Synergistic in vitro effects of indocyanine green and ethylenediamine tetraacetate-mediated antimicrobial photodynamic therapy combined with antibiotics for resistant bacterial biofilms in diabetic foot infection
Synergistic in vitro effects of indocyanine green and ethylenediamine tetraacetate-mediated antimicrobial photodynamic therapy combined with antibiotics for resistant bacterial biofilms in diabetic foot infection
复制标题
吲哚菁绿和乙二胺四乙酸介导的抗菌光动力疗法联合抗生素对糖尿病足感染耐药细菌生物膜的体外协同作用
DOI：
10.1016/j.pdpdt.2019.01.010
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发表时间：
2019-03-01
影响因子：
3.3
通讯作者：
Zhu, Shenyin
中科院分区：
文献类型：
--
作者：
Li, Xuemei;Huang, Wanting;Zhu, Shenyin
背景：抗生素耐药性已成为糖尿病足感染结局的最重要决定因素之一。抗微生物光动力疗法（A-PDT）或光动力抗微生物化学疗法（PACT）已被提出作为灭活细菌，特别是耐药细菌生物膜的替代方法。本研究探讨了光敏剂吲哚菁绿色（ICG）和乙二胺四乙酸（EDTA）介导的PACT与抗生素联合应用对糖尿病足溃疡常见病原菌金黄色葡萄球菌（Staphylococcus aureus）和铜绿假单胞菌（Pseudomonas aeruginosa）的体外协同作用。金黄色葡萄球菌和铜绿假单胞菌与ICG和EDTA一起孵育，然后暴露于激光处理。定量活菌计数估计了光毒性效应对S。金黄色葡萄球菌和铜绿假单胞菌。耐甲氧西林的S.采用纸片扩散法和微量肉汤稀释法检测耐药金黄色葡萄球菌（MRSA）和多重耐药铜绿假单胞菌（MRPA）。采用共聚焦显微镜观察PACT和抗生素处理后生物膜的形态。结果：ICG和EDTA介导的PACT对S.与ICG单独介导的PACT相比，金黄色葡萄球菌和铜绿假单胞菌。铜绿假单胞菌对ICG和EDTA介导的PACT比S.金黄色。PACT治疗后MRSA和MRPA对抗生素的敏感性增加。结论：ICG和EDTA介导的PACT与抗生素联合应用可协同增强杀菌和破坏生物膜的效果。
Background: Antibiotic resistance has emerged as one of the most important determinants in diabetic foot infections outcomes. Antimicrobial Photodynamic therapy(A-PDT) or Photodynamic antimicrobial chemotherapy (PACT) has been proposed as an alternative approach for inactivating bacteria, especially resistant bacterial biofilms. This research investigated the synergistic effects of PACT mediated by the photosensitizer indocyanine green (ICG) and ethylenediamine tetraacetate (EDTA) combined with antibiotics against common pathogens of diabetic foot ulcer infection, including Staphylococcus aureus and Pseudomonas aeruginosa, in vitro.Methods: Planktonic bacteria and biofilms of S. aureus and P. aeruginosa were incubated with ICG and EDTA, and then exposed to laser treatment. Quantitative viable counting estimates the phototoxic effects on S. aureus and P. aeruginosa. The susceptibility of methicillin-resistant S. aureus (MRSA) and multidrug-resistant P. aeruginosa (MRPA) to PACT treatment was detected by disk diffusion and micro-broth dilution methods. Confocal microscopy was used to detect the morphology of biofilms treated with PACT and antibiotics. The resazurin assay was used to quantify the metabolic activity of bacteria in biofilms.Results: PACT mediated by ICG and EDTA led to a more pronounced antibacterial effect in S. aureus and P. aeruginosa compared with ICG alone-mediated PACT. P. aeruginosa was more sensitive to ICG and EDTA-mediated PACT than S. aureus. After PACT treatment, the susceptibility of MRSA and MRPA to antibiotics increased. Furthermore, PACT combined with antibiotic treatment significantly contributed to killing bacteria in the biofilm and disrupting biofilm structure.Conclusions: ICG and EDTA-mediated PACT combined with antibiotics synergistically enhanced the effects of sterilization and biofilm destruction.