Hypertonic glucose inhibits growth and attenuates virulence factors of multidrug-resistant Pseudomonas aeruginosa

• Published in: BMC microbiology 2020-07, Vol.20 (1), p.203-203, Article 203
• Main Authors: Chen, Tao, Xu, Ye, Xu, Wenya, Liao, Wenli, Xu, Chunquan, Zhang, Xiucai, Cao, Jianming, Zhou, Tieli
• Format: Article
• Language: English
• Subjects: Analysis; Antibiotics; Antimicrobial agents; Bacterial Proteins - genetics; Biofilm; Biofilms; Biofilms - drug effects; Care and treatment; China; Diabetes; Diabetes mellitus; Diabetic foot; Diabetic Foot - microbiology; Drug resistance; Drug Resistance, Multiple, Bacterial - drug effects; Elastase; Feet; Foot diseases; Gene expression; Gene Expression Regulation, Bacterial - drug effects; Glucose; Glucose Solution, Hypertonic - pharmacology; Granulation; Growth; Health aspects; Humans; Hypertonic glucose; Infection; Infection control; Infections; Larvae; Leg ulcers; Microbial drug resistance; Microbial Sensitivity Tests; Microbial Viability - drug effects; Mortality; Motility; Multidrug resistance; Multidrug resistant organisms; Pancreatic Elastase - genetics; Pathogens; Pseudomonas aeruginosa; Pseudomonas aeruginosa - genetics; Pseudomonas aeruginosa - growth & development; Pseudomonas aeruginosa - isolation & purification; Pseudomonas aeruginosa - pathogenicity; Pyocyanin; Pyocyanine - genetics; Quorum Sensing; Resistance factors; RhlR protein; Strains (organisms); Survival; Swimming; Tertiary Care Centers; Ulcers; Virulence; Virulence (Microbiology); Virulence factors; Virulence Factors - genetics; Wounds
• ISSN: 1471-2180; 1471-2180
• DOI: 10.1186/s12866-020-01889-2

Pseudomonas aeruginosa is the most common Gram-negative pathogen responsible for chronic wound infections, such as diabetic foot infections, and further exacerbates the treatment options and cost of such conditions. Hypertonic glucose, a commonly used prolotherapy solution, can accelerate the proliferation of granulation tissue and improve microcirculation in wounds. However, the action of hypertonic glucose on bacterial pathogens that infect wounds is unclear. In this study, we investigated the inhibitory effects of hypertonic glucose on multidrug-resistant P. aeruginosa strains isolated from diabetic foot infections. Hypertonic glucose represents a novel approach to control chronic wound infections caused by P. aeruginosa. Four multidrug-resistant P. aeruginosa clinical strains isolated from diabetic foot ulcers from a tertiary hospital in China and the reference P. aeruginosa PAO1 strain were studied. Hypertonic glucose significantly inhibited the growth, biofilm formation, and swimming motility of P. aeruginosa clinical strains and PAO1. Furthermore, hypertonic glucose significantly reduced the production of pyocyanin and elastase virulence factors in P. aeruginosa. The expression of major quorum sensing genes (lasI, lasR, rhlI, and rhlR) in P. aeruginosa were all downregulated in response to hypertonic glucose treatment. In a Galleria mellonella larvae infection model, the administration of hypertonic glucose was shown to increase the survival rates of larvae infected by P. aeruginosa strains (3/5). Hypertonic glucose inhibited the growth, biofilm formation, and swimming motility of P. aeruginosa, as well as reduced the production of virulence factors and quorum sensing gene expression. Further studies that investigate hypertonic glucose therapy should be considered in treating chronic wound infections.