction of biofilms by pulse waveform was the strongest. Sinusoidal low-frequency and low-intensity ultrasound can enhance the biofilm permeability. For a period of time after the ultrasound was applied, the biofilm permeability increased, however, changes faded away over time. Conclusions Low-frequency and low-intensity sinusoidal ultrasound significantly increased the permeability of the biofilms, which was positively correlated with the time and the intensity of ultrasound. Simultaneous action of ultrasound and HMME was the most effective way to increase the permeability of the biofilms.

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Ultrasound‐mediated therapies for the treatment of biofilms in chronic wounds: a review of present knowledge

Cited by 64 publications

References 157 publications

Biofilms as Promoters of Bacterial Antibiotic Resistance and Tolerance

Biofilms as Promoters of Bacterial Antibiotic Resistance and Tolerance

A Microfluidic-Based Investigation of Bacterial Attachment in Ureteral Stents

The penetration effect of HMME-mediated low-frequency and low-intensity ultrasound against the Staphylococcus aureus bacterial biofilm

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