Effect of cold plasma on some virulence factors in Pseudomonas aeruginosa isolated from clinical cases

Objective: Pseudomonas aeruginosa infections pose a significant challenge due to their ability to resist various antibiotics and form biofilms. Excessive antibiotic use accelerates the development of multidrug-resistant P. aeruginosa, which is further enhanced by its ability to form biofilms. Therefore, alternative treatment options are needed to control antibiotic resistance and biofilm formation. Cold plasma contains a mixture of reactive oxygen and nitrogen species, which directly kill bacteria, modify virulence factors, and enhance innate immune responses. This study aimed to evaluate the effect of cold plasma on P. aeruginosa antibiotic resistance and ability to form biofilms. Methods: Clinical isolates of P. aeruginosa were exposed to cold plasma for different periods (3, 6, and 9 minutes). Changes in susceptibility to several antibiotics were assessed using the disk diffusion method, and biofilm formation was examined using crystal violet staining. Results: The results demonstrated the clear effectiveness of cold plasma against antibiotic resistance and the biofilm-forming ability of P. aeruginosa. The effectiveness of the tested antibiotics was increased, and the bacteria lost their ability to form biofilms by 100%. The results support the idea of using cold plasma technology as an alternative to antibiotics to eliminate pathogenic and antibiotic-resistant bacteria, thereby treating diseases associated with these bacteria. Conclusions: The results demonstrated the potential of using cold plasma technology as an alternative to antibiotics to treat diseases associated with this bacterium.