Staphylococcus aureus infections of the skin and soft tissue pose a major concern to public health, largely owing to the steadily increasing prevalence of drug resistant isolates. As an alternative mode of treatment both bacteriophage endolysins and bacteriocins have been shown to possess antimicrobial efficacy against multiple species of bacteria including otherwise drug resistant strains. Despite this, the administration and exposure of such antimicrobials should be restricted until required in order to discourage the continued evolution of bacterial resistance, whilst maintaining the activity and stability of such proteinaceous structures. Utilising the increase in skin temperature during infection, the truncated bacteriophage endolysin CHAPK and the staphylococcal bacteriocin lysostaphin have been co-administered in a thermally triggered manner from Poly(N-isopropylacrylamide) (PNIPAM) nanoparticles. The thermoresponsive nature of the PNIPAM polymer has been employed in order to achieve the controlled expulsion of a synergistic enzybiotic cocktail consisting of CHAPK and lysostaphin. The point at which this occurs is modifiable, in this case corresponding to the threshold temperature associated with an infected wound. Consequently, bacterial lysis was observed at 37 °C, whilst growth was maintained at the uninfected skin temperature of 32 °C.Figure optionsDownload full-size imageDownload high-quality image (85 K)Download as PowerPoint slide

The crystalline biofilms of Proteus mirabilis can seriously complicate the care of patients undergoing long-term indwelling urinary catheterisation. Expression of bacterial urease causes a significant increase in urinary pH, leading to the supersaturation and precipitation of struvite and apatite crystals. These crystals become lodged within the biofilm, resulting in the blockage of urine flow through the catheter. Here, we describe an infection-responsive surface coating for urinary catheters, which releases a therapeutic dose of bacteriophage in response to elevated urinary pH, in order to delay catheter blockage. The coating employs a dual-layered system comprising of a lower hydrogel ‘reservoir’ layer impregnated with bacteriophage, capped by a ‘trigger’ layer of the pH-responsive polymer poly(methyl methacrylate-co-methacrylic acid) (EUDRAGIT®S 100). Evaluation of prototype coatings using a clinically reflective in vitro bladder model system showed that catheter blockage time was doubled (13 h to 26 h (P < 0.05)) under conditions of established infection (108 CFU ml−1) in response to a ‘burst-release’ of bacteriophage (108 PFU ml−1). Coatings were stable both in the absence of infection, and in the presence of urease-negative bacteria. Quantitative and visual analysis of crystalline biofilm reduction show that bacteriophage constitute a promising strategy for the prevention of catheter blockage, a clinical problem for which there is currently no effective control method.

The early detection of wound infection in situ can dramatically improve patient care pathways and clinical outcomes. There is increasing evidence that within an infected wound the main bacterial mode of living is a biofilm: a confluent community of adherent bacteria encased in an extracellular polymeric matrix. Here we have reported the development of a prototype wound dressing, which switches on a fluorescent color when in contact with pathogenic wound biofilms. The dressing is made of a hydrated agarose film in which the fluorescent dye containing vesicles were mixed with agarose and dispersed within the hydrogel matrix. The static and dynamic models of wound biofilms, from clinical strains of Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Enterococcus faecalis, were established on nanoporous polycarbonate membrane for 24, 48, and 72 h, and the dressing response to the biofilms on the prototype dressing evaluated. The dressing indicated a clear fluorescent/color response within 4 h, only observed when in contact with biofilms produced by a pathogenic strain. The sensitivity of the dressing to biofilms was dependent on the species and strain types of the bacterial pathogens involved, but a relatively higher response was observed in strains considered good biofilm formers. There was a clear difference in the levels of dressing response, when dressings were tested on bacteria grown in biofilm or in planktonic cultures, suggesting that the level of expression of virulence factors is different depending of the growth mode. Colorimetric detection on wound biofilms of prevalent pathogens (S. aureus, P. aeruginosa, and E. faecalis) is also demonstrated using an ex vivo porcine skin model of burn wound infection.

The use of hydrogels as safe, biocompatible materials for wound healing has been widely utilized in recent years. Here, we investigated the use of a composite hydrogel to impart a “trigger” mechanism into an antimicrobial hydrogel system. The system was comprised of a bilayer hydrogel architecture: a lower agarose layer containing the antimicrobial virus Bacteriophage K (ΦK) and an upper layer formed of photo-cross-linkable hyaluronic acid methacrylate (HAMA) which creates the hydrogel trigger. This trigger is sensitive to the enzyme hyaluronidase, an enzyme known to be secreted by the majority of Staphylococcus aureus strains. In the presence of hyaluronidase, HAMA is degraded, releasing ΦK into the surrounding environment which consequently go on to kill surrounding bacteria. Our results show that on incubation with hyaluronidase (purified or from S. aureus), large pores form in HAMA as degradation goes on, which facilitates ΦK release.

Phospholipid vesicles have been the focus of attention as potential vehicles for drug delivery, as they are biomimetic, easy to produce, and contain an aqueous compartment which can be used to carry hydrophilic material, such as drugs or dyes. Lipid vesicles used for this purpose present a particular challenge, as they are not especially stable and can rapidly break down and release their contents away from the target area, especially at physiological temperatures/environments. This study aims to investigate optimum methods for vesicle stabilization where the vesicles are employed as part of a system or technology that signals the presence of pathogenic bacteria via the effect of secreted cytolytic virulence factors on a sensor interface.(1) A number of approaches have been investigated and are presented here as a systematic study of the long-term (14 day) stability at 37 °C, and at various pHs. The response of vesicles, both in suspension and within hydrogels, to Staphylococcus aureus (RN 4282) and Pseudomonas aeruginosa (PAO1) whole bacteria, and supernatants from overnight cultures of both (containing secreted proteins but free of cells), was measured via a sensitive encapsulated carboxyfluorescein release assay. The results showed that lipid chain length, cholesterol concentration, and stabilization via photopolymer stable components were critical in achieving stability. Finally, dispersion of the optimum vesicle formulation in hydrogel matrixes was investigated, culminating in the in vivo demonstration of a simple prototype wound dressing.

Thermally responsive Poly(N-isopropylacrylamide) co-allylamine (PNIPAM-co-ALA) nano-gels were synthesised and grafted onto non-woven polypropylene. Silver nitrate was incorporated into the nano-gels in their expanded state and their antimicrobial properties tested. Bacterial growth was measured before and after the Lower Critical Solution Temperature. Below the LCST, bacteria grew, above the LCST bacterial growth was prevented or retarded.

A system for incorporating antimicrobial zinc into polymeric materials, in particular hydrogel type polymers has been developed. Zn(Bipy-(MMOES)2) a zinc carboxylate monomer was designed with the purpose of mimicking commercial cross linking agents such as ethylene glycol diacrylate, as well as containing antimicrobial zinc ions (Zn2+), with the intention that it can be used to cross link into any polymeric material, the example here being polyacrylic acid. Two systems were studied: a homopolymer of the Zn(Bipy-(MMOES)2) and copolymers of Zn(Bipy-(MMOES)2) with acrylic acid (AA). The AA – Zn(Bipy-(MMOES)2) produced water swellable polymers which retained antimicrobial activity. The ability of the polymers to release the zinc ions was shown to be pH responsive and the leachate analysed to give a proposed mechanism of action. The Zn(Bipy-(MMOES)2) monomer and polymers have shown antibacterial activity against both gram positive Methicillin susceptible staphylococcus aureus (MSSA 476) and gram negative Pseudomonas aeruginosa (PA01).Zn(Bipy-(MMOES)2) A novel antimicrobial cross-linking agent for hydrogels.

Pathogenic bacteria secrete various virulence factors, including toxins, lipases and proteases that allow them to infect, breakdown and colonize host tissue. Among various modes of action that the pathogenic bacteria use to damage the host, pore formation (by pore forming toxins (PFTs)) and lipid hydrolysis (by phospholipases) modes are common in damaging the eukaryotic cell membrane. PFTs in their monomeric form are extracellular diffusible and able to form hydrophilic pores in cell membrane while phospholipases cleaves and hydrolyzes the ester bonds of most phospholipids in cell membrane. Both modes of action cause uncontrolled permeation of ions and molecules across cell membrane, leading to cell death by apoptosis or necrosis. In this work, the toxins secreted by two clinically important human pathogens, methicillin susceptible Staphylococcus aureus (MSSA476) and Pseudomonas aeruginosa (PAO1) were studied via their interaction with a planar tethered bilayer lipid membrane (pTBLM) using surface plasmon resonance spectroscopy (SPR) and electrochemical impedance spectroscopy (EIS). Detection and discrimination is based on lipid-loss (lipid hydrolysis by phospholipases) or non lipid-loss (pore formation by PFTs) from pTBLM upon interaction with supernatant of pathogenic bacteria. Using EIS and SPR, it is demonstrated that major toxins of S. auerus are PFTs while most of toxin associated with P. aeruginosa are more lipid damaging lipolytic enzymes. Such a format might have future utility as a simple assay for measuring the presence membrane lytic virulence factors in clinical samples.

This paper describes the modification of nonwoven fabric such that it responds by releasing an encapsulated antimicrobial from within an attached vesicle in response to two species of pathogenic bacteria (Staphylococcus aureus MSSA 476 and Pseudomonas aeruginosa PAO1), but does not respond to nonpathogenic Escherichia coli DH5α. This concept is based on the generalization that a majority of pathogenic bacteria secrete virulence factors such as toxins and lipases that actively damage cell membranes, typically observed as tissue damage around infected wounds, while nonpathogenic bacteria do not (or not at high concentration). The eventual aim of this work is to produce responsive dressings which release antimicrobials and change color only on infected wounds. This paper details preliminary approaches to achieving this goal, including vesicle−bacteria studies in aqueous suspension, and fluorescence imaging of fluorescein containing vesicles lysed by S. aureus and P. aeruginosa, but not by E. coli.

Pathogenic bacteria secrete various virulence factors that can directly interact with the outer lipid bilayer membrane of eukaryotic cells, inducing cell death by apoptosis or necrosis. Such virulence factors account for much of the toxic action associated with bacterial infection; therefore the detection of such proteins could provide a methodology for sensing/detection of pathogenic bacteria in, for example, food or human tissue. Detection and identification of pathogenic bacteria by conventional methods such as plating and counting in laboratory is expensive and time consuming. With growing concerns over emergence and re-emergence of pathogenic bacteria with high resistant to current antibiotics, there is a potential need for effective detection of pathogenic toxins in-vitro. This paper presents the application of tethered bilayer lipid membrane (TBLM) as a sensing platform for the detection of the clinically relevant pathogenic bacterial, Staphylococcus aureus MSSA 476 and Pseudomonas aeruginosa PAO1 via their secreted virulence factors, using electrochemical impedance spectroscopy (EIS). A non-pathogenic strain of bacteria, E. coli DH5α was used as a control. A clear difference in the impedance of the TBLM for the pathogenic vs. non-pathogenic species was observed.

In this communication we describe the synthesis, characterisation and plasma deposition of a novel organo-silver compound for the prevention of the growth of Pseudomonas aeruginosa on both polystyrene surfaces and polypropylene non-woven fabrics.

The development of a single-step, separation-free method for measurement of low concentrations of fatty acid using a surface plasmon resonance-enhanced fluorescence competition assay with a surface-bound antibody is described. The assay behavior was unexpectedly complex. A nonlinear coverage-dependent self-quenching of emission from surface-bound fluorescent label was deduced from the response kinetics and attributed to a surface plasmon-mediated energy transfer between adsorbed fluorophores, modified by the effects of plasmon interference. Principles of assay design to avoid complications from such effects are discussed. An anti-fatty acid mouse monoclonal antibody reacting to the alkyl chain was prepared and supported on a gold chip at a spacing appropriate for surface-plasmon field-enhanced fluorescence spectroscopy (SPEFS), by applying successively a self-assembled biotinylated monolayer, then streptavidin, then biotinylated protein A, and then the antibody, which was crosslinked to the protein A. Synthesis of a fluorescently (Cy5) tagged C-11 fatty acid is reported. SPEFS was used to follow the kinetics of the binding of the labeled fatty acid to the antibody, and to implement a competition assay with free fatty acid (undecanoic acid), sensitive at the 1 μM scale, a sensitivity limit caused by the low affinity of antibodies for free fatty acids, rather than the SPEFS technique itself. Free fatty acid concentration in human serum is in the range 0.1–1 mM, suggesting that this measurement approach could be applied in a clinical diagnostic context. Finally, a predictive, theoretical model of fatty acid binding was developed that accounted for the observed “overshoot” kinetics.

This paper describes the utilisation of methoxy-resorufin ether as an electrochemical probe for studying cytochrome P450 CYP6G1. Methoxy-resorufin ether is well established as a versatile substrate for cytochrome P450, as its demethylated product, resorufin, is a fluorophore. We show that in addition to these established properties, methoxy-resorufin ether also exhibits reversible two electron transfer on glassy carbon and edge plane graphite electrodes. Cyclic voltammetry measurements and differential pulse voltammetry measurements show that methoxy-resorufin ether can be easily detected at low concentrations (down to 200 nM) in a conventional three electrode electrochemical cell. These properties of methoxy-resorufin ether mean that it could be used as an electrochemical probe, to follow the rate of its demethylation by CYP6G1. We show that electrochemical measurements could discriminate between the enzyme activity of protein microsomes taken from two strains of Drosophila melanogaster (fruit fly).

Electrochemical measurements of large unilamellar vesicles encapsulating potassium ferrocyanide showed that the lysis of vesicles by Crotalus adamanteus venom could be measured showing both time and concentration dependent responses.

This communication describes the synthesis of an electrochemically active oligonucleotide probe and its application in sensing complementary oligonucleotides sequences using a T7 exonuclease enzyme. Target oligonucleotides are detected by hybridisation with a ferrocene labelled probe oligonucleotide followed by addition of T7 exonuclease. The T7 enzyme is a double strand specific exonuclease that removes the terminal 5′ nucleotide of the probe sequence. The 5′ nucleotide is attached to a ferrocene label, which is subsequently detected at an electrode using differential pulse voltammetry. Time and temperature resolved measurements were performed and an associated study using dual labelled fluorophore–quencher labelled probes was performed to confirm the validity of the electrochemical assay.

This paper describes the synthesis and application of a novel ferrocene (Fc) label that can be efficiently attached to oligonucleotides. We demonstrate how pulse electrochemical methods can be used to measure very low concentrations of ferrocene label and, importantly, show good electroanalytical discrimination between a labelled oligonucleotide and an enzyme digested labelled oligonucleotide, in which the ferrocene label nucleotide conjugate has been released. Real time in situ analysis gives a much greater understanding of the process. Potential applications include the detection of specific nucleic acid sequences and measurement of nuclease activity.

•Development of a dual-layered diagnostic coating sensor for urinary catheter.•Provides advance warning of infection by P. mirabilis in response to alkaline urine.•Read out via release of carboxyfluorescein dye from coating into urine leg bag.•Catheter prototypes ‘report’ infection 12 h before blockage by P. mirablis.We describe a novel infection-responsive coating for urinary catheters that provides a clear visual early warning of Proteus mirabilis infection and subsequent blockage. The crystalline biofilms of P. mirabilis can cause serious complications for patients undergoing long-term bladder catheterisation. Healthy urine is around pH 6, bacterial urease increases urine pH leading to the precipitation of calcium and magnesium deposits from the urine, resulting in dense crystalline biofilms on the catheter surface that blocks urine flow. The coating is a dual layered system in which the lower poly(vinyl alcohol) layer contains the self-quenching dye carboxyfluorescein. This is capped by an upper layer of the pH responsive polymer poly(methyl methacrylate-co-methacrylic acid) (Eudragit S100®). Elevation of urinary pH (>pH 7) dissolves the Eudragit layer, releasing the dye to provide a clear visual warning of impending blockage. Evaluation of prototype coatings using a clinically relevant in vitro bladder model system demonstrated that coatings provide up to 12 h advanced warning of blockage, and are stable both in the absence of infection, and in the presence of species that do not cause catheter blockage. At the present time, there are no effective methods to control these infections or provide warning of impending catheter blockage.A pH-responsive diagnostic coating for urinary catheters is presented, to provide advance warning of encrustation and blockage by P. mirabilis. Diagnosis is facilitated by the stimulated release of 5(6)-carboxyfluorescein from a hydrogel reservoir in response to increased urinary pH. Catheter prototypes are tested using a clinically relevant continuous flow in vitro bladder model system, and artificial urine.Figure optionsDownload full-size imageDownload high-quality image (184 K)Download as PowerPoint slide

Thermally responsive Poly(N-isopropylacrylamide) co-allylamine (PNIPAM-co-ALA) nano-gels were synthesised and grafted onto non-woven polypropylene. Silver nitrate was incorporated into the nano-gels in their expanded state and their antimicrobial properties tested. Bacterial growth was measured before and after the Lower Critical Solution Temperature. Below the LCST, bacteria grew, above the LCST bacterial growth was prevented or retarded.

In this communication we describe the synthesis, characterisation and plasma deposition of a novel organo-silver compound for the prevention of the growth of Pseudomonas aeruginosa on both polystyrene surfaces and polypropylene non-woven fabrics.

The crystalline biofilms of Proteus mirabilis can seriously complicate the care of patients undergoing long-term indwelling urinary catheterisation. Expression of bacterial urease causes a significant increase in urinary pH, leading to the supersaturation and precipitation of struvite and apatite crystals. These crystals become lodged within the biofilm, resulting in the blockage of urine flow through the catheter. Here, we describe an infection-responsive surface coating for urinary catheters, which releases a therapeutic dose of bacteriophage in response to elevated urinary pH, in order to delay catheter blockage. The coating employs a dual-layered system comprising of a lower hydrogel ‘reservoir’ layer impregnated with bacteriophage, capped by a ‘trigger’ layer of the pH-responsive polymer poly(methyl methacrylate-co-methacrylic acid) (EUDRAGIT®S 100). Evaluation of prototype coatings using a clinically reflective in vitro bladder model system showed that catheter blockage time was doubled (13 h to 26 h (P < 0.05)) under conditions of established infection (108 CFU ml−1) in response to a ‘burst-release’ of bacteriophage (108 PFU ml−1). Coatings were stable both in the absence of infection, and in the presence of urease-negative bacteria. Quantitative and visual analysis of crystalline biofilm reduction show that bacteriophage constitute a promising strategy for the prevention of catheter blockage, a clinical problem for which there is currently no effective control method.