Bakgrund: Ett av de största globala hoten idag är multiresistenta bakterier, alltså bakterier som är resistenta mot antibiotika. När en patient blir smittad av MRSA- bakterien räknas det som en vårdskada då patienten har smittats inom vården. En smittspridning av MRSA-bakterier kan leda till allvarliga konsekvenser för patienternas hälsa. Ju mer MRSA-bakterier sprids desto svårare blir det att bota bakterieinfektioner med hjälp av antibiotika som är vanligt inom vården. Trots att det finns riktlinjer kring hur spridningen av MRSA ska förebyggas är det fortfarande ett stort problem inom sjukvården idag. Syfte: Syftet var att belysa faktorer som kan minska smittspridning av MRSA i vårdpersonalens omvårdnadsarbete. Metod: Detta arbete har utförts genom att använda en litteraturöversikt med både kvalitativa och kvantitativa vetenskapliga artiklar. Resultat: Faktorer som minskar smittspridningen av MRSA inom vården är ytterligare utbildning av omvårdnadspersonal angående ämnet, en förbättring av vårdhygienrutiner, gott samarbete och kommunikation mellan personal och individuellt ansvar bland vårdpersonal.  Slutsats: Aktuella riktlinjer är inte tillräckliga för att undvika spridningen av MRSA inom vården. En minskad spridning av MRSA är möjlig om omvårdnadspersonal utbildas om ämnet, om det sker en förbättring i hygienrutiner och om personalen har ett gott samarbete med varandra och tar personligt ansvar. / Backgraound: One of the biggest global threats today is multi-resistant bacteria, thatis bacteria that are resistant to antibiotics. When a patient becomes infected with the MRSA bacterium, it counts as a healthcare injury as the patient has been infected in healthcare. A spread of MRSA bacteria can lead to serious consequences for patients' health. The more MRSA bacteria spread, the more difficult it becomes to cure bacterial infections with the help of antibiotics that are common in healthcare. Although there are guidelines on how to prevent the spread of MRSA, it is still a major problem in healthcare today. Aim: The aim was to highlight which factors reduce the spread of MRSA in the nursing staff's nursing work. Method: This work has been carried out using a literature review with both qualitative and quantitative scientific articles. Results: Factors that reduce the spread of MRSA in healthcare are further training of healthcare staff regarding the subject, an improvement of healthcare hygiene routines, good cooperation and communication between healthcare staff and individual responsibility among them.  Conclusion: Current guidelines are not sufficient to avoid the spread of MRSA in healthcare. A reduced spread of MRSA is possible if nursing staff are trained on the subject, if there is an improvement in hygiene routines and if the staff have a good collaboration with each other and take personal responsibility.

Sepsis är ett livshotande tillstånd som orsakas av bakterier i blodbanan. Tidig och korrekt antibiotikabehandling är viktig, antibiotikaresistens är ett ökande problem och resistensbestämning är därför essentiell. Vid sepsisdiagnostik med blododling krävs ofta minst två dygn innan resistensbesked kan ges. Antibiotikabehandling måste därför påbörjas innan odlingssvar. Rutinmetod för resistensbestämning vid svenska mikrobiologiska laboratorier är diskdiffusionsmetoden som är standardiserad av European Committee on Antimicrobial Susceptibility Testing (EUCAST). Vid diskdiffusion odlas bakterier på agarplattor och hämningszoner kring pappersdiskar med antibiotika används som mått på antibiotikaeffekt. Metoden kräver framväxta bakteriekolonier på agarplattor som ursprungsmaterial och utförandet tar 16-20 timmar. EUCAST har vidareutvecklat diskdiffusionsmetoden för snabb resistensbestämning (Rapid Antimicrobial Susceptibility Testing, (RAST)). Resistensbestämning med diskdiffusion utförs då direkt från positiv blododlingsflaska och hämningszoner mäts redan efter 4, 6 och 8 timmar. I metoden används olika brytpunkter för känslighetskategorisering vid de olika tidpunkterna. Syftet med studien var att undersöka hur väl RAST fungerade för Staphylococcus aureus och Streptococcus pneumoniae genom att undersöka bakterieisolat inokulerade i blododlingsflaskor. Totalt 31 isolat; 23 S.aureus och 8 S.pneumoniae undersöktes varav en hög andel med betalaktamresistens. Till båda bakteriearterna användes 5 sorters antibiotika. Zondiametrar mättes av två personer oberoende av varandra och resultaten jämfördes med de från standardiserad diskdiffusion. För S.aureus var vid 4 timmar 102/184 (55 %) avläsningar kategoriseringsbara, vid 6 timmar 164/184 (89 %) och vid 8 timmar 174/184 (95 %). Sammanlagt inträffade 7 felkategoriseringar varav 5 gällde underskattning av klindamycinresistens vid 4 timmar. S.pneumoniae hade sämre tillväxt och metoden var därför svårare att tillämpa. För S.pneumoniae var vid 4 timmar 74/80 (92 %) avläsningar kategoriseringsbara, vid 6 timmar 73/80 (91 %) och vid 8 timmar 77/80 (96 %). Resistens överskattades vid 21 zonmätningar vid 4 timmar. RAST fungerade väl för S.aureus efter 6 timmar. För S.pneumoniae kan sannolikt bedömning av penicillinresistens efter 6 timmar fungera men ytterligare undersökningar krävs. / Bacteria in the bloodstream may cause sepsis, therefore early and correct treatment is important. Antibiotic resistance is an increasing problem and antimicrobial susceptibility testing (AST) is essential for the patients survival. In sepsis with diagnosis based on blood culture, at least two days are required for results from AST. Routine AST-method in Swedish microbiological laboratories is the disc diffusion method standardized by the European Committee on Antimicrobial Susceptibility Testing (EUCAST). In disc diffusion, bacteria are grown on agar plates and inhibition zones around paper disks with antibiotics are used to measure the antibiotic effect. The method requires bacterial colonies as source material and takes 16–20 hours. EUCAST has further developed the method for Rapid Antimicrobial Susceptibility Testing (RAST). RAST is performed directly from positive blood culture bottles and inhibition zones are measured at 4, 6 and 8 hours. The method uses different breakpoints for categorization at the different timepoints. The purpose of the study was to evaluate RAST for Staphylococcus aureus and Streptococcus pneumoniae by examining bacterial isolates inoculated into blood culture bottles. Zone diameters were measured, and results were compared with those of standardized disk diffusion. For S.aureus, at 4 hours 102/184 (55%) readings were categorizable, at 6 hours 164/184 (89%) and at 8 hours 174/184 (95%). A total of 7 error categorizations occurred, 5 of which were underestimation of clindamycin resistance at 4 hours. For S.pneumoniae at 4 hours, 74/80 (92%) readings were categorizable, at 6 hours 73/80 (91%) and at 8 hours 77/80 (96%). Resistance was overestimated at 21 zone measurements at 4 hours.. RAST showed good results for S.aureus after 6 hours. For S.pneumoniae, further studies are required but RAST may work after 6 hours for penicillin resistance assessment.

Seventy-four methicillin-resistant Staphylococcus aureus (MRSA) from two Malaysian hospitals were characterised by both phenotypic and genotypic techniques. These isolates were collected over an 18 year time period in the years, 1982, 1989, 1994 and 2000. All of the Malaysian MRSA isolates were found to be multiresistant and resistant to at least five different antimicrobial agents. Over 30% of them were non-typable by the International Basic Set of bacteriophages. The majority of the typable isolates were susceptible to the group III phages, especially phage 85. The majority of the isolates carried one to six plasmids. Only two isolates were plasmid free. The plasmid profiles of these isolates, other than the 1982 isolates, were very similar to each other. Contour-clamped homogeneous electric field (CHEF) gel electrophoresis was used to examine the genetic relatedness of the isolates. Twenty-six CHEF patterns were found among the isolates. These CHEF patterns were closely related to each other. The predominant CHEF pattern A was found in the 1982, 1989 and 1994 isolates. The CHEF patterns of the year 2000 isolates were different to CHEF pattern A, but still closely related. All of the isolates were found to carry the Allotype III SCCmec and have coagulase-gene type 24. Multilocus sequence typing was preformed on the isolates with CHEF pattern A collected in different years. These isolates were found to have either sequence type 239 (ST239), or its single locus variant. The predominant Malaysian clone belongs to the pandemic clone ST239-MRSA-III that is pandemic in Asian countries. (Enright, 2003, Ko et al., 2005). / A 1.5 kb cryptic plasmid found in Malaysian isolates was indistinguishable from a cryptic plasmid found in an Australian isolate. A 3.0 kb cryptic plasmid found in Malaysian isolates was undistinguishable from a 3.0 kb plasmid found in Singaporean isolates. Class II multiresistance plasmids of 28, 30.5 and 35 kb were commonly found together in many Malaysian MRSA isolates. Both the 28 and 30.5 kb plasmids encode resistance to the heavy-metals and nucleic acid-binding (NAB) compounds. The 35 kb plasmid carries heavy-metal and NAB resistance but also encodes β-lactamase. Structurally these three plasmids are almost identical and probably have the same origin. The differences observed between these plasmids is probably due to excision or partial deletion of the β-lactamase transposon of the original plasmid. The 28 kb plasmid is identical to the 28 kb plasmid of Singaporean and some Australian isolates. A 20 kb plasmid in Indonesian isolates was found to be closely related to these three plasmids. A conjugative plasmid, pWBG707, conferring trimethoprim-resistance was found in Malaysian isolates. It did not carry either of the two staphylococcal trimethoprim-resistance genes, dfrA and dfrD. (Lyon and Skurray, 1987, Dale et al., 1995b) It either encodes a novel resistance gene or the recently discovered dfrG gene. (Sekiguchi et al., 2005) pWBG707 was also found to mobilise a small 3.0 kb kanamycin-resistance plasmid during conjugation. / The mecR1 and mecI genes regulating the transcription of the methicillin-resistance gene, mecA, were also examined in the isolates. The Malaysian isolate, WBG7422, with the predominant CHEF pattern A has a nonsense mutation in its mecI gene that disables it. However, its mecR1 gene is intact. The eastern Australia MRSA (EA MRSA), WBG525, has a CHEF pattern that is closely related to the Malaysian predominant CHEF pattern A and its mecI gene has a mutation identical to the Malaysian isolate. Unlike the Malaysian isolate however, its mecR1 gene has a 166 bp deletion. Both WBG7422 and WBG525 express Class III heterogeneous methicillin resistance. However, WBG525 has more highly resistant cell in its population than WBG7422. The loss of aminoglycoside resistance, together with c. 114 kb of chromosomal DNA, was observed in some Malaysian isolates. The deleted segment was found to carry the aacA-aphD gene that encodes a bifunctional aminoglycoside-modifying enzyme conferring resistance to many of the aminoglycosides. The Malaysian isolates were compared with MRSA from different countries. These MRSA included 18 epidemic MRSA (EMRSA) from the United Kingdom, 15 Australian nosocomial MRSA, five classical MRSA, 22 community-acquired MRSA (CMRSA) from Australia and New Zealand and 46 nosocomial MRSAs from eight Asian-Pacific countries and South Africa. These Asian-Pacific countries were Australia, PR China, Hong Kong, Indonesia, Japan, Philippines, Singapore and Taiwan. / The CHEF patterns of most of the Asian-Pacific and South African isolates were closely related to the Malaysian isolates. Isolates from Singapore, Indonesia and Philippines were found to have an identical CHEF pattern to the Malaysian CHEF patterns A5. The Asian-Pacific and South African isolates, including the Malaysian isolates, were found to be closely related to EMRSA-1, -4 and -7. These EMRSA belong to the ST239-MRSA-III clone and are coagulase-gene type 24. The isolates from Japan were the only Asian-Pacific isolates not related to the other Asian-Pacific isolates and EMRSAs. EMRSA-1 and EA MRSA have the same 166 bp deletion in their mecR1 gene. Both of these strains have closely related CHEF patterns, the same sequence type, coagulase-gene type and SCCmec. These results indicate that these two strains belongs to the same clone and confirms the international spread of this clone in the early 1980s. However, the Malaysian isolates have CHEF patterns that are more closely related to EMRSA-4 than to EMRSA-1. Similar to the Malaysian isolates EMRSA-4 has an intact mecR1 gene. The CMRSA isolates were not related to any of the nosocomial MRSA. They also have very diverse genetic backgrounds but carry less diverse SCCmec allotypes. Most of the CMRSA carry either Allotype IV or V SCCmec These results show that the spread of Malaysian MRSA is due to a single clonal expansion. Infection control measures would have to have been more efficient if this clone was to have been contained. The Malaysian epidemic clone is the Asian pandemic clone, ST239-MRSA-III. The Malaysian isolates and EMRSA-4 probably share the same ancestor. / The presence of the same MRSA strain in Malaysian hospitals and in the hospitals of neighbouring countries indicates that the inter-hospital spread of an epidemic MRSA has occurred. This observation also suggests that the infection control measures in Malaysian hospitals have not been totally effective. The ineffectiveness of infection control has left Malaysian hospitals vulnerable to the future importation of new pandemic clones and/or highly virulent or resistant clones.

A large part of the antibiotics consumed ends up in wastewater, and in the wastewater the antibiotics may exert selective pressure for or maintain resistance among microorganisms. Antibiotic resistant bacteria and genes encoding antibiotic resistance are commonly detected in wastewater, often at higher rates and concentrations compared to surface water. Wastewater can also provide favourable conditions for the growth of a diverse bacterial community, which constitutes a basis for the selection and spread of antibiotic resistance. Therefore, wastewater treatment plants have been suggested to play a role in the dissemination and development of antibiotic resistant bacteria. Methicillin-resistant Staphylococcus aureus (MRSA) is a large problem worldwide as a nosocomial pathogen, but knowledge is limited about occurrence in non-clinical environments, such as wastewater, and what role wastewater plays in dissemination and development of MRSA.   In this thesis we investigated the occurrence of MRSA in a full-scale wastewater treatment plant (WWTP). We also investigated the concentration of genes encoding resistance to aminoglycosides (aac(6’)-Ie+aph(2’’)), β-lactam antibiotics (mecA) and tetracyclines (tetA and tetB) in three wastewater-associated environments: (1) soil from an overland flow area treating landfill leachates, (2) biofilm from a municipal wastewater treatment plant, and (3) sludge from a hospital wastewater pipeline. In addition, concentrations of mecA, tetA and tetB were investigated over the treatment process in the WWTP. These investigations were performed to determine how the prevalence and concentration of MRSA and the antibiotic resistence genes are affected in wastewater and wastewater treatment processes over time. The occurrence of MRSA was investigated by cultivation and a commercially available real-time PCR assay. In order to determine concentrations of the genes aac(6’)-Ie+aph(2’’), mecA, tetA and tetB in wastewater we developed a LUXTM real-time PCR assay for each gene.   Using cultivation and real-time PCR we could for the first time describe the occurrence of MRSA in wastewater and show that it had a stable occurrence over time in a WWTP. MRSA could mainly be detected in the early treatment steps in the WWTP, and the wastewater treatment process reduced the number and diversity of cultivated MRSA. However, our results also indicate that the treatment process selects for strains with more extensive resistance and possibly higher virulence. The isolated wastewater MRSA strains were shown to have a close genetic relationship to clinical isolates, and no specific wastewater lineages could be detected, indicating that they are a reflection of carriage in the community. Taken together, these data indicate that wastewater may be a potential reservoir for MRSA and that MRSA are more prevalent in wastewater than was previously thought.   The real-time PCR assays, for aac(6’)-Ie+aph(2’’), mecA, tetA, and tetB that we developed, were shown to be sensitive, fast, and reproducible methods for detection and quantification of these genes in wastewater environments. The highest concentrations of all genes were observed in the hospital pipeline, and the lowest in the overland flow system, with tetA and aac(6´)-Ie+aph(2´´) detected in all three environments. In the full-scale WWTP, we continuously detected mecA, tetA and tetB over the treatment process and over time. In addition, it was shown that the treatment process reduces concentrations of all three genes. The data presented in this thesis also indicate that the reduction for all three genes may be connected to the removal of biomass, and in the reduction of tetA and tetB, sedimentation and precipitation appear to play an important role.

Osteomyelitis is an infection of bone or bone marrow, usually caused by pyogenic bacteria. It can cultivate by hematogen way or it can cultivate by the help of local soft tissue infection. Osteomyelitis often requires prolonged antibiotic therapy and surgery. But for therapy / antibiotic must reach to effective dose in the bone. So that / for prevention and treatment of osteomyelitis controlled antibiotic release systems can be used. These systems have been developed to deliver antibiotics directly to infected tissue. As a carrier material / polymers are widely use. Polymer can be biodegradable or non biodegradable. The advantage of biodegradable polymers is / you do not need a second surgery for the removal of the carrier material from the body. In this study / vancomycin loaded PLLA/TCP composites were developed and characterized to treat implant related chronic osteomyelitis in experimental rat osteomyelitis model. Some of the composites were prepared by coating the vancomycin loaded composites with PLLA to observe the difference between the coated and uncoated composites. Also, some composites were developed free from the vancomycin to determine the biocompatibility of the composite for the bone tissue. The coating extended the release of the vancomycin up to 5 weeks and changed the surface morphology of the composites. According to the cell culture studies, vancomycin loaded PLLA/TCP composites promoted cell adhesion, cell proliferation and mineralization so / the composite was biocompatible with bone tissue. Radiological and microbiological evaluations showed that vancomycin loaded and coated vancomycin loaded PLLA/TCP composites inhibited MRSA proliferation and treat implant related chronic osteomyelitis.

The Turos laboratory has been working with N-thiolated β-lactams for years trying to understand the mode of action and structural features it needs to have biological activity. Over the years new data has shown promising inhibitory activity against various microbes. In this dissertation, a review of the vast amount of work carried out on N-thiolated β-lactams in Turos laboratory has been done and their novelty, in terms of structure and mechanism has been discussed. A complete outline of our work in the discovery and ongoing development of these compounds, starting from our initial, unexpected finding of antimicrobial activity for one of the lead compounds, to a more complete understanding of their chemical and biological mode of action and potential utility as antibacterial compounds, has been provided. Previous researches by graduate students in the Turos laboratory have shown that N-thiolated β-lactams targets Type II Fatty Acid Synthesis (FAS). In process of understanding this further, other FAS inhibiting antibiotics like Triclosan were compared to our lactams by adding excess of exogenous fatty acids. Results revealed vast differences in the MIC value of triclosan and N-thiolated β-lactams, giving an idea that there might be a different mode of action or a different target altogether. The third chapter discusses the study of attaching hydrophilic C3 side chains like amino acids and carbohydrates on N-thiolated β-lactams while studying the influence of microbiological activity. From the study it was found that the lengthening of the side chain halts the inhibitory activity regardless of whether the side chain contains unsaturation or branching. Results showed that polar groups were not well tolerated and the inhibitory activity goes down regardless of polarity. Finally, research on dual-action antibiotics was discussed. Antibiotics cause continuous bacterial resistance and in this aspect use of two drugs with different mode of action can call for reduction of the resistance. Herein, N-acyl ciprofloxacin and N-thiolated β-lactams were connected together via an ester linkage. Six new hybrid compounds have been synthesized successfully and tested against E. faecium, K. pneumoniae, A. baumannii, P. aeruginosa, and E. cloacae.

Made available in DSpace on 2014-06-12T16:31:41Z (GMT). No. of bitstreams: 2 arquivo6185_1.pdf: 1986687 bytes, checksum: 8a72beab280fcdc564c73079c55a4aee (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2007 / O aumento da resistência bacteriana aos antibióticos é uma ameaça à saúde da população mundial, aumentando as recorrências por doenças infecciosas, devido ao surgimento de bactérias multirresistentes que dificulta e onera o tratamento antimicrobiano. Um exemplo importante destes germes, é o S. aureus MRSA que no Brasil, como em outras partes do mundo, são os microorganismos frequentemente isolados, tendo sua maior prevalência a nível hospitalar, sendo também uma importante causa de infecções na comunidade. A ocorrência de S. aureus MRSA multirresistentes susceptíveis só a vancomicina, constitui um grave problema a resolver, ainda mais, com o surgimento recente de cepas de S. aureus com susceptibilidade intermediária e resistentes a vancomicina. Deste fato, é de fundamental importância, a pesquisa de compostos alternativos, principalmente a partir de plantas medicinais que constitui uma fonte inesgotável de novas moléculas. No presente trabalho, foram escolhidas duas plantas para estudar o perfil fitoquímico e antimicrobiano: Caesalpinia pyramidalis Tull. (Catingueira), das leguminosas e Schinopsis brasiliensis Engl. (Baraúna ou braúna), das anacardiáceas, ambas as famílias com representantes de reconhecida atividade biológica, incluída a antimicrobiana. Neste sentido foi estudada a atividade dos extratos secos (por extração hexanólica, em acetato de etila ou metanol) da folha, casca do caule, casca da raiz, flor, vagem e semente da Braúna e Catingueira inicialmente frente a padrões ATCC de bactérias Gram negativas e Gram positivas, confirmando-se uma melhor ação para Staphylococcus aureus. Na segunda etapa os ensaios foram realizados com 22 cepas de Staphylococcus aureus, 18 isolados clínicos MRSA multirresistentes identificados como Clones Epidêmicos, 2 isolados S. aureus MSSA e 2 cepas padrões ATCC. Dos resultados obtidos para as plantas em estudo, a Schinopsis brasiliensis apresentou melhor atividade sobre as cepas de S. aureus, inclusive os clones epidêmicos mais resistentes. Os extratos secos de extração metanólica foram mais ativos com dados de CMI para a flor e raiz de Braúna de 125 μg.mL-1 quanto que pela técnica de poços foram obtidos para uma das cepas de Staphylococcus aureus MRSA multirresistente (CEB) halos da ordem de 20 mm. Os extratos secos de extração por acetato de etila mostraram-se menor ação, o que pode ser atribuído à uma difusão diminuída no agar. Nos testes, os antibióticos usados como padrão foram tetraciclina e oxacilina na determinação das CMI e tetraciclina na técnica de poços, confirmando a oxacilina o caráter MRSA ou MSSA das cepas e a tetraciclina seu perfil de resistência. Os dois diluentes utilizados DMSO à 50% e Tween 80 à 4% não apresentaram nenhuma inibição. Concluindo, considera-se que as plantas em estudo e particularmente a Schinopsis brasiliensis apresentou uma atividade promissora sobre as cepas de S. aureus MRSA inclusive os clones multirresistentes, considerando-se que em parte esta atividade é justificada pela presença de flavonóides e, especialmente, ácidos fenólicos que foram detectados experimentalmente por bioautografia confirmando dados da literatura e por screening fitoquímico

Carbon-infiltrated carbon nanotube (CICNT) forests are carbon nanotube (CNT) forests infiltrated with pyrolytic carbon to increase durability by becoming a solid material. This material can be tuned to maintain the nanotube geometry of a CNT forest and can also be fabricated on a variety of materials and geometries. Additionally, the present work has indicated that CICNT forests may resist bacterial proliferation and biofilm formation. This phenomenon is not due to the CICNT chemistry; it is presumably due to the CICNT nanostructure morphology. Thus, both silicon and stainless steel substrates were used to investigate CICNT's structural resistance to Methicillin-resistant Staphylococcus aureus (MRSA) biofilm. From in vitro experimental testing, CICNT on both these substrates resisted MRSA cell attachment and biofilm proliferation. The discovery of this non-pharmaceutical biofilm resistance expands the potential applications of CICNT to include medical devices that are prone to infection and/or devices that contribute to infection. Two representative applications were investigated: external fixator pins and scalpel blades. CICNT-coated versions of these applications underwent additional MRSA biofilm resistance testing as well as mechanical testing. In particular, external fixator pins were identified as a high potential application of CICNT surface coating technology. Previous work on both CNT and CICNT forests has largely been performed on planar structures. However, any potential medical device applications involve curved substrates. In particular, concave curvatures are challenging due to the potential for stress-related CICNT forest defects. Thus, the present work also included a study of the incidence rates and determining factors of these defects. SEM images of the cross-sections revealed different types of microscale forest defects while the top surface showed morphologies that are largely consistent with flat substrates. CICNT forest height and substrate curvature were identified as contributing factors to CICNT forest defect incidence rates. Thus, the present work advances the understanding of bacterial resistance and microstructure-related properties of CICNT surface coatings, with applications in medical devices.

Background: Bacterial contamination of surfaces with methicillin-resistant Staphylococcus aureus (MRSA) is a serious problem in the hospital environment and is responsible for significant nosocomial infections. The pathogenic contaminants form biofilms, which are difficult to treat with routine biocides. Thus, a continuous search for novel disinfection methods is essential for effective infection control measures. This demonstration of a novel technique for the control of virulent pathogens in planktonic form as well as in established biofilms may provide a progressive alternative to standard methodology. Methods: We evaluated a novel technique of normal atmospheric nonthermal plasma known as floating-electrode dielectric-barrier discharge (FE-DBD) plasma against a control of planktonic and biofilm forms of Escherichia coli, S aureus, multidrug-resistant methicillin-resistant S aureus (MRSA) -95 (clinical isolate), -USA300, and -USA400, using widely accepted techniques such as colony count assay, LIVE/DEAD BacLight Bacterial Viability assay, and XTT (2,3-Bis(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide) assay. Results: Exposure of free living planktonic forms of E coli, S aureus, and MRSA were rapidly inactivated by DBD plasma. Approximately 107 bacterial cells were completely (100%) killed, whereas 108 and 109 were reduced by approximately 90% to 95% and 40% to 45%, respectively, in less than 60 seconds (7.8 J/cm2) and completely disinfected in ≤120 seconds. In established biofilms, the susceptibility of MRSA USA400 was comparable with USA300 but less susceptible than MRSA95 (clinical isolate), S aureus, and E coli (P < .05) to FE-DBD plasma, and plasma was able to kill MRSA more than 60% within 15 seconds (1.95 J/cm2). The killing responses were plasma exposure-time dependent, and cell density dependent. The plasma was able disinfect surfaces in a less than 120 seconds. Conclusion: Application of DBD plasma can be a valuable decontamination technique for the removal of planktonic and biofilm-embedded bacteria such as MRSA -USA 300, -USA 400, methicillin-sensitive S aureus (MSSA), and E coli, the more common hospital contaminants. Of interest, E coli was more resistant than S aureus phenotypes.

No description available.