Biofilm formation on three different endotracheal tubes: a prospective clinical trial

Abstract Background: Biofilm formation on endotracheal tubes (ETTs) is an early and frequent event in mechanically ventilated patients. The biofilm is believed to act as a reservoir for infecting microorganisms and thereby, contribute to development and relapses of ventilator-associated pneumonia (VAP). Once a biofilm has formed on an ETT surface, it is difficult to eradicate. This clinical study aimed to compare biofilm formation on three widely used ETTs with different surface properties and to explore factors potentially predictive of biofilm formation.Methods: We compared the grade of biofilm formation on ETTs made of uncoated polyvinyl chloride (PVC), silicone-coated PVC, and PVC coated with noble metals after > 24 hours of mechanical ventilation in critically ill patients. The comparison was based on scanning electron microscopy of ETT surfaces, biofilm grading, surveillance and biofilm cultures, and occurrence of VAP.Results: High-grade (score ≥ 7) biofilm formation on the ETTs was associated with development of VAP (OR 4.17 [95% CI 1.14–15.3], p = 0.031). Compared to uncoated PVC ETTs, the silicone-coated and noble-metal-coated PVC ETTs were independently associated with reduced high-grade biofilm formation (OR 0.18 [95% CI 0.06–0.59], p = 0.005 and OR 0.34 [95% CI 0.13–0.93], p = 0.036, respectively). No significant difference was observed between silicon-coated ETTs and noble-metal-coated ETTs (OR 0.54 [95% CI 0.17–1.65] p = 0.278). The microbes found in the ETT biofilm were frequently found in surveillance cultures at intubation and often remained in the biofilm despite appropriate antibiotic therapy. High-grade biofilm formation on ETTs was not predicted by either colonization with common VAP pathogens in surveillance cultures or duration of invasive ventilation.Conclusion: High-grade biofilm formation on ETTs was associated with development of VAP. Compared to the uncoated PVC ETTs, the silicone-coated and noble-metal coated PVC ETTs were independently associated with reduced high-grade biofilm formation. Methods aimed at the continuous monitoring of biofilm formation are warranted. Routines for biofilm removal need further study.Trial registration: ClinicalTrials.gov, NCT02284438. Retrospectively registered on 21 October 2014, URL: https://clinicaltrials.gov/ct2/show/NCT02284438.

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Biofilm formation on three different endotracheal tubes: A prospective clinical trial

10.21203/rs.3.rs-17258/v4 ◽

2020 ◽

Author(s):

Hulda Rosa Thorarinsdottir ◽

Thomas Kander ◽

Anna Holmberg ◽

Sarunas Petronis ◽

Bengt Klarin

Keyword(s):

Noble Metal ◽

Biofilm Formation ◽

Noble Metals ◽

Ventilator Associated Pneumonia ◽

High Grade ◽

Invasive Ventilation ◽

Mechanically Ventilated ◽

Endotracheal Tubes ◽

Frequent Event ◽

Significant Difference

Abstract Background: Biofilm formation on endotracheal tubes (ETTs) is an early and frequent event in mechanically ventilated patients. The biofilm is believed to act as a reservoir for infecting microorganisms and thereby contribute to development and relapses of ventilator-associated pneumonia (VAP). Once a biofilm has formed on an ETT surface, it is difficult to eradicate. This clinical study aimed to compare biofilm formation on three widely used ETTs with different surface properties and to explore factors potentially predictive of biofilm formation.Methods: We compared the grade of biofilm formation on ETTs made of uncoated polyvinyl chloride (PVC), silicone-coated PVC, and PVC coated with noble metals after > 24 hours of mechanical ventilation in critically ill patients. The comparison was based on scanning electron microscopy of ETT surfaces, biofilm grading, surveillance and biofilm cultures, and occurrence of VAP.Results: High-grade (score ≥ 7) biofilm formation on the ETTs was associated with development of VAP (OR 4.17 [95% CI 1.14–15.3], p = 0.031). Compared to uncoated PVC ETTs, the silicone-coated and noble-metal-coated PVC ETTs were independently associated with reduced high-grade biofilm formation (OR 0.18 [95% CI 0.06–0.59], p = 0.005, and OR 0.34 [95% CI 0.13–0.93], p = 0.036, respectively). No significant difference was observed between silicon-coated ETTs and noble-metal-coated ETTs (OR 0.54 [95% CI 0.17–1.65], p = 0.278). In 60% of the oropharyngeal cultures and 58% of the endotracheal cultures collected at intubation, the same microorganism was found in the ETT biofilm at extubation. In patients who developed VAP, the causative microbe remained in the biofilm in 56% of cases, despite appropriate antibiotic therapy. High-grade biofilm formation on ETTs was not predicted by either colonization with common VAP pathogens in surveillance cultures or duration of invasive ventilation.Conclusion: High-grade biofilm formation on ETTs was associated with development of VAP. Compared to the uncoated PVC ETTs, the silicone-coated and noble-metal-coated PVC ETTs were independently associated with reduced high-grade biofilm formation. Further research on methods to prevent, monitor, and manage biofilm occurrence is needed.Trial registration: ClinicalTrials.gov, NCT02284438. Retrospectively registered on 21 October 2014, URL: https://clinicaltrials.gov/ct2/show/NCT02284438.

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Biofilm formation on three different endotracheal tubes: A prospective clinical trial

10.21203/rs.3.rs-17258/v1 ◽

2020 ◽

Author(s):

Hulda Rosa Thorarinsdottir ◽

Thomas Kander ◽

Anna Holmberg ◽

Sarunas Petronis ◽

Bengt Klarin

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

Biofilm Formation ◽

Noble Metals ◽

High Grade ◽

Mechanically Ventilated ◽

Endotracheal Tubes ◽

Surveillance Cultures ◽

Frequent Event ◽

Significant Difference

Abstract Background: Biofilm formation on endotracheal tubes (ETTs) is an early and frequent event in mechanically ventilated patients. The biofilm is anticipated to act as a reservoir for infecting microorganisms, contributing to the development and relapses of ventilator-associated pneumonia (VAP). Once a biofilm has formed on an ETT surface it is difficult to eradicate. The aims of this clinical study were to compare biofilm formation on three widely used ETT´s with different surface properties and to explore possible predictive factors of biofilm formation. Methods: The grade of biofilm formation on endotracheal tubes of polyvinyl chloride (PVC), silicone-coated PVC, and PVC coated by noble metals were compared after mechanical ventilation for > 24 hours in critically ill patients. The comparison was based on scanning electron microscopy (SEM) observations of ETT surfaces and biofilm grading, surveillance and biofilm cultures, and the occurrence of VAP. Results: A high-grade (score ≥ 7) biofilm formation on the ETTs was associated with the development of VAP (OR, 4.17; 95% CI 1.14 to 15.3; p = 0.031). Silicone-coated ETTs and PVC tubes coated with noble metals were independently associated with reduced high-grade biofilm formation compared to non-coated PVC ETTs (OR, 0.18; 95% CI 0.06 to 0.59; p = 0.005 and OR, 0.34; 95% CI 0.13 to 0.93; p = 0.036, respectively). No significant difference was detected between silicon-coated ETTs and noble metal-coated ETTs (OR, 0.54; 95% CI 0.17 to 1.65; p = 0.278). The microbes found in the ETT biofilm were frequently found in surveillance cultures at intubation and often remained in the biofilm after appropriate antibiotic therapy. Colonization with common VAP pathogens in surveillance cultures or duration of invasive ventilation did not predict higher biofilm formation on ETTs. Conclusion: Biofilm formation on ETTs were an early and frequent event in critically ill patients. High-grade biofilm formation on ETTs was associated with the development of VAP. Silicone-coated ETTs and PVC tubes coated with noble metals were independently associated with reduced high-grade biofilm formation in comparison to non-coated PVC ETTs. Clinicians may consider changing the ETT after an episode of VAP to avoid microbial persistence and possibly VAP relapse.

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Biofilm formation on three different endotracheal tubes: a prospective clinical trial

10.21203/rs.3.rs-17258/v3 ◽

2020 ◽

Author(s):

Hulda Rosa Thorarinsdottir ◽

Thomas Kander ◽

Anna Holmberg ◽

Sarunas Petronis ◽

Bengt Klarin

Keyword(s):

Noble Metal ◽

Biofilm Formation ◽

Noble Metals ◽

Ventilator Associated Pneumonia ◽

High Grade ◽

Invasive Ventilation ◽

Mechanically Ventilated ◽

Endotracheal Tubes ◽

Frequent Event ◽

Significant Difference

Abstract Background: Biofilm formation on endotracheal tubes (ETTs) is an early and frequent event in mechanically ventilated patients. The biofilm is believed to act as a reservoir for infecting microorganisms and thereby contribute to development and relapses of ventilator-associated pneumonia (VAP). Once a biofilm has formed on an ETT surface, it is difficult to eradicate. This clinical study aimed to compare biofilm formation on three widely used ETTs with different surface properties and to explore factors potentially predictive of biofilm formation.Methods: We compared the grade of biofilm formation on ETTs made of uncoated polyvinyl chloride (PVC), silicone-coated PVC, and PVC coated with noble metals after > 24 hours of mechanical ventilation in critically ill patients. The comparison was based on scanning electron microscopy of ETT surfaces, biofilm grading, surveillance and biofilm cultures, and occurrence of VAP.Results: High-grade (score ≥ 7) biofilm formation on the ETTs was associated with development of VAP (OR 4.17 [95% CI 1.14–15.3], p = 0.031). Compared to uncoated PVC ETTs, the silicone-coated and noble-metal-coated PVC ETTs were independently associated with reduced high-grade biofilm formation (OR 0.18 [95% CI 0.06–0.59], p = 0.005, and OR 0.34 [95% CI 0.13–0.93], p = 0.036, respectively). No significant difference was observed between silicon-coated ETTs and noble-metal-coated ETTs (OR 0.54 [95% CI 0.17–1.65], p = 0.278). In 60% of the oropharyngeal cultures and 58% of the endotracheal cultures collected at intubation, the same microorganism was found in the ETT biofilm at extubation. In patients who developed VAP, the causative microbe remained in the biofilm in 56% of cases, despite appropriate antibiotic therapy. High-grade biofilm formation on ETTs was not predicted by either colonization with common VAP pathogens in surveillance cultures or duration of invasive ventilation.Conclusion: High-grade biofilm formation on ETTs was associated with development of VAP. Compared to the uncoated PVC ETTs, the silicone-coated and noble-metal-coated PVC ETTs were independently associated with reduced high-grade biofilm formation. Further research on methods to prevent, monitor, and manage biofilm occurrence is needed.Trial registration: ClinicalTrials.gov, NCT02284438. Retrospectively registered on 21 October 2014, URL: https://clinicaltrials.gov/ct2/show/NCT02284438.

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Bioelectric Effect of a Microcurrent Toothbrush on Plaque Removal

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168255 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8255

Author(s):

Ji-Hyun Lee ◽

Jin-Hee Ha

Keyword(s):

Bacterial Flora ◽

Gingival Index ◽

Direct Electric Current ◽

Plaque Removal ◽

Bioelectric Effect ◽

Biofilm Removal ◽

Significant Difference ◽

The Us ◽

Before And After ◽

Previous State

This study evaluated the effectiveness of a microcurrent toothbrush (approved by the US Food and Drug Administration [FDA]), which employs a superimposed alternating and direct electric current, named as a Proxywave® technology, similar to the intensity of the biocurrent, in plaque removal and reducing gingivitis by biofilm removal through the bioelectric effect. This study enrolled 40 volunteers with gingivitis. Dental observations were made every two weeks, before and after the use of each toothbrush. We randomly assigned participants into two groups: one group used the Proxywave® toothbrush (PB) for two weeks followed by the control toothbrush (CB) for two weeks, while the other group used the CB for two weeks followed by the PB. The participants had a two-week washout period. If the toothbrush used earlier has had an effect on the bacterial flora in the oral cavity, this is to remove this effect and return it to its previous state. During each dental visit, we recorded plaque index (PI) and gingival index (GI) scores. The PI and GI scores were significantly lower in both the PB and the CB (p < 0.05). Considering the PI, there was no significant difference between the toothbrushes on all the surfaces. Considering the GI, the PB showed a significant decrease in the interproximal surface, compared to the CB (p < 0.05). The PB showed a significant decrease in the interproximal GI and had a beneficial effect in the interproximal area where the bristles could not reach. No adverse events were observed in the participants during the clinical trial. The microcurrent toothbrush is a device that can be safely used for plaque removal.

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A descriptive analysis of end-of-life discussions for high-grade glioma patients

Neuro-Oncology Practice ◽

10.1093/nop/npab010 ◽

2021 ◽

Author(s):

Ai Chikada ◽

Sayaka Takenouchi ◽

Yoshiki Arakawa ◽

Kazuko Nin

Keyword(s):

End Of Life ◽

Health Care Providers ◽

Patient Participation ◽

High Grade Glioma ◽

Team Approach ◽

High Grade ◽

Care Providers ◽

Patient Goals ◽

Significant Difference ◽

Eol Care

Abstract Background End-of-life discussions (EOLDs) in patients with high-grade glioma (HGG) have not been well described. Therefore, this study examined the appropriateness of timing and the extent of patient involvement in EOLDs and their impact on HGG patients. Methods A cross-sectional survey was conducted among 105 bereaved families of HGG patients at a university hospital in Japan between July and August 2019. Fisher’s exact test and the Wilcoxon rank-sum test were used to assess the association between patient participation in EOLDs and their outcomes. Results In total, 77 questionnaires were returned (response rate 73%), of which 20 respondents replied with refusal documents. Overall, 31/57 (54%) participated in EOLDs at least once in acute hospital settings, and a significant difference was observed between participating and nonparticipating groups in communicating the patient’s wishes for EOL care to the family (48% vs 8%, P = .001). Moreover, >80% of respondents indicated that the initiation of EOLDs during the early diagnosis period with patients and families was appropriate. Most EOLDs were provided by neurosurgeons (96%), and other health care providers rarely participated. Additionally, patient goals and priorities were discussed in only 28% of the EOLDs. Patient participation in EOLDs was not associated with the quality of EOL care and a good death. Conclusions Although participation in EOLDs is relatively challenging for HGG patients, this study showed that participation in EOLDs may enable patients to express their wishes regarding EOL care. It is important to initiate EOLDs early on through an interdisciplinary team approach while respecting patient goals and priorities.

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Adsorption of the Gas Molecules (NH3, C2H6O, C3H6O, CO, H2S) on noble metal (Ag, Au, Pt, Pd, Ru)–Doped MoSe2 Monolayer: A First-Principles Study

New Journal of Chemistry ◽

10.1039/d1nj01705e ◽

2021 ◽

Author(s):

Lanjuan Zhou ◽

Sujing Yu ◽

Yan Yang ◽

Qi Li ◽

Tingting Li ◽

...

Keyword(s):

Density Functional Theory ◽

Noble Metal ◽

First Principles ◽

Density Functional ◽

Noble Metals ◽

Gas Sensing ◽

Functional Theory ◽

First Principles Study ◽

Gas Molecules ◽

Sensing Performance

In this paper, the effects of five noble metals (Au, Pt, Pd, Ag, Ru) doped MoSe2 on improving gas sensing performance were predicted through density functional theory (DFT) based on...

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Luminescent Supramolecular Nano- or Microstructures Formed in Aqueous Media by Amphiphile-Noble Metal Complexes

Journal of Nanomaterials ◽

10.1155/2020/5395048 ◽

2020 ◽

Vol 2020 ◽

pp. 1-24 ◽

Cited By ~ 1

Author(s):

Carmen Cretu ◽

Loredana Maiuolo ◽

Domenico Lombardo ◽

Elisabeta I. Szerb ◽

Pietro Calandra

Keyword(s):

Noble Metal ◽

Smart Materials ◽

Self Assembly ◽

Noble Metals ◽

Photophysical Properties ◽

Aqueous Media ◽

Molecular Architecture ◽

Stimuli Responsive ◽

Panoramic View ◽

Amphiphilic Molecules

The involvement of metal ions within the self-assembly spontaneously occurring in surfactant-based systems gives additional and interesting features. The electronic states of the metal, together with the bonds that can be established with the organic amphiphilic counterpart, are the factors triggering new photophysical properties. Moreover, the availability of stimuli-responsive supramolecular amphiphile assemblies, able to disassemble in a back-process, provides reversible switching particularly useful in novel approaches and applications giving rise to truly smart materials. In particular, small amphiphiles with an inner distribution, within their molecular architecture, of various polar and apolar functional groups, can give a wide variety of interactions and therefore enriched self-assemblies. If it is joined with the opportune presence and localization of noble metals, whose chemical and photophysical properties are undiscussed, then very interesting materials can be obtained. In this minireview, the basic concepts on self-assembly of small amphiphilic molecules with noble metals are shown with particular reference to the photophysical properties aiming at furnishing to the reader a panoramic view of these exciting problematics. In this respect, the following will be shown: (i) the principles of self-assembly of amphiphiles that involve noble metals, (ii) examples of amphiphiles and amphiphile-noble metal systems as representatives of systems with enhanced photophysical properties, and (iii) final comments and perspectives with some examples of modern applications.

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Effectiveness and safety of a new dental plaque removal device utilizing micro mist spray for removing oral biofilm in vitro

BMC Oral Health ◽

10.1186/s12903-021-01647-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hiroki Hihara ◽

Ryo Tagaino ◽

Jumpei Washio ◽

Kittipong Laosuwan ◽

Dimas Prasetianto Wicaksono ◽

...

Keyword(s):

Surface Roughness ◽

Mucous Membrane ◽

Oral Mucosa ◽

Dental Plaque ◽

Tooth Surface ◽

Oral Biofilm ◽

Plaque Removal ◽

Treated Area ◽

Biofilm Removal ◽

Significant Difference

Abstract Background Removal of oral biofilm from the oral mucosa is essential for preventing risk of respiratory and gastrointestinal infection in elderly people. Currently, no device is available which can remove oral biofilm from oral mucosa effectively and safely. Therefore, the effectiveness and safety of the Micro Scale Mist UNIT (MSM-UNIT), a newly developed dental plaque removal device utilizing high speed sprays of fine water droplets, were evaluated for biofilm removal, including the rate and surface roughness for simulated tooth surface and mucous membrane. Methods Simulated tooth and oral mucosa coated with an artificial biofilm of Streptococcus mutans were used for evaluation of effectiveness, with uncoated substrates as the controls. The MSM-UNIT and a conventional air ablation device were operated under recommended instructions. The effectiveness was evaluated from the rate of removal of the biofilm, and the safety was evaluated from the damage observed by scanning electron microscope and surface roughness. Results The biofilm removal rate of the MSM-UNIT was significantly higher than that of AIRFLOW. Little damage was observed in the area treated by the MSM-UNIT. The surface roughness of the MSM-UNIT treated area on simulated tooth surface and oral mucosa showed no significant difference to the control area. In contrast, cracks and powder were observed in the area treated by AIRFLOW. In particular, the surface roughness of the AIRFLOW treated area for Toughsilon was significantly larger than that of the control. Conclusions The MSM-UNIT could be used safely and effectively for removing biofilm not only on simulated tooth surfaces but also simulated mucous membrane. The MSM-UNIT has no harmful effect on teeth or oral mucosa, and may be used for comprehensive oral care for patients during nursing care and the perioperative period.

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Current Strategies for Noble Metal Nanoparticle Synthesis

Nanoscale Research Letters ◽

10.1186/s11671-021-03480-8 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Giyaullah Habibullah ◽

Jitka Viktorova ◽

Tomas Ruml

Keyword(s):

Noble Metal ◽

Noble Metals ◽

Drug Carriers ◽

Industrial Applications ◽

Metal Nanoparticle ◽

Noble Metal Nanoparticles ◽

Synthesis Methods ◽

Gold And Silver Nanoparticles ◽

Diverse Range ◽

The Past

AbstractNoble metals have played an integral part in human history for centuries; however, their integration with recent advances in nanotechnology and material sciences have provided new research opportunities in both academia and industry, which has resulted in a new array of advanced applications, including medical ones. Noble metal nanoparticles (NMNPs) have been of great importance in the field of biomedicine over the past few decades due to their importance in personalized healthcare and diagnostics. In particular, platinum, gold and silver nanoparticles have achieved the most dominant spot in the list, thanks to a very diverse range of industrial applications, including biomedical ones such as antimicrobial and antiviral agents, diagnostics, drug carriers and imaging probes. In particular, their superior resistance to extreme conditions of corrosion and oxidation is highly appreciated. Notably, in the past two decades there has been a tremendous advancement in the development of new strategies of more cost-effective and robust NMNP synthesis methods that provide materials with highly tunable physicochemical, optical and thermal properties, and biochemical functionalities. As a result, new advanced hybrid NMNPs with polymer, graphene, carbon nanotubes, quantum dots and core–shell systems have been developed with even more enhanced physicochemical characteristics that has led to exceptional diagnostic and therapeutic applications. In this review, we aim to summarize current advances in the synthesis of NMNPs (Au, Ag and Pt).

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