Abstract
Human skin banks around the world face a serious problem with the high number of allogeneic skins that are discarded and cannot be used for grafting due to persistent bacterial contamination even after antibiotic treatment. The biofilm formation capacity of these microorganisms may contribute to the antibiotic tolerance; however, this is not yet widely discussed in the literature. Thisstudy analyzed bacterial strains isolated from allogeneic human skin samples,which were obtained from a hospital skin bank that had already been discardeddue to microbial contamination. Biofilm formation and susceptibility topenicillin, tetracycline, and gentamicin were evaluated by crystal violetbiomass quantification and determination of the minimum inhibitoryconcentration (MIC), minimum biofilm inhibitory concentration (MBIC), andminimum biofilm eradication concentration (MBEC) by the broth microdilutionmethod with resazurin dye. A total of 216 bacterial strains were evaluated, and204 (94.45%) of them were classified as biofilm formers with varying degrees ofadhesion. MBICs were at least 512 times higher than MICs, and MBECs were atleast 512 times higher than MBICs. Thus, the presence of biofilm in allogeneicskin likely contributes to the inefficiency of the applied treatments as antibiotictolerance is known to be much higher when bacteria are in the biofilmconformation. Thus, antibiotic treatment protocols in skin banks shouldconsider biofilm formation and should include compounds with antibiofilmaction.
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References
Johnston C, Callum J, Mohr J et al (2016) Disinfection of human skin allografts in tissue banking: a systematic review report. Cell Tissue Bank 17:585–592. https://doi.org/10.1007/s10561-016-9569-2
Singh R, Singh D, Singh A (2016) Radiation sterilization of tissue allografts: a review World. J Radiol 8:355–369. https://doi.org/10.1007/s10561-021-09946-4
Pirnay JP, Verween G, Pascual B et al (2012) Evaluation of a microbiological screening and acceptance procedure for cryopreserved skin allografts based on 14 day cultures. Cell Tissue Bank 13:287–295. https://doi.org/10.1007/s10561-011-9256-2
Gaucher S, Khaznadar Z, Gourevitch JC, Jarraya M (2016) Skin donors and human skin allografts: evaluation of an 11-year practice and discard in a referral tissue bank. Cell Tissue Bank 17:11–19. https://doi.org/10.1007/s10561-015-9528-3
Obeng MK, McCauley RL, Barnett JR, Heggers JP, Sheridan K, Schutzler SS (2001) Cadaveric allograft discards as a result of positive skin cultures. Burns 27:267–271. https://doi.org/10.1016/S0305-4179(00)00116-9
Pianigiani E, Ierardi F, Cuciti C, Brignali S, Oggioni M, Fimiani M (2010) Processing efficacy in relation to microbial contamination of skin allografts from 723 donors. Burns 36:347–351. https://doi.org/10.1016/j.burns.2009.04.020
Eastlund T (2006) Bacterial infection transmitted by human tissue allograft transplantation. Cell Tissue Bank 7:147–166. https://doi.org/10.1007/s10561-006-0003-z
Silva CRM, Borges ML, Watanabe CM, Diogo Filho A, Gontijo Filho PP (2002) Centros cirúrgicos e microflora ambiental nas salas de cirurgia dos hospitais de Uberlância, Minas Gerais. Bioscience J:14
Ghalavand Z, HeidaryRouchi A, Bahraminasab H et al (2018) Molecular testing of Klebsiella pneumoniae contaminating tissue allografts recovered from deceased donors. Cell Tissue Bank 19:391–398. https://doi.org/10.1007/s10561-018-9684-3
Pitt TL, Tidey K, Roy A, Ancliff S, Lomas R, McDonald CP (2014) Activity of four antimicrobial cocktails for tissue allograft decontamination against bacteria and Candida spp. of known susceptibility at different temperatures. Cell Tissue Bank 15:119–125. https://doi.org/10.1007/s10561-013-938391-3982-0
Rooney P, Eagle M, Hogg P, Lomas R, Kearney J (2008) Sterilisation of skin allograft with gamma irradiation. Burns 34:664–673. https://doi.org/10.1016/j.burns.2007.08.021
Meneghetti KL, do Canto Canabarro M, Otton LM, Dos Santos Hain T, Geimba MP, Corção G, (2018) Bacterial contamination of human skin allografts and antimicrobial resistance: a skin bank problem. BMC Microbiol 18:121. https://doi.org/10.1186/s12866-018-1261-1
Birk SE, Haagensen JAJ, Johansen HK, Molin S, Nielsen LH, Boisen A (2020) Microcontainer delivery of antibiotic improves treatment of Pseudomonas aeruginosa biofilms. Adv Healthc Mater 9:e1901779. https://doi.org/10.1002/adhm.202070027
del Pozo JL, Patel R (2007) The challenge of treating biofilm-associated bacterial infections. Clin Pharmacol Ther 82:204–209. https://doi.org/10.1038/sj.clpt.6100247
Omar A, Wright JB, Schultz G, Burrell R, Nadworny P (2017) Microbial biofilms and chronic wounds. Microorganisms : 5. https://doi.org/10.3390/microorganisms5010009
Welch K, Cai Y, Strømme M (2012) A method for quantitative determination of biofilm viability. J Funct Biomater 3:418–431. https://doi.org/10.3390/jfb3020418
Macià MD, Rojo-Molinero E, Oliver A (2014) Antimicrobial susceptibility testing in biofilm-growing bacteria. Clin Microbiol Infect 20:981–990. https://doi.org/10.1111/1469-0691.12651
Mah TF, O’Toole GA (2001) Mechanisms of biofilm resistance to antimicrobial agents. Trends Microbiol 9:34–39. https://doi.org/10.1016/S0966-842X(00)01913-2
Marcinkiewicz J, Strus M, Pasich E (2013) Antibiotic resistance: a “dark side” of biofilm-associated chronic infections. Pol Arch Med Wewn 123:309–313
Høiby N, Ciofu O, Johansen HK et al (2011) The clinical impact of bacterial biofilms. Int J Oral Sci 3:55–65. https://doi.org/10.4248/IJOS11026
Olsen I (2015) Biofilm-specific antibiotic tolerance and resistance. Eur J Clin Microbiol Infect Dis 34:877–886. https://doi.org/10.1007/s10096-015-2323-z
Venkatesan N, Perumal G, Doble M (2015) Bacterial resistance in biofilm-associated bacteria. Future Microbiol 10:1743–1750. https://doi.org/10.2217/fmb.15.69
Iliescu Nelea M, Paek L, Dao L et al (2019) In-situ characterization of the bacterial biofilm associated with Xeroform TM and Kaltostat TM dressings and evaluation of their effectiveness on thin skin engraftment donor sites in burn patients. Burns 45:1122–1130. https://doi.org/10.1016/j.burns.2019.02.024
Russu E, Mureșan A, Grigorescu B (2011) Vascular graft infections management. Manag Health 15:16–19
Trampuz A, Zimmerli W (2006) Diagnosis and treatment of infections associated with fracture-fixation devices. Injury 37:S59-66. https://doi.org/10.1016/j.injury.2006.04.010
Peeters A, Putzeys G, Thorrez L (2019) Current insights in the application of bone grafts for local antibiotic delivery in bone reconstruction surgery. J Bone Joint Infect 4:245–253. https://doi.org/10.7150/jbji.38373
Mathur T, Singhal S, Khan S, Upadhyay DJ, Fatma T, Rattan A (2006) Detection of biofilm formation among the clinical isolates of Staphylococci: an evaluation of three different screening methods. Indian J Med Microbiol 24:25–29. https://doi.org/10.1016/S0255-0857(21)02466-X
Suzuki T, Kawamura Y, Uno T, Ohashi Y, Ezaki T (2005) Prevalence of Staphylococcus epidermidis strains with biofilm-forming ability in isolates from conjunctiva and facial skin. Am J Ophthalmol 140:844–850. https://doi.org/10.1016/j.ajo.2005.05.050
Clauss M, Tafin UF, Bizzini A, Trampuz A, Ilchmann T (2013) Biofilm formation by staphylococci on fresh, fresh-frozen and processed human and bovine bone grafts. Eur Cell Mater 25:159–166. https://doi.org/10.22203/ecm.v025a11
Cairns LS, Hobley L, Stanley-Wall NR (2014) Biofilm formation by Bacillus subtilis: new insights into regulatory strategies and assembly mechanisms. Mol Microbiol 93:587–598. https://doi.org/10.1111/mmi.12697
Tran SL, Guillemet E, Gohar M, Lereclus D, Ramarao N (2010) CwpFM (EntFM) is a Bacillus cereus potential cell wall peptidase implicated in adhesion, biofilm formation, and virulence. J Bacteriol 192:2638–2642. https://doi.org/10.1128/JB.01315-09
Stepanovic S, Vukovic D, Dakic I, Savic B, Svabic-Vlahovic M (2000) A modified microtiter-plate test for quantification of staphylococcal biofilm formation. J Microbiol Meth 40:175–179. https://doi.org/10.1016/S0167-7012(00)00122-6
CLSI (2017) Performance standards for antimicrobial susceptibility testing. 27th ed. CLSI supplement M100. Wayne, PA: Clinical and Laboratory Standards Institute
CLSI (2010) Methods for antimicrobial dilution and disk susceptibility testing of infrequently isolated or fastidious bacteria. In. Second Edition M45-A2 ed. Wayne, PA: Clinical and Laboratory Standards Institute
Pettit RK, Weber CA, Kean MJ et al (2005) Microplate Alamar blue assay for Staphylococcus epidermidis biofilm susceptibility testing. Antimicrob Agents Chemother 49:2612–2617. https://doi.org/10.1128/AAC.49.7.2612-2617.2005
Flemming K, Klingenberg C, Cavanagh JP et al (2009) High in vitro antimicrobial activity of synthetic antimicrobial peptidomimetics against staphylococcal biofilms. J Antimicrob Chemother 63:136–145. https://doi.org/10.1093/jac/dkn464
Matioski AR, Pereira da Silva CRGB, Silva-Cunha DR, Calomeno LHA, Bonato FT, Nigro MVA (2015) First-year experience of a new skin bank in Brazil. Plastic and Aesthetic Research 2:6. https://doi.org/10.4103/2347-9264.169496
Bockstael K, Geukens N, Van Mellaert L, Herdewijn P, Anné J, Van Aerschot A (2009) Evaluation of the type I signal peptidase as antibacterial target for biofilm-associated infections of Staphylococcus epidermidis. Microbiology 155:3719–3729. https://doi.org/10.1099/mic.0.031765-0
Ciofu O, Rojo-Molinero E, Macià MD, Oliver A (2017) Antibiotic treatment of biofilm infections. APMIS 125:304–319. https://doi.org/10.1111/apm.12673
Pettit RK, Weber CA, Pettit GR (2009) Application of a high throughput Alamar blue biofilm susceptibility assay to Staphylococcus aureus biofilms. Ann Clin Microbiol Antimicrob 8:28. https://doi.org/10.1186/1476-0711-8-28
Mottola C, Matias CS, Mendes JJ et al (2016) Susceptibility patterns of Staphylococcus aureus biofilms in diabetic foot infections. BMC Microbiol 16:119. https://doi.org/10.1186/s12866-016-0737-0
Setlow P (2014) Germination of spores of Bacillus species: what we know and do not know. J Bacteriol 196:1297–1305. https://doi.org/10.1128/JB.01455-13
Fisher RA, Gollan B, Helaine S (2017) Persistent bacterial infections and persister cells. Nat Rev Microbiol 15:453–464. https://doi.org/10.1038/nrmicro.2017.42
Knobloch JK, Von Osten H, Horstkotte MA, Rohde H, Mack D (2002) Minimal attachment killing (MAK): a versatile method for susceptibility testing of attached biofilm-positive and -negative Staphylococcus epidermidis. Med Microbiol Immunol 191:107–114. https://doi.org/10.1007/s00430-002-0125-2
Labthavikul P, Petersen PJ, Bradford PA (2003) In vitro activity of tigecycline against Staphylococcus epidermidis growing in an adherent-cell biofilm model. Antimicrob Agents Chemother 47:3967–3969. https://doi.org/10.1128/AAC.47.12.3967-3969.2003
Pibalpakdee P (2012) Wongratanacheewin S, Taweechaisupapong S, Niumsup PR. Diffusion and activity of antibiotics against Burkholderiapseudomallei biofilms. Int J Antimicrob Agents 39:356–359. https://doi.org/10.1016/j.ijantimicag.2011.12.010
Sawasdidoln C, Taweechaisupapong S, Sermswan RW, Tattawasart U, Tungpradabkul S, Wongratanacheewin S (2010) Growing Burkholderiapseudomallei in biofilm stimulating conditions significantly induces antimicrobial resistance. PLoS ONE 5:e9196. https://doi.org/10.1371/journal.pone.0009196
Toté K, Berghe DV, Deschacht M, de Wit K, Maes L, Cos P (2009) Inhibitory efficacy of various antibiotics on matrix and viable mass of Staphylococcus aureus and Pseudomonas aeruginosa biofilms. Int J Antimicrob Agents 33:525–531. https://doi.org/10.1016/j.ijantimicag.2008.11.004
Acknowledgements
We would like to thank Aline Francielle Damo Souza and Luana Pretto from the skin bank of Dr. Roberto Corrêa Chem from the Hospital Complex Santa Casa de Misericórdia de Porto Alegre for preparing the skin allografts samples for this study.
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This study was financed in part by the Coordination of Superior Level Staff Improvement–Brazil (CAPES).
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Conceptualization and design: Karine Lena Meneghetti, Mercedes Passos Geimba, Gertrudes Corção. Methodology: Micaela do Canto Canabarro, Karine Lena Meneghetti. Formal analysis and investigation: Micaela do Canto Canabarro, Karine Lena Meneghetti. Writing—original draft preparation: Micaela do Canto Canabarro. Writing—review and editing: Karine Lena Meneghetti, Mercedes Passos Geimba, Gertrudes Corção. Supervision: Mercedes Passos Geimba, Gertrudes Corção. Funding acquisition: Gertrudes Corção. All authors read and approved the final manuscript.
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This study was approved by the Research Ethics Committees of Universidade Federal do Rio Grande do Sul (protocol CAAE 36949514.8.0000.5347) and of Irmandade da Santa Casa de Misericórdia de Porto Alegre (protocol CAAE 45100215.1.0000.5335).
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do Canto Canabarro, M., Meneghetti, K.L., Geimba, M.P. et al. Biofilm formation and antibiotic susceptibility of Staphylococcus and Bacillus species isolated from human allogeneic skin. Braz J Microbiol 53, 153–160 (2022). https://doi.org/10.1007/s42770-021-00642-9
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DOI: https://doi.org/10.1007/s42770-021-00642-9