Limited therapeutic options are available for multidrug-resistant Acinetobacter baumannii (MDR-AB), and the development of effective treatments is urgently needed. The efficacy of four aerosolized antibiotics (gentamicin, amikacin, imipenem, and meropenem) on three different MDR-AB strains was evaluated using hypertonic saline (HS, 7 g/100 mL) as the aerosol carrier. HS aerosol effectively hindered biofilm formation by specific MDR-AB strains. It could also interrupt the swarming dynamics of MDR-AB and the production of extracellular polymeric substances, which are essential for biofilm progression. Biofilms protect the microorganisms from antibiotics. The use of HS aerosol as a carrier resulted in a decreased tolerance to gentamicin and amikacin in the biofilm-rich MDR-AB. Moreover, we tested the aerosol characteristics of antibiotics mixed with HS and saline, and results showed that HS enhanced the inhaled delivery dose with a smaller particle size distribution of the four antibiotics. Our findings demonstrate the potential of using “old” antibiotics with our “new” aerosol carrier, and potentiate an alternative therapeutic strategy to eliminate MDR-AB infections from a biofilm-disruption perspective.

中文翻译：

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雾化高渗盐水阻碍生物膜形成以增强耐多药鲍曼不动杆菌的抗生素敏感性

多重耐药鲍曼不动杆菌的治疗选择有限(MDR-AB)，迫切需要开发有效的治疗方法。使用高渗盐水（HS，7 g/100 mL）作为气雾剂载体评估了四种雾化抗生素（庆大霉素、阿米卡星、亚胺培南和美罗培南）对三种不同 MDR-AB 菌株的疗效。HS 气溶胶有效地阻碍了特定 MDR-AB 菌株的生物膜形成。它还可以中断 MDR-AB 的集群动态和细胞外聚合物的产生，这对生物膜进展至关重要。生物膜保护微生物免受抗生素侵害。使用 HS 气雾剂作为载体导致富含生物膜的 MDR-AB 对庆大霉素和阿米卡星的耐受性降低。此外，我们测试了抗生素与 H2S 和生理盐水混合的气溶胶特性，结果表明，HS 提高了吸入给药剂量，四种抗生素的粒径分布更小。我们的研究结果证明了将“旧”抗生素与我们的“新”气雾剂载体一起使用的潜力，并增强了从生物膜破坏的角度消除 MDR-AB 感染的替代治疗策略。