Comparison of the in vitro antibiofilm activities of otic cleansers against canine otitis externa pathogens

Abstract

Background: Biofilm production by canine otitis externa (COE) pathogens and resistance development to multiple antimicrobials are commonly reported problems in veterinary practice. The use of adjuvants to disrupt biofilms may be a viable adjunctive therapy. Hypothesis/Objectives: To compare the in vitro antibiofilm activity against COE pathogens of three otic cleansers: PHMB-EDTA (poly [hexamethylene] biguanide hydrochloride and disodium edetate), N-acetylcysteine (NAC) and Triz-EDTA. Animals/Isolates: Thirty isolates of each species, including Staphylococcus pseudintermedius, Pseudomonas aeruginosa, Streptococcus canis, Proteus mirabilis, Escherichia coli, and Malassezia pachydermatis, were collected from COE cases and stored at −80°C until tested. Methods and Materials: Biofilm production was determined by Congo-red agar and microtitre plate-assay methods. Ten of the best biofilm-producing isolates per species were selected to determine minimum biofilm eradication concentration (MBEC) values. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values were determined to compare MBEC/MIC and MBEC/MBC. Results: PHMB-EDTA possessed antibiofilm activity at low concentrations (MBEC range 3.9/2.3–500/300 μg/mL) against all tested COE pathogens. NAC demonstrated antibiofilm activity for all tested bacterial COE pathogens (MBEC range 4,925–19,700 μg/mL); however, most M. pachydermatis isolates exhibited MBEC values >20,000 μg/mL. Triz/EDTA at the highest concentration tested (3,025/19,520 μg/mL) did not demonstrate antibiofilm activity against most COE pathogens except for S. canis (94.5/610 μg/mL). Conclusions and Clinical Relevance: PHMB-EDTA had intrinsic antibiofilm activity at low concentrations against all COE pathogens. Therefore, it is likely to be a very effective adjuvant when used in conjunction with other antimicrobials for the treatment of COE caused by biofilm-producing pathogens.