Pseudomonas aeruginosa: Infections and novel approaches to treatment "Knowing the enemy" the threat of Pseudomonas aeruginosa and exploring novel approaches to treatment

Assessment of furobenzopyran from Ammi visnaga in disrupting Pseudomonas aeruginosa biofilms and suppressing associated virulence factors

Ammi visnaga, an herbal plant containing the furobenzopyran derivative (khellin) with therapeutic effects, remains unexplored for its potential to disrupt the biofilm formation and suppress the virulence factors mediated through the Las quorum-sensing system in Pseudomonas aeruginosa. The current study investigates the efficacy of khellin in inhibiting biofilm formation, suppressing biofilm-associated virulence factors at sub-minimum inhibitory concentration (sub-MIC) levels of ≤9 μg/mL, and its interactions with LasR are evaluated through molecular docking and dynamics simulation. In-silico analysis using the 'aBiofilm' web tool predicted a strong antibiofilm potential for khellin, with no prior reports of such activity. This prediction was supported by confocal laser scanning microscopy, which demonstrated significant biofilm inhibition at 9 μg/mL, along with noticeable microbial distortion. Further assessments showed that sub-MIC levels of khellin effectively reduced biofilm-associated virulence factors, including swimming and swarming motility, rhamnolipid content, cell surface hydrophobicity, alginate, and exopolysaccharide production, in a dose-dependent manner, though the extent of inhibition varied among these factors. Molecular docking analysis yielded a score of -7.285 kcal/mol, indicating a favorable binding, and 'Molecular Mechanics Generalized Born Surface Area' binding free energy of -28.32 kcal/mol confirms a stable and energetically favorable interaction with the target protein. The stability of the khellin-protein complex was validated through a 100 ns molecular dynamics simulation using the 'Optimized Potentials for Liquid Simulations-All Atom' force field model. Results of root mean square deviation, root mean square fluctuation, radius of gyration, intramolecular hydrogen bonds, molecular surface area, solvent accessible surface area, and polar surface area confirmed that khellin maintained stable interactions throughout the simulation. These findings suggest khellin as a potential candidate for treating Pseudomonas-associated biofilm infections and provide strong evidence that khellin may function as a quorum-sensing inhibitor of the P.aeruginosa's LasR protein.

Bacterial and Fungal Pathogens in Chronic Suppurative Otitis Media and Otitis Externa With Persistent Otorrhea: A Cross-Sectional Study in a Low- to Middle-Income Country (Pakistan)

OBJECTIVE

This study aimed to determine the prevalence and distribution of bacterial and fungal pathogens in cases of chronic suppurative otitis media (CSOM) and otitis externa presenting with persistent otorrhea and to compare associated pathogen profiles between these two conditions in a low-middle-income country setting (Pakistan). Design, setting, and duration: This cross-sectional study was conducted at Creek General Hospital and United Hospital in Karachi, Pakistan, over a three-month period from 1 December 2024 till 28 February 2025.

METHODS

A total of 384 patients aged 11-65 years diagnosed with CSOM or otitis externa and exhibiting persistent otorrhea were recruited through convenient sampling. Demographic and microbiological data, including pathogen identification and characterization, were collected using a structured evaluation form. Data analysis employed Statistical Product and Service Solutions (SPSS, version 27; IBM SPSS Statistics for Windows, Armonk, NY), with the chi-square test to assess variable associations and significant variations between the groups (p < 0.05 considered significant).  Primary outcome: To identify the frequency of common pathogen types isolated from patients with CSOM and otitis externa.

SECONDARY OUTCOME

 The comparative distribution of bacterial and fungal pathogens isolated from patients diagnosed with CSOM and otitis externa presenting with persistent otorrhea.

RESULTS

Of 384 participants, 50.8% were male, and 49.2% were female, predominantly aged 21-30 years and from urban areas. CSOM was the most prevalent diagnosis (46.6%), followed by otitis externa (42.7%), with co-infections in 10.7%. Bacterial pathogens (50%) were more common than fungal (28.6%) or mixed infections (21.4%). The most frequently identified bacterial pathogen was Pseudomonas aeruginosa (34.6%), while Aspergillus spp. (49.7%) predominated among fungi. Pathogen-type distribution showed no significant variation between CSOM and otitis externa (p > 0.05).

CONCLUSION

This study highlights the high prevalence of P. aeruginosa and Aspergillus spp. as the most common pathogens in CSOM and otitis externa in Karachi, Pakistan. The findings underscore the importance of pathogen-specific treatment protocols tailored to local microbial patterns. Given the region's environmental factors, such as poor sanitation and humidity, integrating these microbial profiles into local healthcare strategies is crucial for effective antimicrobial stewardship. There was no significant variation between pathogen distribution across CSOM and otitis externa (p > 0.05), indicating that the choice of pathogen was not strongly linked to clinical condition. While this study did not explore the links between pathogen type and clinical severity or treatment outcomes, these results provide valuable insights for guiding clinicians in optimizing treatment regimens. Ultimately, such strategies could improve patient outcomes and reduce the burden of these infections in similar low-resource settings.

Inhibition of Clinical Multidrug-Resistant Pseudomonas aeruginosa Biofilms by Cinnamaldehyde and Eugenol From Essential Oils: In Vitro and In Silico Analysis

Pseudomonas aeruginosa causes nosocomial infections and chronic diseases. Cinnamomum cassia and Syzygium aromaticum are used natural antimicrobials. Essential oil (EO) from C. cassia (CCEO) and S. aromaticum (CEO) was characterized using GC-MS analysis. Eugenol (82.31%), eugenol acetate (10.57%), and β-caryophyllene (3.41%) were major constituents in CEO while cinnamaldehyde (88.18%), cinnamyl acetate (2.85%) and 2-methoxy cinnamaldehyde (1.77%) were main components in CCEO. The EOs and major constituents exhibited good antimicrobial activity against clinical strains of P. aeruginosa. Cinnamaldehyde exhibited the best antimicrobial effect with minimal inhibitory concentration (MIC) as low as 0.031% ± 0.07% (v/v) and inhibition zones reaching 30 ± 0.5 mm diameter. Test samples showed antibiofilm activities against two culture types and seven clinical strains of P. aeruginosa at concentrations of 2MIC to MIC/4. CCEO and its major constituent cinnamaldehyde were more active, compared to CEO and its major constituent eugenol. Scanning electron microscopy images showed untreated colonies with well-developed biofilms while there was significant reduction of biofilms with distorted architecture and cell shrinkage upon treatment with test samples. In silico studies indicated great interactions between the major compounds, eugenol and cinnamaldehyde, with the receptor proteins of P. aeruginosa revealed by negative binding energies. Eugenol and cinnamaldehyde exhibited appreciable druglikeness.

The power of DNA-encoded chemical libraries in the battle against drug-resistant bacteria

Drug-resistant bacteria are increasingly posing an imminent existential threat, as many bacteria have developed resistance mechanisms that render most antibiotics ineffective. In the meantime, the number of newly approved antibiotics or new clinical antibacterial drug candidates is sharply declining. A key challenge is finding effective pharmacophores that can penetrate and accumulate inside bacterial cells. DNA-encoded chemical libraries (DECLs) play vital roles in accelerating hit identification and screening against various bacterial protein targets. In this review, we highlight the pivotal role of DECLs in accelerating the identification of new pharmacophores and hit compounds against drug-resistant bacteria. This review focuses on the protein targets, where DECLs have directly contributed to the rapid identification of new inhibitors. In addition, this review explores the methods used to screen DECLs against various bacterial targets and discusses the current outlook and perspectives on the role of DECLs in tackling antimicrobial resistance.

Green Biosynthesis of Bimetallic Copper Oxide-Selenium Nanoparticles Using Leaf Extract of Lagenaria Siceraria: Antibacterial, Anti-Virulence Activities Against Multidrug-Resistant Pseudomonas Aeruginosa

Introduction

Clinical isolates of Pseudomonas aeruginosa (P. aeruginosa) are among the most recovered bacteria with phenotypic antimicrobial resistance. Bimetallic nanoparticles (BNPs) have received much attention for antimicrobial activity in the last decade. This research aimed to biosynthesize bimetallic copper oxide-selenium nanoparticles (CuO-Se BNPs) and to assess its bioactivity on various P. aeruginosa clinical isolates.

Methodology

Based on the possible synergistic effects, CuO-Se BNPs were selected and biosynthesized using leaf extract of Lagenaria siceraria (L. siceraria) for the first time. The obtained BNPs were characterized using UV-vis spectroscopy, X-ray diffraction (XRD), energy dispersive X-ray spectroscopy (EDX), and transmission and scanning electron microscopes. The capability of Cu-Se BNPs to cease the growth of P. aeruginosa isolates and to reduce their virulence characters was evaluated. Also, different cell lines were used to assess its cytotoxicity and anticancer activity.

Results

The elemental composition of CuO and Se was revealed by the UV, XRD, and EDX data, indicating the synthesis of CuO-Se core shell BNPs with a size of 50 nm. In well diffusion assay, CuO-Se BNPs P. aeruginosa growth with 10-21 mm inhibition zone diameter and 38-95% inhibition. Also, the minimum inhibitory concentration and minimum bactericidal concentration were in a relatively wide range of 7.8-250 μg/mL and 31.2-500 μg/mL, respectively, with tolerance level range of 2-16. Additionally, CuO-Se BNPs shown anti-pyocyanin activity of 4.35-63.21% inhibition while the anti-proteolytic activity was in a range of 4.96-12.59% and anti-pyoverdine effect was in a range of 0.24-83.41%. The IC50 against Wi-38 normal cells was 267.2 µg/mL while the IC50 were 31.1 and 83.4 µg/mL against MCF-7 and Hep-G2, respectively, indicating promising anticancer activity.

Conclusion

This research demonstrates the promising antibacterial, anti-virulence, and antitumor properties with safe low concentrations of CuO-Se NPs, synthesized via an eco-friendly green synthesis method without the use of toxic chemicals, offering a sustainable and cost-effective alternative.

The Interactive Dynamics of Pseudomonas aeruginosa in Global Ecology

Pseudomonas aeruginosa is an opportunistic bacterium widely distributed in both natural and urban environments, playing a crucial role in global microbial ecology. This article reviews the interactive dynamics of P. aeruginosa across different ecosystems, highlighting its capacity for adaptation and resistance in response to environmental and therapeutic pressures. We analyze the mechanisms of antibiotic resistance, including the presence of resistance genes and efflux systems, which contribute to its persistence in both clinical and nonclinical settings. The interconnection between human, animal, and environmental health, within the context of the One Health concept, is discussed, emphasizing the importance of monitoring and sustainable management practices to mitigate the spread of resistance. Through a holistic approach, this work offers insights into the influence of P. aeruginosa on public health and biodiversity.

Globotriaosylceramide as a potential biomarker for auxiliary detection of lower respiratory tract infections of Pseudomonas aeruginosa

Lower respiratory tract infections (LRTIs) caused by Pseudomonas aeruginosa (PA) are a significant health concern, notably among vulnerable populations. The glycosphingolipid receptor globotriaosylceramide (Gb3) has been implicated in PA pathogenicity, however, its clinical implications remain underexplored. The present study aimed to investigate the clinical value of Gb3 concentrations in serum and bronchoalveolar lavage fluid (BALF) as a biomarker for PA-induced LRTIs. In the current prospective study, 54 PA-infected patients and 54 healthy individuals were enrolled as controls. Gb3 levels were measured using a Gb3 ELISA kit and the levels of inflammatory markers were assessed. The diagnostic accuracy of Gb3 was evaluated using receiver operating characteristic (ROC) curve analysis. The patients with PA-induced LRTIs exhibited significantly higher Gb3 concentration levels in both serum and BALF compared with those noted in healthy controls, with more pronounced elevations noted in BALF. The area under the ROC curve was 0.899 for serum Gb3 and 0.812 for BALF Gb3, indicating high sensitivity and specificity for diagnosis of PA infection. Gb3 levels were also found to be correlated with C-reactive protein and procalcitonin levels, suggesting its potential in reflecting infection severity. Overall, the present findings revealed a significant association between Gb3 levels and PA-induced LRTIs, proposing Gb3 as a promising biomarker for early detection and diagnosis. Further research is warranted to validate the role of Gb3 in various patient populations and to explore its dynamics over the course of infection.

Effects of different mechanisms on antimicrobial resistance in Pseudomonas aeruginosa: a strategic system for evaluating antibiotics against gram-negative bacteria

Our previous studies constructed a strategic system for testing antibiotics against specific resistance mechanisms using Klebsiella pneumoniae and Acinetobacter baumannii. However, it lacked resistance mechanisms specifically expressed only in Pseudomonas species. In this study, we constructed this system using Pseudomonas aeruginosa. In-frame deletion, site-directed mutagenesis, and plasmid transformation were used to generate genetically engineered strains with various resistance mechanisms from two fully susceptible P. aeruginosa strains. Antimicrobial susceptibility testing was used to test the efficacy of antibiotics against these strains in vitro. A total of 31 engineered strains with various antimicrobial resistance mechanisms from P. aeruginosa KPA888 and ATCC 27853 were constructed, and the same antibiotic resistance mechanism showed a similar effect on the MICs of the two strains. Compared to the parental strains, the engineered strains lacking porin OprD or lacking the regulator genes of efflux pumps all showed a ≥4-fold increase on the MICs of some of the 19 antibiotics tested. Mechanisms due to GyrA/ParC mutations and β-lactamases also contributed to their corresponding resistance as previously published. The strains constructed in this study possess well-defined resistance mechanisms and can be used to screen and evaluate the effectiveness of antibiotics against specific resistance mechanisms in P. aeruginosa. Building upon our previous studies on K. pneumoniae and A. baumannii, this strategic system, including a P. aeruginosa panel, has been expanded to cover almost all the important antibiotic resistance mechanisms of gram-negative bacteria that are in urgent need of new antibiotics.IMPORTANCEIn this study, an antibiotic assessment system for P. aeruginosa was developed, and the system can be expanded to include other key pathogens and resistance mechanisms. This system offers several benefits: (i) compound design: aid in the development of compounds that can bypass or counteract resistance mechanisms, leading to more effective treatments against specific resistant strains; (ii) combination therapies: facilitate the exploration of combination therapies, where multiple antibiotics may work synergistically to overcome resistance and enhance treatment efficacy; and (iii) targeted treatments: enable healthcare providers to prescribe more targeted treatments, reducing unnecessary antibiotic use and helping to slow the spread of antibiotic resistance. In summary, this system could streamline the development process, reduce costs, increase the success rate of new antibiotics, and help prevent and control antimicrobial resistance.

Hand-to-surface bacterial transfer and healthcare-associated infections prevention: a pilot study on skin microbiome in a molecular biology laboratory

Background

Healthcare-associated infections (HAIs) are a major global public health problem, contributing significantly to patient morbidity and mortality. This study analyses differences in type and amounts of bacteria transferred from volunteers' dominant palm to two healthcare-relevant surfaces (glass and laminate table), both before and after hand washing with water and antibacterial soap. The aim was to understand hand-to-surface microbial contamination and support the development of HAI prevention strategies.

Methods

Microbial DNA was extracted and sequenced to identify bacteria species. Taxonomic and statistical analyses were performed to evaluate bacterial diversity and abundance across the experimental groups.

Results

The results confirmed greater bacteria abundance and species richness on palm compared to surfaces, with a significant reduction after hand washing, especially on glass. Taxa analysis highlighted the increased persistence of Gram-negative HAIs-related bacteria on laminate surface, while Gram-positive opportunistic bacteria were more abundant on palms and glass surface. Beta diversity confirmed significant differences in microbial composition between the groups, highlighting the importance of bacteria-surface characteristics in designing preventive measures.

Conclusion

Despite some limitations, our study emphasizes the importance of microbiological surveillance for all opportunistic bacteria with pathogenic potential. These findings can contribute to more effective guidelines for surface disinfection and hand washing, key elements in preventing HAIs.

Complete genome sequences of three Pseudomonas aeruginosa phages of the genus Phikmvvirus

We describe the genomes of three lytic Pseudomonas aeruginosa phages of the genus Phikmvvirus. The genomes of phages vB_Pae4841-AFR43, vB_Pae10145-KEN1, and vB_Pae9718-KEN10 consist of 43,426, 43,406, and 43,118 bp, with 62.4%, 62.3%, and 62.2% GC content, contain 63, 66, and 64 coding sequences, respectively, and no tRNA genes.

Chronic suppurative otitis media: disrupted host-microbial interactions and immune dysregulation

Recent research has uncovered new mechanisms that disrupt the balance between the host and microbes in the middle ear, potentially leading to dysbiosis and chronic suppurative otitis media (CSOM). Dysbiotic microbial communities, including core pathogens such as persister cells, are recognized for displaying cooperative virulence. These microbial communities not only evade the host's immune defenses but also promote inflammation that leads to tissue damage. This leads to uncontrolled disorder and pathogen proliferation, potentially causing hearing loss and systemic complications. In this discussion, we examine emerging paradigms in the study of CSOM that could provide insights into other polymicrobial inflammatory diseases. Additionally, we underscore critical knowledge gaps essential for developing a comprehensive understanding of how microbes interact with both the innate and adaptive immune systems to trigger and maintain CSOM.

The role of Lysinibacillus fusiformis S01 in cadmium removal from water and immobilization in soil

Cadmium pollution is widespread in water and soil worldwide. Microbial remediation is an effective method for removing heavy metals. This study explored the cadmium remediation mechanism and efficiency of Lysinibacillus fusiformis S01. The removal process includes extracellular adsorption, intracellular accumulation, biomineralization, extracellular polymer sequestration, and binding to cell surface functional groups. In an aqueous solution with a 20 % v/v bacterial dosage, 71.22 % of 10 mg/L Cd2 + was removed within 7 days, with a dissolution rate below 3 % after 15 days. A sequencing batch reactor (V=1 L) was done with an initial concentration of 5 mg/L Cd2+ and only 200 mL of bacterial solution, over 2-day cycles, achieving an 80 % removal rate with a stable pH of around 8.30. In artificially contaminated soil experiments, 76.96 % of exchangeable cadmium was passivated in low concentration soil (3.504 mg/kg), while the passivation rate was 66.43 % in high concentration soil (9.324 mg/kg) after 7 days, with 5 mL of bacterial solution added to every 30 g of soil at 30°C. In actual contaminated soil (8.190 mg/kg), it was reduced from 22.75 % to about 14 % after 28 days. The high-throughput sequencing of the soil experiments revealed that L. fusiformis S01 became the dominant strain (from 0.01 % to 5.10 %), increasing diversity (Shannon index from 2.94 to 3.41 and Simpson index from 0.15 to 0.08) and reducing harmful organisms. The study demonstrates the potential of L. fusiformis S01 for cadmium pollution remediation.

Global epidemiology of high priority and pandemic Pseudomonas aeruginosa in pets, livestock, wild, and aquatic animals: a systematic review and meta-analysis

High-priority and international high-risk Pseudomonas aeruginosa (PA) are emergent strains. Here, we performed the first systematic review and meta-analysis of studies that reported the frequency of PA, carbapenem (CARBR), and colistin (COLR) resistant PA in healthy and sick livestock (A), pets (B), wild (C), and aquatic animals (D) from January 2013 to January 2023, globally. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 57 cross-sectional and eight prospective studies were found eligible. Random-effect models were used to determine the pooled prevalences. Phylogenetic analyses based on core-genome single nucleotide polymorphisms (SNPs) were performed using CSI Phylogeny 1.4. The overall pooled prevalence of PA, COLR-PA, and CARBR-PA were 18.6%, 4%, and 11.7%, respectively. Wild animals had the highest pooled prevalence of PA, 33.5%. The pooled prevalence of COLR was significantly higher in PA strains from sick than healthy animals (P < 0.0001). Furthermore, COLR was significantly highest in PA strains from wild animals, 9.8% [95% confidence interval (CI): 0.8-58.9], while CARBR was highest in PA strains from pets, 14.8% (95% CI: 6.7-29.8). Seven (ST235, ST111, ST233, ST244, ST357, ST308, and ST277) of the 10 high-risk CARBR-PA clones carrying ExoS/U were reported in animals. The SNP-based phylogenetic analysis of 23 genomes of CARBR-PA from animals obtained from publicly available databases revealed two closely related blaGES-carrying strains (<100 SNPs) in sick pets, suggesting a transmission event. A higher frequency of high-risk carbapenem than colistin-resistant PA strains exists in animals. These findings highlight the roles of different animal species, especially pets and wild animals in the persistence and dissemination of high-priority PA.

Targeting Pseudomonas aeruginosa PAO1 pathogenicity: The role of Glycyrrhiza glabra in inhibiting virulence factors and biofilms

Pseudomonas aeruginosa (P. aeruginosa) is a Gram-negative opportunistic pathogen posing serious risks to immunocompromised individuals due to its virulence factors and biofilm formation. This study evaluated the efficacy of methanol extract of Glycyrrhiza glabra (G. glabra) in mitigating P. aeruginosa PAO1 pathogenesis through in-vitro assays, including Minimum Inhibitory Concentration (MIC), biofilm assay, growth curve analysis, pyocyanin quantification, and molecular docking. The extract inhibited PAO1 growth at 5 mg/mL and demonstrated significant antibiofilm activity at sub-MIC levels, reducing biofilm formation by 50.22 %, 22.13 %, and 11.53 % at concentrations of 1.25 mg/mL, 0.625 mg/mL, and 0.312 mg/mL, respectively. Pyocyanin production was also significantly suppressed. Molecular docking revealed that 4-(4-Trifluoromethyl-benzoylamino)-benzoic acid and betulinic acid, identified in the extract, exhibited strong binding affinities (-6.4 kcal/mol and -6.9 kcal/mol) to the QS regulator 7XNJ. These findings underscore the potential of G. glabra as an antipathogenic agent against P. aeruginosa, warranting further investigation into its clinical applications.

Glutathione-Encoding Genes (gshA and gshB) are Associated with Oxidative Stress and Antibiotic Susceptibility in Pseudomonas aeruginosa

Pseudomonas aeruginosa is a human pathogen causing mild skin to life-threatening bloodstream infections. Antibiotic treatment of P. aeruginosa is uneasy because the bacterium possesses intrinsic resistance mechanisms to various antibiotics and can acquire resistance to nearly all available antibiotics. It was reported that some antibiotics can induce oxidative stress that contributes to cellular death, but bacterial cells can detoxify oxidative stress by the oxidative stress-scavenging systems. The relative amount of antibiotic-induced oxidative stress to oxidative stress-scavenging systems may determine the roles of antibiotic-induced oxidative stress in cellular death. Glutathione is one of the oxidative-scavenging systems and is synthesized by glutamyl-cysteine synthetase encoded by gshA and glutathione synthetase encoded by gshB. This study aims to determine the roles of glutathione in oxidative stress and antibiotic susceptibility in P. aeruginosa. Glutathione-encoding genes were knocked out in P. aeruginosa PAO1, and the mutant strains (gshA::Gm, gshB::Gm, and gshA::Gm/gshB::Tc) were used to determine susceptibility to hydrogen peroxide, superoxide-producing paraquat, and antibiotics. The mutant strains were 2- to eightfold more susceptible to hydrogen peroxide and superoxide and 2- to fourfold more susceptible to all tested antibiotics than their parental strain. The susceptibility of hydrogen peroxide, superoxide, and antibiotics was genetically complemented in P. aeruginosa PAO1. Overall results indicate that glutathione is crucial in detoxifying oxidative stress induced internally and by antibiotics in P. aeruginosa. This finding suggests that glutathione is one of the oxidative stress-scavenging systems and one of the intrinsic resistance mechanisms to antibiotics and, thus, a potential drug target for P. aeruginosa.

Synthesis, characterization, and biomedical applications (antibacterial, antibiofilm, anticancer and effects on hospital-acquired pneumonia infection) of copper titanium oxide nanostructures

Hospital-acquired pneumonia (HAP) is the second most common cause of nosocomial infections and is responsible for 15% of nosocomial infections, with a high mortality rate, which has led to increased concern and significant costs in healthcare settings. The most significant agents of HAP are Pseudomonas aeruginosa and Klebsiella pneumoniae, which create a biofilm that results in a resistant infection. We aimed to study the synthesis of Cu2Ti2O5 nanoparticles, their effects on the growth and biofilms of Pseudomonas aeruginosa and Klebsiella pneumoniae isolated from respiratory infections, and their anticancer effects. In this study, for the first time, the Pechini method was used to synthesize Cu2Ti2O5 nanostructures. The effects of nanoparticles on the growth and biofilms of Pseudomonas aeruginosa and Klebsiella pneumoniae were evaluated using a microdilution broth and the microtiter plate method, and the cytotoxic effect of the nanoparticles on the A549 cell line was also assessed by MTT. The characteristics of the nanoparticles were confirmed through XRD, FTIR, SEM, and TEM techniques. Cu2Ti2O5 showed a minimum inhibitory effect in concentrations of 156.25 to 625 μg mL-1 for ten isolates of K. pneumoniae and 625 to 1250 μg mL-1 for ten isolates of P. aeruginosa and at sub-MIC concentrations as well. It reduced the biofilms of K. pneumoniae and P. aeruginosa strains by 75% and 44.4%. The nanoparticles killed 50% of A549 cancer cells in 48 h at concentrations of 30 to 40 μg mL-1 and in 24 h at concentrations of 200 to 250 μg mL-1. The findings of this study show the antibacterial, anti-biofilm, and anti-cancer effects of Cu2Ti2O5 nanoparticles. Therefore, these nanoparticles can be considered potential antimicrobial candidates; however, these effects should be confirmed with more bacterial isolates.

Alpinia officinarum Hance Essential Oil as Potent Antipseudomonal Agent: Chemical Profile, Antibacterial Activity, and Computational Study

Alpinia officinarum Hance, is an aromatic and medicinal herb with a very interesting history and prominent chemical and biological prospects. We aimed to investigate the antibacterial activity of Alpinia officinarum essential oil and the preferred molecular targets of its constituents together with their pharmacokinetic properties and toxicity profile. According to GC-MS analysis, eucalyptol was the main compound (27.52 %) identified in Alpinia officinarum essential oil, followed by α-terpineol, and β-sesquiphellandrene. As opposed to the weak antiradical activity estimated by DPPH and ABTS tests, the essential oil caused inhibition of all the bacteria following well-diffusion and microdilution methods, especially the gram-negative Pseudomonas aeruginosa and Escherichia coli. It displayed exceptionally remarkable activity against Pseudomonas aeruginosa by totally inhibiting its growth on the agar plate exceeding the effect of chloramphenicol standard. This bactericidal effect was confirmed by very low MIC and MBC values of 0.82 and 6.562 μg/mL, respectively. The molecular docking showed interesting binding affinity between the major compounds and various drug targets in Pseudomonas aeruginosa, also good pharmacokinetic and toxicity behavior. These encouraging findings are particularly relevant in light of the increasingly pressing challenge to find alternative substances with antibacterial aptitude to address the issue of antibiotic resistance among infectious bacteria.

Whole-Genome Sequencing of Resistance, Virulence and Regulation Genes in Extremely Resistant Strains of Pseudomonas aeruginosa

BACKGROUND/OBJECTIVES

Pseudomonas aeruginosa is a clinically significant opportunistic pathogen, renowned for its ability to acquire and develop diverse mechanisms of antibiotic resistance. This study examines the resistance, virulence, and regulatory mechanisms in extensively drug-resistant clinical strains of P. aeruginosa.

METHODS

Antibiotic susceptibility was assessed using the Minimum Inhibitory Concentration (MIC) method, and whole-genome sequencing (WGS) was performed on the Illumina NovaSeq platform.

RESULTS

The analysis demonstrated a higher prevalence of virulence genes compared to resistance and regulatory genes. Key virulence factors identified included secretion systems, motility, adhesion, and biofilm formation. Resistance mechanisms observed comprised efflux pumps and beta-lactamases, while regulatory systems involved two-component systems, transcriptional regulators, and sigma factors. Additionally, phenotypic profiles were found to correlate with resistance genes identified through genotypic analysis.

CONCLUSIONS

This study underscores the significant resistance and virulence of the clinical P. aeruginosa strains analyzed, highlighting the urgent need for alternative strategies to address infections caused by extensively drug-resistant bacteria.

Activity of Antiseptics Against Pseudomonas aeruginosa and Its Adaptation Potential

BACKGROUND/OBJECTIVES

Pseudomonas aeruginosa rapidly acquires antibiotic resistance and demonstrates increasing tolerance to antiseptics. This study evaluated the activity of eight antiseptics against P. aeruginosa, assessed its ability to develop adaptation to these antiseptics, and, for the first time, determined the Karpinski Adaptation Index (KAI) for this bacterium.

METHODS

The minimal inhibitory concentration (MIC), susceptibility to antibiotics, bactericidal time according to EN 1040:2005, adaptation potential, and KAI of P. aeruginosa strains were evaluated.

RESULTS

The most effective antiseptics against P. aeruginosa, based on MIC activity, were octenidine dihydrochloride (OCT; mean MIC 11.3 ± 4.5 µg/mL), polyhexamethylene biguanide (PHMB; MIC 22.6 ± 8.0 µg/mL), and chlorhexidine digluconate (CHX; MIC 26.6 ± 14.4 µg/mL). Sodium hypochlorite (NaOCl) and ethacridine lactate (ET) showed moderate activity, while boric acid (BA), povidone-iodine (PVI), and potassium permanganate (KMnO4) exhibited the weakest MIC activity. MIC values for NaOCl (95 ± 15.4 µg/mL) and KMnO4 (>10 mg/mL) were close to or exceeded the clinical concentrations used in commercial products. OCT, CHX, and PVI exhibited the fastest bactericidal effect within 1 min. Bactericidal times were up to 15 min for PHMB, up to 60 min for ET, and more than 60 min for BA, NaOCl, and KMnO4. The lowest KAI values, indicating a low resistance risk, were observed for OCT (0.12), PHMB (0.19), and BA (0.19). Moderate resistance risk was noted for PVI (0.21), CHX (0.29), and ET (0.47). The highest KAI values, signifying a very high resistance risk, were found for NaOCl (1.0) and KMnO4 (≥1.0).

CONCLUSIONS

Antiseptics like OCT, CHX, and partially PVI can be critical in quick antibacterial action on infected wounds, while agents such as PHMB might be reserved for cases where prolonged contact times are possible. Given the rapid adaptation of P. aeruginosa to the clinical concentrations of NaOCl and KMnO4 currently in use, reconsideration of their effectiveness in treating skin and mucous membrane infections is recommended.

Boc-Protected Phenylalanine and Tryptophan-Based Dipeptides: A Broad Spectrum Anti-Bacterial Agent

Dipeptides were constructed using hydrophobic amino acid residues following AMP prediction. After that Boc-modification was performed on the screened peptides and finally Boc-Phe-Trp-OMe and Boc-Trp-Trp-OMe were synthesized. Even though no inhibition zones were observed in agar well diffusion assays, minimum inhibitory concentration (MIC) analysis revealed anti-bacterial activity against both Gram-positive and Gram-negative bacteria, with MIC90 ranging from 230 to 400 μg/mL. The crystal violet assay confirmed the dipeptides' biofilm eradication and disruption capabilities. Furthermore, membrane permeabilization assays indicated outer and inner membrane permeabilization, while SEM analysis revealed the formation of fibril and spherical nanostructures, likely contributing to this effect. The peptides also exhibited resistance to protein adsorption, non-cytotoxicity, and non-hemolytic properties, making them promising broad-spectrum anti-bacterial agents with biofilm eradication and disruption potential. This study concludes that Boc-protected phenylalanine- and tryptophan-based dipeptides can self-assemble and can be used as broad-spectrum anti-bacterial agents. The self-assembly of these peptides offers a versatile platform for designing biomaterials with tailored properties and functionalities. Research exploring the anti-bacterial potential of Boc-protected dipeptides has been limited, prompting our investigation to shed light on this overlooked area. Our analysis of synthesized Boc-protected dipeptides revealed notable anti-bacterial activity, marking a significant advancement. This finding suggests that these dipeptides could emerge as potent, broad-spectrum anti-bacterial agents, addressing the urgent need for effective treatments against bacterial resistance and opening new avenues in therapy. This study not only enhances our understanding of these dipeptides but also highlights their potential as innovative and efficacious anti-bacterial agents, making a substantial impact in the clinical field.

Immune efficacy of oprH chitosan nanoparticle DNA vaccine against Pseudomonas aeruginosa

Background

Pseudomonas aeruginosa is a zoonotic pathogen that poses a threat to human and animal health. However, no vaccine exists for controlling this bacterium.

Aims

This study aimed to evaluate the immune efficacy of a chitosan nanoparticle DNA vaccine of the oprH gene from P. aeruginosa.

Methods

The naked DNA vaccine based on the oprH gene of P. aeruginosa was constructed. Then, the chitosan nanoparticle DNA vaccine of the oprH gene was prepared and the shape, size, encapsulation efficiency, stability, and ability of anti-DNA enzyme degradation were detected. Chickens were divided into five groups, namely the naked DNA vaccine group (poprH group), chitosan nanoparticle DNA vaccine group (CpoprH group), outer membrane protein vaccine group (OMP group), inactive vaccine group, and PBS group. After being vaccinated with corresponding vaccines, the levels of serum antibodies, lymphocyte proliferation assays, interferon-γ (IFN-γ), interleukin-2 (IL-2), and interleukin-4 (IL-4) concentrations were detected. Groups of chickens were challenged with live virulent P. aeruginosa 2 weeks after the last vaccination and the survival numbers were counted until day 15 post challenge. Then, the protective rates were calculated.

Results

The particle size of the chitosan nanoparticle DNA vaccine was approximately 200 nm and close to spherical; the encapsulation efficiency was 95.88%, and it could effectively resist degradation by DNase. Following vaccination, serum antibodies, stimulation index (SI) value, and concentrations of IFN-γ, IL-2, and IL-4 in chickens immunized with the chitosan nanoparticle DNA vaccine were significantly higher than those that were vaccinated with the naked DNA vaccine (P<0.05). The protective rates of poprH, CoprH, OMP vaccine, and inactive vaccine groups were 55%, 75%, 75%, and 90%, respectively.

Conclusion

Chitosan could significantly enhance the immune response and protection provided by the naked DNA vaccine of the oprH gene.

Genomic profiling and molecular dynamics analysis of parDEPa toxin-antitoxin homologs targeting DNA gyrase in Pseudomonas aeruginosa: insights from computational investigations

In the realm of hospital-acquired and chronic infections, Pseudomonas aeruginosa stands out, demonstrating significant associations with increased morbidity, mortality, and antibiotic resistance. Antibiotic-resistant strains are believed to contribute to thousands of deaths each year. Chronic and latent infections are associated with the bacterial toxin-antitoxin (TA) system, although the mechanisms involved are poorly understood. This study focuses on a novel type II TA system, parDEPa, identified in the genome of P. aeruginosa ATCC 27853. We explored its structural features, functional relationships, and genetic configurations. Our research identified parDEPa homologs in P. aeruginosa, clarified their interactions, and highlighted connections to essential cellular metabolic processes. Notably, homologs of the ParDPa antitoxin were found to be more conserved than the ParEPa toxin. Structural models of the ParEPa toxin and ParDPa antitoxin confirmed their integrity. Through docking and molecular dynamics simulations, we showed that the ParEPa toxin binds to DNA gyrase, inhibiting replication. The stability of the ParDPa-ParEPa complex is primarily driven by hydrophobic interactions (-1763.2 kcal/mol), while the ParEPa-GyrAPa interaction is sustained by strong electrostatic forces (-1294.9 kcal/mol). The RMSD scores indicated greater stability for the ParDPa-ParEPa complex (1.11 Å) than the ParEPa-GyrAPa complex (1.16 Å). RMSF analysis identified key residues involved in the ParDPa-ParEPa complex (Leu59, Gly60, Arg115, Asn116, Arg117) and the ParEPa-GyrAPa complex (Pro48, Gln49, Ser55, Asp94, Gln95). These findings significantly enhance our understanding of the structural and metabolic roles of the chromosomally encoded parDEPa TA module in P. aeruginosa.

Zinc Oxide-Loaded Recycled PET Nanofibers for Applications in Healthcare and Biomedical Devices

Polyethylene terephthalate (PET) is a widely utilized synthetic polymer, favored in various applications for its desirable physicochemical characteristics and widespread accessibility. However, its extensive utilization, coupled with improper waste disposal, has led to the alarming pollution of the environment. Thus, recycling PET products is essential for diminishing global pollution and turning waste into meaningful materials. Therefore, this study proposes the fabrication of electrospun membranes made of recycled PET nanofibers as a cost-effective valorization method for PET waste. ZnO nanoparticles were coated onto polymeric materials to enhance the antimicrobial properties of the PET fibers. Morphostructural investigations revealed the formation of fibrillar membranes made of unordered nanofibers (i.e., 40-100 nm in diameter), on the surface of which zinc oxide nanoparticles of 10-20 nm were attached. PET@ZnO membranes demonstrated effective antimicrobial and antibiofilm activity against Gram-positive and Gram-negative bacteria, yeasts, and molds, while imparting no toxicity to amniotic fluid stem cells. In vivo tests confirmed the materials' biocompatibility, as no side effects were observed in mice following membrane implantation. Altogether, these findings highlight the potential of integrating ZnO nanoparticles into recycled PET to develop multifunctional materials suitable for healthcare facilities (such as antimicrobial textiles) and biomedical devices, including applications such as textiles, meshes, and sutures.

Citrus flavonoids diosmin, myricetin and neohesperidin as inhibitors of Pseudomonas aeruginosa: Evidence from antibiofilm, gene expression and in vivo analysis

Citrus flavonoids are group of bioactive polyphenols. Here, we investigated the potential of diosmin, myricetin and neohesperidin as possible inhibitors of Pseudomonas aeruginosa. This bacterium is a major clinical challenge due to its propensity to form resistant biofilm. The aims of this study were to examine flavonoids antibacterial activity using the microdilution method, assays intended to determine several antibiofilm mechanisms (crystal violet, congo red binding, extracellular DNA (eDNA) test and confocal laser scanning microscopy (CLSM) live/dead cell imaging), followed by virulence genes RT-qPCR analysis. Furthermore, we aimed to examine in vivo toxicity of the compounds as well as their efficacy in P. aeruginosa zebrafish embryo infection model. Minimal inhibitory concentrations of tested flavonoids towards P. aeruginosa were in range 0.05 - 0.4 mg/mL. A high potential of the compounds to disturb both the formation of the bacterial biofilm and its eradication was recorded, including significant reduction in biofilm biomass, exopolysaccharide and eDNA production. Biofilm treatment with diosmin resulted in the lowest percentage of live microbial cells as observed in the CLSM live/dead cell imaging. The lasI, pvdS, and rhlC genes were found to be downregulated in the presence of diosmin and myricetin. Only diosmin stood out as non-embryotoxic. Consequently, in vivo analysis using a zebrafish model of P. aeruginosa infection showed an antivirulence effect of diosmin. Our findings suggest that diosmin could be potential candidate for the development of new agent that target P. aeruginosa infections by reducing its virulence mechanisms.

Multidrug resistance in Pseudomonas aeruginosa: genetic control mechanisms and therapeutic advances

Pseudomonas aeruginosa is a significant opportunistic pathogen, and its complex mechanisms of antibiotic resistance pose a challenge to modern medicine. This literature review explores the advancements made from 1979 to 2024 in understanding the regulatory networks of antibiotic resistance genes in Pseudomonas aeruginosa, with a particular focus on the molecular underpinnings of these resistance mechanisms. The review highlights four main pathways involved in drug resistance: reducing outer membrane permeability, enhancing active efflux systems, producing antibiotic-inactivating enzymes, and forming biofilms. These pathways are intricately regulated by a combination of genetic regulation, transcriptional regulators, two-component signal transduction, DNA methylation, and small RNA molecules. Through an in-depth analysis and synthesis of existing literature, we identify key regulatory elements mexT, ampR, and argR as potential targets for novel antimicrobial strategies. A profound understanding of the core control nodes of drug resistance offers a new perspective for therapeutic intervention, suggesting that modulating these elements could potentially reverse resistance and restore bacterial susceptibility to antibiotics. The review looks forward to future research directions, proposing the use of gene editing and systems biology to further understand resistance mechanisms and to develop effective antimicrobial strategies against Pseudomonas aeruginosa. This review is expected to provide innovative solutions to the problem of drug resistance in infectious diseases.

Exploiting the Zebrafish Model for Sepsis Research: Insights into Pathophysiology and Therapeutic Potentials

Sepsis, a severe condition instigated by infections, continues to be a primary global cause of death, typified by systemic inflammation and advancing immune dysfunction. Comprehending the complex pathological processes that underlie sepsis is integral to the creation of efficacious treatments. Despite the inability of animal models to entirely reproduce the clinical intricacies related to sepsis, they are invaluable instruments for the exploration and development of therapeutic approaches. Within this context, the zebrafish model is particularly noteworthy due to its genetic tractability, transparency, and appropriateness for high-throughput screening of genetic mutants and therapeutic compounds. This scholarly review emphasizes the crucial role that the zebrafish disease model plays in enhancing our comprehension of sepsis, by exploring its applications in deciphering immune and inflammatory responses, evaluating the consequences of genetic alterations, and examining novel therapeutic agents. The Insights derived from zebrafish research not only augment our understanding of the underlying mechanisms of sepsis, but also possess considerable potential for the transference of these discoveries into clinical therapies, thus potentially transforming the approach to sepsis management. The objective of this scholarly article is to underscore the importance of zebrafish in the realm of biomedical research pertaining to sepsis, and to delineate forthcoming opportunities for utilizing this model in clinical applications.

Inhibition of Pseudomonas aeruginosa Carbonic Anhydrases, Exploring Ciprofloxacin Functionalization Toward New Antibacterial Agents: An In-Depth Multidisciplinary Study

Ciprofloxacin (CPX) is one of the most employed antibiotics in clinics to date. However, the rise of drug-resistant bacteria is dramatically impairing its efficacy, especially against life-threatening pathogens, such as Pseudomonas aeruginosa. This Gram-negative bacterium is an opportunistic pathogen, often infecting immuno-compromised patients with severe or fatal outcomes. The evidence of the possibility of exploiting Carbonic Anhydrase (CA, EC: 4.2.1.1) enzymes as pharmacological targets along with their role in P. aeruginosa virulence inspired the derivatization of CPX with peculiar CA-inhibiting chemotypes. Thus, a large library of CPX derivatives was synthesized and tested on a panel of bacterial CAs and human isoenzymes I and II. Selected derivatives were evaluated for antibacterial activity, revealing bactericidal and antibiofilm properties for some compounds. Importantly, promising preliminary absorption, distribution, metabolism, and excretion (ADME) properties in vitro were found and no cytotoxicity was detected for some representative compounds when tested in Galleria mellonella larvae.

Does Every Strain of Pseudomonas aeruginosa Attack the Same? Results of a Study of the Prevalence of Virulence Factors of Strains Obtained from Different Animal Species in Northeastern Poland

BACKGROUND

Pseudomonas aeruginosa is a pathogen that causes infections in animals and humans, with veterinary implications including ear infections in dogs, respiratory diseases in cats, and mastitis in ruminants. In humans, it causes severe hospital-acquired infections, particularly in immunosuppressed patients. This study aimed to identify and assess the prevalence of specific virulence factors in Pseudomonas aeruginosa isolates.

METHODS

We analyzed 98 Pseudomonas aeruginosa isolates from various animal samples (dogs, cats, ruminants, fowl) from northeastern Poland in 2019-2022 for virulence-related genes (toxA, exoU, exoT, exoS, lasB, plcN, plcH, pldA, aprA, gacA, algD, pelA, endA, and oprF) by PCR and assessed biofilm formation at 48 and 72 h. Genomic diversity was assessed by ERIC-PCR.

RESULTS

The obtained results showed that all strains harbored the pelA gene (100%), while the lowest prevalence was found for pldA (24%) and exoU (36%). Regardless of the animal species, strong biofilm forming ability was prevalent among the strains after both 48 h (75%) and 72 h (74%). We obtained as many as 87 different genotyping profiles, where the dominant one was profile ERIC-48, observed in four strains.

CONCLUSIONS

No correlation was found between presence or absence of determined genes and the nature of infection. Similarly, no correlation was found between biofilm-forming genes and biofilm strength. The high genetic diversity indicates challenges for effective prevention, emphasizing the need for ongoing monitoring and research.

Clinical Characteristics and Predictors of Mortality of Patients with Post-Neurosurgical Meningitis-A 900-Cases Cohort Study

Aim

To express the clinical characteristics of patients with post-neurosurgical meningitis (PNM) and launch a survival analysis to screen mortality predictors.

Methods

A cohort analysis containing more than 70000 patients was evaluated, and all of them received neurosurgical procedure. Clinical and microbial epidemiology, therapy and mortality of PNM patients were reviewed. Multi-variable Cox proportional hazard models were applied to achieve survival analysis.

Results

About 900 PNM patients from 3244 cases were selected for characteristics and survival analysis, the mean age of them was 41 (27-54) years, 516 (57.3%) were men and 384 (42.7%) were women. The 28-day mortality was 12.4% (112 of 900) in patients with PNM. Hypertension, external ventricular drainage (EVD), and lumbar drainage (LD) are mortality predictors for PNM, with a hazard ratio (HR) of 2.641 (95% C.I. 1.563-4.464, P<0.001), 2.196 (95% C.I. 1.317-3.662, P=0.003), and 1.818 (95% C.I. 1.126-2.936, P=0.014). In treatment, the outcome of patients receiving three or more antibiotic combinations is better than that of patients receiving dual-drug combinations.

Conclusion

The mortality of patients with PNM was relatively high, and the risk factors related to 28-days mortality were hypertension, EVD and LD and treatment with three or more antibiotics are much better.

Development of erythromycin loaded PLGA nanoparticles for improved drug efficacy and sustained release against bacterial infections and biofilm formation

Bacterial infections are a common cause of sepsis, often leading to high patient mortality. Such infections are challenging to treat due to bacterial resistance to many existing drugs. Erythromycin (Ery) is a macrolide antibiotic used against bacterial infections with reported resistance. Recently, synthetic poly-lactide co-glycolic acid (PLGA) polymer nanoparticles (NPs) have displayed improved drug delivery characteristics and biocompatibility. In this study, PLGA-Ery NPs were synthesized by the o/w emulsion diffusion method, having a particle size of 159 ± 23 nm and displayed 71.89 % of encapsulation efficiency. The PLGA-Ery NPs showed 1.5, 2.1 and 1.5-fold improved MIC and antibacterial efficacy against E. coli, S. aureus, and P. aeruginosa, respectively than the pure drug. As illustrated by scanning electron microscopy, PLGA-Ery NPs caused damage to the bacterial cell walls. Furthermore, a surface coating with PLGA-Ery NPs on a glass surface showed efficient inhibition (>90 %) of the biofilm formation by P. aeruginosa, as determined by fluorescence microscopy and MTT assay. This study demonstrates that PLGA-Ery NPs can increase the efficiency of erythromycin and can suppress the growth and biofilm formation of P. aeruginosa. Such polymeric nanoparticles drug nanoformulations have potential as an antimicrobial and as a surface coating for medical devices.

Unveiling the Launaea nudicaulis (L.) Hook medicinal bioactivities: phytochemical analysis, antibacterial, antibiofilm, and anticancer activities

Commonly used antimicrobial agents are no longer effective due to their overuse or misuse. In addition, many medicinal plant extracts can combat infectious diseases due to their main active constituents or secondary metabolites. The current study aimed to assess the bioactivities of Launaea nudicaulis (LN) leaf extract (LE) against different multi-drug resistant (MDR) Pseudomonas aeruginosa (P. aeruginosa) isolates. The ethyl acetate extract of a Launaea nudicaulis (LN) leaf was analyzed using GC-MS, which identified 27 key bioactive compounds. The major constituents found were as follows: 7-acetyl-6-ethyl-1,1,4,4-tetramethyltetralin, isopropyl myristate, thiocarbamic acid, N,N-dimethyl, S-1,3-diphenyl-2-butenyl ester, hahnfett, cyclopentane acetic acid, 3-oxo-2-pentyl-, methyl ester, hexadecanoic acid, and dotriacontane. Our study demonstrated that the LN leaf was a rich source of other important phytochemicals, including phenolic acids, tannins, saponins, and steroids. The relative biosafety of the L. nudicaulis LE was determined from the elevated inhibitory concentration 50 (IC50) of 262 μg/mL, as calculated from the cytotoxicity assay against the Wi-38 normal cell line. Conversely, 12.7 and 24.5 μg/mL were the recorded low IC50 values for the tested extract against the MCF-7 and Hep-G2 cancerous cell lines, respectively, reflecting its potent activity against the tested cancerous cell lines. Microbiologically, the susceptible P. aeruginosa isolates to the tested extract showed a growth inhibition zone diameter, in the well diffusion assay, ranging from 11.34 ± 0.47 to 26.67 ± 0.47 mm, and a percent inhibition (PI) value of 50-106.2%, reflecting its acceptable activity. In addition, the broth microdilution assay recorded minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) in the ranges of 15.625-1,000 μg/mL and 125-1,000 μg/mL, respectively. In conclusion, the L. nudicaulis LE revealed showed promising activity and high selectivity against P. aeruginosa. Moreover, the extract exhibited natural anticancer activities with safe low concentrations, indicating its potential as a superior candidate for future studies of its active constituents.

Murepavadin Enhances the Killing Efficacy of Ciprofloxacin against Pseudomonas aeruginosa by Inhibiting Drug Efflux

Pseudomonas aeruginosa is a multidrug-resistant Gram-negative pathogen and one of the leading causes of ventilator-associated pneumonia and infections in patients with chronic obstructive pulmonary disease and cystic fibrosis. Murepavadin is a peptidomimetic that specifically targets outer-membrane lipopolysaccharide transport protein LptD of P. aeruginosa. In this study, we find that murepavadin enhances the bactericidal efficacy of ciprofloxacin. We further demonstrate that murepavadin increases intracellular accumulation of ciprofloxacin by suppressing drug efflux. In addition, the murepavadin-ciprofloxacin combination exhibits a synergistic bactericidal effect in an acute murine pneumonia model. In conclusion, our results identify an effective drug combination for the treatment of P. aeruginosa infections.

Capsid structure of bacteriophage ΦKZ provides insights into assembly and stabilization of jumbo phages

Jumbo phages are a group of tailed bacteriophages with large genomes and capsids. As a prototype of jumbo phage, ΦKZ infects Pseudomonas aeruginosa, a multi-drug-resistant (MDR) opportunistic pathogen leading to acute or chronic infection in immunocompromised individuals. It holds potential to be used as an antimicrobial agent and as a model for uncovering basic phage biology. Although previous low-resolution structural studies have indicated that jumbo phages may have more complicated capsid structures than smaller phages such as HK97, the detailed structures and the assembly mechanism of their capsids remain largely unknown. Here, we report a 3.5-Å-resolution cryo-EM structure of the ΦKZ capsid. The structure unveiled ten minor capsid proteins, with some decorating the outer surface of the capsid and the others forming a complex network attached to the capsid's inner surface. This network seems to play roles in driving capsid assembly and capsid stabilization. Similar mechanisms of capsid assembly and stabilization are probably employed by many other jumbo viruses.

Detection of Pseudomonas aeruginosa pus wound isolate using a polymerase chain reaction targeting 16S rRNA and gyrB genes: A case from Indonesia

Infectious wounds on the skin surface are easily colonized by bacteria from pyogenic group that manifest as inflammation, such as Pseudomonas aeruginosa. P. aeruginosa is a Gram-negative bacterium and an opportunistic pathogen known for causing invasive state in critically ill and immunocompromised patients. The aim of this study was to detect the 16S rRNA and gyrB genes in P. aeruginosa using polymerase chain reaction (PCR) method. The sample in this study was pus isolate from a 5-year-old boy with leg wounds. The bacteria were isolated on brain heart infusion broth (BHIB) media and identified with molecular identification. Sequencing and BLAST analysis were carried out to determine the similarity of gene identity by comparing sample sequence with other isolate sequences on the Gene Bank. The results of molecular identification showed amplification DNA band of around 934 base pairs (bp) for 16S rRNA and 225 bp for gyrB gene. The BLAST program demonstrated that the sample had 99.89% similarity with P. aeruginosa strain XC4 (accession code ON795960.1) for the 16S rRNA gene. Meanwhile, the gyrB gene exhibited 99.10% similarity with the P. aeruginosa strain PSA-1.2 (accession code KP172300.1).

Cilostazol is a promising anti-pseudomonal virulence drug by disruption of quorum sensing

Resistance to antibiotics is a critical growing public health problem that desires urgent action to combat. To avoid the stress on bacterial growth that evokes the resistance development, anti-virulence agents can be an attractive strategy as they do not target bacterial growth. Quorum sensing (QS) systems play main roles in controlling the production of diverse virulence factors and biofilm formation in bacteria. Thus, interfering with QS systems could result in mitigation of the bacterial virulence. Cilostazol is an antiplatelet and a vasodilator FDA approved drug. This study aimed to evaluate the anti-virulence activities of cilostazol in the light of its possible interference with QS systems in Pseudomonas aeruginosa. Additionally, the study examines cilostazol's impact on the bacterium's ability to induce infection in vivo, using sub-inhibitory concentrations to minimize the risk of resistance development. In this context, the biofilm formation, the production of virulence factors and influence on the in vivo ability to induce infection were assessed in the presence of cilostazol at sub-inhibitory concentration. Furthermore, the outcome of combination with antibiotics was evaluated. Cilostazol interfered with biofilm formation in P. aeruginosa. Moreover, swarming motility, biofilm formation and production of virulence factors were significantly diminished. Histopathological investigation revealed that liver, spleen and kidney tissues damage was abolished in mice injected with cilostazol-treated bacteria. Cilostazol exhibited a synergistic outcome when used in combination with antibiotics. At the molecular level, cilostazol downregulated the QS genes and showed considerable affinity to QS receptors. In conclusion, Cilostazol could be used as adjunct therapy with antibiotics for treating Pseudomonal infections. This research highlights cilostazol's potential to combat bacterial infections by targeting virulence mechanisms, reducing the risk of antibiotic resistance, and enhancing treatment efficacy against P. aeruginosa. These findings open avenues for repurposing existing drugs, offering new, safer, and more effective infection control strategies.

Global diversity of airborne pathogenic bacteria and fungi from wastewater treatment plants

Wastewater treatment plants (WWTPs) have been recognized as one of the major potential sources of the spread of airborne pathogenic microorganisms under the global pandemic of COVID-19. The differences in research regions, wastewater treatment processes, environmental conditions, and other aspects in the existing case studies have caused some confusion in the understanding of bioaerosol pollution characteristics. In this study, we integrated and analyzed data from field sampling and performed a systematic literature search to determine the abundance of airborne microorganisms in 13 countries and 37 cities across four continents (Asia, Europe, North America, and Africa). We analyzed the concentrations of bioaerosols, the core composition, global diversity, determinants, and potential risks of airborne pathogen communities in WWTPs. Our findings showed that the culturable bioaerosol concentrations of global WWTPs are 102-105 CFU/m3. Three core bacterial pathogens, namely Bacillus, Acinetobacter, and Pseudomonas, as well as two core fungal pathogens, Cladosporium and Aspergillus, were identified in the air across global WWTPs. WWTPs have unique core pathogenic communities and distinct continental divergence. The sources of airborne microorganisms (wastewater) and environmental variables (relative humidity and air contaminants) have impacts on the distribution of airborne pathogens. Potential health risks are associated with the core airborne pathogens in WWTPs. Our study showed the specificity, multifactorial influences, and potential pathogenicity of airborne pathogenic communities in WWTPs. Our findings can improve the understanding of the global diversity and biogeography of airborne pathogens in WWTPs, guiding risk assessment and control strategies for such pathogens. Furthermore, they provide a theoretical basis for safeguarding the health of WWTP workers and ensuring regional ecological security.

Repression of resistance mechanisms of Pseudomonas aeruginosa: implications of the combination of antibiotics and phytoconstituents

Antimicrobial resistance is a prevalent problem witnessed globally and creating an alarming situation for the treatment of infections caused by resistant pathogens. Available armaments such as antibiotics often fail to exhibit the intended action against resistant pathogens, leading to failure in the treatments that are causing mortality. New antibiotics or a new treatment approach is necessary to combat this situation. P. aeruginosa is an opportunistic drug resistant pathogen and is the sixth most common cause of nosocomial infections. P. aeruginosa due to its genome organization and other factors are exhibiting resistance against drugs. Bacterial biofilm formation, low permeability of outer membrane, the production of the beta-lactamase, and the production of several efflux systems limits the antibacterial potential of several classes of antibiotics. Combination of phytoconstituents with antibiotics is a promising strategy to combat multidrug resistant P. aeruginosa. Phytoconstituents such as flavonoids, terpenoids, alkaloids, polypeptides, phenolics, and essential oils are well known antibacterial agents. In this review, the activity of combination of the phytoconstituents and antibiotics, and their corresponding mechanism of action was discussed elaborately. The combination of antibiotics and plant-derived compounds exhibited better efficacy compared to antibiotics alone against the antibiotic resistance P. aeruginosa infections.

Pseudomonas aeruginosa Isolates from Water Samples of the Gulf of Mexico Show Similar Virulence Properties but Different Antibiotic Susceptibility Profiles than Clinical Isolates

Pseudomonas aeruginosa is an opportunistic pathogen found in a wide variety of environments, including soil, water, and habitats associated with animals, humans, and plants. From a One Health perspective, which recognizes the interconnectedness of human, animal, and environmental health, it is important to study the virulence characteristics and antibiotic susceptibility of environmental bacteria. In this study, we compared the virulence properties and the antibiotic resistance profiles of seven isolates collected from the Gulf of Mexico with those of seven clinical strains of P. aeruginosa. Our results indicate that the marine and clinical isolates tested exhibit similar virulence properties; they expressed different virulence factors and were able to kill Galleria mellonella larvae, an animal model commonly used to analyze the pathogenicity of many bacteria, including P. aeruginosa. In contrast, the clinical strains showed higher antibiotic resistance than the marine isolates. Consistently, the clinical strains exhibited a higher prevalence of class 1 integron, an indicator of anthropogenic impact, compared with the marine isolates. Thus, our results indicate that the P. aeruginosa marine strains analyzed in this study, isolated from the Gulf of Mexico, have similar virulence properties, but lower antibiotic resistance, than those from hospitals.

Anti-Biofilm Activity of Oleacein and Oleocanthal from Extra-Virgin Olive Oil toward Pseudomonas aeruginosa

New antimicrobial molecules effective against Pseudomonas aeruginosa, known as an antibiotic-resistant "high-priority pathogen", are urgently required because of its ability to develop biofilms related to healthcare-acquired infections. In this study, for the first time, the anti-biofilm and anti-virulence activities of a polyphenolic extract of extra-virgin olive oil as well as purified oleocanthal and oleacein, toward P. aeruginosa clinical isolates were investigated. The main result of our study was the anti-virulence activity of the mixture of oleacein and oleocanthal toward multidrug-resistant and intermediately resistant strains of P. aeruginosa isolated from patients with ventilator-associated pneumonia or surgical site infection. Specifically, the mixture of oleacein (2.5 mM)/oleocanthal (2.5 mM) significantly inhibited biofilm formation, alginate and pyocyanin production, and motility in both P. aeruginosa strains (p < 0.05); scanning electron microscopy analysis further evidenced its ability to inhibit bacterial cell adhesion as well as the production of the extracellular matrix. In conclusion, our results suggest the potential application of the oleacein/oleocanthal mixture in the management of healthcare-associated P. aeruginosa infections, particularly in the era of increasing antimicrobial resistance.

Phenotypic and genotypic characterization of resistance and virulence in Pseudomonas aeruginosa isolated from poultry farms in Egypt using whole genome sequencing

Pseudomonas aeruginosa (P. aeruginosa) is an ESKAPE pathogen that can quickly develop resistance to most antibiotics. This bacterium is a zoonotic pathogen that can be found in humans, animals, foods, and environmental samples, making it a One-Health concern. P. aeruginosa threatens the poultry industry in Egypt, leading to significant economic losses. However, the investigation of this bacterium using NGS technology is nearly non-existent in Egypt. In this study, 38 isolates obtained from broiler farms of the Delta region were phenotypically investigated, and their genomes were characterized using whole genome sequencing (WGS). The study found that 100% of the isolates were resistant to fosfomycin and harbored the fosA gene. They were also resistant to trimethoprim/sulfamethoxazole, although only one isolate harbored the sul1 gene. Non-susceptibility (resistant, susceptible with increased dose) of colistin was observed in all isolates. WGS analysis revealed a high level of diversity between isolates, and MLST analysis allocated the 38 P. aeruginosa isolates into 11 distinct sequence types. The most predominant sequence type was ST267, found in 13 isolates, followed by ST1395 in 8 isolates. The isolates were susceptible to almost all tested antibiotics carrying only few different antimicrobial resistance (AMR) genes. Various AMR genes that confer resistance mainly to ß-lactam, aminoglycoside, sulfonamide, and phenicol compounds were identified. Additionally, several virulence associated genes were found without any significant differences in number and distribution among isolates. The majority of the virulence genes was identified in almost all isolates. The fact that P. aeruginosa, which harbors several AMR and virulence-associated factors, is present in poultry farms is alarming and threatens public health. The misuse of antimicrobial compounds in poultry farms plays a significant role in resistance development. Thus, increasing awareness and implementing strict veterinary regulations to guide the use of veterinary antibiotics is required to reduce health and environmental risks. Further studies from a One-Health perspective using WGS are necessary to trace the potential transmission routes of resistance between animals and humans and clarify resistance mechanisms.

Antibacterial activity of cinnamon essential oil and its main component of cinnamaldehyde and the underlying mechanism

Background: Plant essential oils have long been regarded as repositories of antimicrobial agents. In recent years, they have emerged as potential alternatives or supplements to antimicrobial drugs. Although literature reviews and previous studies have indicated that cinnamon essential oil (CIEO) and its major component, cinnamaldehyde (CID), possess potent antibacterial activities, their antibacterial mechanisms, especially the in vivo antibacterial mechanisms, remain elusive. Methods: In this study, we utilized the in vivo assessment system of Caenorhabditis elegans (C. elegans) to investigate the effects and mechanisms of high dose (100 mg/L) and low dose (10 mg/L) CIEO and CID in inhibiting Pseudomonas aeruginosa (P. aeruginosa). In addition, we also examined the in vitro antibacterial abilities of CIEO and CID against other common pathogens including P. aeruginosa and 4 other strains. Results: Our research revealed that both high (100 mg/L) and low doses (10 mg/L) of CIEO and CID treatment significantly alleviated the reduction in locomotion behavior, lifespan, and accumulation of P. aeruginosa in C. elegans infected with the bacteria. During P. aeruginosa infection, the transcriptional expression of antimicrobial peptide-related genes (lys-1 and lys-8) in C. elegans was upregulated with low-dose CIEO and CID treatment, while this trend was suppressed at high doses. Further investigation suggested that the PMK-1 mediated p38 signaling pathway may be involved in the regulation of CIEO and CID during nematode defense against P. aeruginosa infection. Furthermore, in vitro experimental results also revealed that CIEO and CID exhibit good antibacterial effects, which may be associated with their antioxidant properties. Conclusion: Our results indicated that low-dose CIEO and CID treatment could activate the p38 signaling pathway in C. elegans, thereby regulating antimicrobial peptides, and achieving antimicrobial effects. Meanwhile, high doses of CIEO and CID might directly participate in the internal antimicrobial processes of C. elegans. Our study provides research basis for the antibacterial properties of CIEO and CID both in vivo and in vitro.

Optimized preparation pipeline for emergency phage therapy against Pseudomonas aeruginosa at Yale University

Bacteriophage therapy is one potential strategy to treat antimicrobial resistant or persistent bacterial infections, and the year 2021 marked the centennial of Felix d'Hérelle's first publication on the clinical applications of phages. At the Center for Phage Biology & Therapy at Yale University, a preparatory modular approach has been established to offer safe and potent phages for single-patient investigational new drug applications while recognizing the time constraints imposed by infection(s). This study provides a practical walkthrough of the pipeline with an Autographiviridae phage targeting Pseudomonas aeruginosa (phage vB_PaeA_SB, abbreviated to ΦSB). Notably, a thorough phage characterization and the evolutionary selection pressure exerted on bacteria by phages, analogous to antibiotics, are incorporated into the pipeline.

Inhaled CD24-Enriched Exosomes (EXO-CD24) as a Novel Immune Modulator in Respiratory Disease

Acute Respiratory Distress Syndrome (ARDS) is a major health concern with urgent unmet need for treatment options. There are three million new ARDS cases annually, and the disease's mortality rate is high (35-46%). Cluster of differentiation 24 (CD24), a long-known protein with multifaceted functions, is a small, heavily glycosylated, membrane-anchored protein which functions as an immune checkpoint control. CD24 allows for immune discrimination between Damage-Associated Molecular Patterns and Pathogen-Associated Molecular Patterns derived from pathogens. Exosomes are intraluminal vesicles which play an important role in intercellular communication. Exosomes offer the advantage of targeted delivery, which improves safety and efficacy. The safety and efficacy of EXO-CD24 is promising, as was shown in >180 ARDS patients in phase 1b/2a, phase 2b, and compassionate use. CD24 binds Damage-associated molecular patterns (DAMPs) and inhibits the activation of the NF-ĸB pathway, a pivotal mediator of inflammatory responses. In contrast to anti-inflammatory therapies that are cytokine-specific or steroids that shut down the entire immune system, EXO-CD24 acts upstream, reverting the immune system back to normal activity. Herein, the safety and efficacy of mEXO-CD24 is shown in murine models of several pulmonary diseases (sepsis, allergic asthma, Chronic Obstructive Pulmonary Disease(COPD), fibrosis). EXO CD24 can suppress the hyperinflammatory response in the lungs in several pulmonary diseases with a significant unmet need for treatment options.

Resistance in Pseudomonas aeruginosa: A Narrative Review of Antibiogram Interpretation and Emerging Treatments

Pseudomonas aeruginosa is a ubiquitous Gram-negative bacterium renowned for its resilience and adaptability across diverse environments, including clinical settings, where it emerges as a formidable pathogen. Notorious for causing nosocomial infections, P. aeruginosa presents a significant challenge due to its intrinsic and acquired resistance mechanisms. This comprehensive review aims to delve into the intricate resistance mechanisms employed by P. aeruginosa and to discern how these mechanisms can be inferred by analyzing sensitivity patterns displayed in antibiograms, emphasizing the complexities encountered in clinical management. Traditional monotherapies are increasingly overshadowed by the emergence of multidrug-resistant strains, necessitating a paradigm shift towards innovative combination therapies and the exploration of novel antibiotics. The review accentuates the critical role of accurate antibiogram interpretation in guiding judicious antibiotic use, optimizing therapeutic outcomes, and mitigating the propagation of antibiotic resistance. Misinterpretations, it cautions, can inadvertently foster resistance, jeopardizing patient health and amplifying global antibiotic resistance challenges. This paper advocates for enhanced clinician proficiency in interpreting antibiograms, facilitating informed and strategic antibiotic deployment, thereby improving patient prognosis and contributing to global antibiotic stewardship efforts.