Could electric field-based dressings help fight biofilm resistance?

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Researchers from the Ohio State University Wexner Medical Center (OH, USA) have demonstrated that electric field-based dressings could be used to disrupt bacterial biofilms in order to prevent infections, combat antibiotic resistance and enable healing in infected burn wounds.

“Drug resistance in bacteria is a major threat, and antibiotic-resistant biofilm infections are estimated to account for at least 75% of bacterial infections in the United States,” stated Chandan Sen, lead author of the recently published study in the Annals of Surgery. “This is the first pre-clinical long-term porcine study to recognize the potential of ‘electroceuticals’ as an effective platform technology to combat wound biofilm infection.”

Bacteria rely on electrostatic interactions to adhere to surfaces, which is an important aspect of biofilm formation. The concept of weak electrical fields having anti-biofilm properties was first reported in 1992. In 2014, Sen investigated the use of a wireless electroceutical dressing (WED) using silver and zinc printed on fabric. WED can be used like any other disposable dressing, as when moistened, it generates a weak electric field without using any external power.

In this current study, Sen builds on this concept by testing WED in a polymicrobial biofilm infection model involving inoculation with Pseudomonas aeruginosa and Acinetobacter baumanii.

“The fact that wireless electric dressing is FDA-cleared and already in clinical use heightens the need to understand underlying mechanisms to enable optimal use,” commented Sen. “Since it relies on electrical principles, it’s not subject to the mechanisms that may promote drug resistance. Understanding how this novel dressing may influence microbial, host and host–microbe interactions will determine the optimal use of this simple technology platform,” he added.

Within their study, WED was applied within 2 hours of wound infection to test its ability to prevent biofilm formation. Additionally, WED was applied after 7 days of infection to study disruption of established biofilm. Wounds were treated with placebo dressing or WED twice-a-week for 56 days.

Their results demonstrated that: WED prevented and disrupted wound biofilm aggregates; WED accelerated functional wound closure by restoring skin barrier function; WED blunted biofilm-induced expression of certain genes and silencing of E-cadherin; and WED rescued against biofilm-induced persistent inflammation by circumventing NF-ĸB activation and its downstream cytokine response.

“The Ohio State researchers are teaming up with a burn care team within the Department of Defence to start a clinical trial within the next month to test this technology on burn wounds in humans,” Sen concluded.

Sources: Barki KG, Das A, Dixith S et al. Electric field based dressing disrupts mixed-species bacterial biofilm infection and restores functional wound healing. Ann. Surg. doi:10.1097/SLA.0000000000002504 (2017) (Epub ahead of print); www.eurekalert.org/pub_releases/2017-11/m-sse110617.php

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