Although different strategies to control biofilm formation on endotracheal tubes have been proposed, there are scarce scientific data on applying phages for both removing and preventing Pseudomonas aeruginosa biofilms on the device surface. Here, the anti-biofilm capacity of five bacteriophages was evaluated by a high content screening assay. We observed that biofilms were significantly reduced after phage treatment, especially in multidrug-resistant strains. Considering the anti-biofilm screens, two phages were selected as cocktail components, and the cocktail’s ability to prevent colonization of the endotracheal tube surface was tested in a dynamic biofilm model. Phage-coated tubes were challenged with different P. aeruginosa strains. The biofilm growth was monitored from 24 to 168 h by colony forming unit counting, metabolic activity assessment, and biofilm morphology observation. The phage cocktail promoted differences of bacterial colonization; nonetheless, the action was strain dependent. Phage cocktail coating did not promote substantial changes in metabolic activity. Scanning electron microscopy revealed a higher concentration of biofilm cells in control, while tower-like structures could be observed on phage cocktail-coated tubes. These results demonstrate that with the development of new coating strategies, phage therapy has potential in controlling the endotracheal tube-associated biofilm.

中文翻译：

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噬菌体鸡尾酒介导的气管导管表面铜绿假单胞菌生物膜抑制作用

尽管已经提出了控制气管插管上生物膜形成的不同策略，但是在应用噬菌体去除和预防装置表面的铜绿假单胞菌生物膜方面缺乏科学数据。在这里，通过高含量筛选试验评估了五个噬菌体的抗生物膜能力。我们观察到，噬菌体处理后，生物膜明显减少，尤其是在多药耐药株中。考虑到抗生物膜的筛选，选择了两个噬菌体作为鸡尾酒成分，并在动态生物膜模型中测试了鸡尾酒防止气管内导管表面定殖的能力。用不同的铜绿假单胞菌攻击噬菌体包被的试管株。通过集落形成单位计数，代谢活性评估和生物膜形态观察来监测24至168小时的生物膜生长。噬菌体混合物促进细菌定殖的差异；然而，该动作是应变依赖的。噬菌体鸡尾酒涂层没有促进代谢活性的实质性变化。扫描电子显微镜显示，对照中生物膜细胞的浓度较高，而在噬菌体混合物包被的试管中可以观察到塔状结构。这些结果表明，随着新的包被策略的发展，噬菌体疗法具有控制气管内导管相关生物膜的潜力。