Staphylococcus aureus small colony variants: A potentially underestimated microbiological challenge in peritoneal dialysis.

INTRODUCTION: Peritonitis remains the major infectious complication in the setting of peritoneal dialysis (PD). Despite known only moderate pathogenicity, the most frequently detected pathogens in PD-related peritonitis are surprisingly coagulase-negative staphylococci. However, this could be explained, at least in part, by Staphylococcus aureus small colony variants (SCVs) induced by PD fluids (PDFs) and misidentified by routinely used microbiological methods. MATERIAL AND METHODS: Bacteria were exposed to commonly used PDFs in various regimens designed to simulate daily use as closely as possible. Wild-type isolates and SCVs were subsequently used to determine minimum inhibitory concentrations (MICs), in vitro biofilm formation capacities, and auxotrophies. Underlying genetic alterations were investigated using whole-genome sequencing, and various microbial identification methods were tested to determine their performance for wild-types and SCVs. RESULTS: Stable SCVs could be isolated most successfully after exposure to glucose-containing PDFs alone. The reading of MICs was significantly affected by the reduced growth of SCVs, resulting in lower MIC values in 44% of all tests. Nonsynonymous mutations were found in all but one SCV, while only two isolates showed typical auxotrophic responses. While MALDI-TOF, PCR and Pastorex Staph-Plus correctly identified all S. aureus SCVs, API-Staph and VITEK-2 yielded identification rates of only 40% and 10%, respectively. CONCLUSIONS: Overall, the present study has shown that commercially available PDFs induce S. aureus SCVs in vitro, which are difficult to identify and test for antimicrobial susceptibility and can potentially lead to recurrent or persistent infections. Thus, they represent a potentially underappreciated challenge not only for microbiologists, but also for clinicians.

Advances in CO2-switchable surfactants towards the fabrication and application of responsive colloids.

CO2-switchable surfactants have selective surface-activity, which can be activated or deactivated either by adding or removing CO2 from the solution. This feature enables us to use them in the fabrication of responsive colloids, a group of dispersed systems that can be controlled by changing the environmental conditions. In chemical processes, including extraction, reaction, or heterogeneous catalysis, colloids are required in some specific steps of the processes, in which maximum contact area between immiscible phases or reactants is desired. Afterward, the colloids must be broken for the postprocessing of products, solvents, and agents, which can be facilitated by using CO2-switchable surfactants in surfactant-stabilized colloids. These surfactants are mainly cationic and can be activated by the protonation of a nitrogen-containing group upon sparging CO2 gas. Also, CO2-switchable superamphiphiles can be formed by non-covalent bonding between components at least one of which is CO2-switchable. So far, CO2-switchable surfactants have been used in CO2-switchable spherical and wormlike micelles, vesicles, emulsions, foams, and Pickering emulsions. Here, we review the fabrication procedure, chemical structure, switching scheme, stability, environmental conditions, and design philosophy of such responsive colloids. Their fields of application are wide, including emulsion polymerization, catalysis, soil washing, drug delivery, extraction, viscosity control, and oil transportation. We also emphasize their application for the CO2-assisted enhanced oil recovery (EOR) process as a promising approach for carbon capture, utilization, and storage to combat climate change.

Application of Population Balance Models in Particle-Stabilized Dispersions.

In this study, a first approach to model drop size distributions in agitated nanoparticle-stabilized liquid/liquid systems with population balance equations is presented. Established coalescence efficiency models fail to predict the effect of steric hindrance of nanoparticles at the liquid/liquid interface during the film drainage process. A novel modified coalescence efficiency is developed for the population balance framework based on the film drainage model. The elaborate submodel considers the desorption energy required to detach a particle from the interface, representing an energy barrier against coalescence. With an additional implemented function in the population balance framework, the interface coverage rate by particles is calculated for each time step. The transient change of the coverage degree of the phase interface by particles is thereby considered in the submodel. Validation of the modified submodel was performed with experimental data of agitated water-in-oil (w/o) dispersions, stabilized by well-defined spherical silica nanoparticles. The nanospheres with a size of 28 nm are positively charged and were hydrophobized by silanization with dimethyloctadecyl[3-(trimethoxysilyl)propyl]ammoniumchloride. This modeling approach is a first step toward predicting time-resolved dynamic drop size distributions of nanoparticle-stabilized liquid/liquid systems.

Synergistic Effect of Cefazolin Plus Fosfomycin Against Staphylococcus aureus in vitro and in vivo in an Experimental Galleria mellonella Model.

Objectives: This study investigated the synergistic in vitro and in vivo activity of cefazolin plus fosfomycin against methicillin-susceptible and methicillin-resistant S. aureus (MSSA and MRSA) to provide the basis for a potential treatment alternative. Methods: Antimicrobial susceptibility and in vitro synergy tests were performed with five MSSA and five MRSA isolates using the broth microdilution and chequerboard assays, respectively. The in vivo efficacy of cefazolin plus fosfomycin for the treatment of MRSA infections was assessed using the Galleria mellonella survival assay. Results: Using fractional inhibitory concentration index (FICI), the evaluated combination of cefazolin plus fosfomycin showed synergistic in vitro activity against all MSSA and MRSA isolates tested. In addition, cefazolin susceptibility was recovered in all MRSA isolates except one fosfomycin-resistant strain when combined with fosfomycin at readily achievable concentrations. The G. mellonella survival assay demonstrated highly synergistic in vivo activity of cefazolin plus fosfomycin, resulting in a 44-52% reduction in mortality when compared to cefazolin-alone and fosfomycin-alone, respectively. Conclusion: If susceptibility to fosfomycin is either confirmed or can be assumed based on local resistance patterns, combination therapy with cefazolin plus fosfomycin could be a valuable treatment option for empirical as well as targeted therapy of S. aureus and MRSA infections. Future studies proving the clinical significance of this combination therapy are therefore warranted.