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Innovative cold atmospheric plasma (iCAP) decreases corneal ulcer formation and bacterial loads and improves anterior chamber health in methicillin resistant Staphylococcus aureus keratitis
Bacterial keratitis is a vision-threatening infection of the cornea that is typically treated with antibiotics. However, antibiotics sometimes fail to eradicate the infection and do not prevent or repair the damage caused directly by the bacteria or the host immune response to the infection. Our gro...
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| Published in: | Experimental eye research 2023-12, Vol.237, p.109692-109692, Article 109692 |
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| container_end_page | 109692 |
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| container_title | Experimental eye research |
| container_volume | 237 |
| creator | Carr, Mary A. Marquart, Mary E. Sanchez, Miguel Saleem, Waqar Wellington, Ocean I. Lovell, K. Michael McCallister, Aaliyah Lightfoot, Victoria Ost, Evan B. Wise, Hua Z. Huang, Bo Sharma, Anjal C. |
| description | Bacterial keratitis is a vision-threatening infection of the cornea that is typically treated with antibiotics. However, antibiotics sometimes fail to eradicate the infection and do not prevent or repair the damage caused directly by the bacteria or the host immune response to the infection. Our group previously demonstrated that treatment of Pseudomonas aeruginosa keratitis in rabbits with innovative cold atmospheric plasma (iCAP) resulted in reduced edema, ulcer formation, and bacterial load. In this study, we investigated the efficacy of iCAP treatment in methicillin-resistant Staphylococcus aureus (MRSA). New Zealand white rabbits were infected intrastromally with MRSA then treated with iCAP, moxifloxacin, vancomycin, or combination of iCAP with each antibiotic to assess the safety and efficacy of iCAP treatment compared to untreated controls and antibiotics. iCAP treatment significantly reduced bacterial loads and inflammation, improved anterior chamber clarity, and prevented corneal ulceration compared to untreated controls and antibiotic treatment. Safety assessments of grimace test scores and tear production showed that iCAP was not significantly different from either antibiotic treatment in terms of distress or tear production. Combination iCAP/antibiotic treatment did not appear to provide significant added benefit over iCAP alone. Our findings suggest that the addition of iCAP may be a viable tool in reducing damage to the cornea and anterior chamber of the eye following S. aureus keratitis.
•An innovative cold atmospheric plasma (iCAP) device was developed for treatment of bacterial keratitis.•ICAP treatment of rabbit corneas infected with methicillin-resistant Staphylococcus aureus significantly reduced bacterial burden and inflammation compared to antibiotics or untreated controls.•Combining iCAP with antibiotics did not provide additional efficacy or prevention of inflammation. |
| doi_str_mv | 10.1016/j.exer.2023.109692 |
| format | article |
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•An innovative cold atmospheric plasma (iCAP) device was developed for treatment of bacterial keratitis.•ICAP treatment of rabbit corneas infected with methicillin-resistant Staphylococcus aureus significantly reduced bacterial burden and inflammation compared to antibiotics or untreated controls.•Combining iCAP with antibiotics did not provide additional efficacy or prevention of inflammation.</description><identifier>ISSN: 0014-4835</identifier><identifier>EISSN: 1096-0007</identifier><identifier>DOI: 10.1016/j.exer.2023.109692</identifier><identifier>PMID: 37884203</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Animals ; Anti-Bacterial Agents - therapeutic use ; Antimicrobial ; Bacterial Load ; Cold atmospheric plasma ; Corneal Ulcer - drug therapy ; Corneal Ulcer - microbiology ; Eye Infections, Bacterial - drug therapy ; Eye Infections, Bacterial - microbiology ; Eye Infections, Bacterial - prevention & control ; Keratitis ; Keratitis - drug therapy ; Keratitis - microbiology ; Keratitis - prevention & control ; Methicillin-Resistant Staphylococcus aureus ; MRSA ; Rabbits ; Staphylococcal Infections - drug therapy ; Staphylococcal Infections - microbiology ; Staphylococcus aureus</subject><ispartof>Experimental eye research, 2023-12, Vol.237, p.109692-109692, Article 109692</ispartof><rights>2023</rights><rights>Copyright © 2023 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c307t-8feac8fa1283c8705679efe985d60d97f260fd768627802ff5328bc56cbacf3c3</cites><orcidid>0000-0002-3557-6048</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37884203$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Carr, Mary A.</creatorcontrib><creatorcontrib>Marquart, Mary E.</creatorcontrib><creatorcontrib>Sanchez, Miguel</creatorcontrib><creatorcontrib>Saleem, Waqar</creatorcontrib><creatorcontrib>Wellington, Ocean I.</creatorcontrib><creatorcontrib>Lovell, K. Michael</creatorcontrib><creatorcontrib>McCallister, Aaliyah</creatorcontrib><creatorcontrib>Lightfoot, Victoria</creatorcontrib><creatorcontrib>Ost, Evan B.</creatorcontrib><creatorcontrib>Wise, Hua Z.</creatorcontrib><creatorcontrib>Huang, Bo</creatorcontrib><creatorcontrib>Sharma, Anjal C.</creatorcontrib><title>Innovative cold atmospheric plasma (iCAP) decreases corneal ulcer formation and bacterial loads and improves anterior chamber health in methicillin resistant Staphylococcus aureus keratitis</title><title>Experimental eye research</title><addtitle>Exp Eye Res</addtitle><description>Bacterial keratitis is a vision-threatening infection of the cornea that is typically treated with antibiotics. However, antibiotics sometimes fail to eradicate the infection and do not prevent or repair the damage caused directly by the bacteria or the host immune response to the infection. Our group previously demonstrated that treatment of Pseudomonas aeruginosa keratitis in rabbits with innovative cold atmospheric plasma (iCAP) resulted in reduced edema, ulcer formation, and bacterial load. In this study, we investigated the efficacy of iCAP treatment in methicillin-resistant Staphylococcus aureus (MRSA). New Zealand white rabbits were infected intrastromally with MRSA then treated with iCAP, moxifloxacin, vancomycin, or combination of iCAP with each antibiotic to assess the safety and efficacy of iCAP treatment compared to untreated controls and antibiotics. iCAP treatment significantly reduced bacterial loads and inflammation, improved anterior chamber clarity, and prevented corneal ulceration compared to untreated controls and antibiotic treatment. Safety assessments of grimace test scores and tear production showed that iCAP was not significantly different from either antibiotic treatment in terms of distress or tear production. Combination iCAP/antibiotic treatment did not appear to provide significant added benefit over iCAP alone. Our findings suggest that the addition of iCAP may be a viable tool in reducing damage to the cornea and anterior chamber of the eye following S. aureus keratitis.
•An innovative cold atmospheric plasma (iCAP) device was developed for treatment of bacterial keratitis.•ICAP treatment of rabbit corneas infected with methicillin-resistant Staphylococcus aureus significantly reduced bacterial burden and inflammation compared to antibiotics or untreated controls.•Combining iCAP with antibiotics did not provide additional efficacy or prevention of inflammation.</description><subject>Animals</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antimicrobial</subject><subject>Bacterial Load</subject><subject>Cold atmospheric plasma</subject><subject>Corneal Ulcer - drug therapy</subject><subject>Corneal Ulcer - microbiology</subject><subject>Eye Infections, Bacterial - drug therapy</subject><subject>Eye Infections, Bacterial - microbiology</subject><subject>Eye Infections, Bacterial - prevention & control</subject><subject>Keratitis</subject><subject>Keratitis - drug therapy</subject><subject>Keratitis - microbiology</subject><subject>Keratitis - prevention & control</subject><subject>Methicillin-Resistant Staphylococcus aureus</subject><subject>MRSA</subject><subject>Rabbits</subject><subject>Staphylococcal Infections - drug therapy</subject><subject>Staphylococcal Infections - microbiology</subject><subject>Staphylococcus aureus</subject><issn>0014-4835</issn><issn>1096-0007</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9UcuO1DAQtBCIHQZ-gAPycTlkcJyXR-KyGvFYaSWQgLPl6bQVD04cbGfEfhz_RodZOHLqdnVVtdrF2MtS7EpRtm9OO_yJcSeFrAjYt3v5iG3WphBCdI_ZRoiyLmpVNVfsWUonQqu6q5-yq6pTqpai2rBft9MUzia7M3IIvucmjyHNA0YHfPYmjYZfu8PN59e8R4hoEiYixgmN54sHjNyGOJJBmLiZen40kElMUx9Mn_5gbpxjOOP6WGchchjMeCTtQDZ54G7iI-bBgfOe-ojJpUxk_iWbebj3AQLAQvolIpXvGGlhduk5e2KNT_jioW7Zt_fvvh4-FnefPtwebu4KqESXC2XRgLKmlKoC1Ymm7fZoca-avhX9vrOyFbbvWtXKTglpbVNJdYSmBbrGVlBt2fXFl-74sWDKenQJ0HszYViSloo-WdWCktgyeaFCDClFtHqObjTxXpdCr7Hpk15j02ts-hIbiV49-C_HEft_kr85EeHthYB05dmRPIHDCbB3ESHrPrj_-f8GRjSuwg</recordid><startdate>202312</startdate><enddate>202312</enddate><creator>Carr, Mary A.</creator><creator>Marquart, Mary E.</creator><creator>Sanchez, Miguel</creator><creator>Saleem, Waqar</creator><creator>Wellington, Ocean I.</creator><creator>Lovell, K. 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Michael ; McCallister, Aaliyah ; Lightfoot, Victoria ; Ost, Evan B. ; Wise, Hua Z. ; Huang, Bo ; Sharma, Anjal C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c307t-8feac8fa1283c8705679efe985d60d97f260fd768627802ff5328bc56cbacf3c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Animals</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antimicrobial</topic><topic>Bacterial Load</topic><topic>Cold atmospheric plasma</topic><topic>Corneal Ulcer - drug therapy</topic><topic>Corneal Ulcer - microbiology</topic><topic>Eye Infections, Bacterial - drug therapy</topic><topic>Eye Infections, Bacterial - microbiology</topic><topic>Eye Infections, Bacterial - prevention & control</topic><topic>Keratitis</topic><topic>Keratitis - drug therapy</topic><topic>Keratitis - microbiology</topic><topic>Keratitis - prevention & control</topic><topic>Methicillin-Resistant Staphylococcus aureus</topic><topic>MRSA</topic><topic>Rabbits</topic><topic>Staphylococcal Infections - drug therapy</topic><topic>Staphylococcal Infections - microbiology</topic><topic>Staphylococcus aureus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Carr, Mary A.</creatorcontrib><creatorcontrib>Marquart, Mary E.</creatorcontrib><creatorcontrib>Sanchez, Miguel</creatorcontrib><creatorcontrib>Saleem, Waqar</creatorcontrib><creatorcontrib>Wellington, Ocean I.</creatorcontrib><creatorcontrib>Lovell, K. 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Michael</au><au>McCallister, Aaliyah</au><au>Lightfoot, Victoria</au><au>Ost, Evan B.</au><au>Wise, Hua Z.</au><au>Huang, Bo</au><au>Sharma, Anjal C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Innovative cold atmospheric plasma (iCAP) decreases corneal ulcer formation and bacterial loads and improves anterior chamber health in methicillin resistant Staphylococcus aureus keratitis</atitle><jtitle>Experimental eye research</jtitle><addtitle>Exp Eye Res</addtitle><date>2023-12</date><risdate>2023</risdate><volume>237</volume><spage>109692</spage><epage>109692</epage><pages>109692-109692</pages><artnum>109692</artnum><issn>0014-4835</issn><eissn>1096-0007</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Bacterial keratitis is a vision-threatening infection of the cornea that is typically treated with antibiotics. However, antibiotics sometimes fail to eradicate the infection and do not prevent or repair the damage caused directly by the bacteria or the host immune response to the infection. Our group previously demonstrated that treatment of Pseudomonas aeruginosa keratitis in rabbits with innovative cold atmospheric plasma (iCAP) resulted in reduced edema, ulcer formation, and bacterial load. In this study, we investigated the efficacy of iCAP treatment in methicillin-resistant Staphylococcus aureus (MRSA). New Zealand white rabbits were infected intrastromally with MRSA then treated with iCAP, moxifloxacin, vancomycin, or combination of iCAP with each antibiotic to assess the safety and efficacy of iCAP treatment compared to untreated controls and antibiotics. iCAP treatment significantly reduced bacterial loads and inflammation, improved anterior chamber clarity, and prevented corneal ulceration compared to untreated controls and antibiotic treatment. Safety assessments of grimace test scores and tear production showed that iCAP was not significantly different from either antibiotic treatment in terms of distress or tear production. Combination iCAP/antibiotic treatment did not appear to provide significant added benefit over iCAP alone. Our findings suggest that the addition of iCAP may be a viable tool in reducing damage to the cornea and anterior chamber of the eye following S. aureus keratitis.
•An innovative cold atmospheric plasma (iCAP) device was developed for treatment of bacterial keratitis.•ICAP treatment of rabbit corneas infected with methicillin-resistant Staphylococcus aureus significantly reduced bacterial burden and inflammation compared to antibiotics or untreated controls.•Combining iCAP with antibiotics did not provide additional efficacy or prevention of inflammation.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>37884203</pmid><doi>10.1016/j.exer.2023.109692</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-3557-6048</orcidid></addata></record> |
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| ispartof | Experimental eye research, 2023-12, Vol.237, p.109692-109692, Article 109692 |
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| subjects | Animals Anti-Bacterial Agents - therapeutic use Antimicrobial Bacterial Load Cold atmospheric plasma Corneal Ulcer - drug therapy Corneal Ulcer - microbiology Eye Infections, Bacterial - drug therapy Eye Infections, Bacterial - microbiology Eye Infections, Bacterial - prevention & control Keratitis Keratitis - drug therapy Keratitis - microbiology Keratitis - prevention & control Methicillin-Resistant Staphylococcus aureus MRSA Rabbits Staphylococcal Infections - drug therapy Staphylococcal Infections - microbiology Staphylococcus aureus |
| title | Innovative cold atmospheric plasma (iCAP) decreases corneal ulcer formation and bacterial loads and improves anterior chamber health in methicillin resistant Staphylococcus aureus keratitis |
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