The Effect of Fluoroquinolones and Antioxidans on Biofilm Formation by Proteus Mirabilis Strains

Overview

Journal Ann Clin Microbiol Antimicrob

Publisher Biomed Central

Specialties Infectious Diseases
Microbiology

Date 2022 Jun 2

PMID 35655208

Authors

Jana Przekwas

Jakub Gebalski

Joanna Kwiecinska-Pirog

Natalia Wiktorczyk-Kapischke

Ewa Walecka-Zacharska

Eugenia Gospodarek-Komkowska

Dorota Rutkowska

Krzysztof Skowron

Affiliations

Soon will be listed here.

Abstract

Background: Fluoroquinolones are a group of antibiotics used in urinary tract infections. Unfortunately, resistance to this group of drugs is currently growing. The combined action of fluoroquinolones and other antibacterial and anti-biofilm substances may extend the use of this therapeutic option by clinicians. The aim of the study was to determine the effect of selected fluoroquinolones and therapeutic concentrations of ascorbic acid and rutoside on biofilm formation by Proteus mirabilis.

Materials And Methods: The study included 15 strains of P. mirabilis isolated from urinary tract infections in patients of the University Hospital No. 1 dr A. Jurasz in Bydgoszcz (Poland). The metabolic activity of the biofilm treated with 0.4 mg/ml ascorbic acid, 0.02 µg/ml rutoside and chemotherapeutic agents (ciprofloxacin, norfloxacin) in the concentration range of 0.125-4.0 MIC (minimum inhibitory concentration) was assessed spectrophotometrically.

Results: Both ciprofloxacin and norfloxacin inhibited biofilm formation by the tested strains. The biofilm reduction rate was correlated with the increasing concentration of antibiotic used. No synergism in fluoroquinolones with ascorbic acid, rutoside or both was found. The ascorbic acid and rutoside combination, however, significantly decreased biofilm production.

Conclusions: Our research proves a beneficial impact of ascorbic acid with rutoside supplementation on biofilm of P. mirabilis strains causing urinary tract infections.

Citing Articles

The SOS Response Activation and the Risk of Antibiotic Resistance Enhancement in spp. Strains Exposed to Subinhibitory Concentrations of Ciprofloxacin.

Zablotni A, Schmidt M, Siwinska M Int J Mol Sci. 2025; 26(1).

PMID: 39795976 PMC: 11720175. DOI: 10.3390/ijms26010119.

Fluoroquinolones and Biofilm: A Narrative Review.

Geremia N, Giovagnorio F, Colpani A, De Vito A, Botan A, Stroffolini G Pharmaceuticals (Basel). 2025; 17(12.

PMID: 39770514 PMC: 11679785. DOI: 10.3390/ph17121673.

Characteristics and Outcome of Vascular Graft Infections: A Risk Factor and Survival Analysis.

Stockschlader L, Margaryan D, Omran S, Schomaker M, Greiner A, Trampuz A Open Forum Infect Dis. 2024; 11(6):ofae271.

PMID: 38868303 PMC: 11167665. DOI: 10.1093/ofid/ofae271.

Potential antivirulence activity of sub-inhibitory concentrations of ciprofloxacin against Proteus mirabilis isolates: an in-vitro and in-vivo study.

Elhosseini M, El-Banna T, Sonbol F, El-Bouseary M Ann Clin Microbiol Antimicrob. 2024; 23(1):48.

PMID: 38802894 PMC: 11131287. DOI: 10.1186/s12941-024-00704-4.

References

Mah T, OToole G . Mechanisms of biofilm resistance to antimicrobial agents. Trends Microbiol. 2001; 9(1):34-9. DOI: 10.1016/s0966-842x(00)01913-2. View

Bernard F, Sable S, Cameron B, Provost J, Desnottes J, Crouzet J . Glycosylated flavones as selective inhibitors of topoisomerase IV. Antimicrob Agents Chemother. 1997; 41(5):992-8. PMC: 163839. DOI: 10.1128/AAC.41.5.992. View

Mace S, Truelstrup Hansen L, Rupasinghe H . Anti-Bacterial Activity of Phenolic Compounds against Streptococcus pyogenes. Medicines (Basel). 2017; 4(2). PMC: 5590061. DOI: 10.3390/medicines4020025. View

Syal K, Chatterji D . Vitamin C: A Natural Inhibitor of Cell Wall Functions and Stress Response in Mycobacteria. Adv Exp Med Biol. 2019; 1112:321-332. DOI: 10.1007/978-981-13-3065-0_22. View

Scheld W . Maintaining fluoroquinolone class efficacy: review of influencing factors. Emerg Infect Dis. 2003; 9(1):1-9. PMC: 2873754. DOI: 10.3201/eid0901.020277. View

Guz J, Olinski R . The role of vitamin C in epigenetic regulation. Postepy Hig Med Dosw (Online). 2017; 71(1):747-760. DOI: 10.5604/01.3001.0010.3853. View

Alvarez M, Debattista N, Pappano N . Antimicrobial activity and synergism of some substituted flavonoids. Folia Microbiol (Praha). 2008; 53(1):23-8. DOI: 10.1007/s12223-008-0003-4. View

Pandit S, Ravikumar V, Abdel-Haleem A, Derouiche A, Mokkapati V, Sihlbom C . Low Concentrations of Vitamin C Reduce the Synthesis of Extracellular Polymers and Destabilize Bacterial Biofilms. Front Microbiol. 2018; 8:2599. PMC: 5748153. DOI: 10.3389/fmicb.2017.02599. View

Syal K, Bhardwaj N, Chatterji D . Vitamin C targets (p)ppGpp synthesis leading to stalling of long-term survival and biofilm formation in Mycobacterium smegmatis. FEMS Microbiol Lett. 2016; 364(1). DOI: 10.1093/femsle/fnw282. View

10.

Chen C, Chen Y, Lu P, Lin W, Chen T, Lin C . Proteus mirabilis urinary tract infection and bacteremia: risk factors, clinical presentation, and outcomes. J Microbiol Immunol Infect. 2012; 45(3):228-36. DOI: 10.1016/j.jmii.2011.11.007. View

11.

Goswami M, Mangoli S, Jawali N . Involvement of reactive oxygen species in the action of ciprofloxacin against Escherichia coli. Antimicrob Agents Chemother. 2006; 50(3):949-54. PMC: 1426460. DOI: 10.1128/AAC.50.3.949-954.2006. View

12.

Amin M, Khurram M, Khattak B, Khan J . Antibiotic additive and synergistic action of rutin, morin and quercetin against methicillin resistant Staphylococcus aureus. BMC Complement Altern Med. 2015; 15:59. PMC: 4364681. DOI: 10.1186/s12906-015-0580-0. View

13.

Guz J, Dziaman T, Szpila A . [Do antioxidant vitamins influence carcinogenesis?]. Postepy Hig Med Dosw (Online). 2007; 61:185-98. View

14.

Schaffer J, Pearson M . Proteus mirabilis and Urinary Tract Infections. Microbiol Spectr. 2015; 3(5). PMC: 4638163. DOI: 10.1128/microbiolspec.UTI-0017-2013. View

15.

Ganeshpurkar A, Saluja A . The Pharmacological Potential of Rutin. Saudi Pharm J. 2017; 25(2):149-164. PMC: 5355559. DOI: 10.1016/j.jsps.2016.04.025. View

16.

Silva H, de Souza G, Fernandes J, Constantino C, Winkelstroter L . Unravelling the effects of the food components ascorbic acid and capsaicin as a novel anti-biofilm agent against . J Food Sci Technol. 2020; 57(3):1013-1020. PMC: 7026335. DOI: 10.1007/s13197-019-04134-5. View

17.

Ran L, Zhao W, Wang H, Zhao Y, Bu H . Vitamin C as a Supplementary Therapy in Relieving Symptoms of the Common Cold: A Meta-Analysis of 10 Randomized Controlled Trials. Biomed Res Int. 2020; 2020:8573742. PMC: 7569434. DOI: 10.1155/2020/8573742. View

18.

Arima H, Ashida H, Danno G . Rutin-enhanced antibacterial activities of flavonoids against Bacillus cereus and Salmonella enteritidis. Biosci Biotechnol Biochem. 2002; 66(5):1009-14. DOI: 10.1271/bbb.66.1009. View

19.

Wang A, Wang Q, Kudinha T, Xiao S, Zhuo C . Effects of Fluoroquinolones and Azithromycin on Biofilm Formation of Stenotrophomonas maltophilia. Sci Rep. 2016; 6:29701. PMC: 4942784. DOI: 10.1038/srep29701. View

20.

Saini H, Chhibber S, Harjai K . Azithromycin and ciprofloxacin: a possible synergistic combination against Pseudomonas aeruginosa biofilm-associated urinary tract infections. Int J Antimicrob Agents. 2015; 45(4):359-67. DOI: 10.1016/j.ijantimicag.2014.11.008. View