Efficacy of sodium hypochlorite in overcoming antimicrobial resistance and eradicating biofilms in clinical pathogens from pressure ulcers.

Autor: Fabrizio G; Department of Biology and Biotechnology 'C. Darwin', Sapienza University of Rome, Rome, Italy., Sivori F; Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy., Cavallo I; Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy., Truglio M; Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy., Toma L; Medical Directorate, IRCCS Regina Elena National Cancer Institute, Rome, Italy., Sperati F; UOSD Clinical Trial Center, Biostatistics and Bioinformatics, IRCCS San Gallicano Dermatological Institute, Rome, Italy., Francalancia M; Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy., Obregon F; Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy., Pamparau L; Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy., Kovacs D; Cutaneous Physiopathology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy., Pimpinelli F; Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy., Di Domenico EG; Department of Biology and Biotechnology 'C. Darwin', Sapienza University of Rome, Rome, Italy.
Jazyk: angličtina
Zdroj: Frontiers in microbiology [Front Microbiol] 2024 Jul 10; Vol. 15, pp. 1432883. Date of Electronic Publication: 2024 Jul 10 (Print Publication: 2024).
DOI: 10.3389/fmicb.2024.1432883
Abstrakt: Sodium hypochlorite (NaOCl) is widely recognized for its broad-spectrum antimicrobial efficacy in skin wound care. This study investigates the effectiveness of NaOCl against a range of bacterial and fungal isolates from pressure ulcer (PU) patients. We analyzed 20 bacterial isolates from PU patients, comprising carbapenem-resistant Klebsiella pneumoniae (CRKP), multidrug-resistant Acinetobacter baumannii (MDRAB), methicillin-resistant Staphylococcus aureus (MRSA), methicillin-susceptible Staphylococcus aureus (MSSA), along with 5 Candida albicans isolates. Antibiotic resistance profiles were determined using standard susceptibility testing. Whole-genome sequencing (WGS) was employed to identify antimicrobial resistance genes (ARGs) and disinfectant resistance genes (DRGs). Genetic determinants of biofilm formation were also assessed. The antimicrobial activity of NaOCl was evaluated by determining the minimum inhibitory concentration (MIC) and the minimal biofilm eradication concentration (MBEC) for both planktonic and biofilm-associated cells. CRKP and MDRAB showed resistance to fluoroquinolones and carbapenems, while MRSA exhibited resistance to β-lactams and levofloxacin. MSSA displayed a comparatively lower resistance profile. WGS identified significant numbers of ARGs in CRKP and MDRAB, with fewer DRGs compared to MRSA and MSSA. All isolates possessed genes associated with fimbriae production and adhesion, correlating with pronounced biofilm biomass production. NaOCl demonstrated substantial antimicrobial activity against both planktonic cells and biofilms. The MIC 90 for planktonic bacterial cells was 0.125 mg/mL, and the MBEC 90 ranged from 0.225 to 0.5 mg/mL. For planktonic C. albicans , the MIC 90 was 0.150 mg/mL, and the MBEC 90 was 0.250 mg/mL. These results highlight the challenge in treating biofilm-associated infections and underscore the potential of NaOCl as a robust antimicrobial agent against difficult-to-treat biofilm infections at concentrations lower than those typically found in commercial disinfectants.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.
(Copyright © 2024 Fabrizio, Sivori, Cavallo, Truglio, Toma, Sperati, Francalancia, Obregon, Pamparau, Kovacs, Pimpinelli and Di Domenico.)
Databáze: MEDLINE