Laura A Novotny1, Tendy Chiang2,3,4, Steven D Goodman1,2, Charles A Elmaraghy2,3,4, Lauren O Bakaletz1,2,3. 1. Center for Microbial Pathogenesis, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, U.S.A. 2. The Ohio State University College of Medicine, Columbus, Ohio, U.S.A. 3. Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A. 4. Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, Ohio, U.S.A.
Abstract
OBJECTIVES/HYPOTHESIS: To evaluate the ability of humanized monoclonal antibody fragments directed against a bacterial DNABII protein plus ofloxacin delivered directly into the chinchilla middle ear via tympanostomy tube (TT) to enhance the ability of ofloxacin to eradicate biofilms formed by nontypeable Haemophilus influenzae (NTHI). STUDY DESIGN: A blinded pre-clinical study of comparative efficacy of single versus combinatorial treatment strategies. METHODS: NTHI was allowed to form biofilms in the middle ears of chinchillas prior to TT placement. Ofloxacin, humanized Fab fragments against a bacterial DNABII protein that disrupts biofilms or Fab fragments plus ofloxacin were instilled into the middle ear via TT. For two consecutive days, ofloxacin was delivered twice-a-day, Fab fragments were delivered once-a-day, or these treatments were combined. Relative biofilm resolution (as determined via two outcome measures) and eradication of viable NTHI were assessed 1-day later. RESULTS: Whereas ofloxacin alone did not resolve biofilms or eradicate NTHI from the middle ear, delivery of Fab fragments significantly reduced both biofilms and NTHI burden over this short course of treatment. Notably, co-delivery of ofloxacin plus humanized Fab fragments eradicated both NTHI and biofilms from the middle ear, an enhanced outcome compared to receipt of either treatment alone. CONCLUSION: This study demonstrated a powerful combinatorial approach to release bacteria from their protective biofilms and rapidly render them vulnerable to killing by a previously ineffective antibiotic. An approach to combine ofloxacin with humanized Fab fragments that disrupt biofilms has tremendous potential to quickly resolve chronic otorrhea suffered by children with chronic suppurative otitis media or chronic post-tympanostomy tube otorrhea and thereby improve their quality of life. LEVEL OF EVIDENCE: NA Laryngoscope, 131:E2698-E2704, 2021.
OBJECTIVES/HYPOTHESIS: To evaluate the ability of humanized monoclonal antibody fragments directed against a bacterial DNABII protein plus ofloxacin delivered directly into the chinchilla middle ear via tympanostomy tube (TT) to enhance the ability of ofloxacin to eradicate biofilms formed by nontypeable Haemophilus influenzae (NTHI). STUDY DESIGN: A blinded pre-clinical study of comparative efficacy of single versus combinatorial treatment strategies. METHODS: NTHI was allowed to form biofilms in the middle ears of chinchillas prior to TT placement. Ofloxacin, humanized Fab fragments against a bacterial DNABII protein that disrupts biofilms or Fab fragments plus ofloxacin were instilled into the middle ear via TT. For two consecutive days, ofloxacin was delivered twice-a-day, Fab fragments were delivered once-a-day, or these treatments were combined. Relative biofilm resolution (as determined via two outcome measures) and eradication of viable NTHI were assessed 1-day later. RESULTS: Whereas ofloxacin alone did not resolve biofilms or eradicate NTHI from the middle ear, delivery of Fab fragments significantly reduced both biofilms and NTHI burden over this short course of treatment. Notably, co-delivery of ofloxacin plus humanized Fab fragments eradicated both NTHI and biofilms from the middle ear, an enhanced outcome compared to receipt of either treatment alone. CONCLUSION: This study demonstrated a powerful combinatorial approach to release bacteria from their protective biofilms and rapidly render them vulnerable to killing by a previously ineffective antibiotic. An approach to combine ofloxacin with humanized Fab fragments that disrupt biofilms has tremendous potential to quickly resolve chronic otorrhea suffered by children with chronic suppurative otitis media or chronic post-tympanostomy tube otorrhea and thereby improve their quality of life. LEVEL OF EVIDENCE: NA Laryngoscope, 131:E2698-E2704, 2021.
Authors: Jodi E Gustave; Joseph A Jurcisek; Karen S McCoy; Steven D Goodman; Lauren O Bakaletz Journal: J Cyst Fibros Date: 2012-11-17 Impact factor: 5.482
Authors: Kathryn M Harmes; R Alexander Blackwood; Heather L Burrows; James M Cooke; R Van Harrison; Peter P Passamani Journal: Am Fam Physician Date: 2013-10-01 Impact factor: 3.292
Authors: Aishwarya Devaraj; John Buzzo; Christopher J Rocco; Lauren O Bakaletz; Steven D Goodman Journal: Microbiologyopen Date: 2017-12-12 Impact factor: 3.139
Authors: Kalyan K Dewan; Colleen Sedney; Amanda D Caulfield; Yang Su; Longhuan Ma; Uriel Blas-Machado; Eric T Harvill Journal: Front Cell Infect Microbiol Date: 2022-01-24 Impact factor: 5.293