Antimicrobial effects of bacterial binding to a dialkylcarbamoyl chloride-coated wound dressing: an in vitro study.

OBJECTIVE: Wound dressings that inactivate or sequestrate microorganisms, such as those with a hydrophobic, bacteria-binding dialkylcarbamoyl chloride (DACC) surface, can reduce the risk of clinical infections. This 'passive' bioburden control, avoiding bacterial cell wall disruption with associated release of bacterial endotoxins aggravating inflammation, is advantageous in hard-to-heal wounds. Hence, the full scope of DACC dressings, including the potential impact of higher inoculum densities, increased protein load and different pH on antibacterial activity, needs to be evaluated. METHOD: The Japanese Industrial Standard (JIS) L 1902 challenge test was used to evaluate the antimicrobial activity of the DACC-coated dressing against several World Health Organization (WHO)-prioritised wound pathogens (e.g., meticillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, microorganisms with extended-spectrum beta-lactamases and Acinetobacter baumannii), the effect of repeated bacterial challenge in an adverse wound environment, and antimicrobial performance at wound-related pH. RESULTS: High antibacterial activity of the DACC-coated dressing against the WHO-prioritised bacteria strains by its irreversible binding and inhibition of growth of bound bacteria was confirmed using JIS L 1902. At increased inoculation densities, compared to standard conditions, the DACC-coated dressing still achieved strong-to-significant antibacterial effects. Augmenting the media protein content also affected antibacterial performance; a 0.5-1 log reduction in antibacterial activity was observed upon addition of 10% fetal calf serum. The pH did not influence antibacterial performance. The DACC-coated dressing also sustained antibacterial activity over subsequent reinfection steps. CONCLUSION: It can be assumed that the DACC-coated dressing exerts beneficial effects in controlling the wound bioburden, reducing the overall demand placed on antibiotics, without using antimicrobial substances.

Significant and rapid reduction of free endotoxin using a dialkylcarbamoyl chloride-coated wound dressing.

OBJECTIVE: Endotoxin causes inflammation and can impair wound healing. Conventional methods that reduce bioburden in wounds by killing microorganisms using antibiotics, topical antimicrobials or antimicrobial dressings may induce endotoxin release from Gram-negative bacteria. Another approach is to reduce bioburden by adsorbing microorganisms, without killing them, using dialkylcarbamoyl chloride (DACC)-coated wound dressings. This study evaluated the endotoxin-binding ability of a DACC-coated wound dressing (Sorbact Compress, Abigo Medical AB, Sweden) in vitro, including its effect on the level of natural endotoxin released from Gram-negative bacteria. METHOD: Different concentrations of purified Pseudomonas aeruginosa endotoxin and a DACC-coated dressing were incubated at 37°C for various durations. After incubation, the dressing was removed and endotoxin concentration in the solution was quantified using a Limulus amebocyte lysate (LAL) assay. The DACC-coated dressing was also incubated with Pseudomonas aeruginosa cells for one hour at 37°C. After incubation, the dressing and bacterial cells were removed and shed endotoxin remaining in the solution was quantified. RESULTS: Overnight incubation of the DACC-coated wound dressing with various concentrations of purified Pseudomonas aeruginosa endotoxin (96-11000 EU/ml) consistently and significantly reduced levels of free endotoxin by 93-99% (p<0.0001). A significant endotoxin reduction of 39% (p<0.001) was observed after five minutes. The DACC-coated dressing incubated with clinically relevant Pseudomonas aeruginosa cells also reduced shed endotoxin by >99.95% (p<0.0001). CONCLUSION: In this study, we showed that a DACC-coated wound dressing efficiently and rapidly binds both purified and shed endotoxin from Pseudomonas aeruginosa in vitro. This ability to remove both endotoxin and bacterial cells could promote the wound healing process.

Expression of Staphylococcal Enterotoxins under Stress Encountered during Food Production and Preservation.

Staphylococcal food poisoning (SFP) is the most prevalent cause of food-borne intoxications worldwide. Consumption of enterotoxins preformed in food causes violent vomiting and can be fatal in children and the elderly. While being repressed by competing bacteria in most matrices, Staphylococcus aureus benefits from crucial competitive advantages in foods with high osmolarity or low pH. During recent years, the long-standing belief in the feasibility of assessing SFP risk based on colony-forming units of S. aureus present in food products has been disproven. Instead, researchers and food business operators are acutely aware of the imminent threat arising from unforeseeable enterotoxin production under stress conditions. This paradigm shift led to a variety of new publications enabling an improved understanding of enterotoxin expression under stress conditions encountered in food. The wealth of data provided by these studies is extremely diverse, as it is based on different methodological approaches, staphylococcal strains, stressors, and enterotoxins. Therefore, in this review, we aggregated and critically evaluated the complex findings of these studies, to provide readers with a current overview of the state of research in the field.

Reduced Enterotoxin D Formation on Boiled Ham in Staphylococcus Aureus Δagr Mutant.

Staphylococcal food poisoning (SFP) is a common cause of foodborne illness worldwide, and enterotoxin D (SED) is one of the most frequent Staphylococcus aureus enterotoxins associated with it. It has been reported that the expression and formation of SED in S. aureus is regulated by the quorum sensing Agr system. In this study, the effect of agr deletion on sed expression in S. aureus grown on boiled ham was investigated. Growth, sed mRNA and SED protein levels in an S. aureus wild type strain and its isogenic Δagr mutant were monitored for 14 days at 22 °C. The results showed that although deletion of the agr gene did not affect the growth rate or maximum cell density of S. aureus on boiled ham, it had a pronounced effect on SED formation during the first 5 days of incubation. The SED concentration was not reflected in the amount of preceding sed transcripts, suggesting that sed transcription levels may not always reflect SED formation. The expression of RNAIII transcript, the regulatory signal of the Agr system, was also monitored. Similar transcription patterns were observed for RNAIII and sed. Surprisingly, in the Δagr mutant, sed expression was comparable to that in the wild type strain, and was thus unaffected by deletion of the Agr system. These results demonstrate that the Agr system appears to only partially affect SED formation, even in a real food environment.

Prophage-Encoded Staphylococcal Enterotoxin A: Regulation of Production in Staphylococcus aureus Strains Representing Different Sea Regions.

The present study investigates the nature of the link between the staphylococcal enterotoxin A (SEA) gene and the lifecycle of Siphoviridae bacteriophages, including the origin of strain variation regarding SEA production after prophage induction. Five strains representing three different genetic lines of the sea region were studied under optimal and prophage-induced growth conditions and the Siphoviridae lifecycle was followed through the phage replicative form copies and transcripts of the lysogenic repressor, cro. The role of SOS response on prophage induction was addressed through recA transcription in a recA-disruption mutant. Prophage induction was found to increase the abundance of the phage replicative form, the sea gene copies and transcripts and enhance SEA production. Sequence analysis of the sea regions revealed that observed strain variances were related to strain capacity for prophage induction, rather than sequence differences in the sea region. The impact of SOS response activation on the phage lifecycle was demonstrated by the absence of phage replicative form copies in the recA-disruption mutant after prophage induction. From this study it emerges that all aspects of SEA-producing strain, the Siphoviridae phage and the food environment must be considered when evaluating SEA-related hazards.