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The Combination of Low-Frequency Ultrasound and Antibiotics Improves the Killing of In Vitro <i>Staphylococcus aureus</i> and <i>Pseudomonas aeruginosa</i> Biofilms
oleh: Lasse Kvich, Mads H. Christensen, Malgorzata K. Pierchala, Konstantin Astafiev, Rasmus Lou-Moeller, Thomas Bjarnsholt
Format: | Article |
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Diterbitkan: | MDPI AG 2022-10-01 |
Deskripsi
Due to an increase in underlying predisposing factors, chronic wounds have become an increasing burden on healthcare systems worldwide. Chronic infections often contain biofilm-forming bacteria, which are challenging to eradicate due to increased antibiotic tolerance; thus, new and improved therapeutic strategies are warranted. One such strategy is the combination of ultrasound and antibiotics. Therefore, this study aimed to investigate the combinatory effects of low-frequency (50 kHz) ultrasound delivered by specially designed ultrasound patches using flexible piezoelectric material, PiezoPaint™, in combination with antibiotics against biofilms with <i>Staphylococcus aureus</i> and <i>Pseudomonas aeruginosa</i>. The reduction in viable cells in <i>S. aureus</i> and <i>P. aeruginosa</i> biofilms was evaluated post-treatment with fusidic acid, clindamycin, ciprofloxacin, and colistin in combination with ultrasound treatment. Two-hour ultrasound treatment significantly increased the bactericidal effect of all four antibiotics, resulting in a 96–98% and 90–93% reduction in <i>P. aeruginosa</i> and <i>S. aureus</i>, respectively. In addition, an additive effect was observed when extending treatment to 4 h, resulting in >99% and 95–97% reduction in <i>P. aeruginosa</i> and <i>S. aureus</i>, respectively. These results contrasted the lack of effect observed when treating filter-biofilms with antibiotics alone. The combined effect of ultrasound and antibiotic treatment resulted in a synergistic effect, reducing the viability of the clinically relevant pathogens <i>S. aureus</i> and <i>P. aeruginosa</i>. The modularity of the specially designed patches intended for topical treatment holds promising applications as a supplement in chronic wound therapy. Further studies are warranted with clinically isolated strains and other clinically relevant antibiotics before proceeding to studies where safety and applicability are investigated.