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Prevention and Killing Efficacy of Carbapenem Resistant Enterobacteriaceae (CRE) and Vancomycin Resistant Enterococci (VRE) Biofilms by Antibiotic-Loaded Calcium Sulfate Beads.


ABSTRACT: Carbapenem-resistant Enterobacteriaceae (CRE) and vancomycin-resistant Enterococci (VRE) have emerged as multidrug-resistant (MDR) pathogens associated with periprosthetic joint infections (PJI). In this study, we evaluated the efficacy of antibiotic-loaded calcium sulfate beads (ALCSB) in inhibiting bacterial growth, encouraging biofilm formation and killing preformed biofilms of CRE and VRE. Three strains of Klebsiella pneumoniae (KP) and a strain of Enterococcus faecalis (EF) were used. ALCSB of 4.8-mm diameter were loaded with vancomycin (V) and gentamicin (G), V and rifampicin (R), V and tobramycin (T) or R and meropenem (M), and placed onto tryptic soy agar (TSA), spread with one of the test strains and incubated for 24 h at 37 °C. Beads were transferred daily onto fresh TSA spread plates and the zone of inhibition (ZOI) was recorded until no inhibition was observed. ALCSB containing R + M or R + V produced the most extensive ZOI up to 5 weeks. Biofilm prevention efficacy was investigated by challenging ALCSB daily with 5 × 105 CFU/mL bacterial cells and analyzing for biofilm formation at challenges 1, 2 and 3. In the biofilm killing experiments, ALCSB were added to pre-grown 3-day biofilms of KP and EF strains, which were then analyzed at days 1 and 3 post-exposure. The CFU counts and confocal images of the attached cells showed that ALCSB treatment reduced colonization and biofilm formation significantly (5-7 logs) with combinations of R + M or R + V, compared to unloaded beads. This study provides evidence that the local release of antibiotics from ALCSB may be useful in treating the biofilms of multidrug-resistant strains of CRE and VRE.

SUBMITTER: Stoodley P 

PROVIDER: S-EPMC7436038 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Prevention and Killing Efficacy of Carbapenem Resistant <i>Enterobacteriaceae</i> (CRE) and Vancomycin Resistant <i>Enterococci</i> (VRE) Biofilms by Antibiotic-Loaded Calcium Sulfate Beads.

Stoodley Paul P   Brooks Jacob J   Peters Casey W CW   Jiang Nan N   Delury Craig P CP   Laycock Phillip A PA   Aiken Sean S SS   Dusane Devendra H DH  

Materials (Basel, Switzerland) 20200722 15


Carbapenem-resistant <i>Enterobacteriaceae</i> (CRE) and vancomycin-resistant <i>Enterococci</i> (VRE) have emerged as multidrug-resistant (MDR) pathogens associated with periprosthetic joint infections (PJI). In this study, we evaluated the efficacy of antibiotic-loaded calcium sulfate beads (ALCSB) in inhibiting bacterial growth, encouraging biofilm formation and killing preformed biofilms of CRE and VRE. Three strains of <i>Klebsiella pneumoniae</i> (KP) and a strain of <i>Enterococcus faecal  ...[more]

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