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Hypertonic glucose, a commonly used prolotherapy solution, can accelerate the proliferation of granulation tissue and improve microcirculation in wounds. However, the action of hypertonic glucose on bacterial pathogens that infect wounds is unclear\n                      <jats:italic>.<\/jats:italic>\n                      In this study, we investigated the inhibitory effects of hypertonic glucose on multidrug-resistant\n                      <jats:italic>P. aeruginosa<\/jats:italic>\n                      strains isolated from diabetic foot infections. Hypertonic glucose represents a novel approach to control chronic wound infections caused by\n                      <jats:italic>P. aeruginosa<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Four multidrug-resistant\n                      <jats:italic>P. aeruginosa<\/jats:italic>\n                      clinical strains isolated from diabetic foot ulcers from a tertiary hospital in China and the reference\n                      <jats:italic>P. aeruginosa<\/jats:italic>\n                      PAO1 strain were studied. Hypertonic glucose significantly inhibited the growth, biofilm formation, and swimming motility of\n                      <jats:italic>P. aeruginosa<\/jats:italic>\n                      clinical strains and PAO1. Furthermore, hypertonic glucose significantly reduced the production of pyocyanin and elastase virulence factors in\n                      <jats:italic>P. aeruginosa<\/jats:italic>\n                      . The expression of major quorum sensing genes (\n                      <jats:italic>lasI<\/jats:italic>\n                      ,\n                      <jats:italic>lasR<\/jats:italic>\n                      ,\n                      <jats:italic>rhlI<\/jats:italic>\n                      , and\n                      <jats:italic>rhlR<\/jats:italic>\n                      ) in\n                      <jats:italic>P. aeruginosa<\/jats:italic>\n                      were all downregulated in response to hypertonic glucose treatment. In a\n                      <jats:italic>Galleria mellonella<\/jats:italic>\n                      larvae infection model, the administration of hypertonic glucose was shown to increase the survival rates of larvae infected by\n                      <jats:italic>P. aeruginosa<\/jats:italic>\n                      strains (3\/5).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Hypertonic glucose inhibited the growth, biofilm formation, and swimming motility of\n                      <jats:italic>P. aeruginosa<\/jats:italic>\n                      , as well as reduced the production of virulence factors and quorum sensing gene expression\n                      <jats:italic>.<\/jats:italic>\n                      Further studies that investigate hypertonic glucose therapy should be considered in treating chronic wound infections.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12866-020-01889-2","type":"journal-article","created":{"date-parts":[[2020,7,9]],"date-time":"2020-07-09T04:08:50Z","timestamp":1594267730000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Hypertonic glucose inhibits growth and attenuates virulence factors of multidrug-resistant Pseudomonas aeruginosa"],"prefix":"10.1186","volume":"20","author":[{"given":"Tao","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenya","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenli","family":"Liao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunquan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiucai","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianming","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2171-4710","authenticated-orcid":false,"given":"Tieli","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,7,9]]},"reference":[{"key":"1889_CR1","doi-asserted-by":"publisher","first-page":"18160","DOI":"10.1038\/s41598-019-54576-2","volume":"9","author":"J Lu","year":"2019","unstructured":"Lu J, Cokcetin NN, Burke CM, Turnbull L, Liu M, Carter DA, et al. 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