scholarly journals Enterococcus faecalis Polymicrobial Interactions Facilitate Biofilm Formation, Antibiotic Recalcitrance, and Persistent Colonization of the Catheterized Urinary Tract

2020 ◽  
Author(s):  
Jordan Gaston ◽  
Marissa Andersen ◽  
Alexandra Johnson ◽  
Kirsten Bair ◽  
Christopher Sullivan ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Enterococcus Faecalis ◽  
Biofilm Formation ◽  
Pioneer Species ◽  
Urinary Catheters ◽  
Healthcare Settings ◽  
Biofilm Architecture ◽  
Prospective Assessment ◽  
Catheter Urine

Indwelling urinary catheters are common in healthcare settings and can lead to catheter-associated urinary tract infection (CAUTI). Long-term catheterization causes polymicrobial colonization of the catheter and urine, for which the clinical significance is poorly understood. Through prospective assessment of catheter urine colonization, we identified Enterococcus faecalis and Proteus mirabilis as the most prevalent and persistent co-colonizers. Clinical isolates of both species successfully co-colonized in a murine model of CAUTI, and they were observed to co-localize on catheter biofilms during infection. We further demonstrate that P. mirabilis preferentially adheres to E. faecalis during biofilm formation, and that contact-dependent interactions between E. faecalis and P. mirabilis facilitate establishment of a robust biofilm architecture that enhances antimicrobial resistance for both species. E. faecalis may therefore act as a pioneer species on urinary catheters, establishing an ideal surface for persistent colonization by more traditional pathogens such as P. mirabilis.

scholarly journals Enterococcus faecalis Polymicrobial Interactions Facilitate Biofilm Formation, Antibiotic Recalcitrance, and Persistent Colonization of the Catheterized Urinary Tract

Pathogens ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 835
Author(s):  
Jordan R. Gaston ◽  
Marissa J. Andersen ◽  
Alexandra O. Johnson ◽  
Kirsten L. Bair ◽  
Christopher M. Sullivan ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Enterococcus Faecalis ◽  
Biofilm Formation ◽  
Pioneer Species ◽  
Urinary Catheters ◽  
Health Care Settings ◽  
Biofilm Architecture ◽  
Prospective Assessment ◽  
Catheter Urine

Indwelling urinary catheters are common in health care settings and can lead to catheter-associated urinary tract infection (CAUTI). Long-term catheterization causes polymicrobial colonization of the catheter and urine, for which the clinical significance is poorly understood. Through prospective assessment of catheter urine colonization, we identified Enterococcus faecalis and Proteus mirabilis as the most prevalent and persistent co-colonizers. Clinical isolates of both species successfully co-colonized in a murine model of CAUTI, and they were observed to co-localize on catheter biofilms during infection. We further demonstrate that P. mirabilis preferentially adheres to E. faecalis during biofilm formation, and that contact-dependent interactions between E. faecalis and P. mirabilis facilitate establishment of a robust biofilm architecture that enhances antimicrobial resistance for both species. E. faecalis may therefore act as a pioneer species on urinary catheters, establishing an ideal surface for persistent colonization by more traditional pathogens such as P. mirabilis.

Species interactions in mixed-community crystalline biofilms on urinary catheters

2007 ◽  
Vol 56 (11) ◽  
pp. 1549-1557 ◽  
Author(s):  
Sarah M. Macleod ◽  
David J. Stickler
Keyword(s):  
Urinary Tract ◽  
Species Interactions ◽  
The Other ◽  
Experimental Investigations ◽  
Crystal Formation ◽  
Urinary Catheters ◽  
E Coli ◽  
Pure Cultures ◽  
Providencia Stuartii

Previous experimental investigations of the crystalline biofilms that colonize and block urinary catheters have focussed on their formation by pure cultures of Proteus mirabilis. In the urine of patients undergoing long-term catheterization, P. mirabilis is commonly found in mixed communities with other urinary tract pathogens. Little is known about the effect that the other species have on the rate at which P. mirabilis encrusts catheters. In the present study, a set of data on the nature of the bacterial communities on 106 catheter biofilms has been analysed and it was found that while species such as Providencia stuartii and Klebsiella pneumoniae were commonly associated with P. mirabilis, when Escherichia coli, Morganella morganii or Enterobacter cloacae were present, P. mirabilis was rarely or never found. The hypothesis that the absence of P. mirabilis from some biofilm communities could be due to its active exclusion by other species has also been examined. Experiments in laboratory models showed that co-infection of P. mirabilis with M. morganii, K. pneumoniae or E. coli had no effect on the ability of P. mirabilis to encrust and block catheters. Co-infection with Ent. cloacae or Pseudomonas aeruginosa, however, significantly increased the time that catheters took to block (P <0.05). The growth of Ent. cloacae, M. morganii, K. pneumoniae or E. coli in the model for 72 h prior to superinfection with P. mirabilis significantly delayed catheter blockage. In the case of Ent. cloacae, for example, the mean time to blockage was extended from 28.7 h to 60.7 h (P ≤0.01). In all cases, however, P. mirabilis was able to generate alkaline urine, colonize the biofilms, induce crystal formation and block the catheters. The results suggest that although there is a degree of antagonism between P. mirabilis and some of the other urinary tract organisms, the effects are temporary and whatever the pre-existing urinary microbiota, infection with P. mirabilis is thus likely to lead to catheter encrustation and blockage.

scholarly journals Comparative biofilm assays using Enterococcus faecalis OG1RF identify new determinants of biofilm formation

2021 ◽  
Author(s):  
Julia L. E. Willett ◽  
Jennifer L. Dale ◽  
Lucy M. Kwiatkowski ◽  
Jennifer L. Powers ◽  
Michelle L. Korir ◽  
...  
Keyword(s):  
Enterococcus Faecalis ◽  
Growth Medium ◽  
Biofilm Formation ◽  
Time Course ◽  
Opportunistic Pathogen ◽  
Genetic Determinants ◽  
Experimental Conditions ◽  
Biofilm Reactors ◽  
Biofilm Architecture ◽  
Biofilm Development

AbstractEnterococcus faecalis is a common commensal organism and a prolific nosocomial pathogen that causes biofilm-associated infections. Numerous E. faecalis OG1RF genes required for biofilm formation have been identified, but few studies have compared genetic determinants of biofilm formation and biofilm morphology across multiple conditions. Here, we cultured transposon (Tn) libraries in CDC biofilm reactors in two different media and used Tn sequencing (TnSeq) to identify core and accessory biofilm determinants, including many genes that are poorly characterized or annotated as hypothetical. Multiple secondary assays (96-well plates, submerged Aclar, and MultiRep biofilm reactors) were used to validate phenotypes of new biofilm determinants. We quantified biofilm cells and used fluorescence microscopy to visualize biofilms formed by 6 Tn mutants identified using TnSeq and found that disrupting these genes (OG1RF_10350, prsA, tig, OG1RF_10576, OG1RF_11288, and OG1RF_11456) leads to significant time- and medium-dependent changes in biofilm architecture. Structural predictions revealed potential roles in cell wall homeostasis for OG1RF_10350 and OG1RF_11288 and signaling for OG1RF_11456. Additionally, we identified growth medium-specific hallmarks of OG1RF biofilm morphology. This study demonstrates how E. faecalis biofilm architecture is modulated by growth medium and experimental conditions, and identifies multiple new genetic determinants of biofilm formation.ImportanceE. faecalis is an opportunistic pathogen and a leading cause of hospital-acquired infections, in part due to its ability to form biofilms. A complete understanding of the genes required for E. faecalis biofilm formation as well as specific features of biofilm morphology related to nutrient availability and growth conditions is crucial for understanding how E. faecalis biofilm-associated infections develop and resist treatment in patients. We employed a comprehensive approach to analysis of biofilm determinants by combining TnSeq primary screens with secondary phenotypic validation using diverse biofilm assays. This enabled identification of numerous core (important under many conditions) and accessory (important under specific conditions) biofilm determinants in E. faecalis OG1RF. We found multiple genes whose disruption results in drastic changes to OG1RF biofilm morphology. These results expand our understanding of the genetic requirements for biofilm formation in E. faecalis that affect the time course of biofilm development as well as the response to specific nutritional conditions.

Systemic and Topical Antimicrobial Agents in the Prevention of Catheter-Associated Bacteriuria and its Consequences

1986 ◽  
Vol 7 (S2) ◽  
pp. 100-103 ◽  
Author(s):  
Rosemary A. Simpson
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Agents ◽  
Spinal Injuries ◽  
Indwelling Catheter ◽  
Urological Surgery ◽  
Catheter Urine ◽  
Infected Urine ◽  
Topical Antimicrobial ◽  
Methods Of Control

Infection of the urinary tract is acknowledged to be the most common hospital infection, associated closely with the presence of an indwelling catheter. Patients are catheterized for a variety of reasons and for different periods of time, ranging from postoperative catheterization of a few days following urological surgery to the long-term catheterization over many months or years of patients who are unfit for operation, with spinal injuries or neuropathic bladders. The extent of the problem includes patients returning home infected, requiring catheterization before readmission to the hospital or needing nursing at home with a long-term catheter. The risks of infection and its complications as well as methods of control may differ between each group.It is of fundamental importance to distinguish between patients who came to surgery with an existing infection and those with sterile preoperative urine. Other factors include recent previous catheterization and, importantly, the length of time the catheter is inserted. For the patient with sterile preoperative urine, postoperative bacteriuria seldom causes severe symptoms and can be treated with antibiotics or left to clear spontaneously after removal of the catheter. A minority of patients suffer consequences of their infection especially when bacteriuria starts before the catheter is removed postoperatively. Catheter removal often causes transient bacteremia, also induced by instrumentation or operation on infected urine, which may lead to serious complications, particularly of septicemia. In our experience in Bristol, about 1 in 4 patients admitted for urological surgery already has infected urine as defined by the presence of ≥105 bacteria/ml midstream urine or ≥=104 bacteria/ml catheter urine. Of those admitted with infected urine, 3 in 4 have a catheter already inserted compared with only 1 catheterized patient in 4 admitted to operation with sterile urine.

scholarly journals Contribution of Individual Ebp Pilus Subunits of Enterococcus faecalis OG1RF to Pilus Biogenesis, Biofilm Formation and Urinary Tract Infection

PLoS ONE ◽  
2013 ◽  
Vol 8 (7) ◽  
pp. e68813 ◽  
Author(s):  
Jouko Sillanpää ◽  
Chungyu Chang ◽  
Kavindra V. Singh ◽  
Maria Camila Montealegre ◽  
Sreedhar R. Nallapareddy ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Enterococcus Faecalis ◽  
Biofilm Formation ◽  
Pilus Biogenesis

scholarly journals 2889. Skin Niche Conditions Trigger C. auris to Form Robust Biofilms That Resist Desiccation

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S78-S78
Author(s):  
Jeniel E Nett ◽  
Tarika Patel ◽  
Chad Johnson ◽  
John Kernien
Keyword(s):  
Medical Devices ◽  
Biofilm Formation ◽  
Fungal Growth ◽  
Emerging Pathogen ◽  
Candida Auris ◽  
Biofilm Growth ◽  
Healthcare Settings ◽  
Axillary Sweat ◽  
Biofilm Architecture ◽  
Sweat Evaporation

Abstract Background Emerging pathogen Candida auris, the first fungus to be labeled as a public health threat, causes nosocomial outbreaks of invasive candidiasis with mortality as high as 60%. Little is known about the pathogenesis of this species that has newly arisen in the last 10 years. It is unclear why this species readily colonizes the skin and transmits efficiently in healthcare settings. We considered the possibility that C. auris may proliferate in conditions of the skin niche. Methods We analyzed the growth of C. auris (B11203) in synthetic sweat media that was designed to mimic human axillary sweat. We included C. albicans SC5314 as a comparison. To simulate sweat evaporation, we examined fungal growth in sweat media that had been concentrated up to 2.5-fold. We utilized OD600 readings to quantify planktonic and biofilm growth. Biofilm architecture was assessed by scanning electron microscopy. To determine the resilience of biofilms, biofilm viability was assessed by viable burden following desiccation. Results In the various concentrations of sweat media, C. auris formed biofilms that were 3.5- to 5-fold greater that those observed for C. albicans (A). In contrast, C. auris biofilms formed in RPMI-MOPS were approximately half the density of the C. albicans biofilms. During planktonic growth in synthetic sweat media, C. auris and C. albicans replicated similarly, including in media that had been concentrated 2.5-fold. This suggests that the various media conditions differently trigger biofilm formation for the two species. The C. auris biofilm formed in sweat media was approximately 100-fold more resistant to 1 week of desiccation (B). Conclusion Skin niche conditions trigger C. auris to form resilient biofilms that resist desiccation. We propose that this unique characteristic may account for the propensity of this species to colonize the skin and for its capacity to persist on the surface of contaminated medical devices. Disclosures All Authors: No reported Disclosures.

scholarly journals Does cranberry have a role in catheter-associated urinary tract infections?

2017 ◽  
Vol 11 (11) ◽  
pp. E421-4 ◽  
Author(s):  
Dominique Thomas ◽  
Matthew Rutman ◽  
Kimberly Cooper ◽  
Andrew Abrams ◽  
Julia Finkelstein ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Bacterial Species ◽  
Signs And Symptoms ◽  
Urine Specimen ◽  
Indwelling Catheters ◽  
Resistance Patterns ◽  
Catheter Urine ◽  
Tract Infections

Introduction: Catheter-associated urinary tract infections (CA-UTIs) are a prevalent and costly condition, with very few therapeutic options. We sought to evaluate the efficacy of an oral cranberry supplement on CA-UTIs over a six-month period. Methods: Subjects with long-term indwelling catheters and recurrent symptomatic CA-UTIs were enrolled to take a once-daily oral cranberry supplement with 36 mg of the active ingredient proanthocyanidin (PACs). Primary outcome was reducing the number of symptomatic CA-UTIs. This was defined by ≥103 (cfu)/mL of ≥1 bacterial species in a single catheter urine specimen and signs and symptoms compatible with CA-UTI. Secondary outcomes included bacterial counts and resistance patterns to antibiotics.Results: Thirty-four patients were enrolled in the trial; 22 patients (mean age 77.22 years, 77.27% were men) completed the study. Cranberry was effective in reducing the number of symptomatic CA-UTIs in all patients (n=22). Resistance to antibiotics was reduced by 28%. Furthermore, colony counts were reduced by 58.65%. No subjects had adverse events while taking cranberry.Conclusions: The cranberry supplement reduced the number of symptomatic CA-UTIs, antibiotic resistances, and major causative organisms in this cohort. Larger, placebo-controlled studies are needed to further define the role of cranberry in CA-UTIs.

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