Inhibition of Biofilm Formation by Esomeprazole in Pseudomonas aeruginosa and Staphylococcus aureus

Abstract

Staphylococcus aureus and Pseudomonas aeruginosa are common nosocomial pathogens responsible for biofilm-associated infections. Proton pump inhibitors (PPI), such as esomeprazole, may have novel antimicrobial properties. The objective of this study was to assess whether esomeprazole prevents sessile bacterial growth and biofilm formation and whether it may have synergistic killing effects with standard antibiotics. The antibiofilm activity of esomeprazole at 0.25 mM was tested against two strains each of S. aureus and P. aeruginosa. Bacterial biofilms were prepared using a commercially available 96-peg-plate Calgary biofilm device. Sessile bacterial CFU counts and biomass were assessed during 72 hours of esomeprazole exposure. The killing activities after an additional 24 hours of vancomycin (against S. aureus) and meropenem (against P. aeruginosa) treatment with or without preexposure to esomeprazole were also assessed by CFU and biomass analyses. P. aeruginosa and S. aureus strains exposed to esomeprazole displayed decreased sessile bacterial growth and biomass (P < 0.001, each parameter). After 72 h of exposure, there was a 1-log 10 decrease in the CFU/ml of esomeprazole-exposed P. aeruginosa and S. aureus strains compared to controls (P < 0.001). After 72 h of exposure, measured absorbance was 100% greater in P. aeruginosa control strains than in esomeprazole-exposed strains (P < 0.001). Increased killing and decreased biomass were observed for esomeprazoletreated bacteria compared to untreated controls exposed to conventional antibiotics (P < 0.001, each parameter). Reduced biofilm growth after 24 h was visibly apparent by light micrographs for P. aeruginosa and S. aureus isolates exposed to esomeprazole compared to untreated controls. In conclusion, esomeprazole demonstrated an antibiofilm effect against biofilm-producing S. aureus and P. aeruginosa. P roton pump inhibitors (PPI) have been shown to have novel antibacterial properties (9, 15). Against Helicobacter pylori, benzimadazole PPI have been shown to have direct antimicrobial effects (15). PPI have also been shown to have other effects on microbiologic activity, including inhibition of urease (12). In 2005, an in vitro study investigated the antibiofilm properties of PPI benzimidazoles against oral streptococci (10). The results showed that the additions of omeprazole and lansoprazole had a significant effect on Streptococcus mutans biofilms, a common organism found in the human oral flora. However, antibiofilm effects of PPI on other bacteria have not been well studied.The two most common nosocomial organisms responsible for catheter-related infections, Pseudomonas aeruginosa and Staphylococcus aureus, have a natural tendency to adhere to catheter surfaces and form biofilms, which prevent eradication of these organisms by the immune system or with antibiotics (16). Theoretically, prevention of biofilm formation by these bacteria could prevent catheter-related infections among hospitalized patients and lead to a major improvement in the care of thes...

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