Combating Biofilm: Melatonin's Role in Mitigating Multidrug-Resistant Uropathogens in Cancer

Background: Multidrug-resistant (MDR) bacterial infections, particularly urinary tract infections (UTIs), are prevalent in cancer patients, due to long-term immunosuppression. Uropathogenic bacteria like Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa, complicate treatment through biofilm formation, enhancing antibiotic resistance. Recent studies has explored the potential of melatonin, an antioxidant hormone, to disrupt bacterial biofilms. Objective(s): This study analyzes the antibiotic resistance of uropathogenic bacteria from cancer patients and evaluates the efficacy of melatonin in inhibiting biofilm formation in these MDR strains. Methodology: 65 urine samples from cancer patients were collected at Sabha Oncology Center. Bacteria were identified using standard techniques, and antibiotic susceptibility was evaluated via the Kirby-Bauer method. Biofilm formation was measured using crystal violet staining, and melatonin’s antibiofilm activity was tested from 10 µg/mL to 1000 µg/mL. Results: E. coli was the most prevalent pathogen (32.69%), followed by K. pneumoniae (17.30%) and P. aeruginosa (15.38%). All isolates exhibited high resistance to amoxicillin/clavulanic acid and cefotaxime with Strong biofilm. Melatonin notably inhibited E. coli biofilm formation at higher concentrations, with lesser effects on K. pneumoniae and P. aeruginosa. Conclusion: The prevalence of MDR uropathogens and their biofilms formation underscore the need for new therapies in cancer patients. Melatonin may serves as a complementary treatment to inhibit biofilm, particularly in E. coli. Additional research is required to assess its clinical application in managing biofilm-associated infections.