TY - JOUR

T1 - Enhanced Antibiotic Tolerance of an In Vitro Multispecies Uropathogen Biofilm Model, Useful for Studies of Catheter‐Associated Urinary Tract Infections

AU - Hou, Jiapeng

AU - Wang, Lutian

AU - Alm, Martin

AU - Thomsen, Peter

AU - Monsen, Tor

AU - Ramstedt, Madeleine

AU - Burmølle, Mette

N1 - Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

PY - 2022

Y1 - 2022

N2 - Catheter‐associated urinary tract infections (CAUTI) are a common clinical concern as they can lead to severe, persistent infections or bacteremia in long‐term catheterized patients. This type of CAUTI is difficult to eradicate, as they are caused by multispecies biofilms that may have reduced susceptibility to antibiotics. Many new strategies to tackle CAUTI have been proposed in the past decade, including antibiotic combination treatments, surface modification and probiotic usage. However, those strategies were mainly assessed on mono‐ or dual‐species biofilms that hardly represent the long‐term CAUTI cases where, normally, 2–4 or even more species can be involved. We developed a four‐species in vitro biofilm model on catheters involving clinical strains of Escherichia coli, Pseudomonas aeruginosa, Klebsiella oxytoca and Proteus mirabilis isolated from indwelling catheters. Interspecies interactions and responses to antibiotics were quantitatively assessed. Collaborative as well as competitive interactions were found among members in our model biofilm and those interactions affected the individual species’ abundances upon exposure to antibiotics as mono‐, dual‐ or multispecies biofilms. Our study shows complex interactions between species during the assessment of CAUTI control strategies for biofilms and highlights the necessity of evaluating treatment and control regimes in a multispecies setting.

AB - Catheter‐associated urinary tract infections (CAUTI) are a common clinical concern as they can lead to severe, persistent infections or bacteremia in long‐term catheterized patients. This type of CAUTI is difficult to eradicate, as they are caused by multispecies biofilms that may have reduced susceptibility to antibiotics. Many new strategies to tackle CAUTI have been proposed in the past decade, including antibiotic combination treatments, surface modification and probiotic usage. However, those strategies were mainly assessed on mono‐ or dual‐species biofilms that hardly represent the long‐term CAUTI cases where, normally, 2–4 or even more species can be involved. We developed a four‐species in vitro biofilm model on catheters involving clinical strains of Escherichia coli, Pseudomonas aeruginosa, Klebsiella oxytoca and Proteus mirabilis isolated from indwelling catheters. Interspecies interactions and responses to antibiotics were quantitatively assessed. Collaborative as well as competitive interactions were found among members in our model biofilm and those interactions affected the individual species’ abundances upon exposure to antibiotics as mono‐, dual‐ or multispecies biofilms. Our study shows complex interactions between species during the assessment of CAUTI control strategies for biofilms and highlights the necessity of evaluating treatment and control regimes in a multispecies setting.

KW - antibiotic tolerance

KW - biofilms

KW - CAUTI

KW - infections

KW - interactions

KW - multispecies

U2 - 10.3390/microorganisms10061207

DO - 10.3390/microorganisms10061207

M3 - Journal article

C2 - 35744727

AN - SCOPUS:85131859553

VL - 10

JO - Microorganisms

JF - Microorganisms

SN - 2076-2607

IS - 6

M1 - 1207

ER -