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<p>Staphylococci are important pathogens that can cause persistent infections due to their biofilm formation capacity. Many biofilm-associated genes such as <i>icaA, icaD</i> and <i>bap</i> are involved in biofilm formation. The aim of this study was to investigate the presence of these biofilm-associated genes in clinical <i>Staphylococcus</i> isolates and the potential of mucolytic agents in combination with vancomycin to combat biofilms. In this context, 104 <i>Staphylococcus</i> strains isolated from patients in different intensive care units were examined. RT-PCR method was used to detect genes; microtiter plate method was used to determine biofilm production. The antibacterial, antibiofilm, and synergistic effects of vancomycin and the mucolytic compounds <i>N</i>-acetylcysteine, ambroxol, bromhexine, sobrerol, and erdosteine were investigated. Of all isolates, 79.81% had <i>icaA</i>, 80.76% had <i>icaD</i>, 11.53% had <i>bap</i> gene and 70.19% produced biofilm. The lowest minimum inhibitory concentration (MIC) and minimum biofilm inhibitory concentration (MBIC) values among mucolytics were observed for ambroxol (<i>p</i> &lt; 0.05). The highest synergistic activity was observed in ambroxol and bromhexine. In isolates with synergistic and additive activity, the MBIC sub-concentrations of mucolytics reduced the MBIC values ​​of vancomycin by 2–8 times. In conclusion, mucolytic agents may penetrate biofilms better than vancomycin and may reduce the MBIC value of vancomycin. While only synergistic doses of <i>N</i>-acetylcysteine ​​can be used in current clinical doses, ambroxol may be a more effective alternative in implant coatings and catheter treatments where higher doses can be used. This study suggests that the use of mucolytics together with antibiotics may have promising therapeutic potential in biofilm-related infections.</p>

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Presence of biofilm-associated genes in clinical staphylococcal isolates and antibiofilm activities of some mucolytic compounds against these strains

  • 期刊论文

  • 发表日期：

    2025年6月3日

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  • Haki Altunova,
  • İbrahim Halil Kılıç

摘要

Staphylococci are important pathogens that can cause persistent infections due to their biofilm formation capacity. Many biofilm-associated genes such as icaA, icaD and bap are involved in biofilm formation. The aim of this study was to investigate the presence of these biofilm-associated genes in clinical Staphylococcus isolates and the potential of mucolytic agents in combination with vancomycin to combat biofilms. In this context, 104 Staphylococcus strains isolated from patients in different intensive care units were examined. RT-PCR method was used to detect genes; microtiter plate method was used to determine biofilm production. The antibacterial, antibiofilm, and synergistic effects of vancomycin and the mucolytic compounds N-acetylcysteine, ambroxol, bromhexine, sobrerol, and erdosteine were investigated. Of all isolates, 79.81% had icaA, 80.76% had icaD, 11.53% had bap gene and 70.19% produced biofilm. The lowest minimum inhibitory concentration (MIC) and minimum biofilm inhibitory concentration (MBIC) values among mucolytics were observed for ambroxol (p < 0.05). The highest synergistic activity was observed in ambroxol and bromhexine. In isolates with synergistic and additive activity, the MBIC sub-concentrations of mucolytics reduced the MBIC values ​​of vancomycin by 2–8 times. In conclusion, mucolytic agents may penetrate biofilms better than vancomycin and may reduce the MBIC value of vancomycin. While only synergistic doses of N-acetylcysteine ​​can be used in current clinical doses, ambroxol may be a more effective alternative in implant coatings and catheter treatments where higher doses can be used. This study suggests that the use of mucolytics together with antibiotics may have promising therapeutic potential in biofilm-related infections.