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Treatment of a cochlear implant biofilm infection: a potential role for alternative antimicrobial agents

Published online by Cambridge University Press:  10 March 2010

A J Brady ,
T B Farnan ,
J G Toner ,
D F Gilpin  and
M M Tunney
A J Brady*
Affiliation:
Clinical and Practice Research Group, School of Pharmacy, Queen's University Belfast Medical Biology Centre, Northern Ireland, UK
T B Farnan
Affiliation:
Department of Otolaryngology, Belfast City Hospital, Belfast Health and Social Care Trust, Northern Ireland, UK
J G Toner
Affiliation:
Department of Otolaryngology, Belfast City Hospital, Belfast Health and Social Care Trust, Northern Ireland, UK
D F Gilpin
Affiliation:
Clinical and Practice Research Group, School of Pharmacy, Queen's University Belfast Medical Biology Centre, Northern Ireland, UK
M M Tunney
Affiliation:
Clinical and Practice Research Group, School of Pharmacy, Queen's University Belfast Medical Biology Centre, Northern Ireland, UK
*
Address for correspondence: Dr A J Brady, 74 Priory Park, Belfast, BT10 0AG, Northern Ireland, UK. Fax: +44(0) 2890247794 E-mail: aaron.brady@qub.ac.uk
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Abstract

Objective:

This study aimed to investigate antimicrobial treatment of an infected cochlear implant, undertaken in an attempt to salvage the infected device.

Methods:

We used the broth microdilution method to assess the susceptibility of meticillin-sensitive Staphylococcus aureus isolate, cultured from an infected cochlear implant, to common antimicrobial agents as well as to novel agents such as tea tree oil. To better simulate in vivo conditions, where bacteria grow as microcolonies encased in glycocalyx, the bactericidal activity of selected antimicrobial agents against the isolate growing in biofilm were also compared.

Results:

When grown planktonically, the S aureus isolate was susceptible to 17 of the 18 antimicrobials tested. However, when grown in biofilm, it was resistant to all conventional antimicrobials. In contrast, 5 per cent tea tree oil completely eradicated the biofilm following exposure for 1 hour.

Conclusion:

Treatment of infected cochlear implants with novel agents such as tea tree oil could significantly improve salvage outcome.

Keywords

Cochlear implantsBiofilmsTea-Tree Oil

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 7 , July 2010 , pp. 729 - 738
Copyright
Copyright © JLO (1984) Limited 2010

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References

1Trinidade, A, Rowlands, G, Obholzer, R, Lavy, J. Late skin flap failure following cochlear implantation. Cochlear Implants Int 2008;9:167–75CrossRefGoogle ScholarPubMed
2Balkany, T, Hodges, AV, Goodman, K. Ethics of cochlear implantation in young children. Otolaryngol Head Neck Surg 1999;121:673–5CrossRefGoogle ScholarPubMed
3Roland, JT Jr, Huang, TC, Cohen, NL. Revision cochlear implantation. Otolaryngol Clin North Am 2006;39:833–9CrossRefGoogle ScholarPubMed
4Lewis, K. Riddle of biofilm resistance. Antimicrob Agents Chemother 2001;45:999–1007CrossRefGoogle ScholarPubMed
5Farnan, TB, McCallum, J, Awa, A, Khan, AD, Hall, SJ. Tea tree oil: in vitro efficacy in otitis externa. J Laryngol Otol 2005;119:198–201CrossRefGoogle ScholarPubMed
6Brady, A, Loughlin, R, Gilpin, D, Kearney, P, Tunney, M. In vitro activity of tea-tree oil against clinical skin isolates of meticillin-resistant and -sensitive Staphylococcus aureus and coagulase-negative staphylococci growing planktonically and as biofilms. J Med Microbiol 2006;55:1375–80CrossRefGoogle ScholarPubMed
7Mack, D, Haeder, M, Siemssen, N, Laufs, R. Association of biofilm production of coagulase-negative staphylococci with expression of a specific polysaccharide intercellular adhesin. J Infect Dis 1996;174:881–4CrossRefGoogle ScholarPubMed
8Wang, X, Preston, JF 3rd, Romeo, T. The pgaABCD locus of Escherichia coli promotes the synthesis of a polysaccharide adhesin required for biofilm formation. J Bacteriol 2004;186:2724–34CrossRefGoogle ScholarPubMed
9Strommenger, B, Kettlitz, C, Werner, G, Witte, W. Multiplex PCR assay for simultaneous detection of nine clinically relevant antibiotic resistance genes in Staphylococcus aureus. J Clin Microbiol 2003;41:4089–94CrossRefGoogle ScholarPubMed
10Andrews, JM. Determination of minimum inhibitory concentrations. J Antimicrob Chemother 2001;48:5–16CrossRefGoogle ScholarPubMed
11Stepanovic, S, Vukovic, D, Dakic, I, Savic, B, Svabic-Vlahovic, M. A modified microtiter-plate test for quantification of staphylococcal biofilm formation. J Microbiol Methods 2000;40:175–9CrossRefGoogle ScholarPubMed
12Cunningham, CD 3rd, Slattery, WH 3rd, Luxford, WM. Postoperative infection in cochlear implant patients. Otolaryngol Head Neck Surg 2004;131:109–14CrossRefGoogle ScholarPubMed
13Howard, NS, Antonelli, PJ. Complications of cochlear implant placement with minimal hair shave. Am J Otolaryngol 2004;25:84–7CrossRefGoogle ScholarPubMed
14Tambyraja, RR, Gutman, MA, Megerian, CA. Cochlear implant complications: utility of federal database in systematic analysis. Arch Otolaryngol Head Neck Surg 2005;131:245–50CrossRefGoogle ScholarPubMed
15Antonelli, PJ, Lee, JC, Burne, RA. Bacterial biofilms may contribute to persistent cochlear implant infection. Otol Neurotol 2004;25:953–7CrossRefGoogle ScholarPubMed
16Pawlowski, KS, Wawro, D, Roland, PS. Bacterial biofilm formation on a human cochlear implant. Otol Neurotol 2005;26:972–5CrossRefGoogle ScholarPubMed
17Hoyle, BD, Jass, J, Costerton, JW. The biofilm glycocalyx as a resistance factor. J Antimicrob Chemother 1990;26:1–5CrossRefGoogle ScholarPubMed
18Buret, A, Ward, KH, Olson, ME, Costerton, JW. An in vivo model to study the pathobiology of infectious biofilms on biomaterial surfaces. J Biomed Mater Res 1991;25:865–74CrossRefGoogle Scholar
19Vlastarakos, P, Nikolopoulos, TP, Maragoudakis, P, Tzagaroulakis, A, Ferekidis, E. Biofilms in ENT infections: How important are they? Laryngoscope 2007;117(4):668–73CrossRefGoogle Scholar
20Ferrini, AM, Mannoni, V, Aureli, P, Salvatore, G, Piccirilli, E, Ceddia, T et al. Melaleuca alternifolia essential oil possesses potent anti-staphylococcal activity extended to strains resistant to antibiotics. Int J Immunopathol Pharmacol 2006;19:539–44CrossRefGoogle ScholarPubMed
21Loughlin, R, Gilmore, BF, McCarron, PA, Tunney, MM. Comparison of the cidal activity of tea tree oil and terpinen-4-ol against clinical bacterial skin isolates and human fibroblast cells. Lett Appl Microbiol 2008;46:428–33CrossRefGoogle ScholarPubMed
22Carson, CF, Cookson, BD, Farrelly, HD, Riley, TV. Susceptibility of methicillin-resistant Staphylococcus aureus to the essential oil of Melaleuca alternifolia. J Antimicrob Chemother 1995;35:421–4CrossRefGoogle Scholar
23Nelson, RR. In-vitro activities of five plant essential oils against methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus faecium. J Antimicrob Chemother 1997;40:305–30CrossRefGoogle ScholarPubMed
24Chan, CH, Loudon, KW. Activity of tea tree oil on methicillin-resistant Staphylococcus aureus (MRSA). J Hosp Infect 1998;39:244–5CrossRefGoogle ScholarPubMed
25Elsom, GK, Hide, D. Susceptibility of methicillin-resistant Staphylococcus aureus to tea tree oil and mupirocin. J Antimicrob Chemother 1999;43:427–8CrossRefGoogle ScholarPubMed
26Banes-Marshall, L, Cawley, P, Phillips, CA. In vitro activity of Melaleuca alternifolia (tea tree) oil against bacterial and Candida spp. isolates from clinical specimens. Br J Biomed Sci 2001;58:139–45Google ScholarPubMed
27Anderson, GG, O'Toole, GA. Innate and induced resistance mechanisms of bacterial biofilms. Curr Top Microbiol Immunol 2008;322:85–105Google ScholarPubMed
28Rohde, H, Burandt, EC, Siemssen, N, Frommelt, L, Burdelski, C, Wurster, S et al. Polysaccharide intercellular adhesin or protein factors in biofilm accumulation of Staphylococcus epidermidis and Staphylococcus aureus isolated from prosthetic hip and knee joint infections. Biomaterials 2007;28:1711–20CrossRefGoogle ScholarPubMed
29Costerton, JW, Montanaro, L, Arciola, CR. Biofilm in implant infections: its production and regulation. Int J Artif Organs 2005;28:1062–8CrossRefGoogle ScholarPubMed
30Olson, ME, Garvin, KL, Fey, PD, Rupp, ME. Adherence of Staphylococcus epidermidis to biomaterials is augmented by PIA. Clin Orthop Relat Res 2006;451:21–4CrossRefGoogle ScholarPubMed
31Rohde, H, Burdelski, C, Bartscht, K, Hussain, M, Buck, F, Horstkotte, MA et al. Induction of Staphylococcus epidermidis biofilm formation via proteolytic processing of the accumulation-associated protein by staphylococcal and host proteases. Mol Microbiol 2005;55:1883–95CrossRefGoogle ScholarPubMed
32Fluckiger, U, Ulrich, M, Steinhuber, A, Doring, G, Mack, D, Landmann, R et al. Biofilm formation, icaADBC transcription, and polysaccharide intercellular adhesin synthesis by staphylococci in a device-related infection model. Infect Immun 2005;73:1811–19CrossRefGoogle Scholar