Enhancing biofilm disruption and bactericidal efficiency using vancomycin-loaded microbubbles in sonodynamic therapy
温 並木, Li Yao, Zhen Guo, Chunping You, Fei Wang, Jianjun Yang
Abstract
Background: Periprosthetic joint infection (PJI) is a significant complication following arthroplasty, attributed to the biofilm formation. This study evaluates the effectiveness of vancomycin-loaded microbubbles (Van-MBs) in conjunction with ultrasound-targeted microbubble destruction (UTMD) on biofilm disruption and bactericidal efficiency. Methods: Van-MBs were prepared using the thin-film hydration method and characterized using microscopy, dynamic light scattering analysis, and high-performance liquid chromatography (HPLC). Confocal laser scanning microscopy (CLSM) was used to assess the penetration of Van and Van-MBs into biofilms. Biofilms were treated with Van, Van-MBs, UTMD, and Van-MBs + UTMD. CLSM and crystal violet staining were utilized to assess the morphology, viability, and biomass of the biofilms. Bacterial activity was examined through scanning electron microscopy (SEM) and plate counting, while gene expression was analyzed using quantitative real-time polymerase chain reaction (qRT-PCR). Results: (MRSA) biofilms compared with Van alone. The combination of Van-MBs and UTMD significantly reduced biofilm thickness, viability, and biomass. qRT-PCR analysis revealed that the Van-MBs + UTMD group exhibited lower transcription levels of the icaA gene, suggesting that the treatment disrupted biofilm formation by suppressing this key gene. SEM further confirmed the efficacy of the treatment, showing that Van-MBs + UTMD induced cytoplasmic shrinkage and separation of the outer and cytoplasmic membranes in MRSA cells, indicating substantial structural damage to the bacterial cells. Conclusion: These findings demonstrate the potential of Van-MBs in combination with UTMD as an innovative approach to enhance antibiotic efficacy and eliminate biofilms in the treatment of PJI.