Efficacy of Lysostaphin functionalized silicon catheter for the prevention of Staphylococcus aureus biofilm.

Staphylococcus aureus readily forms biofilms on tissue and indwelling catheter surfaces. These biofilms are resistant to antibiotics. Consequently, effective prevention and treatment strategies against staphylococcal biofilms are actively being pursued over the past two decades. One of the proposed strategies involve the incorporation of antibiotics and antiseptics into catheters, however, a persistent concern regarding the possible emergence of antimicrobial resistance is associated with these medical devices. In this study, we developed two types of silicone catheters: one with Lysostaphin (Lst) adsorbed onto the surface, and the other with Lst functionalized on the surface. To confirm the presence of Lst protein on the catheter surface, we conducted FTIR-ATR and SEM-EDS analysis. Both catheters exhibited hemocompatibility, biocompatibility, and demonstrated antimicrobial and biofilm prevention activities against both methicillin-sensitive and resistant strains of S. aureus. Furthermore, the silicone catheters that were surface-functionalized with Lst showed substantially better and more persistent anti-biofilm effects when compared to the catheters where Lst was surface-adsorbed, both under in vitro static and flow conditions, as well as in vivo in BALB/c mice. These results indicate that surface-functionalized Lst catheters have the potential to serve as a promising new medical device for preventing S. aureus biofilm infections in humans.

Exploring alternative strategies for Staphylococcus aureus nasal decolonization: insights from preclinical studies.

Nasal decolonization of Staphylococcus aureus with the antibiotic mupirocin is a common clinical practice before complex surgical procedures, to prevent hospital acquired infections. However, widespread use of mupirocin has led to the development of resistant S. aureus strains and there is a limited scope for developing new antibiotics for S. aureus nasal decolonization. It is therefore necessary to develop alternative and nonantibiotic nasal decolonization methods. In this review, we broadly discussed the effectiveness of different nonantibiotic antimicrobial agents that are currently not in clinical practice, but are experimentally proved to be efficacious in promoting S. aureus nasal decolonization. These include lytic bacteriophages, bacteriolytic enzymes, tea tree oil, apple vinegar, and antimicrobial peptides. We have also discussed the possibility of using photodynamic therapy for S. aureus nasal decolonization. This article highlights the importance of further large scale clinical studies for selecting the most suitable and alternative nasal decolonizing agent.

Quantitative Prediction of Change in Chin Position in Le Fort I Impaction.

BACKGROUND: Vertical maxillary excess, a dentofacial deformity present in a large proportion of population impute an increased lower facial height due to increased maxillary height. This results in a clockwise rotation in the mandible, and the chin advances posteriorly and inferiorly. Le Fort I superior repositioning of the maxilla begets movement of pogonion point anteriorly and cranially. Cephalometric analysis helps to access change in position of chin following Le Fort I impaction. In our study, from this analysis a formula was defined to perceive the exact amount of this change in chin position along the vertical and sagittal plane as a result of autorotation. MATERIALS AND METHODS: This experimental study assessed 45 patients with vertical maxillary excess over a period of 2 years and 6 months (January 2016-May 2018) in Government Medical College Hospital, Kottayam, Kerala, India. The planned procedure was Le Fort I superior impaction for correction of vertical maxillary excess. Pre-operative cephalograph was taken initially. Post-operative cephalograph after 3 months was then compared with initial pre-operative cephalograph to assess the change in position of the pogonion and menton. RESULTS: Forty-five participants were studied. The multiple regression model was applied to predict the changes in the chin (dependent factor) according to the vertical change in the maxilla (predictive factor). For every 1 mm change in the maxilla vertically, the chin was estimated to move 0.59 vertically. For a standard deviation increase of 1 in the position of the maxilla, the chin moved superiorly by 0.744 of the standard deviation. For every 1 mm of vertical change in the maxilla, the chin could be expected to move 0.22 mm horizontally. For a standard deviation increase of 1 in the maxillary position, the chin advanced by 0.273 of the standard deviation. CONCLUSION: This study draws to a conclusive finding that the movement of maxilla in the superior direction has an effect on the repositioning of the chin in the anterior and cranial directions. This has led to a formulation that 1 mm of superior impaction of maxilla results in 0.6 mm of vertical and 0.2 mm of sagittal movement of chin. This might help to have a glance of future chin position and aid in deciding the need for mandibular surgery.