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Here, we describe ex vivo and in vivo methods for assessing bacterial dispersal from a wound infection in mice. This protocol can be utilized to test the efficacy of topical antimicrobial and anti-biofilm therapies, or to assess the dispersal capacity of different bacterial strains or species.
Biofilm-related infections are implicated in a wide array of chronic conditions such as non-healing diabetic foot ulcers, chronic sinusitis, reoccurring otitis media, and many more. Microbial cells within these infections are protected by an extracellular polymeric substance (EPS), which can prevent antibiotics and host immune cells from clearing the infection. To overcome this obstacle, investigators have begun developing dispersal agents as potential therapeutics. These agents target various components within the biofilm EPS, weakening the structure, and initiating dispersal of the bacteria, which can theoretically improve antibiotic potency and immune clearance. To determine the efficacy of dispersal agents for wound infections, we have developed protocols that measure biofilm dispersal both ex vivo and in vivo. We use a mouse surgical excision model that has been well-described to create biofilm-associated chronic wound infections. To monitor dispersal in vivo, we infect the wounds with bacterial strains that express luciferase. Once mature infections have established, we irrigate the wounds with a solution containing enzymes that degrade components of the biofilm EPS. We then monitor the location and intensity of the luminescent signal in the wound and filtering organs to provide information about the level of dispersal achieved. For ex vivo analysis of biofilm dispersal, infected wound tissue is submerged in biofilm-degrading enzyme solution, after which the bacterial load remaining in the tissue, versus the bacterial load in solution, is assessed. Both protocols have strengths and weaknesses and can be optimized to help accurately determine the efficacy of dispersal treatments.
The rise of antibiotic resistance worldwide is leading to a lack of antibiotic options to treat a variety of bacterial infections1. In addition to antibiotic resistance, bacteria can gain antibiotic tolerance by adopting a biofilm-associated lifestyle2. A biofilm is a community of microorganisms that are protected by a matrix of polysaccharides, extracellular DNA, lipids, and proteins3, collectively called the extracellular polymeric substance (EPS). As the antibiotic resistance crisis continues, new strategies that prolong the use of, or potentiate the efficacy of, antibiotics are sorely needed. Anti-biofilm agents are one promising solution4.
Amongst the different anti-biofilm strategies that have been proposed, the utilization of dispersal agents, which target different components of the biofilm EPS, are at the forefront of therapeutic development5. Glycoside hydrolases (GH) are one such class of dispersal agent. GH are a large class of enzymes that catalyze the cleavage of different bonds within the polysaccharides that provide structural integrity to the EPS. Our group, as well as others, have shown that GH can effectively degrade biofilms, induce dispersal and improve antibiotic efficacy for a number of different bacterial species, both in vitro and in vivo6,7,8,9,10,11.
With a growing interest in biofilm dispersal,it is important to develop effective methods that assess dispersal efficacy. Here, we present a detailed protocol for the treatment of biofilm-associated wound infections with a dispersal agent in mice, and the assessment of dispersal efficacy, in vivo and ex vivo. The overall goal is to provide effective methods that can be used with preclinical models to measure biofilm dispersal effectively and efficiently.
A murine surgical excision infection model was used in these studies to establish a biofilm-associated infection. We have used this model for over 15 years and published our observations extensively7,9,12,13,14,15,16,17,18,19,20,21. In general, this is a non-lethal infection model where bacteria remain localized to the wound bed and are biofilm-associated (bacteria seen in aggregates surrounded by EPS), setting up a chronic infection that lasts up to 3 weeks. However, if mice are immunocompromised (with Type 1 diabetes for example), they can become more susceptible to developing a fatal systemic infection in this model.
In this report, we provide protocols for assessing the dispersal of bacteria from a wound, both in vivo and ex vivo. Both protocols can be used to examine the efficacy of a dispersal agent and have their own strengths and weaknesses. For example, assessing dispersal in vivo can provide important, real-time information about the spread of bacteria to other parts of the body after dispersal, and how the host responds. On the other hand, assessing dispersal ex vivo may be more desirable for screening multiple agents, doses, or formulations, as the tissue can be divided into multiple sections that can be tested separately, thus reducing the number of mice required. When assessing multiple agents, we typically measure dispersal first in vitro as previously described 6,9,22. We then test the most effective ex vivo and reserve in vivo testing for a limited number of very promising agents.
This animal protocol was reviewed and approved by the Institutional Animal Care and Use Committee of Texas Tech University Health Sciences Center (protocol number 07044). This study was carried out in strict accordance with the recommendations in the Guide for the Care and Use of Laboratory Animals of the National Institutes of Health.
1. Preparing bacteria for mouse infections
NOTE: Here we describe infecting mice only with Pseudomonas aeruginosa. However, other bacterial species may be used to cause infection. Bacterial strains and materials are detailed in the Table of Materials.
2. Preparation of biofilm dispersal enzyme
NOTE: For this study we use a 10% solution of equal parts amylase and cellulase (5% of each), which will be referred to as "GH", for the dispersal treatment.
3. Experimental animals and preoperative setup
4. Dorsal full thickness excision surgery
5. In vivo dispersal treatment
NOTE: Here we describe administration of the dispersal agents by applying a series of 3 topical wound irrigation solutions (Figure 1). However, the protocol can be adapted for other types of delivery such as the application of gels, creams or dressings.
6. In vivo dispersal imaging and analysis
NOTE: If a luminescent strain of bacteria is utilized to initiate infection, an In Vivo Imaging System (IVIS) can be used to visualize dispersal from the wound bed.
7. Assessing dispersal by determining CFU
8. Ex vivo assessment of dispersal (Figure 4)
In this experiment, 8-10 week old female Swiss Webster mice were infected with 104 CFU of PAO1 carrying the luminescence plasmid pQF50-lux. As described above, an infection was allowed to establish for 48 h prior to administering 3 x 30 min treatments of either PBS (vehicle control) or 10% GH (treatment) to digest the biofilm EPS. Mice were imaged pre-treatment, directly after treatment (0 h) and at 10 h and 20 h post-treatment. Figure 2A and Supplemental Figure 1
Here we describe protocols that can be utilized to study the efficacy of biofilm dispersal agents. These protocols can be easily adapted to use with different types of dispersal agents, bacterial species or ex vivo samples, including clinical debridement samples. This protocol also provides a clinically relevant model to collect and study dispersed bacterial cells. The phenotypes of dispersed bacterial cells have been shown to be distinct from those of either planktonic or biofilm cells 5...
The authors have nothing to disclose.
This work was supported by grants from the National Institutes of Health (R21 AI137462-01A1), the Ted Nash Long Life Foundation, the Jasper L. and Jack Denton Wilson Foundation and the Department of Defense (DoD MIDRP W0318_19_NM_PP).
Name | Company | Catalog Number | Comments |
1.5 mL microcentrifuge tube | Fisher | 14823434 | Use to complete serial dilutions of samples |
25G 58 in needle | Fisher | 14823434 | Attaches to 1 mL syringe |
Ampicillin Sodium Salt | Fisher | BP1760-5 | Make a 50 mg/ mL stock solution and add 100 µL to 10 mL of LB broth for both overnight and subculture |
Amylase | MP Biomedicals | 2100447 | Make a 5% w/v solution, vortex- other dispersal agents can be used |
Buprenorphine SR-LAB 5 mL (1 mg/mL) | ZooPharm | RX216118 | Use as pain mainagement- may use other options |
Cellulase | MP Biomedicals | 2150583 | Add 5% w/v to the 5% w/v amylase solution, vortex, activate at 37 °C for 30 min- other dispersal agents can be used |
Depilatory cream | Walmart | 287746 | Use a small amount to massage into the hair follicles on the back of the animal and allot 10 min to remove hair |
Dressing Forceps, Serrated Tips | Fisher | 12-460-536 | Can use other forms of forceps |
Erlenmeyer flasks baffled 125 mL | Fisher | 101406 | Use to grow overnights and sub-cultures of bacteria |
FastPrep-24 Benchtop Homogenizer | MP Biomedicals | 6VFV9 | Use 5 m/s for 60 s two times to homogenize tissue |
Fatal Plus | Vortech Pharmaceuticals | 0298-9373-68 | Inject 0.2 mL intraperitaneal for each mouse |
Homogenizing tubes (Bead Tube 2 mL 2.4 mm Metal) | Fisher | 15340151 | Used to homogenize samples for plating |
Isoflurane | Diamond Back Drugs | ||
Ketamine hydrochloride/xylazine hydrochloride solution C-IIIN | Sigma Aldrich | K4138 | Use as anasethia- other options can also be utilized to gain a surgical field of anasethia |
LB broth, Miller | Fisher | BP1426-2 | Add 25 g/L and autoclave |
Lidocaine 2% Injectable | Diamond Back Drugs | 2468 | Inject 0.05 mL through the side of the marked wound bed area so it is deposited in the center of the mark. Allot 10 min prior to cutting |
Meropenem | Sigma Aldrich | PHR1772-500MG | Make 5 mg/mL to add to the GH solution to apply topically and a 15 mg/mL solution to inject intraperitaneal 4 h prior and 6 h post-treatment |
Non-sterile cotton gauze sponges | Fisher | 13-761-52 | Use to remove the depilatory cream |
PAO1 pQF50-lux bacterial strain | Ref [13] | N/A | PAO1 pgF50-lux was used as the P. aeruginosa strain of interest in this paper's representative results |
Petri dishes | Fisher | PHR1772-500MG | |
Phosphate Buffer Saline 10x | Fisher | BP3991 | Dilute 10x to 1x prior to use |
Polyurethane dressing | Mckesson | 66024007 | Cut the rounded edge off and cut the remaining square into 4 equal sections |
Pseudomonas isolation agar | VWR | 90004-394 | Add 20 mL/L of glycerol and 45 g/mL to water, autoclave, and pour 20 mL into petri dishes |
Refresh P.M. | Walmart | Use on eyes to reduce dryness during procedure. | |
Sterile Alcohol Prep Pads | Fisher | 22-363-750 | Use to clean the skin immediately prior to wounding to disinfect the area |
Straight Delicate Scissors | Fisher | 89515 | Can also use curved scissors |
Swiss Webster mice | Charles River | 551NCISWWEB | Other mice strains can be used |
Syring Slip Tip 1 mL | Fisher | 14823434 | Used to administer drugs and enzyme treatment |
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