High Fluence Increases the Antibacterial Efficacy of PACK Cross-Linking.


Journal

Cornea
ISSN: 1536-4798
Titre abrégé: Cornea
Pays: United States
ID NLM: 8216186

Informations de publication

Date de publication:
Aug 2020
Historique:
pubmed: 19 4 2020
medline: 26 5 2021
entrez: 19 4 2020
Statut: ppublish

Résumé

Photoactivated chromophore for keratitis cross-linking (PACK-CXL) is used as an adjunct therapy to antibiotic medication in infectious keratitis. This experimental study aimed at quantifying the PACK-CXL efficacy as a function of UV fluence using several bacterial strains and irradiated volumes. Six distinct bacterial strains, including standardized strains and clinically isolated strains from patients with keratitis, were analyzed. Bacterial concentrations between 10 and 10 cells/mL were used (simulating small corneal ulcers). Volumes of either 11 μL (≈285 μm stromal thickness) or 40 μL (≈1000 μm stromal thickness) were irradiated within a microtiter plate at different fluences (5.4-27 J/cm) and irradiances (3, 9 and 18 mW/cm). The ratio of bacterial killing (B†) was determined to evaluate the antimicrobial efficacy of PACK-CXL. B† was similar (51 ± 11%) in bacterial concentrations between 10 and 10 per ml. In 11 μL volume, Staphylococcus aureus (SA) 8325-4 ATCC 29213, Bacillus subtilis (BS) 212901, and Pseudomonas aeruginosa (PA) 2016-866624 were most sensitive to PACK-CXL at 5.4 J/cm (on average B† = 49 ± 8%), whereas Klebsiella oxytoca (KO) 2016-86624 (B† = 25%) was least sensitive. When irradiating a larger volume, B† was on average lower in 40 μL (19 ± 18%), compared with 11 μL (45 ± 17%, P < 0.001). By contrast, applying a higher UV fluence increased B† of SA ATCC 29213, from 50% at 5.4 J/cm to 92% at 10.8 J/cm, to 100% at 16.2 J/cm and above. Applying higher UV fluences substantially increases the bacterial killing rates. Safety limits for clinical application require further investigation.

Identifiants

pubmed: 32304431
doi: 10.1097/ICO.0000000000002335
pii: 00003226-202008000-00016
doi:

Substances chimiques

Anti-Bacterial Agents 0
Cross-Linking Reagents 0
Collagen 9007-34-5

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1020-1026

Références

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Auteurs

Sabine Kling (S)

University of Zurich, CABMM, Laboratory for Ocular Cell Biology Group, Zurich, Switzerland.

Fong Siang Hufschmid (FS)

Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland.

Emilio A Torres-Netto (EA)

University of Zurich, CABMM, Laboratory for Ocular Cell Biology Group, Zurich, Switzerland.
Department of Ophthalmology, Paulista School of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil.

J Bradley Randleman (JB)

Cole Eye Institute, Clevelend Clinic, Cleveland, Ohio.

Mark Willcox (M)

School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia.

Reinhard Zbinden (R)

Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland.

Farhad Hafezi (F)

University of Zurich, CABMM, Laboratory for Ocular Cell Biology Group, Zurich, Switzerland.
kELZA Institute AG, Dietikon/Zurich, Switzerland.
Department of Ophthalmology, Wenzhou University, Wenzhou, China.
Faculty of Medicine, University of Geneva, Geneva, Switzerland;and.
Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA.

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