Recovering the susceptibility of antibiotic-resistant bacteria using photooxidative damage.

Multidrug-resistant bacteria are one of the most serious threats to infection control. Few new antibiotics have been developed; however, the lack of an effective new mechanism of their action has worsened the situation. Photodynamic inactivation (PDI) can break antimicrobial resistance, since it potentiates the effect of antibiotics, and induces oxidative stress in microorganisms through the interaction of light with a photosensitizer. This paper addresses the application of PDI for increasing bacterial susceptibility to antibiotics and helping in bacterial persistence and virulence. The effect of photodynamic action on resistant bacteria collected from patients and bacteria cells with induced resistance in the laboratory was investigated. Staphylococcus aureus resistance breakdown levels for each antibiotic (amoxicillin, erythromycin, and gentamicin) from the photodynamic effect (10 µM curcumin, 10 J/cm2) and its maintenance in descendant microorganisms were demonstrated within five cycles after PDI application. PDI showed an innovative feature for modifying the degree of bacterial sensitivity to antibiotics according to dosages, thus reducing resistance and persistence of microorganisms from standard and clinical strains. We hypothesize a reduction in the degree of antimicrobial resistance through photooxidative action combats antibiotic failures.

Breaking down antibiotic resistance in methicillin-resistant Staphylococcus aureus: Combining antimicrobial photodynamic and antibiotic treatments.

The widespread use of antibiotics drives the evolution of antimicrobial-resistant bacteria (ARB), threatening patients and healthcare professionals. Therefore, the development of novel strategies to combat resistance is recognized as a global healthcare priority. The two methods to combat ARB are development of new antibiotics or reduction in existing resistances. Development of novel antibiotics is a laborious and slow-progressing task that is no longer a safe reserve against looming risks. In this research, we suggest a method for reducing resistance to extend the efficacious lifetime of current antibiotics. Antimicrobial photodynamic therapy (aPDT) is used to generate reactive oxygen species (ROS) via the photoactivation of a photosensitizer. ROS then nonspecifically damage cellular components, leading to general impairment and cell death. Here, we test the hypothesis that concurrent treatment of bacteria with antibiotics and aPDT achieves an additive effect in the elimination of ARB. Performing aPDT with the photosensitizer methylene blue in combination with antibiotics chloramphenicol and tetracycline results in significant reductions in resistance for two methicillin-resistant Staphylococcus aureus (MRSA) strains, USA300 and RN4220. Additional resistant S. aureus strain and antibiotic combinations reveal similar results. Taken together, these results suggest that concurrent aPDT consistently decreases S. aureus resistance by improving susceptibility to antibiotic treatment. In turn, this development exhibits an alternative to overcome some of the growing MRSA challenge.

Avoiding ventilator-associated pneumonia: Curcumin-functionalized endotracheal tube and photodynamic action.

Hospital-acquired infections are a global health problem that threatens patients' treatment in intensive care units, causing thousands of deaths and a considerable increase in hospitalization costs. The endotracheal tube (ETT) is a medical device placed in the patient's trachea to assist breathing and delivering oxygen into the lungs. However, bacterial biofilms forming at the surface of the ETT and the development of multidrug-resistant bacteria are considered the primary causes of ventilator-associated pneumonia (VAP), a severe hospital-acquired infection for significant mortality. Under these circumstances, there has been a need to administrate antibiotics together. Although necessary, it has led to a rapid increase in bacterial resistance to antibiotics. Therefore, it becomes necessary to develop alternatives to prevent and combat these bacterial infections. One possibility is to turn the ETT itself into a bactericide. Some examples reported in the literature present drawbacks. To overcome those issues, we have designed a photosensitizer-containing ETT to be used in photodynamic inactivation (PDI) to avoid bacteria biofilm formation and prevent VAP occurrence during tracheal intubation. This work describes ETT's functionalization with curcumin photosensitizer, as well as its evaluation in PDI against Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli A significant photoinactivation (up to 95%) against Gram-negative and Gram-positive bacteria was observed when curcumin-functionalized endotracheal (ETT-curc) was used. These remarkable results demonstrate this strategy's potential to combat hospital-acquired infections and contribute to fighting antimicrobial resistance.

Improving Hazardous Gas Detection Behavior with Palladium Decorated SnO2 Nanobelts Networks.

Transparent Conductive Oxides (TCOs) have been widely used as sensors for various hazardous gases. Among the most studied TCOs is SnO2, due to tin being an abundant material in nature, and therefore being accessible for moldable-like nanobelts. Sensors based on SnO2 nanobelts are generally quantified according to the interaction of the atmosphere with its surface, changing its conductance. The present study reports on the fabrication of a nanobelt-based SnO2 gas sensor, in which electrical contacts to nanobelts are self-assembled, and thus the sensors do not need any expensive and complicated fabrication processes. The nanobelts were grown using the vapor-solid-liquid (VLS) growth mechanism with gold as the catalytic site. The electrical contacts were defined using testing probes, thus the device is considered ready after the growth process. The sensorial characteristics of the devices were tested for the detection of CO and CO2 gases at temperatures from 25 to 75 °C, with and without palladium nanoparticle deposition in a wide concentration range of 40-1360 ppm. The results showed an improvement in the relative response, response time, and recovery, both with increasing temperature and with surface decoration using Pd nanoparticles. These features make this class of sensors important candidates for CO and CO2 detection for human health.

Active-electrode biosensor of SnO2 nanowire for cyclodextrin detection from microbial enzyme.

Cyclodextrin (CD) is a conical compound used in food and pharmaceutical industry to complexation of hydrophobic substances. It is a product of microbial enzymes which converts starch into CD during their activity. We aim to detect CD using active-electrode biosensor of SnO2. They were grown on active electrode by the VLS method. The CD consists of several glucose units which have hydroxyl groups which tend to bind to interface states present in nanowires changing their conductivity. Experimental results of electrical conductivity at different CD concentrations are presented. A model that describes the influence of adsorbed glucose on nanowires and its electrical properties is also presented. Some general observations are performed on the applicability of the CD adsorption method by the nanowire-based biosensor.

Overall Results for a National Program of Photodynamic Therapy for Basal Cell Carcinoma: A Multicenter Clinical Study to Bring New Techniques to Social Health Care.

Along the past years, a national program to implement photodynamic therapy (PDT) for nonmelanoma skin cancer (NMSC) was performed over the Brazilian territory. Using a strategy involving companies, national bank, and medical partners, equipment, medication, and protocols were tested in a multicenter study. With results collected over 6 years, we could reach a great deal of advances concerning the use of PDT for skin cancer. We present the overall reached results of the program and discuss several aspects about it, including public politics of treatment. A discussion about advantages of this technique within conditions of health care is placed, comparing PDT with surgery, including an analysis about the implementation of PDT in countries in development as Brazil, considering not only technical but social aspects, as the distribution of medical doctor in the Brazilian territory. The program resulted in a huge dissemination of PDT in Brazil and many countries in Latin America, in a partnership among public politics, universities, companies, and hospitals and clinics and in the insertion of national technologies as option to treat NMSC. Consequence of the program is mainly the continuation of the use of PDT in Brazil and many countries in Latin America.

A Multicenter Clinical Study of Expected and Unexpected Side Reactions During and After Skin Cancer Treatment by Photodynamic Therapy.

Photodynamic therapy (PDT) has been widely used for oncologic indications, especially nonmelanoma skin cancer such as superficial and nodular basal cell carcinoma (BCC). We present a multicenter clinical study conducted between 2012 and 2014 analyzing the adverse reactions during and after PDT with a standardized protocol in 866 lesions. A total of 728 patients with positive clinical and histopathological diagnosis for BCC with up to 2 cm diameter were treated. The procedure consisted of curettage and topical application of cream containing 20% methyl 5-aminolevulinate. The illumination (630 nm and 150 J/cm2) was performed 3 hours after the cream application. The expected and unexpected effects observed were pain, healing, and inflammatory reactions. The pain intensity was correlated with the anatomical localization of the lesion. The patients reported a higher intensity of pain in lesions located on the head and neck rather than on the trunk and limbs. The number of sessions also influenced the pain response. A total of 83% of patients showed perfect healing and the other 17% presented abnormal healing. PDT plays an important role in BCC because of its low cost, ease of use, and low rate of side effects.

Enhancing the efficacy of antimicrobial photodynamic therapy through curcumin modifications.

Curcumin serves as a photosensitizer (PS) in the context of microbial inactivation when subjected to light exposure, to produce reactive oxygen species, which exhibit efficacy in eradicating microorganisms. This remarkable property underscores the growing potential of antimicrobial photodynamic therapy (aPDT) in the ongoing fight against bacterial infections. Considering this, we investigate the efficacy of various in vitro curcumin formulations within a PDT protocol designed to target Staphylococcus aureus. Specifically, we conduct a comparative analysis involving synthetic curcumin (Cur-Syn) and curcumin derivatives modified with chlorine (Cl), selenium (Se), and iodine (I) (Cur-Cl, Cur-Se, Cur-I). To assess the impact of aPDT, we subject S. aureus to incubation with curcumin, followed by irradiation at 450 nm with energy doses of 3.75, 7.5, and 15 J/cm2. Our investigation encompasses an evaluation of PS uptake and photobleaching across the various curcumin variants. Notably, all three modifications (Cur-Cl, Cur-Se, Cur-I) induce a significant reduction in bacterial viability, approximately achieving a 3-log reduction. Interestingly, the uptake kinetics of Cur-Syn and Cur-Se exhibit similarities, reaching saturation after 20 min. Our findings suggest that modifications to curcumin have a discernible impact on the photodynamic properties of the PS molecule.

Physicochemical mechanisms of bacterial response in the photodynamic potentiation of antibiotic effects.

Antibiotic failures in treatments of bacterial infections from resistant strains have been a global health concern, mainly due to the proportions they can reach in the coming years. Making microorganisms susceptible to existing antibiotics is an alternative to solve this problem. This study applies a physicochemical method to the standard treatment for modulating the synergistic response towards circumventing the mechanisms of bacterial resistance. Photodynamic inactivation protocols (curcumina 10 µM, 10 J/cm2) and their cellular behavior in the presence of amoxicillin, erythromycin, and gentamicin antibiotics were analyzed from the dynamics of bacterial interaction of a molecule that produces only toxic effects after the absorption of a specific wavelength of light. In addition to bacterial viability, the interaction of curcumin, antibiotics and bacteria were imaged and chemically analyzed using confocal fluorescence microscopy and Fourier-transform infrared spectroscopy (FTIR). The interaction between therapies depended on the sequential order of application, metabolic activity, and binding of bacterial cell surface biomolecules. The results demonstrated a potentiating effect of the antibiotic with up to to 32-fold reduction in minimum inhibitory concentrations and mean reductions of 7 log CFU/ml by physicochemical action at bacterial level after the photodynamic treatment. The changes observed as a result of bacteria-antibiotic interactions, such as membrane permeabilization and increase in susceptibility, may be a possibility for solving the problem of microbial multidrug resistance.

Formulations of curcumin and d-mannitol as a photolarvicide against Aedes aegypti larvae: Sublethal photolarvicidal action, toxicity, residual evaluation, and small-scale field trial.

Dengue, Zika, chikungunya, and yellow fever are arboviruses transmitted by Aedes aegypti mosquito. In this regard, a number of techniques have emerged aiming to combat its proliferation. Elimination of Aedes aegypti larvae by photodynamic action has been reported as an efficient approach. In this regard, this study was aimed at synthetize and characterize formulations with different proportions (w/w) of the plant-based photolarvicidal curcumin and d-mannitol (CCD 1-4) and their evaluation on sublethal photolarvicidal efficiency, photodegradation profile,solubility, internalization, elimination time, persistence in simulated field, growth of microorganisms in water and the toxicity using an animal models (Zebrafish). CCD 3 (curcumin:d-mannitol 50:50 w/w) showed the best efficacy (LC50-24h = 0.01 mg/L), and also presented the shortest internalization and longest elimination time, 60 min and 8 days, respectively. This formulation caused an extrusion into the intestine and peritrophic membrane. Moreover, CCD 3 showed a photodegradation of 50% (in 24 h) under white fluorescent lamps. In a small-scale field trial, CCD 3 had a residual time of 14 days and abnormal microbial growth was not observed. Finally, CCD 3 did not present any toxicity in Zebrafish, after exposition for 24 h at 100 mg/L. Overall, these results raise the possibility of reducing virus transmission through the controlled photoinactivation of Aedes aegypti larvae using a non-toxic plant-based formulated photolarvicide.

Synergic dual phototherapy: Cationic imidazolyl photosensitizers and ciprofloxacin for eradication of in vitro and in vivo E. coli infections.

The emergence of new microorganisms with resistance to current antimicrobials is one of the key issues of modern healthcare that must be urgently addressed with the development of new molecules and therapies. Photodynamic inactivation (PDI) in combination with antibiotics has been recently regarded as a promising wide-spectrum therapy for the treatment of localized topical infections. However, further studies are required regarding the selection of the best photosensitizer structures and protocol optimization, in order to maximize the efficiency of this synergic interaction. In this paper, we present results that demonstrate the influence of the structure of cationic imidazolyl-substituted photosensitizers and light on the enhancement of ciprofloxacin (CIP) activity, for the inactivation of Escherichia coli. Structure-activity studies have highlighted the tetra cationic imidazolyl porphyrin IP-H-Me4+ at sub-bactericide concentrations (4-16 nM) as the most promising photosensitizer for combination with sub-inhibitory CIP concentration (<0.25 mg/L). An optimized dual phototherapy protocol using this photosensitizer was translated to in vivo studies in mice wounds infected with E. coli. This synergic combination reduced the amount of photosensitizer and ciprofloxacin required for full E. coli inactivation and, in both in vitro and in vivo studies, the combination therapy was clearly superior to each monotherapy (PDI or ciprofloxacin alone). Overall, these findings highlight the potential of cationic imidazolyl porphyrins in boosting the activity of antibiotics and lowering the probability of resistance development, which is essential for a sustainable long-term treatment of infectious diseases.

Photodynamic viral inactivation: Recent advances and potential applications.

Antibiotic-resistant bacteria, which are growing at a frightening rate worldwide, has put the world on a long-standing alert. The COVID-19 health crisis reinforced the pressing need to address a fast-developing pandemic. To mitigate these health emergencies and prevent economic collapse, cheap, practical, and easily applicable infection control techniques are essential worldwide. Application of light in the form of photodynamic action on microorganisms and viruses has been growing and is now successfully applied in several areas. The efficacy of this approach has been demonstrated in the fight against viruses, prompting additional efforts to advance the technique, including safety use protocols. In particular, its application to suppress respiratory tract infections and to provide decontamination of fluids, such as blood plasma and others, can become an inexpensive alternative strategy in the fight against viral and bacterial infections. Diverse early treatment methods based on photodynamic action enable an accelerated response to emerging threats prior to the availability of preventative drugs. In this review, we evaluate a vast number of photodynamic demonstrations and first-principle proofs carried out on viral control, revealing its potential and encouraging its rapid development toward safe clinical practice. This review highlights the main research trends and, as a futuristic exercise, anticipates potential situations where photodynamic treatment can provide a readily available solution.

COVID-19: Beyond the virus. The use of photodynamic therapy for the treatment of infections in the respiratory tract.

•The World today is facing a great effort for the control of infections.•Nowadays COVID-19 is the large global outbreak and is the major public health issue.•This letter to Editor highlighted the well-established photodynamic therapy protocol as a tool to decrease the viral and bacterial load in the respiratory tract.

A New Possibility for Fermentation Monitoring by Electrical Driven Sensing of Ultraviolet Light and Glucose.

Industrial fermentation generates products through microbial growth associated with the consumption of substrates. The efficiency of industrial production of high commercial value microbial products such as ethanol from glucose (GLU) is dependent on bacterial contamination. Controlling the sugar conversion into products as well as the sterility of the fermentation process are objectives to be considered here by studying GLU and ultraviolet light (UV) sensors. In this work, we present two different approaches of SnO2 nanowires grown by the Vapor-Liquid-Solid (VLS) method. In the GLU sensor, we use SnO2 nanowires as active electrodes, while for the UV sensor, a nanowire film was built for detection. The results showed a wide range of GLU sensing and as well as a significant influence of UV in the electrical signal. The effect of a wide range of GLU concentrations on the responsiveness of the sensor through current-voltage based on SnO2 nanowire films under different concentration conditions ranging was verified from 1 to 1000 mmol. UV sensors show a typical amperometric response of SnO2 nanowires under the excitation of UV and GLU in ten cycles of 300 s with 1.0 V observing a stable and reliable amperometric response. GLU and UV sensors proved to have a promising potential for detection and to control the conversion of a substrate into a product by GLU control and decontamination by UV control in industrial fermentation systems.

Antibacterial Photodynamic Inactivation of Antibiotic-Resistant Bacteria and Biofilms with Nanomolar Photosensitizer Concentrations.

Gram-negative bacteria and bacteria in biofilms are very difficult to eradicate and are the most antibiotic-resistant bacteria. Therapeutic alternatives less susceptible to mechanisms of resistance are urgently needed to respond to an alarming increase of resistant nosocomial infections. Antibacterial photodynamic inactivation (PDI) generates oxidative stress that triggers multiple cell death mechanisms that are more difficult to counteract by bacteria. We explore PDI of multidrug-resistant bacterial strains collected from patients and show how positive charge distribution in the photosensitizer drug impacts the efficacy of inactivation. We demonstrate the relevance of size for drug diffusion in biofilms. The designed meso-imidazolyl porphyrins of small size with positive charges surrounding the macrocycle enabled the inactivation of bacteria in biofilms by 6.9 log units at 5 nM photosensitizer concentration and 5 J cm-2, which offers new opportunities to treat biofilm infections.

Biofilm Destruction on Endotracheal Tubes by Photodynamic Inactivation.

BACKGROUND: Hospital infections are a public health problem that can occur with the use of catheters and endotracheal tubes (ETT). Pathogenic microorganisms may adhere to surfaces of these materials forming a biofilm and produce an extracellular polymer matrix that promotes resistance of microorganisms to factors such as pH, temperature and drugs. The conventional treatment is being made by antibiotics, which has serious adverse effects in immunocompromised patients. Photodynamic therapy (PDT) is an alternative for microbial inactivation noninvasive without the stimulus of microbial resistance. PDT combines light and a photosensitive molecule for produce reactive oxygen species leading to bacterial death. OBJECTIVE: The objective of this study was to determine the efficacy of a PDT protocol in bacterial inactivation of biofilm ETT. METHOD: The photosensitizer (PS) used was curcumin and the light source LED at 450nm. A statistical experimental design was used for optimization of antimicrobial PDT. RESULTS: The highest microbial inactivation was observed with 70% biofilm reduction in conditions 1.25 mg/mL curcumin, 2 h of PS incubation and 50 J/cm2. CONCLUSION: This study described the photodynamic death of bacteria forming a biofilm on ETT. Parameters optimization was important for clinical application of this system.