Studies of the Prevention of Biofilm Growth: The Effects of Tolaasin on Staphylococcus Species' Biofilm Formation, and the Impact of Last Treatment of Enterococcus Faecalis

Staphylococcus aureus and Staphylococcus epidermidis are among the most common causes of hospital-acquired infections5, 7, 8. Despite the advancements in modern antimicrobials, infections from these organisms can be very difficult to treat, and equally as difficult to prevent 6,7. These organisms’ abilities to form biofilms are directly related to their abilities to cause infections. In biofilms, the staphylococcal species can survive antibiotics and immune responses much better than planktonic cells7. Tolaasin—a toxin and natural biosurfactant produced by P. tolaasii—has been briefly tested against biofilm formation, and the results suggested that it could have inhibitory effects. In order to further confirm and expand upon this potentially useful data, additional testing was performed to determine the effects of tolaasin on the two organisms. In addition, laser treatment was tested on E. faecalis in order to supplement our current understanding of biofilm behavior, and provide additional data to suggest alternative agents against biofilm growth.
This thesis addresses the following questions: What are the best methods to test the effects of tolaasin, cephalexin and laser on the biofilms of S. aureus and S. epidermidis? Does tolaasin prevent or disrupt biofilm formation in S. aureus and S. epidermidis? Does tolaasin work synergistically with cephalexin to prevent biofilm growth and maturation in S. aureus and S. epidermidis? And, what effects does laser treatment have on E. faecalis biofilms? In order to answer these questions, tolaasin was isolated from P. tolaasii, and biofilms were pre-treated with tolaasin. Trials were performed with tolaasin, cephalexin, or a combination of both. The effectiveness of each treatment was determined by observing the biofilm growth. The protocols were then optimized and trials were repeated. Additionally, E. faecalis biofilms were exposed to laser treatment. Using confocal microscopy, the biofilms were observed and quantitative results were used to determine the effectiveness of the treatment. Overall, the results indicated that tolaasin has little effect on biofilm growth. However, further investigation is necessary to confirm these results due to some inconsistent data obtained over the course of the trials. Variations and improvements to the protocol are necessary to accurately determine tolaasin’s potential role in healthcare. Finally, the results of the laser trials suggest that EDTA in conjunction with laser treatment could be useful in cleaning root canals and eliminating post-procedural biofilms—thereby preventing infections.