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Percival/Thomas: Dual Hypothesis Pathogenesis INTER-RELATIONSHIP

West Virginia University. Biofilm Research Laboratory. Percival/Thomas: Dual Hypothesis Pathogenesis INTER-RELATIONSHIP.

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Percival/Thomas: Dual Hypothesis Pathogenesis INTER-RELATIONSHIP

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  1. West Virginia University Biofilm Research Laboratory Percival/Thomas: Dual Hypothesis Pathogenesis INTER-RELATIONSHIP CRITICAL COLONIZATION (Anti-Koch) HYPOTHESIS HYPOTHESIS I II BIOFILM RATIO EARLY TISSUE LATE ENDOGENOUS SKIN FLORA EXOGENOUS PATHOGENS Procaryote DEPTH ENVIRONMENT pH/Eh/STRESS 5 – 7 Day Critical Colonization Eucaryote 8 SELECTIVE PRESSURES 1. 2. BI-PHASIC CHRONIC WOUND ENVIRONMENT ORGANISM SELECTION / BF STRUCTURE

  2. West Virginia University Biofilm Research Laboratory Percival/Thomas: Dual Hypothesis Interface of 2 Hypotheses with Wound Development & Treatment Options Reversible Wound Environment pH, Eh Debridement Depth Critical Colonization Hypothesis I (Planktonic) Microbiology Hypothesis II Colonization (Biofilm) Structure (Stage I-II) Breaking the Cycle: Wound Management & Therapeutic Microbiology Debridement Therapeutics Antibiotics (Anti-Tumor) Probiotics

  3. West Virginia University Biofilm Research Laboratory Integrating Biofilm (BF) Stage and Planktonic (P) Transmission“Ping-Pong” Pathogenesis ABIOTIC Eh pH Dressing BF Nutrient Supply & Stress Planktonic Planktonic BF Wound Bed BIOTIC

  4. Biofilm Reactors: Chronic Wounds /Gauze The Covered Wound Bed is a Static Biofilm Reactor Influenced by Eh and pH via Perfusion, Enhancing Up Regulation to Recalcitrant Biofilm Phenotype (PBF) And changing Ratio from Planktonic Phenotype (PP) in Chronic Wounds _ PBF_ PP Planktonic Predominate ≤1 (Susceptible) ≥1 Biofilm Predominate (Recalcitrant)

  5. Tri-Phasic Model West Virginia University Biofilm Research Laboratory

  6. TRI PHASIC (PLUS) WOUND/Perio MODEL pH pH Oxygen tension Procaryote CLSM.SEM RATIO Organisms BF/P Phenotype Zone C Zone B Interface Zone A Target cells Eucaryote Histtoche Live/dead

  7. (CFU’s / ml / cm2) BAD >1 Clinical Outcomes PHENOTYPE Biofilm Planktonic Congo Red+ / Planktonic GOOD <1 Congo Red- / Planktonic (CFU’s / ml / cm2)

  8. West Virginia University Biofilm Research Laboratory COLONIZATION RESISTANCE 1000 µg/ml ANTI-INFECTIVE >5 BAD Clinical Outcomes RATIO MBEC MIC >1 and <5 ANTI-INFECTIVE <1 GOOD MBEC > MIC 0.1 0.01 256 µg/ml

  9. West Virginia University Biofilm Research Laboratory Results

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