Biofilm bacteria cause two-thirds of infections in modern clinical practice, including wound and device- related infections. Host defenses and most available antibiotics are inactive against biofilms, rendering the infections they cause challenging to treat. Given the failure of antibiotics in management of biofilm-associated infections, novel and innovative approaches are needed. Avoiding antibiotics will also decrease the dysbiosis and selection of genotypic antibiotic resistance linked to their use. We are developing electrical anti-biofilm strategies. In the original funding period, we developed the ?electricidal effect,? which uses fixed direct current (DC). Though fixed DC exhibited activity in vitro and in animal models of orthopedic foreign body infection, concerns about mechanistic non-specificity, and challenges in clinical delivery for orthopedic infections (at least as an initial application), led us to propose a new approach. Here, we propose a mechanistically-precise electrochemical strategy (distinct from fixed DC), that will specifically deliver one or the other (or both) of two anti-biofilm chemicals ? hydrogen peroxide (H2O2) and/or hypochlorous acid (HOCl). We have also moved to a more clinically feasible target ? wound infections. Our new approach employs a completely novel, tunable ? potential-controlled ? electrochemical system, which will cleanly deliver continuous low concentrations of H2O2 and/or HOCl, suitable for biofilm killing, without compromising wound healing. Importantly, both chemicals have applications in wound care, but use has been hindered by rapid decomposition of their raw chemical forms. To bring together the biology, microbiology, electrochemistry, engineering and animal model expertise required for our studies, we are newly collaborating with an electrochemist and biofilm engineer, Haluk Beyenal, PhD. In collaboration, we will develop scalable electrochemical bandages (e-bandages) composed of carbon fibers that will generate sustained, controlled quantities of H2O2 and/or HOCl in the presence of specific applied potential, providing an easy-to-use, antibiotic-free approach for treatment of infected wounds and promotion of wound healing. The technology being applied was not available in the prior funding period. We have built prototype devices that generate continuous, controlled concentrations of H2O2 or HOCl (based on applied potential) in amounts that reduce biofilms. Both H2O2- and HOCl-generating prototypes reduced Acinetobacter baumannii, Pseudomonas aeruginosa, and Staphylococcus aureus biofilms in vitro. Further, the HOCl-generating prototype reduced the number of live bacterial cells of all three species on porcine dermal explants, and the H2O2-generating prototype did the same against A. baumannii on explants, without damaging the animal tissue.
In Aim 1, we will build e-bandages and confirm, using in vitro studies, their biofilm treatment properties, tuning them to ensure lack of toxicity.
In Aim 2, we will demonstrate activity and safety of the e-bandages in a murine wound infection model. Our goal is to have a product ready for human testing at the end of our studies.

Public Health Relevance

Microorganisms in biofilms cause a range of human infections and are resistant to most available antibiotics; furthermore, antibiotic resistance, which is heavily influenced by the overuse of antibiotics, is a growing threat to human medicine. To overcome this challenge, we are developing a new ?antibiotic-free? way to treat infection, called an ?e-bandage,? that will electrochemically generate continuous low concentrations of hydrogen peroxide and/or hypochlorous acid, two antimicrobial/anti-biofilm compounds. We propose to apply this novel strategy to an important medical problem, wound infection; we will design and construct e-bandages and test them in the laboratory and then in animals, with our next step (assuming success), being development of an e-bandage for testing in humans

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project (R01)
Project #
2R01AI091594-06A1
Application #
9817211
Study Section
Drug Discovery and Mechanisms of Antimicrobial Resistance Study Section (DDR)
Program Officer
Huntley, Clayton C
Project Start
2011-05-01
Project End
2024-05-31
Budget Start
2019-06-07
Budget End
2020-05-31
Support Year
6
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Mayo Clinic, Rochester
Department
Type
DUNS #
006471700
City
Rochester
State
MN
Country
United States
Zip Code
55905
Wi, Yu Mi; Patel, Robin (2018) Understanding Biofilms and Novel Approaches to the Diagnosis, Prevention, and Treatment of Medical Device-Associated Infections. Infect Dis Clin North Am 32:915-929
Perez, Kimberly; Patel, Robin (2018) Survival of Staphylococcus epidermidis in Fibroblasts and Osteoblasts. Infect Immun :
Schmidt-Malan, Suzannah M; Brinkman, Cassandra L; Greenwood-Quaintance, Kerryl E et al. (2018) Activity of fixed direct electrical current in experimental Staphylococcus aureus foreign-body osteomyelitis. Diagn Microbiol Infect Dis :
Peel, Trisha N; Sedarski, John A; Dylla, Brenda L et al. (2017) Laboratory Workflow Analysis of Culture of Periprosthetic Tissues in Blood Culture Bottles. J Clin Microbiol 55:2817-2826
Peel, Trisha N; Spelman, Tim; Dylla, Brenda L et al. (2017) Optimal Periprosthetic Tissue Specimen Number for Diagnosis of Prosthetic Joint Infection. J Clin Microbiol 55:234-243
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Brinkman, Cassandra L; Schmidt-Malan, Suzannah M; Karau, Melissa J et al. (2016) Exposure of Bacterial Biofilms to Electrical Current Leads to Cell Death Mediated in Part by Reactive Oxygen Species. PLoS One 11:e0168595
Melendez, Dante P; Greenwood-Quaintance, Kerryl E; Berbari, Elie F et al. (2016) Evaluation of a Genus- and Group-Specific Rapid PCR Assay Panel on Synovial Fluid for Diagnosis of Prosthetic Knee Infection. J Clin Microbiol 54:120-6
Peel, Trisha N; Dylla, Brenda L; Hughes, John G et al. (2016) Improved Diagnosis of Prosthetic Joint Infection by Culturing Periprosthetic Tissue Specimens in Blood Culture Bottles. MBio 7:e01776-15

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