A systematic review of the use of bacteriophages for in vitro biofilm control.

Bacteriophages (phages) are very promising biological agents for the prevention and control of bacterial biofilms. However, little is known about the parameters that can influence the efficacy of phages on biofilms. This systematic review provides a summary and analysis of the published data about the use of phages to control pre-formed biofilms in vitro, suggesting recommendations for future experiments in this area. A total of 68 articles, containing data on 605 experiments addressing the efficacy of phages to control biofilms in vitro were included, after a search conducted in Web of Science, Embase, and Medline (PubMed). The data collected from each experiment included information about biofilm growth conditions, phage characteristics, treatment conditions and biofilm reduction. In most cases, biofilms were formed in the surface of microtiter plates (82.5%); the median time for biofilm formation was 24 h, as is the median treatment duration. Quantification of biofilm biomass (52.6%), viable cells (25.5%) and metabolic activity (17.9%) were the most common biofilm assessment methods. Correlation analysis revealed that some phage parameters can influence the treatment outcome: higher phage concentrations were strongly associated with improved biofilm control, leading to higher levels of biofilm reduction, and phages with higher burst sizes and shorter latent periods seem to be the best candidates to control biofilms in vitro. However, the great variability of the methodologies used prompts the need for the development of standardized in vitro methodologies to characterize phage/biofilm interactions and to assess the efficacy of phages to control biofilms.

Bacteriophage Control of Infectious Biofilms.

Biofilm formation, a strategy of bacterial survival, is a significant concern in different areas, including health, where infectious biofilms are very difficult to combat with conventional antimicrobial therapies. Bacteriophages, the viruses that infect bacteria, are promising agents to prevent and control biofilm-related infections. This chapter describes a series of standard procedures that can be used to study the potential of bacteriophages for biofilm control, from biofilm formation to bacteriophage treatment and evaluation of its efficacy.

An overview of the current state of phage therapy for the treatment of biofilm-related infections.

Bacterial biofilms are involved in many chronic and difficult-to-treat infections. Phage therapy against infectious biofilms is becoming a promising strategy, as suggested by the increasing number of publications demonstrating the efficacy of phages against in vitro formed biofilms. However, the translation between in vitro results to in vivo phage therapy outcome is not straightforward due to the complexity of phage-biofilm interactions in clinical contexts. Here, we provide a critical overview of the in vitro studies of phages for biofilm control of clinical pathogens, followed by the major outcomes and lessons learned from the recently reported case studies (between 2018 and 2021) of phage therapy against biofilm-related infections.

Current challenges and future opportunities of phage therapy.

Antibiotic resistance is a major public health challenge worldwide, whose implications for global health might be devastating if novel antibacterial strategies are not quickly developed. As natural predators of bacteria, (bacterio)phages may play an essential role in escaping such a dreadful future. The rising problem of antibiotic resistance has revived the interest in phage therapy and important developments have been achieved over the last years. But where do we stand today and what can we expect from phage therapy in the future? This is the question we set to answer in this review. Here, we scour the outcomes of human phage therapy clinical trials and case reports, and address the major barriers that stand in the way of using phages in clinical settings. We particularly address the potential of phage resistance to hinder phage therapy and discuss future avenues to explore the full capacity of phage therapy.

Ações educativas para prevenção de infecções hospitalares em uma unidade neonatal / Acciones educativas para prevenir infecciones hospitalarias en unidad neonatal / Educational activities for the prevention of hospital infection in a neonatal unit

As infecções hospitalares (IHs), importantes causas de morbimortalidade, são frequentes em recém-nascidos(RNs) internados em unidades neonatais. Para o controle de IH, é importante a orientação aos pacientes e a seusacompanhantes. O objetivo com este trabalho foi avaliar informações assimiladas por mães e acompanhantes de RNsinternados na Unidade Neonatal que participaram de atividades de educação em saúde em prevenção de infecções nosetor. Trata-se de estudo prospectivo, com aplicação de questionários às mães e acompanhantes de RNs na UnidadeNeonatal do Hospital das Clínicas da UFMG, realizado nos meses de agosto de 2008 a abril de 2009. O questionário foiaplicado em duas diferentes amostras: antes e após as orientações de prevenção de infecção. A amostra total foi de268 usuários, sendo que 121 deles receberam a orientação previamente à aplicação do questionário e 147 receberamas informações após o preenchimento deste. Observou-se um percentual de acerto maior após as orientações emtodas as questões e houve diferenças estatísticas significativas (p<0,05) entre os grupos em oito das dez questõesrealizadas. Concluiu-se que essa foi uma medida eficaz para a educação de acompanhantes dos RNs, que adquiriramnoções básicas de infecção após as orientações, por isso podem contribuir para o controle e a prevenção de infecçõesna Unidade e em casa após a alta.

Hospital-acquired infections (HAI) are a major cause of morbidity and mortality and are common in neonatal units. Tocontrol hospital infection it is important to advise patients and their companions on the subject. This study aimed atevaluating the mothers and their companions’ assimilation of information conveyed during health education activitieson the prevention of hospital-acquired infections. This was a prospective study that applied questionnaires to mothersand companions of newborns admitted to the Neonatal Unit of the Clinics Hospital of the Federal University of MinasGerais (UFMG). The study was carried out from August 2008 to April 2009. The questionnaire was administered intwo different samples: one before and another after the training on infection prevention. Total sample size was 268:121 received the information prior to questionnaire application, and 147 received it after questionnaire filling in.Results indicated that there were a higher percentage of correct answers after the groups were given instructions inall questions. There were significant statistical differences (p<0.05) between groups in eight of the ten questions. Inconclusion, this was an effective educational activity for the newborn companion. He/she acquired basic notions oninfection following the training and therefore may contribute to infection control and prevention in the unit and athome after hospital discharge.

Las infecciones hospitalarias (IH), comunes en recién nacidos (RN) internados en unidades neonatales, son la causaprincipal de morbilidad y mortalidad. Para controlar IH es importante instruir pacientes y cuidadores. El objetivo delpresente estudio fue evaluar las informaciones asimiladas por madres y cuidadores de RN internados en una unidad...

Estudo comparativo entre o tonômetro de aplanação de Goldmann e o tonômetro de contorno dinâmico de Pascal no glaucoma primário de ângulo aberto e olhos normais / Dynamic contour tonometry (DCT) versus Goldmann applanation tonometry (GAT) in open-angle glaucoma and normal eyes: a comparative study

OBJETIVO: Comparar as medidas da pressão intra-ocular (PIO) obtidas com o tonômetro de aplanação de Goldmann (TAG) e o tonômetro de contorno dinâmico (TCD) e correlacioná-las com a espessura central da córnea (ECC). MÉTODOS: Estudo transversal, com os pacientes divididos em dois grupos: glaucoma primário de ângulo aberto (GPAA) e olhos normais (ON). As medidas da PIO foram obtidas em todos os pacientes com o TAG e o TCD. Um examinador realizou as tonometrias com o TAG e outro examinador com o TCD. A ECC foi obtida pelo paquímetro ultrassônico. Os resultados foram avaliados através do teste Z para amostras independentes, teste t de Student para amostras relacionadas, teste de correlação linear de Pearson e gráfico de Bland-Altman. RESULTADOS: Foram incluídos 134 olhos de 71 pacientes. O grupo GPAA foi constituído por 85 olhos de 45 pacientes e o grupo ON por 49 olhos de 26 indivíduos com olhos normais. Não houve diferença significativa da ECC entre os dois grupos em ambos os olhos (p= 0,54 OD; p= 0,71 OE). As tonometrias realizadas com o TCD foram maiores nos dois grupos (GPAA: p< 0,01; ON: p= 0,01). Houve correlação significativa entre as tonometrias do TAG e do TCD nos dois grupos separados ou em conjunto (p< 0,001). Não houve correlação significativa entre o TAG ou o TCD e a ECC, exceto no olho direito dos dois grupos em conjunto (p= 0,03; r² = 0,07). O gráfico de Bland-Altman mostrou pouca concordância entre os dois procedimentos. CONCLUSÃO: Nenhum dos métodos mostrou boa correlação com a ECC. Houve pouca concordância entre os dois métodos, sendo maiores, as tonometrias obtidas com o TCD. As medidas realizadas no TCD parecem ser menos influenciadas pelos valores da ECC do que as medidas realizadas no TAG.

PURPOSE: To compare intraocular pressure (IOP) readings of Goldmann applanation tonometry (GAT) and dynamic contour tonometry (DCT), and to correlate central corneal thickness (CCT) with these readings. METHODS: This transversal study included patients in two groups: open-angle glaucoma (OAG) and normal eyes (NE). IOP measurements were obtained in all patients using GAT and DCT. The same examiner made all GAT measurements. Another examiner, who was masked to the GAT readings, made DCT measurements. CCT was determined by ultrasound pachimetry. RESULTS: The study included 134 eyes of 71 subjects. The groups were composed of 85 eyes from 45 patients with OAG and 49 eyes from 26 subjects with NE. There was no statically significant difference between CCT in the two groups (p = 0,54, right eye; p = 0,71, left eye). DCT readings consistently were higher than GAT measurements in the two groups (OAG: p < 0,001; NE: p = 0,01). There was good correlation between GAT and DCT in both groups (p < 0,001). Neither GAT nor DCT showed a significant correlation with CCT, except in the separate analysis of all right eyes (p = 0,03; r² = 0,07). Bland-Altman graphs showed disagreement between GAT and DCT. CONCLUSION: Measurements with both GAT and DCT were not correlated with CCT. The agreement between GAT and DCT were not good. The IOP measurements by GAT were lower when compared with DCT. DCT readings seem to be less dependent on CCT than TAG readings.