use-high-throughput-vitro-microfluidic-system-to-develop-oral-multi

Use of a High-throughput <em>In Vitro</em> Microfluidic System to Develop Oral Multi-species Biofilms

There are few high-throughput in vitro systems which facilitate the development of multi-species biofilms that contain numerous species commonly detected ...

The University of Michigan

Microbial biofilms impinge upon all aspects of our lives. Whilst much of this impact is positive, there are many areas in which the presence and activities of biofilms are regarded as problematic and in need of control. It is in this respect that biofilms reveal their recalcitrance towards many of the long-established antibiotics, and industrial and medical treatment strategies. The nature of the resistance of biofilms, in spite of much research, remains an enigma. Whilst it is recognized that reaction--diffusion limitation properties of the biofilm matrix towards the majority of treatment agents will impede access, this cannot be the sole explanation of the observed resistance. Rather, it will delay the death of cells within the community to various extents. Similarly, it is recognized that biofilm communities are phenotypically heterogeneous and that their eradication will reflect the susceptibility of the most resistant phenotype. The nutrient and gaseous gradients that generate this heterogeneity will, however, be destroyed as a result of antimicrobial treatments and cause the phenotype of the survivors to alter from slow-growing resistant cells to fast-growing susceptible ones. Accordingly both explanations can only delay death of the community. In order to explain more fully the long-term recalcitrance of biofilms towards such a wide variety of biocidal agents, more radical hypotheses must be considered. Amongst these are that multidrug efflux pumps could be up-regulated on expression of a biofilm phenotype. Whilst this is an appealing and simple explanation, because of its ability to explain the breadth of agents to which biofilms are resistant, recent work has suggested that this is not the case. Alternative hypotheses attempt to explain the diversity of agents by invoking a common cause of death for which singular resistance mechanisms could be applied. It is therefore suggested that an altruistic majority of sublethally damaged cells in a population commit suicide (apoptosis), thereby providing some protection to the survivors. A proportion of cells (persisters) is suggested to be defective, or repressed, in their suicide response, and survive. The persisters thereby benefit from the self-sacrifice of their compatriots and maintain the gene pool. A second explanation of the presence of persisters is that the general stress response, well known to include the adoption of a viable, nonculturable state of quiescence, is up-regulated in small pockets of the biofilm community, where nutrients are particularly scarce. Such quiescent cells noted for their resistance towards the metabolically acting biocides would potentially have their dormancy broken after treatment by the replenished supply of nutrients caused by the death of the majority. A more recent hypothesis suggests that extracellular signals, 'alarmones', released from killed cells might prime recipients into a state of resistance. Thus, in biofilm communities deep lying cells might be alerted into a resistant state by the premature death of peripheral cells. It is equally possible that 'alarmones', in this context, are merely the post-treatment 'wake-up' call to a previously quiescent subset of cells. In this review, we attempt to provide a holistic view of the potential mechanisms by which biofilms express resistance. Since these mechanisms are multifaceted then their impact upon resistance will be considered against the context of biofilm formation, growth and maturation.

The physiology and collective recalcitrance of microbial biofilm communities.

We have used heterotrophic plate counts, together with live-dead direct staining and denaturing gradient gel electrophoresis (DGGE), to characterize the eubacterial communities that had formed as biofilms within domestic sink drain outlets. Laboratory microcosms of these environments were established using excised biofilms from two separate drain biofilm samples to inoculate constant-depth film fermentors (CDFFs). Drain biofilms harbored 9.8 to 11.3 log(10) cells of viable enteric species and pseudomonads/g, while CDFF-grown biofilms harbored 10.6 to 11.4 log(10) cells/g. Since live-dead direct staining revealed various efficiencies of recovery by culture, samples were analyzed by DGGE, utilizing primers specific for the V2-V3 region of eubacterial 16S rDNA. These analyses showed that the major PCR amplicons from in situ material were represented in the microcosms and maintained there over extended periods. Sequencing of amplicons resolved by DGGE revealed that the biofilms were dominated by a small number of genera, which were also isolated by culture. One drain sample harbored the protozoan Colpoda maupasi, together with rhabtidid nematodes and bdelloid rotifers. The microcosm enables the maintenance of stable drain-type bacterial communities and represents a useful tool for the modeling of this ecosystem.

Microbial characterization of biofilms in domestic drains and the establishment of stable biofilm microcosms.

Coaggregation is a process by which genetically distinct bacteria become attached to one another via specific molecules. Cumulative evidence suggests that such adhesion influences the development of complex multi-species biofilms. Once thought to occur exclusively between dental plaque bacteria, there are increasing reports of coaggregation between bacteria from other biofilm communities in several diverse habitats. A general role for coaggregation in the formation of multi-species biofilms is discussed.

Bacterial coaggregation: an integral process in the development of multi-species biofilms.

The development of freshwater multispecies biofilms at solid-liquid interfaces occurs both in quiescent waters and under conditions of high shear rates. However, the influence of hydrodynamic shear rates on bacterial biofilm diversity is poorly understood. We hypothesized that different shear rates would significantly influence biofilm diversity and alter the relative proportions of coaggregating and autoaggregating community isolates. In order to study this hypothesis, freshwater biofilms were developed at five shear rates (<0.1 to 305 S(-1)) in a rotating concentric cylinder reactor fed with untreated potable water. Eubacterial diversity was assessed by denaturing gradient gel electrophoresis (DGGE) and culturing on R2A agar. Fifty morphologically distinct biofilm strains and 16 planktonic strains were isolated by culturing and identified by partial 16S rRNA gene sequencing, and their relatedness was determined by the construction of a neighbor-joining phylogenetic tree. Phylogenetic and DGGE analyses showed an inverse relationship between shear rate and bacterial diversity. An in vitro aggregation assay was used to assess the relative proportions of coaggregating and autoaggregating species from each biofilm. The highest proportion of autoaggregating bacteria was present at high shear rates (198 to 305 S(-1)). The intermediate shear rate (122 S(-1)) selected for the highest proportion of coaggregating bacteria (47%, or 17 of a possible 36 coaggregation interactions). Under static conditions (<0.1 S(-1)), 41 (33%) of a possible 125 coaggregation interactions were positive. Few coaggregation (3.3%) or autoaggregation (25%) interactions occurred between the 16 planktonic strains. In conclusion, these data show that shear rates affect biofilm diversity as well as the relative proportions of aggregating bacteria.

Shear rate moderates community diversity in freshwater biofilms.

The initial microbial colonization of tooth surfaces is a repeatable and selective process, with certain bacterial species predominating in the nascent biofilm. Characterization of the initial microflora is the first step in understanding interactions among community members that shape ensuing biofilm development. Using molecular methods and a retrievable enamel chip model, we characterized the microbial diversity of early dental biofilms in three subjects. A total of 531 16S rRNA gene sequences were analyzed, and 97 distinct phylotypes were identified. Microbial community composition was shown to be statistically different among subjects. In all subjects, however, 4-h and 8-h communities were dominated by Streptococcus spp. belonging to the Streptococcus oralis/Streptococcus mitis group. Other frequently observed genera (comprising at least 5% of clone sequences in at least one of the six clone libraries) were Actinomyces, Gemella, Granulicatella, Neisseria, Prevotella, Rothia, and Veillonella. Fluorescence in situ hybridization (FISH) confirmed that the proportion of Streptococcus sp. sequences in the clone libraries coincided with the proportion of streptococcus probe-positive organisms on the chip. FISH also revealed that, in the undisturbed plaque, not only Streptococcus spp. but also the rarer Prevotella spp. were usually seen in small multigeneric clusters of cells. This study shows that the initial dental plaque community of each subject is unique in terms of diversity and composition. Repetitive and distinctive community composition within subjects suggests that the spatiotemporal interactions and ecological shifts that accompany biofilm maturation also occur in a subject-dependent manner.

Molecular characterization of subject-specific oral microflora during initial colonization of enamel.

4,5-Dihydroxy-2,3-pentanedione (DPD), a product of the LuxS enzyme in the catabolism of S-ribosylhomocysteine, spontaneously cyclizes to form autoinducer 2 (AI-2). AI-2 is proposed to be a universal signal molecule mediating interspecies communication among bacteria. We show that mutualistic and abundant biofilm growth in flowing saliva of two human oral commensal bacteria, Actinomyces naeslundii T14V and Streptococcus oralis 34, is dependent upon production of AI-2 by S. oralis 34. A luxS mutant of S. oralis 34 was constructed which did not produce AI-2. Unlike wild-type dual-species biofilms, A. naeslundii T14V and an S. oralis 34 luxS mutant did not exhibit mutualism and generated only sparse biofilms which contained a 10-fold lower biomass of each species. Restoration of AI-2 levels by genetic or chemical (synthetic AI-2 in the form of DPD) complementation re-established the mutualistic growth and high biomass characteristic for the wild-type dual-species biofilm. Furthermore, an optimal concentration of DPD was determined, above and below which biofilm formation was suppressed. The optimal concentration was 100-fold lower than the detection limit of the currently accepted AI-2 assay. Thus, AI-2 acts as an interspecies signal and its concentration is critical for mutualism between two species of oral bacteria grown under conditions that are representative of the human oral cavity.

Autoinducer 2: a concentration-dependent signal for mutualistic bacterial biofilm growth.

Bacterial interactions and successions during plaque development.

Chronic wounds contain complex polymicrobial communities of sessile organisms that have been underappreciated because of limitations of standard culture techniques. The aim of this work was to combine recently developed next-generation investigative techniques to comprehensively describe the microbial characteristics of chronic wounds. Tissue samples were obtained from 15 patients with chronic wounds presenting to the Johns Hopkins Wound Center. Standard bacteriological cultures demonstrated an average of three common bacterial species in wound samples. By contrast, high-throughput pyrosequencing revealed increased bacterial diversity with an average of 17 genera in each wound. Data from microbial community profiling of chronic wounds were compared with published sequenced analyses of bacteria from normal skin. Increased proportions of anaerobes, Gram-negative rods and Gram-positive cocci were found in chronic wounds. In addition, chronic wounds had significantly lower populations of Propionibacterium compared with normal skin. Using epifluorescence microscopy, wound bacteria were visualized in highly organized thick confluent biofilms or as scattered individual bacterial cells. Fluorescent in situ hybridization allowed for the visualization of Staphylococcus aureus cells in a wound sample. Quorum-sensing molecules were measured by bioassay to evaluate signaling patterns among bacteria in the wounds. A range of autoinducer-2 activities was detected in the wound samples. Collectively, these data provide new insights into the identity, organization, and behavior of bacteria in chronic wounds. Such information may provide important clues to effective future strategies in wound healing.

The importance of a multifaceted approach to characterizing the microbial flora of chronic wounds.

The aim of this work was to develop two static-model multispecies oral biofilm systems to compare the efficacy of a placebo mouthwash to an alcohol-free mouthwash containing 0.075% CPC.

Efficacy of an alcohol-free CPC-containing mouthwash against oral multispecies biofilms.

Streptococcus gordonii and Streptococcus oralis are among the first bacterial species to colonize clean tooth surfaces. Both produce autoinducer-2 (AI-2): a family of inter-convertible cell-cell signal molecules synthesized by the LuxS enzyme. The overall aim of this work was to determine whether AI-2 alters interspecies interactions between S. gordonii DL1 and S. oralis 34 within dual-species biofilms in flowing human saliva. Based upon AI-2 bioluminescence assays, S. gordonii DL1 produced more AI-2 activity than S. oralis 34 in batch culture, and both were able to remove AI-2 activity from solution. In single-species, saliva-fed flowcell systems, S. oralis 34 formed scant biofilms that were similar to the luxS mutant. Conversely, S. gordonii DL1 formed confluent biofilms while the luxS mutant formed architecturally distinct biofilms that possessed twofold greater biovolume than the wild-type. Supplementing saliva with 0.1-10 nM chemically synthesized AI-2 (csAI-2) restored the S. gordonii DL1 luxS biofilm phenotype to that which was similar to the wild-type; above or below this concentration range, biofilms were architecturally similar to that formed by the luxS mutant. In dual-species biofilms, S. gordonii DL1 was always more abundant than S. oralis 34. Compared with dual-species, wild-type biofilms, the biovolume occupied by S. oralis 34 was reduced by greater than sevenfold when neither species produced AI-2. The addition of 1 nM csAI-2 to the dual-species luxS-luxS mutant biofilms re-established the biofilm phenotype to resemble that of the wild-type pair. Thus, this work demonstrates that AI-2 can alter the biofilm structure and composition of pioneering oral streptococcal biofilms. This may influence the subsequent succession of other species into oral biofilms and the ecology of dental plaque.

Autoinducer-2 influences interactions amongst pioneer colonizing streptococci in oral biofilms.

Staphylococcus aureus is an opportunistic pathogen that colonizes the skin and mucosal surfaces of mammals. Persistent staphylococcal infections often involve surface-associated communities called biofilms. Here we report the discovery of a novel extracellular fibril structure that promotes S. aureus biofilm integrity. Biochemical and genetic analysis has revealed that these fibers have amyloid-like properties and consist of small peptides called phenol soluble modulins (PSMs). Mutants unable to produce PSMs were susceptible to biofilm disassembly by matrix degrading enzymes and mechanical stress. Previous work has associated PSMs with biofilm disassembly, and we present data showing that soluble PSM peptides disperse biofilms while polymerized peptides do not. This work suggests the PSMs' aggregation into amyloid fibers modulates their biological activity and role in biofilms.

Functional amyloids composed of phenol soluble modulins stabilize Staphylococcus aureus biofilms.

Showerheads support the development of multi-species biofilms that can be unsightly, produce malodor, and may harbor pathogens. The outer-surface spray-plates of many showerheads support visible biofilms that likely contain a mixture of bacteria from freshwater and potentially from human users. Coaggregation, a mechanism by which genetically distinct bacteria specifically recognize one another, may contribute to the retention and enrichment of different species within these biofilms. The aim of this work was to describe the bacterial composition of outer spray-plate biofilms of three domestic showerheads and to determine the intra- and inter-biofilm coaggregation ability of each culturable isolate. The bacterial composition of the three biofilms was determined by using bacterial tag-encoded FLX amplicon pyrosequencing (bTEFAP) and by culturing on R2A medium. An average of 31 genera per biofilm were identified using bTEFAP and a total of 30 isolates were cultured. Even though the microbial diversity of each showerhead biofilm differed, every cultured isolate was able to coaggregate with at least one other isolate from the same or different showerhead biofilm. Promiscuous coaggregating isolates belonged to the genera Brevundimonas, Micrococcus, and Lysobacter. This work suggests that coaggregation may be a common feature of showerhead biofilms. Characterization of the mechanisms mediating coaggregation, and the inter-species interactions they facilitate, may allow for novel strategies to inhibit biofilm development.

Coaggregation occurs amongst bacteria within and between biofilms in domestic showerheads.

Few model systems are amenable to developing multi-species biofilms in parallel under environmentally germane conditions. This is a problem when evaluating the potential real-world effectiveness of antimicrobials in the laboratory. One such antimicrobial is cetylpyridinium chloride (CPC), which is used in numerous over-the-counter oral healthcare products. The aim of this work was to develop a high-throughput microfluidic system that is combined with a confocal laser scanning microscope (CLSM) to quantitatively evaluate the effectiveness of CPC against oral multi-species biofilms grown in human saliva.

A high-throughput microfluidic dental plaque biofilm system to visualize and quantify the effect of antimicrobials.

It is now clear that the most common oral diseases, dental caries and periodontitis, are caused by mixed-species communities rather than by individual pathogens working in isolation. Oral streptococci are central to these disease processes since they are frequently the first microorganisms to colonize oral surfaces and they are numerically the dominant microorganisms in the human mouth. Numerous interactions between oral streptococci and other bacteria have been documented. These are thought to be critical for the development of mixed-species oral microbial communities and for the transition from oral health to disease. Recent metagenomic studies are beginning to shed light on the co-occurrence patterns of streptococci with other oral bacteria. Refinements in microscopy techniques and biofilm models are providing detailed insights into the spatial distribution of streptococci in oral biofilms. Targeted genetic manipulation is increasingly being applied for the analysis of specific genes and networks that modulate interspecies interactions. From this work, it is clear that streptococci produce a range of extracellular factors that promote their integration into mixed-species communities and enable them to form social networks with neighboring taxa. These "community integration factors" include coaggregation-mediating adhesins and receptors, small signaling molecules such as peptides or autoinducer-2, bacteriocins, by-products of metabolism including hydrogen peroxide and lactic acid, and a range of extracellular enzymes. Here, we provide an overview of various types of community interactions between oral streptococci and other microorganisms, and we consider the possibilities for the development of new technologies to interfere with these interactions to help control oral biofilms.

Article	Year
The physiology and collective recalcitrance of microbial biofilm communities. Advances in microbial physiology\| PubMed ID: 12073654	2002
Microbial characterization of biofilms in domestic drains and the establishment of stable biofilm microcosms. Applied and environmental microbiology\| PubMed ID: 12513993	2003
Bacterial coaggregation: an integral process in the development of multi-species biofilms. Trends in microbiology\| PubMed ID: 12598132	2003
Shear rate moderates community diversity in freshwater biofilms. Applied and environmental microbiology\| PubMed ID: 15574945	2004
Molecular characterization of subject-specific oral microflora during initial colonization of enamel. Applied and environmental microbiology\| PubMed ID: 16597990	2006
Autoinducer 2: a concentration-dependent signal for mutualistic bacterial biofilm growth. Molecular microbiology\| PubMed ID: 16796680	2006
Bacterial interactions and successions during plaque development. Periodontology 2000\| PubMed ID: 16930306	2006
The importance of a multifaceted approach to characterizing the microbial flora of chronic wounds. Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society\| PubMed ID: 22092791	2011
Efficacy of an alcohol-free CPC-containing mouthwash against oral multispecies biofilms. The Journal of clinical dentistry\| PubMed ID: 22403974	2011
Autoinducer-2 influences interactions amongst pioneer colonizing streptococci in oral biofilms. Microbiology (Reading, England)\| PubMed ID: 22493304	2012
Functional amyloids composed of phenol soluble modulins stabilize Staphylococcus aureus biofilms. PLoS pathogens\| PubMed ID: 22685403	2012
Coaggregation occurs amongst bacteria within and between biofilms in domestic showerheads. Biofouling\| PubMed ID: 23194413	2013
A high-throughput microfluidic dental plaque biofilm system to visualize and quantify the effect of antimicrobials. The Journal of antimicrobial chemotherapy\| PubMed ID: 23800904	2013
Community interactions of oral streptococci. Advances in applied microbiology\| PubMed ID: 24581389	2014

Alexander H. Rickard

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