Photodynamic Therapy of Bacterial and Fungal Biofilm Infections
Photodynamic Therapy of Bacterial and Fungal Biofilm Infections
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DOI：
10.1007/978-1-60761-697-9_13
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发表时间：
2010-01-01
期刊：
影响因子：
--
通讯作者：
Biel, Merrill A.
中科院分区：
文献类型：
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作者：
Biel, Merrill A.
已经发现生物膜参与了体内各种各样的微生物感染，据估计占所有感染的80%。其中涉及生物膜的感染过程包括常见问题，如尿路感染、导管感染、中耳感染、鼻窦炎、牙菌斑形成、牙龈炎、隐形眼镜涂层、心内膜炎、囊性纤维化感染和永久性留置装置如关节假体和心脏瓣膜的感染。生活在生物膜中的细菌通常具有与相同物种的自由漂浮细菌显著不同的特性，因为膜的密集和受保护的环境允许它们以各种方式合作和相互作用。这种环境的一个好处是增加了对清洁剂和抗生素的抵抗力，因为致密的细胞外基质和细胞外层保护了群落的内部。在某些情况下，抗生素耐药性可能增加1000倍。此外，生物膜细菌分泌毒素，可逆地阻断重要的过程，如翻译和保护细胞免受对非活性靶标无效的杀菌抗生素的影响。在头部和颈部区域，生物膜是牙周炎、伤口感染、口腔念珠菌病以及鼻窦和耳部感染的主要病因。在过去的几十年里，文献中已经报道了光动力治疗使用不同的光敏剂、不同波长的光和不同的光源有效地根除各种微生物。PDT已被进一步研究，以证明其根除革兰氏阴性和革兰氏阳性耐药细菌的有效性。本章将重点介绍使用光动力疗法治疗耐药生物膜，耐药伤口感染，并使用亚甲蓝为基础的光动力疗法唑耐药口腔念珠菌病。
Biofilms have been found to be involved in a wide variety of microbial infections in the body, by one estimate 80% of all infections. Infectious processes in which biofilms have been implicated include common problems such as urinary tract infections, catheter infections, middle-ear infections, sinusitis, formation of dental plaque, gingivitis, coating contact lenses, endocarditis, infections in cystic fibrosis, and infections of permanent indwelling devices such as joint prostheses and heart valves. Bacteria living in a biofilm usually have significantly different properties from free-floating bacteria of the same species, as the dense and protected environment of the film allows them to cooperate and interact in various ways. One benefit of this environment is increased resistance to detergents and antibiotics, as the dense extracellular matrix and the outer layer of cells protect the interior of the community. In some cases antibiotic resistance can be increased 1000-fold. Also, the biofilm bacteria excrete toxins that reversibly block important processes such as translation and protecting the cell from bactericidal antibiotics that arc ineffective against inactive targets. In the head and neck area, biofilms are a major etiologic factor in periodontitis, wound infections, oral candidiasis, and sinus and ear infections. For the past several decades, photodynamic treatment has been reported in the literature to be effective in eradicating various microorganisms using different photosensitizers, different wavelengths of light, and different light sources. PDT has been further studied to demonstrate its effectiveness for the eradication of both Gram-negative and Gram-positive antibiotic-resistant bacteria. This chapter will focus on the use of PDT in the treatment of antibiotic-resistant biofilms, antibiotic-resistant wound infections, and azole-resistant oral candidiasis using methylene blue-based photodynamic therapy.