Biofilm Infection Control (BIC) – Novel approaches to the diagnosis and treatment of chronic periprosthetic and wound infections
MoRE2020 Fellow Margarita Trobos, outgoing mobility from the University of Gothenburg to Navarrabiomed - Biomedical Research Center, Spain
This project addresses two major threats to global health today: chronic biofilm infections and antibiotic resistance, with consequences in patient mortality and healthcare costs. Bacterial biofilms (community of bacterial cells connected by their secreted extracellular matrix) are commonly involved in chronic persistent infections, and are extremely resistant to antibiotics and host defenses. Chronic biofilm infections lead to longer hospital stays, higher medical costs, and increased morbidity and mortality. Orthopaedic implant infections and chronic wounds are examples of chronic biofilm infections and both represent a societal challenge and cause a significant reduced quality of life for patients. The mechanisms surrounding a biofilm infection also play a crucial role in the development of antibiotic resistance – recognized as an international societal problem. The objective of this multidisciplinary project is to increase the scientific knowledge within the field of chronic biofilm infections (associated to medical devices and wound infections) with the main goals of 1) developing diagnostic tools for implant-related infections and; 2) developing novel treatments for chronic wound infections which can act as alternatives for antibiotics. These practical applications will be developed in collaboration with two clinical end-users (Orthopaedics and Infectious Diseases) and one industrial end-user (Mölnlycke Heatlh Care). Through direct collaboration with end-users this project will impact patient care practices, development of new commercial products and diagnostic methods, therefore being highly relevant for the growth of the region of Västra Götaland in the areas of Life science and Material sciences, strengthening competitiveness and international collaboration.
Collaborating end-users: Mölnlycke Health Care AB, Sahlgrenska University Hospital Department of Orthopedics and Department of Infections diseases
Summary of Project Results
Chronic biofilm infections lead to longer hospital stays, higher medical costs, increased morbidity/mortality and development of antibiotic resistence. Orthopedic implant infections and chronic wounds are common examples of chronic biofilm infections, which lead to significantly reduced quality of life for patients. The end-users involved in this project are very eager to solve this societal and industrial challenge, by providing knowledge and feedback on the needs to the involved research and innovation milieus in VGR (Sweden) and Navarra (Spain). The research and innovation milieus, with complementary expertise in infections associated to medical devices, molecular mechanisms of staphylococcal biofilms and host defenses, are partnering efforts with the end-users to develop a new-targeted diagnostic tool and an alternative treatment to antibiotics.
The project is currently in a phase of final analysis and manuscript writing. A total of 140 staphylococcal strains isolated fom patients that suffered from orthopedic implant infections and wound infections have been characterized to evaluate their capabilities to cause infection. We have performed whole-genome sequencing on all the clinical strains and we are analysing the results with the help of bioinformatics in order to learn what type of pathogenic genes they contain, for example genes related to the production of toxins, genes that help forming biofilms on the surfaces of medical implants, and those giving resistance to antibiotics. Then, these bacteria have been used to test a new diagnostic tool, which determines the type and amount of antibiotics needed to treat these bacteria when they form a biofilm on an implant. Also these strains will be tested against novel compounds which target is to decrease the bacteria's ability to cause infection. In the project, we have also developed several green fluorescent strains of Staphylococcus aureus that can now be used to validate the anti-virulence effect mechanism of the novel compounds.
The main outcomes of this project have been:
- A better understanding on the virulence of staphylococci causing orthopedic implant infections and chronic wounds
- Provide clinicians with a diagnostic tool for biofilm susceptibility testing for the treatment of orthopaedic implant infections
- Created crucial knowledge grounds, mutant bacterial strains and in vitro models for the concept development of virulence inhibitors as a new treatment strategy for hard-to-heal wounds.
This project has provided the fellow with a great opportunity to expand her technical skills and increase the international collaboration network, and the fellow will continue the fruitful collaboration in the future in different ways, for examole, sharing knowledge and research materials, joint publications, funding applications and the mobility exchange of researchers.