Berkes EA, Subhadra B, Henson M, Krier J, Monsul N
Introduction: Skin health, particularly in patients with atopic dermatitis, includes homeostasis among the microbes comprising the dermatologic microbiome. Biofilms are the surface-colonizing form of life preferred by most microbes, including pathogens, and grow on most surfaces. Commensals may help support a healthy skin barrier by inhibiting pathogenic biofilms such as methicillin resistant Staphylococcus aureus (MRSA). Using a patent-pending bio-extract from a novel probiotic human commensal organism, we defined MRSA anti- biofilm activities of potential clinical relevance in the prevention and treatment of MRSA biofilms.
Methods: Using a 96-well biofilm microplate assay, proprietary bio-extracts were tested against clinical MRSA isolates for 2 anti-biofilm activities: anti-biofilm adhesion and detachment of MRSA biofilm. Both biofilm activities were compared against vancomycin, meropenem or both.
Results: Anti-adhesion: The proprietary bio-extract was 2-3x more effective than antibiotic controls, with 35% anti-adhesion at 0.01 mg/ml, 50% at 0.05 mg/ml, 58% at 0.1 mg/ml, 85% at 0.5 mg/ml and 90% at 1 mg/ml when compared against untreated growth control. Biofilm detachment: The proprietary bio-extract was up to 10 times more effective than antibiotic controls: 0.05 mg/ml detached 50% of MRSA biofilm, whereas vancomycin and meropenem both detached approximately 5%. Unlike the anti-adhesive assay, there was no apparent dose-dependence, as percent detachment declined as bio-extract concentration increased. Lack of dose- dependence may reflect non-metabolic mechanisms of action and/or brief application time.
Conclusion: The novel human-probiotic derived bio-extract could synergistically and safely treat and prevent MRSA biofilms present on biologic surfaces such as the skin in clinically relevant chronic disease states of the skin, such as atopic dermatitis. Skin of AD patients is diffusely colonized by Staphylococcus aureus (S. aureus) and methicillin-resistant Staphylococcus aureus (MRSA). Increased burden of these microbes have been shown to be associated with acute exacerbations; chronically, presence of these microbes are associated with inflammation, decreased skin immune defense, a skew towards an allergic milieau and a weakened skin barrier. Recently, MRSA biofilms have been shown to be a key factor in the persistence of these microbes in AD patients. Treatments such as antibiotics and bleach baths have been used but carry their own challenges, including antibiotic resistance, skin microbiome derangement, cost, further skin barrier damage, exposure to oxidants and patient/family treatment adherence. This novel, human probiotic-derived bio-extract may be able to overcome these challenges while avoiding additional medication, especially antibiotic exposure, by presenting a novel and naturally-derived means to safely and topically prevent and reduce MRSA biofilm burden in the large atopic dermatitis population.