Hypertonic thermal solutions as a putative strategy for respiratory biofilm disruption

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Abstract
Objectives: Upper respiratory tract infections pose a significant challenge for healthcare systems worldwide. Forming biofilms-complex polymicrobial communities encased in an exopolymer matrix plays a pivotal role in the persistence of these infections, contributing to enhanced resistance against conventional treatments and host immune responses. Consequently, developing innovative strategies to disrupt biofilms has become a therapeutic imperative.This study investigated the in vitro efficacy of a hypertonic solution of salsobromoiodic thermal water, in mitigating biofilm formation by key upper respiratory tract pathogens. Methods: Biofilm formation by Staphylococcus aureus , Moraxella catarrhalis , Haemophilus influenzae , Streptococcus pneumoniae , Candida albicans , Candida parapsilosis , and Candida tropicalis was assessed using the MBEC Assay ® system. The effects of the hypertonic salsobromoiodic thermal water solution were compared with standard saline (0.9 % NaCl). Results: A significant, concentration-dependent reduction in biofilm biomass was observed in all tested microorganisms when treated with the hypertonic solution. This effect was also evident in polymicrobial biofilms, indicating a broad and consistent antibiofilm potential. Conclusions: The hypertonic solution of salsobromoiodic thermal water demonstrated notable in vitro activity against biofilm formation by major upper respiratory tract pathogens. These findings highlight its potential as novel therapeutic approach for managing biofilm-associated respiratory infections and enhancing conventional antimicrobial treatments effectiveness.

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