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The potential of visible blue light (405?nm) as a novel decontamination strategy for carbapenemase-producing enterobacteriaceae (CPE).

ABSTRACT:

Background

Carbapenemase-producing Enterobacteriaceae (CPE) pose a considerable threat to modern medicine. New treatment options and methods to limit spread need to be investigated. Blue light (BL) is intrinsically antimicrobial, and we have previously demonstrated significant antimicrobial effects on biofilms of a panel of isolates, including two CPEs.This study was performed to assess the antibacterial activity of 405?nm BL against a panel of CPE isolates (four encoding bla _NDM, three bla _KPC, two bla _OXA-48, and three encoding both NDM and OXA-48 carbapenemases).

Methods

In vitro experiments were conducted on 72?h old biofilms of CPEs which were exposed to 60?mW/cm² of BL. Changes to biofilm seeding were assessed by measuring the optical density of treated and untreated biofilms.

Results

Twelve bacterial clinical isolates (comprising eight Klebsiella pnemoniae, one K. oxytoca, and three Escherichia coli) were tested. BL was delivered for 5, 15 and 30?min, achieving doses of 162, 54, and 108?J/cm², respectively.All of the CPEs were susceptible to BL treatment, with increasing reductions in seeding with increasing durations of exposure. At 30?min, reductions in biofilm seeding of ?80% were observed for 11 of the 12 isolates, compared to five of 12 after 15?min. CPE_8180 was less susceptible than the rest, with a maximum reduction in seeding of 66% at 30?min.

Conclusions

BL is effective at reducing the seeding of mature CPE biofilms in vitro, and offers great promise as a topical decontamination/treatment agent for both clinical and environmental applications.

SUBMITTER: Halstead FD

PROVIDER: S-EPMC6335786 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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The potential of visible blue light (405 nm) as a novel decontamination strategy for carbapenemase-producing enterobacteriaceae (CPE).

Halstead Fenella D FD Ahmed Zahra Z Bishop Jonathan R B JRB Oppenheim Beryl A BA

Antimicrobial resistance and infection control 20190117

<h4>Background</h4>Carbapenemase-producing <i>Enterobacteriaceae</i> (CPE) pose a considerable threat to modern medicine. New treatment options and methods to limit spread need to be investigated. Blue light (BL) is intrinsically antimicrobial, and we have previously demonstrated significant antimicrobial effects on biofilms of a panel of isolates, including two CPEs.This study was performed to assess the antibacterial activity of 405 nm BL against a panel of CPE isolates (four encoding <i>bla</ ...[more]

PMID: 30675341

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Project description:Background:Carbapenemase Producing Enterobacteriaceae (CPE) has spread rapidly and presents a growing challenge in antimicrobial resistance (AMR) management internationally. Screening for CPE may involve a rectal swab, there are limited treatment options for affected patients, and colonised patients are cared for in isolation to protect others. These measures are sound infection prevention precautions; however, the acceptability of CPE screening and its consequences are currently unknown.The aim of this study was 'To determine factors influencing acceptability of CPE screening from the perspectives of nursing staff and the general public.' Methods:National cross-sectional surveys of nursing staff (n?=?450) and the general public (n?=?261). The Theoretical Domains Framework (TDF) guided data collection and analysis. Regression modelling was used to identify factors that predicted acceptability of CPE screening. Results:For nursing staff, the following predictor variables were significant: intention to conduct CPE screening (OR 14.19, CI 5.14-39.22); belief in the severity of the consequences of CPE (OR 7.13, CI 3.26-15.60); knowledge of hospital policy for screening (OR 3.04, CI 1.45-6.34); preference to ask patients to take their own rectal swab (OR 2.89, CI 1.39-6.0); awareness that CPE is an organism of growing concern (OR 2.44, CI 1.22-4.88). The following predictor variables were significant for the general public: lack of knowledge of AMR (??-?.11, p?=?.01); social influences (? .14, p?=?.032); social norms (? .21p?=?.00); acceptability of being isolated if colonised (? .22, p?=?.000), beliefs about the acceptability of rectal swabbing (? .15, p?=?.00), beliefs about the impact of careful explanation about CPE screening from a health professional (? .32, p?=?.00).Integrating results from staff and public perspectives points to the importance of knowledge of AMR, environmental resources, and social influences in shaping acceptability. Conclusions:This is the first study to systematically examine the acceptability of CPE screening across nursing staff and the public. The use of TDF enabled identification of the mechanisms of action, or theoretical constructs, likely to be important in understanding and changing CPE related behaviour amongst professionals and public alike.