What is the best technic to dislodge Staphylococcus epidermidis biofilm on medical implants?

Abstract

Background Bacterial biofilm can occur on all medical implanted devices and lead to infection and/or dysfunction of the device. In this study, artificial biofilm was formed on four different medical implants (silicone, piccline, peripheral venous catheter and endotracheal tube) of interest for our daily clinical and/or research practice. We investigated the best conventional technic to dislodge the biofilm on the implants and quantified the number of bacteria. Staphylococcus epidermidis previously isolated from a breast implant capsular contracture on a patient in the university hospital of Dijon was selected for its ability to produce biofilm on the implants. Different technics (sonication, Digest-EUR®, mechanized bead mill, combination of sonication plus Digest-EUR®) were tested and compared to detach the biofilm before quantifying viable bacteria by colony counting. Results For all treatments, the optical and scanning electron microscope images showed substantial less biofilm biomass remaining on the silicone implant compared to non-treated implant. This study demonstrated that the US procedure was statistically superior to the other physical treatment: beads, Digest-EUR® alone and Digest-EUR® + US (p < 0.001) for the flexible materials (picc-line, PIV, and silicone). The number of bacteria released by the US is significantly higher with a difference of 1 log on each material. The result for a rigid endotracheal tube were different with superiority for the chemical treatment dithiothreitol: Digest-EUR®. Surprisingly the combination of the US plus Digest-EUR® treatment was consistently inferior for the four materials. Conclusions Depending on the materials used, the biofilm dislodging technique must be adapted. The US procedure was the best technic to dislodge S. epidermidis biofilm on silicone, piccline, peripheral venous catheter but not endotracheal tube. This suggested that scientists should compare themselves different methods before designing a protocol of biofilm study on a given material.

Endotracheal tube biofilm in critically ill patients during the COVID-19 pandemic : description of an underestimated microbiological compartment

“…However, the ESCMID Biofilm guidelines published in 2015 clearly stated that regarding patients with ETT biofilm, “mucus from within the ETT can be aspirated and cultured to identify ETT pathogens in ETT biofilms that may have caused VAP 35 ”. Moreover, our group recently demonstrated a clear superiority of the chemical treatment dithiothreitol (Digest-EUR) over sonication for the dislodgement of Staphylococcus epidermidis biofilm on ETT 24 . Based on both our recent experience and the ESCMID Biofilm guidelines, the present work used a mucus reagent (Digest-EUR) for the microbiological processing of biofilm.…”

“…The remaining half of the ETT sections (below- and above-the-cuff sections) were gently homogenized in a 20% Digest-EUR® solution (Eurobio Scientific, Les Ulis, France) for 15 min at 37 °C according to a previously described protocol 16 , 24 . After a few seconds of gentle shaking, an aliquot of the solution was then spread on different culture plates (trypticase soy agar, blood agar under aerobic and anaerobic atmospheres, Drigalski agar, chocolate agar with the addition of 5% CO 2 , and Sabouraud agar) incubated for 48 h at 37 °C, either pure or at 1/10 dilution.…”

Surface Topography, Microbial Adhesion, and Immune Responses in Silicone Mammary Implant-Associated Capsular Fibrosis

“…In 1981, a case report suggested a potential link between latent bacterial infection and capsular contracture [ 52 , 53 , 54 , 55 ]. Subsequent studies, spanning nearly two decades, further demonstrated the isolation of coagulase-negative bacteria Staphylococcus epidermidis from the implant or tissue in cases of capsular contracture [ 38 , 39 , 40 , 41 , 44 , 56 , 57 , 58 , 59 ]. The formation of S. epidermidis biofilms was investigated on differently textured silicone surfaces, revealing that rougher surfaces attract more bacteria and support thicker biofilm growth [ 59 ].…”

Biofilms Formation by Pathogenic Bacteria. Review

“…Biofilm originated as a defense mechanism for prokaryotes against too harsh conditions, it has garnered a lot of interest due to higher effect to public health, medicine, food and pharmaceutical industry. Structured groups of microbial cells attached together and collapsed in an extracellular matrix with different density and composition were defined as biofilms [3]. Biofilm considered as adaption mode which enable microbial cell to survive in hard conditions such as UV radiation, sudden changes in pH values and draining [4].…”