Antimicrobial Activity of Chitosan Scaffold Loaded with Soluble Factors of Different Probiotic Strains Against Multidrug Resistant Pseudomonas aeruginosa

Background: Bacterial infection remains the most frequent complication of burn injury, which can lead to sepsis, even if antibiotics are used topically and systemically. Pseudomonas aeruginosa (P. aeruginosa) is the main causative agent in many cases. The emergence of antibiotic -resistant strains in recent years has increased the need to find novel alternative therapies, such as probiotics. Therefore, this study aimed to examine the antimicrobial properties of probiotic cell -free supernatant (CFS), along with the potential use of a chitosan scaffold both as an antimicrobial agent and as a carrier for the delivery of these complexes. Objective: Evaluation of the antimicrobial properties of cell -free soluble factors of probiotic bacteria both alone and in combination with chitosan scaffolds Materials and Methods: Nine isolates ofP. aeruginosa previously identified by standard diagnostic tests were investigated. The antimicrobial effects of probiotics in the form of Pedilact (R) oral drop which contained three probiotic strains, Kidilact (R) sachet, which contained seven probiotic strains, and strains of Lactobacillus casei (L. casei) and Lactobacillus acidophilus (L. acidophilus) isolated from yogurt were studied by an agar well diffusion assay and by using CFS harvested at various growth stages, without pH neutralization. Chitosan with different concentrations of glutaraldehyde (GA) as a crosslinking agent was fabricated to produce a suitable scaffold for loading cell -free supernatants of probiotic strains. The scaffolds were then characterized using scanning electron microscopy. The antimicrobial properties of the CFS, chitosan, and chitosan scaffolds loaded with CFS were analyzed against MDR P. aeruginosa. Results: In the agar well diffusion assay, CFS obtained from probiotic strains effectively inhibited the growth of a clinical strain of P. aeruginosa. This effect was observed when CFS was assessed without pH neutralization. Kidilact (R) was the most promising synbiotic formulation based on its inhibitory activity. The chitosan scaffold was successfully fabricated, as shown by SEM, and its structure was not affected by acidic CFS. The fabricated scaffolds were able to deliver CFS and, interestingly, antibacterial activity against P. aeruginosa when CFS was loaded on the chitosan scaffold was enhanced significantly. Conclusion: The results of this study showed chitosan scaffold loaded with cell -free probiotics metabolites can be considered to be a promising antimicrobial dressing in wound healing applications