Standards for fecal microbiota transplant: Tools and therapeutic advances.

Fecal microbiota transplantation (FMT) has been demonstrated to be efficacious in preventing recurrent Clostridioides difficile (C. difficile) infections, and is being investigated for treatment of several other diseases including inflammatory bowel disease, cancer, obesity, liver disease, and diabetes. To speed up the translation of FMT into clinical practice as a safe and standardized therapeutic intervention, additional evidence-based technical and regulatory guidance is needed. To this end in May of 2022, the International Alliance for Biological Standardization (IABS) and the BIOASTER Microbiology Technology Institute hosted a second webinar to discuss key issues still impeding the advancement and standardization of FMT. The goal of this two-day webinar was to provide a forum for scientific experts to share and discuss data and key challenges with one another. Discussion included a focus on the evaluation of safety, efficacy, clinical trial design, reproducibility and accuracy in obtained microbiome measurements and data reporting, and the potential for standardization across these areas. It also focused on increasing the application potential and visibility of FMT beyond treating C. difficile infections.

Particle-Driven Effects at the Bacteria Interface: A Nanosilver Investigation of Particle Shape and Dose Metric.

Design criteria for controlling engineered nanomaterial (ENM) antimicrobial performance will enable advances in medical, food production, processing and preservation, and water treatment applications. In pursuit of this goal, better resolution of how specific ENM properties, such as nanoparticle shape, influence antimicrobial activity is needed. This study probes the antimicrobial activity toward a model Gram-negative bacterium, Escherichia coli (E. coli), that results from interfacial interactions with differently shaped silver nanoparticles (AgNPs): cube-, disc-, and pseudospherical-AgNPs. The EC50 value (i.e., the concentration of AgNPs that inactivates 50% of the microbial population) for each shape is identified and presented as a function of mass, surface area, and particle number. Further, shifts in relative potency are identified from the associated dose-response curves (e.g., shifts left, to lower concentrations, indicate greater potency). When using a mass-based dose metric, the disc-AgNPs present the highest antimicrobial activity of the three shapes (EC50: 2.39 ± 0.26 µg/mL for discs, 2.99 ± 0.96 µg/mL for cubes, 116.33 ± 6.43 µg/mL for pseudospheres). When surface area and particle number are used as dose metrics, the cube-AgNPs possess the highest antimicrobial activity (EC50-surface area: 4.70 × 10-5 ± 1.51 × 10-5 m2/mL, EC50-particle: 5.97 × 109 ± 1.92 × 109 particles/mL), such that the relative trend in potency becomes cubes > discs > pseudospheres and cubes ≫ discs ⩾ pseudospheres, respectively. The results reveal that the antimicrobial potency of disc-AgNPs is sensitive to the dose metric, significantly decreasing in potency (∼5-30×) upon conversion from a mass-based concentration to surface area and particle number and influencing the conclusions drawn. The shift in relative particle potency highlights the importance of investigating various dose metrics within the experimental design and signals different particle parameters influencing shape-based antimicrobial activity. To probe shape-dependent behavior, we use a unique empirical approach where the physical and chemical properties (ligand chemistry, surface charge) of the AgNP shapes are carefully controlled, and total available surface area is equivalent across shapes as made through modifications to particle size and concentration. The results herein suggest that surface area alone does not drive antimicrobial activity as the different AgNP shapes at equivalent particle surface area yield significantly different magnitudes of antimicrobial activity (i.e., 100% inactivation for cube-AgNPs, <25% inactivation for disc- and pseudospherical-AgNPs). Further, the particle shapes studied possess different crystal facets, illuminating their potential influence on differentiating interactions between the particle surface and the microbe. Whereas surface area may partly contribute to antimicrobial activity in certain ENM shapes (i.e., disc-AgNPs in relation to the pseudospherical-AgNPs), the different magnitudes of antimicrobial activity across shape provide insight into the likely role of other particle-specific factors, such as crystal facets, driving the antimicrobial activity of other shapes (i.e., cube-AgNPs).

Role of bacterial motility in differential resistance mechanisms of silver nanoparticles and silver ions.

Unlike conventional antimicrobials, the study of bacterial resistance to silver nanoparticles (AgNPs) remains in its infancy and the mechanism(s) through which it evolves are limited and inconclusive. The central question remains whether bacterial resistance is driven by the AgNPs, released Ag(I) ions or a combination of these and other factors. Here, we show a specific resistance in an Escherichia coli K-12 MG1655 strain to subinhibitory concentrations of AgNPs, and not Ag(I) ions, as indicated by a statistically significant greater-than-twofold increase in the minimum inhibitory concentration occurring after eight repeated passages that was maintained after the AgNPs were removed and reintroduced. Whole-population genome sequencing identified a cusS mutation associated with the heritable resistance that possibly increased silver ion efflux. Finally, we rule out the effect of particle aggregation on resistance and suggest that the mechanism of resistance may be enhanced or mediated by flagellum-based motility.

Best-practices approach to determination of blood alcohol concentration (BAC) at specific time points: Combination of ante-mortem alcohol pharmacokinetic modeling and post-mortem alcohol generation and transport considerations.

Alcohol concentrations in biological matrices offer information regarding an individual's intoxication level at a given time. In forensic cases, the alcohol concentration in the blood (BAC) at the time of death is sometimes used interchangeably with the BAC measured post-mortem, without consideration for alcohol concentration changes in the body after death. However, post-mortem factors must be taken into account for accurate forensic determination of BAC prior to death to avoid incorrect conclusions. The main objective of this work was to describe best practices for relating ante-mortem and post-mortem alcohol concentrations, using a combination of modeling, empirical data and other qualitative considerations. The Widmark modeling approach is a best practices method for superimposing multiple alcohol doses ingested at various times with alcohol elimination rate adjustments based on individual body factors. We combined the selected ante-mortem model with a suggestion for an approach used to roughly estimate changes in BAC post-mortem, and then analyzed the available data on post-mortem alcohol production in human bodies and potential markers for alcohol production through decomposition and putrefaction. Hypothetical cases provide best practice approaches as an example for determining alcohol concentration in biological matrices ante-mortem, as well as potential issues encountered with quantitative post-mortem approaches. This study provides information for standardizing BAC determination in forensic toxicology, while minimizing real world case uncertainties.