{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:54:30Z","timestamp":1789005270162,"version":"build-2803163510"},"reference-count":90,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:p>\n                    Susceptibility testing of clinical multidrug-resistant (MDR) and reference\n                    <jats:italic>P. aeruginosa<\/jats:italic>\n                    strains was performed using the standard twofold serial dilution method. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of antiseptics were determined. MIC and MBC values were also interpreted as the bacteriostatic index of antiseptic activity (BSIAA) and the bactericidal index of antiseptic activity (BCIAA). The ability of strains to form biofilms, the inhibition of biofilm formation, and the destruction of mature biofilms under the influence of bacteriostatic, bactericidal, and \u00bd of the initial antiseptic concentration were modeled using Christensen\u2019s test. Antiseptics from the detergent group, decamethoxine (0.1 and 0.02%) and polyhexanide (0.1%), demonstrated the highest antimicrobial activity. Their bacteriostatic concentrations were 63.2\u202f\u00b1\u202f5.2\u202f\u03bcg\/mL and 68.7\u202f\u00b1\u202f4.2\u202f\u03bcg\/mL, respectively. The ranking of antiseptics by bacteriostatic efficacy was: decamethoxine &amp;gt; polyhexanide &amp;gt; octenidine &amp;gt; miramistin &amp;gt; chlorhexidine. The highest BSIAA values were observed for povidone-iodine 10%, decamethoxine 0.1%, octenidine 0.1%, and polyhexanide 0.1%. The highest bactericidal IAA values were found for povidone-iodine 10%, decamethoxine 0.1%, octenidine 0.1%, and polyhexanide 0.1%. Miramistin 0.01% was deemed insufficiently effective. Polyhexanide exhibited the highest bactericidal activity, with a BCIAA to BSIAA ratio of 0.88. For all other antiseptics, this ratio ranged from 0.5 to 0.6. All tested strains exhibited a high capacity for biofilm formation. All antiseptics significantly inhibited biofilm formation. Octenidine had the strongest effect on immature biofilms, reducing their formation by 28.5% (\n                    <jats:italic>p<\/jats:italic>\n                    \u202f&amp;lt;\u202f0.0001). The MICs of most antiseptics stimulated mature biofilm development. The bacteriostatic concentration of octenidine led to the eradication of biofilm by 4.7% (\n                    <jats:italic>p<\/jats:italic>\n                    \u202f&amp;lt;\u202f0.001) compared to the control. The MBC of most antiseptics (except chlorhexidine) eradicated mature biofilms by 4\u201330.6%, whereas chlorhexidine stimulated mature biofilm growth by 17.9%. All antiseptics, at half their initial concentration, partially eradicated MDR\n                    <jats:italic>Pseudomonas<\/jats:italic>\n                    biofilms by 11.3\u201342.4%. Analysing the effect of octenidine at different concentrations and stages of biofilm formation highlights its strong activity against\n                    <jats:italic>P. aeruginosa<\/jats:italic>\n                    biofilms. Our findings underscore the importance of carefully monitoring\n                    <jats:italic>P. aeruginosa<\/jats:italic>\n                    isolates for antiseptic susceptibility. This approach can help prevent the development of selective conditions that promote resistant microorganisms and limit their spread.\n                  <\/jats:p>","DOI":"10.3389\/fmicb.2025.1656270","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T05:25:07Z","timestamp":1761888307000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Modern antiseptics against multidrug-resistant Pseudomonas aeruginosa, emerging from war-related injuries in Ukraine"],"prefix":"10.3389","volume":"16","author":[{"given":"Oleksandr","family":"Nazarchuk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian","family":"Riesbeck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentyn","family":"Kovalchuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetiana","family":"Denysko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariia","family":"Faustova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Chornopyshchuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halyna","family":"Nazarchuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oleg","family":"Parkhomenko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nataliia","family":"Bahniuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dmytro","family":"Dmytriiev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasyl","family":"Nagaichuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2155","DOI":"10.14202\/vetworld.2021.2155-2159","article-title":"Pseudomonas aeruginosa infection of avian origin: zoonosis and one health implications","volume":"14","author":"Abd El-Ghany","year":"2021","journal-title":"Vet. World"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/j.jgar.2021.08.001","article-title":"Environmental antimicrobial resistance and its drivers: a potential threat to public health","volume":"27","author":"Ahmad","year":"2021","journal-title":"J. Global Antimicrob. Resistance"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.jhin.2022.09.021","article-title":"Role of antiseptics in the prevention and treatment of infections in nursing homes","volume":"131","author":"Alves","year":"2023","journal-title":"J. Hosp. Infect."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"771510","DOI":"10.3389\/fcimb.2021.771510","article-title":"Antibiotic resistance: one health one world outlook","volume":"11","author":"Aslam","year":"2021","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.2147\/IDR.S173867","article-title":"Antibiotic resistance: a rundown of a global crisis","volume":"11","author":"Aslam","year":"2018","journal-title":"Infection Drug Resis."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.12968\/jowc.2016.25.sup3.s3","article-title":"Octenidine dihydrochloride: chemical characteristics and antimicrobial properties","volume":"25","author":"Assadian","year":"2016","journal-title":"J. Wound Care"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.3390\/ph14121253","article-title":"Wound antiseptics and European guidelines for antiseptic application in wound treatment","volume":"14","author":"Babalska","year":"2021","journal-title":"Pharmaceuticals"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1186\/s12866-022-02524-y","article-title":"Phenotype and genetic determination of resistance to common disinfectants among biofilm-producing and non-producing Pseudomonas aeruginosa strains from clinical specimens in Iran","volume":"22","author":"Bakht","year":"2022","journal-title":"BMC Microbiol."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/nar\/gks1039","article-title":"A dynamic and intricate regulatory network determines Pseudomonas aeruginosa virulence","volume":"41","author":"Balasubramanian","year":"2013","journal-title":"Nucleic Acids Res."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1216","DOI":"10.3389\/fmicb.2015.01216","article-title":"The role of biofilms as environmental reservoirs of antibiotic resistance","volume":"6","author":"Balc\u00e1zar","year":"2015","journal-title":"Front. Microbiol."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"11270","DOI":"10.3390\/ijms231911270","article-title":"Antibiofilm properties of antiseptic agents used on Pseudomonas aeruginosa isolated from diabetic foot ulcers","volume":"23","author":"Barrigah-Benissan","year":"2022","journal-title":"Int. J. Mol. Sci."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"42","DOI":"10.3390\/antibiotics10010042","article-title":"It's not easy being green: a narrative review on the microbiology, virulence and therapeutic prospects of multidrug-resistant Pseudomonas aeruginosa","volume":"10","author":"Behzadi","year":"2021","journal-title":"Antibiotics (Basel, Switzerland)"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"614","DOI":"10.3390\/antibiotics11050614","article-title":"Evaluating the effectiveness of hospital antiseptics on multidrug-resistant Acinetobacter baumannii: understanding the relationship between microbicide and antibiotic resistance","volume":"11","author":"Betchen","year":"2022","journal-title":"Antibiotics (Basel, Switzerland)"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1852","DOI":"10.1093\/gbe\/evy139","article-title":"Comparative genomics of nonoutbreak Pseudomonas aeruginosa strains underlines genome plasticity and geographic relatedness of the global clone ST235","volume":"10","author":"Br\u00fcggemann","year":"2018","journal-title":"Genome Biol. Evol."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"3227","DOI":"10.1128\/AAC.02969-15","article-title":"Evaluation of the in vitro activity of ceftazidime-avibactam and ceftolozane-tazobactam against meropenem-resistant Pseudomonas aeruginosa isolates","volume":"60","author":"Buehrle","year":"2016","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref16","article-title":"One health. Centers for Disease Control and Prevention","year":"2019"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1089\/mdr.2018.0027","article-title":"Relationship between biofilm formation and antimicrobial resistance in gram-negative bacteria","volume":"25","author":"Cepas","year":"2019","journal-title":"Microb. Drug Resist."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"8836","DOI":"10.1038\/s41598-022-12840-y","article-title":"The effects of rotating magnetic field and antiseptic on in vitro pathogenic biofilm and its milieu","volume":"12","author":"Ciecholewska-Ju\u015bko","year":"2022","journal-title":"Sci. Rep."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1111\/apm.13010","article-title":"The environmental occurrence of Pseudomonas aeruginosa","volume":"128","author":"Crone","year":"2019","journal-title":"APMIS"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"3334","DOI":"10.1128\/IAI.00090-06","article-title":"Transcriptional induction of the Pseudomonas aeruginosa type III secretion system by low Ca2+ and host cell contact proceeds through two distinct signaling pathways","volume":"74","author":"Dasgupta","year":"2006","journal-title":"Infect. Immun."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1128\/MMBR.00016-10","article-title":"Origins and evolution of antibiotic resistance","volume":"74","author":"Davies","year":"2010","journal-title":"Microbiol Mol Biol Rev."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"932467","DOI":"10.3389\/fmicb.2022.932467","article-title":"In vitro evaluation of the antimicrobial activity of antiseptics against clinical Acinetobacter baumannii strains isolated from combat wounds","volume":"13","author":"Denysko","year":"2022","journal-title":"Front. Microbiol."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1099\/mic.0.000860","article-title":"Microbe profile: Pseudomonas aeruginosa: opportunistic pathogen and lab rat","volume":"166","author":"Diggle","year":"2020","journal-title":"Microbiology"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"351","DOI":"10.2165\/00003495-200767030-00003","article-title":"The epidemiology, pathogenesis and treatment of Pseudomonas aeruginosa infections","volume":"67","author":"Driscoll","year":"2007","journal-title":"Drugs"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"836","DOI":"10.1126\/science.173.3999.836","article-title":"Pseudomonas aeruginosa: growth in distilled water from hospitals","volume":"173","author":"Favero","year":"1971","journal-title":"Science"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"S155","DOI":"10.1093\/ofid\/ofx163.260","article-title":"Clinical characteristics and resistance patterns of Pseudomonas aeruginosa isolated from operations enduring freedom and Iraqi freedom trauma patients","volume":"4","author":"Ford","year":"2017","journal-title":"Open Forum Infect. Dis."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"471","DOI":"10.2174\/1389203720666190207100415","article-title":"Anti-virulence strategy against the multidrug-resistant bacterial pathogen Pseudomonas aeruginosa: Pseudolysin (elastase B) as a potential Druggable target","volume":"20","author":"Galdino","year":"2019","journal-title":"Curr. Protein Pept. Sci."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"360","DOI":"10.3390\/antibiotics13040360","article-title":"A review of the impact of streptococcal infections and antimicrobial resistance on human health","volume":"13","author":"Gergova","year":"2024","journal-title":"Antibiotics."},{"key":"ref29","article-title":"GARDP and CARB-X welcome renewed commitment by G7 leaders to address antimicrobial resistance","year":""},{"key":"ref30","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1007\/978-3-031-08491-1_9","article-title":"Pseudomonas aeruginosa Antivirulence strategies: targeting the type III secretion system","volume":"1386","author":"Goldberg","year":"2022","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1007\/s00284-023-03257-5","article-title":"Anti-biofilm activity of povidone-iodine and Polyhexamethylene Biguanide: evidence from in vitro tests","volume":"80","author":"Gryson","year":"2023","journal-title":"Curr. Microbiol."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1177\/1757177420963829","article-title":"Ability of chlorhexidine, octenidine, polyhexanide and chloroxylenol to inhibit metabolism of biofilm-forming clinical multidrug-resistant organisms","volume":"22","author":"G\u00fcnther","year":"2021","journal-title":"J. Infect. Prev."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"96","DOI":"10.4103\/JPBS.JPBS_24_18","article-title":"Emerging biocide resistance among multidrug-resistant Bacteria: myth or reality? A pilot study","volume":"10","author":"Gupta","year":"2018","journal-title":"J. Pharm. Bioallied Sci."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"214","DOI":"10.4103\/0972-5229.118416","article-title":"Association of biofilm production with multidrug resistance among clinical isolates of Acinetobacter baumannii and Pseudomonas aeruginosa from intensive care unit","volume":"17","author":"Gurung","year":"2013","journal-title":"Indian J. Crit. Care Med."},{"key":"ref35","article-title":"Joint programming initiative on antimicrobial resistance","year":""},{"key":"ref36","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1111\/iwj.12057","article-title":"Efficacy of antiseptics containing povidone-iodine, octenidine dihydrochloride and ethacridine lactate against biofilm formed by Pseudomonas aeruginosa and Staphylococcus aureus measured with the novel biofilm-oriented antiseptics test","volume":"11","author":"Junka","year":"2014","journal-title":"Int. Wound J."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1007\/s10096-016-2792-8","article-title":"Determinants for persistence of Pseudomonas aeruginosa in hospitals: interplay between resistance, virulence and biofilm formation","volume":"36","author":"Kaiser","year":"2017","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref38","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1089\/mdr.2019.0274","article-title":"Meta-analysis of biofilm formation, antibiotic resistance pattern, and biofilm-related genes in Pseudomonas aeruginosa isolated from clinical samples","volume":"26","author":"Karballaei Mirzahosseini","year":"2020","journal-title":"Microb. Drug Resist."},{"key":"ref39","first-page":"135","article-title":"Efficacy of Octenidine against Pseudomonas Aeruginosa strains","volume":"9","author":"Karpi\u0144ski","year":"2019","journal-title":"Eur. J. Biol. Res."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"399","DOI":"10.3390\/antibiotics12020399","article-title":"Evidence-based treatment of Pseudomonas aeruginosa infections: a critical reappraisal","volume":"12","author":"Karruli","year":"2023","journal-title":"Antibiotics (Basel, Switzerland)"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1016\/j.jgar.2019.01.015","article-title":"Mutant selection window of disinfectants for Staphylococcus aureus and Pseudomonas aeruginosa","volume":"17","author":"Kawamura","year":"2019","journal-title":"J. Global Antimicrob. Resist."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"1712","DOI":"10.1093\/jac\/dkq212","article-title":"Standardized comparison of antiseptic efficacy of triclosan, PVP-iodine, octenidine dihydrochloride, polyhexanide and chlorhexidine digluconate","volume":"65","author":"Koburger","year":"2010","journal-title":"J. Antimicrob. Chemother."},{"key":"ref43","doi-asserted-by":"publisher","first-page":"e2024030","DOI":"10.23750\/abm.v95i2.15395","article-title":"A current view on the phenotypic antibiotic resistance of leading pathogens in wounded patients during the war in Ukraine","volume":"95","author":"Kovalchuk","year":"2024","journal-title":"Acta Biomed"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1159\/000481545","article-title":"Consensus on wound antisepsis: update 2018","volume":"31","author":"Kramer","year":"2018","journal-title":"Skin Pharmacol. Physiol."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"62","DOI":"10.3390\/membranes11010062","article-title":"In vitro evaluation of polihexanide, octenidine and NaClO\/HClO-based antiseptics against biofilm formed by wound pathogens","volume":"11","author":"Krasowski","year":"2021","journal-title":"Membranes"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"1366600","DOI":"10.3389\/fpubh.2024.1366600","article-title":"Impact of war-associated factors on spread of sexually transmitted infections: a systemic review","volume":"12","author":"Kvasnevska","year":"2024","journal-title":"Front. Public Health"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1186\/s12913-015-0917-x","article-title":"Healthcare utilization and costs associated with S. aureus and P. aeruginosa pneumonia in the intensive care unit: a retrospective observational cohort study in a US claims database","volume":"15","author":"Kyaw","year":"2015","journal-title":"BMC Health Serv. Res."},{"key":"ref48","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/j.ijantimicag.2016.05.008","article-title":"Synergistic antibiofilm efficacy of various commercial antiseptics, enzymes and EDTA: a study of Pseudomonas aeruginosa and Staphylococcus aureus biofilms","volume":"48","author":"Lefebvre","year":"2016","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1016\/j.idc.2004.04.012","article-title":"Pharmacodynamics of antimicrobial drugs","volume":"18","author":"Levison","year":"2004","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref50","doi-asserted-by":"publisher","first-page":"e0198384","DOI":"10.1371\/journal.pone.0198384","article-title":"Pseudomonas aeruginosa displays a dormancy phenotype during long-term survival in water","volume":"13","author":"Lewenza","year":"2018","journal-title":"PLoS One"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"926758","DOI":"10.3389\/fcimb.2022.926758","article-title":"Virulence factors of Pseudomonas aeruginosa and Antivirulence strategies to combat its drug resistance","volume":"12","author":"Liao","year":"2022","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref52","doi-asserted-by":"publisher","first-page":"e6217","DOI":"10.7717\/peerj.6217","article-title":"Antimicrobial susceptibility and virulence genes of clinical and environmental isolates of Pseudomonas aeruginosa","volume":"7","author":"Liew","year":"2019","journal-title":"PeerJ"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1016\/S1473-3099(23)00291-8","article-title":"Highly multidrug-resistant gram-negative bacterial infections in war victims in Ukraine, 2022","volume":"23","author":"Ljungquist","year":"2023","journal-title":"Lancet Infect. Dis."},{"key":"ref54","doi-asserted-by":"publisher","first-page":"2905","DOI":"10.1007\/s11845-023-03401-x","article-title":"War in Ukraine: incursion of antimicrobial resistance","volume":"192","author":"Loban\u2019","year":"2023","journal-title":"Ir. J. Med. Sci."},{"key":"ref55","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.eimc.2016.02.008","article-title":"In vitro activity of a polyhexanide-betaine solution against high-risk clones of multidrug-resistant nosocomial pathogens","volume":"35","author":"L\u00f3pez-Rojas","year":"2017","journal-title":"Enferm. Infecc. Microbiol. Clin."},{"key":"ref56","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","article-title":"Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance","volume":"18","author":"Magiorakos","year":"2012","journal-title":"Clin. Microbiol. Infect."},{"key":"ref57","doi-asserted-by":"publisher","first-page":"dlab027","DOI":"10.1093\/jacamr\/dlab027","article-title":"Antimicrobial stewardship of antiseptics that are pertinent to wounds: the need for a united approach","volume":"3","author":"Maillard","year":"2021","journal-title":"JAC-antimicrobial resistance"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"376","DOI":"10.3390\/antibiotics11030376","article-title":"Does the COVID pandemic modify the antibiotic resistance of uropathogens in female patients? A new storm?","volume":"11","author":"Mare\u0219","year":"2022","journal-title":"Antibiotics"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1165\/rcmb.2017-0321tr","article-title":"Pseudomonas aeruginosa biofilms: host response and clinical implications in lung infections","volume":"58","author":"Maurice","year":"2018","journal-title":"Am. J. Respir. Cell Mol. Biol."},{"key":"ref60","doi-asserted-by":"publisher","first-page":"o2731","DOI":"10.1136\/bmj.o2731","article-title":"How war is spreading drug resistant superbugs across Ukraine and beyond","volume":"379","author":"Melwani","year":"2022","journal-title":"BMJ"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1093\/milmed\/usab131","article-title":"Multidrug-resistant and virulent organisms trauma infections: trauma infectious disease outcomes study initiative","volume":"187","author":"Mende","year":"2022","journal-title":"Mil. Med."},{"key":"ref62","doi-asserted-by":"publisher","first-page":"39","DOI":"10.3389\/fcimb.2017.00039","article-title":"Pseudomonas aeruginosa lifestyle: a paradigm for adaptation, survival, and persistence","volume":"7","author":"Moradali","year":"2017","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref63","doi-asserted-by":"publisher","first-page":"e01603\u2013e1615","DOI":"10.1128\/mBio.01603-15","article-title":"Intrinsic antimicrobial resistance determinants in the superbug Pseudomonas aeruginosa","volume":"6","author":"Murray","year":"2015","journal-title":"MBio"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"318","DOI":"10.18484\/2305-0047.2019.3.318","article-title":"Microbiological characteristics of infectious complications, actual aspects of their prevention and treatment in surgical patients","volume":"27","author":"Nazarchuk","year":"2019","journal-title":"Nov. Khir."},{"key":"ref65","doi-asserted-by":"publisher","first-page":"12","DOI":"10.15574\/ps.2024.3(84).1221","article-title":"Properties of the antimicrobial activity of polyhexanide drugs against the dominant pathogens of wound infection in Ukraine: modern realities","volume":"3","author":"Nazarchuk","year":"2024","journal-title":"Paediatr. Surg. Ukraine"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.3390\/antibiotics10111393","article-title":"Sub-inhibitory antibiotic exposure and virulence in Pseudomonas aeruginosa","volume":"10","author":"Nolan","year":"2021","journal-title":"Antibiotics (Basel, Switzerland)"},{"key":"ref67","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.drup.2015.08.002","article-title":"The increasing threat of Pseudomonas aeruginosa high-risk clones","author":"Oliver","year":"2015","journal-title":"Drug Resist. Updat."},{"key":"ref68","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.biotechadv.2018.11.013","article-title":"Antibiotic resistance in Pseudomonas aeruginosa: mechanisms and alternative therapeutic strategies","volume":"37","author":"Pang","year":"2019","journal-title":"Biotechnol. Adv."},{"key":"ref69","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1097\/01.sla.0000251707.32332.c1","article-title":"Trauma-related infections in battlefield casualties from Iraq","volume":"245","author":"Petersen","year":"2007","journal-title":"Ann. Surg."},{"key":"ref70","doi-asserted-by":"publisher","first-page":"1210","DOI":"10.3390\/microorganisms11051210","article-title":"Relative abundance and detection of Pseudomonas aeruginosa from chronic wound infections globally","volume":"11","author":"Phan","year":"2023","journal-title":"Microorganisms"},{"key":"ref71","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1093\/cid\/ciz816","article-title":"Ceftolozane\/tazobactam vs polymyxin or aminoglycoside-based regimens for the treatment of drug-resistant Pseudomonas aeruginosa","volume":"71","author":"Pogue","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref72","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1111\/jam.15191","article-title":"Occurrence, virulence, carbapenem resistance, susceptibility to disinfectants and public health hazard of Pseudomonas aeruginosa isolated from animals, humans and environment in intensive farms","volume":"132","author":"Rasha Gharieb","year":"2021","journal-title":"J. Appl. Microbiol."},{"key":"ref73","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.bjm.2016.11.004","article-title":"Carbapenem-resistant Pseudomonas aeruginosa: association with virulence genes and biofilm formation","volume":"48","author":"Rossi Gon\u00e7alves","year":"2017","journal-title":"Braz. J. Microbiol."},{"key":"ref74","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/j.coph.2014.09.006","article-title":"Update on the antibiotic resistance crisis","volume":"18","author":"Rossolini","year":"2014","journal-title":"Curr. Opin. Pharmacol."},{"key":"ref75","doi-asserted-by":"publisher","first-page":"e00084-21","DOI":"10.1128\/AAC.00084-21","article-title":"In vitro susceptibility of multidrug-resistant Pseudomonas aeruginosa following treatment-emergent resistance to ceftolozane-tazobactam","volume":"65","author":"Rubio","year":"2021","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref76","doi-asserted-by":"publisher","first-page":"182","DOI":"10.3389\/fcimb.2019.00182","article-title":"Repair process impairment by Pseudomonas aeruginosa in epithelial tissues: major features and potential therapeutic avenues","volume":"9","author":"Ruffin","year":"2019","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref77","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1186\/1471-2334-13-47","article-title":"Biofilm formation by clinical isolates and the implications in chronic infections","volume":"13","author":"Sanchez","year":"2013","journal-title":"BMC Infect. Dis."},{"key":"ref78","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1186\/s12866-023-02832-x","article-title":"Recent advances in therapeutic targets identification and development of treatment strategies towards Pseudomonas aeruginosa infections","volume":"23","author":"Sanya","year":"2023","journal-title":"BMC Microbiol."},{"key":"ref79","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1016\/j.imj.2023.05.003","article-title":"Pseudomonas aeruginosa: infections and novel approaches to treatment \u201cknowing the enemy\u201d the threat of Pseudomonas aeruginosa and exploring novel approaches to treatment","volume":"2","author":"Sathe","year":"2023","journal-title":"Inf. Med."},{"key":"ref80","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1111\/wrr.12590","article-title":"Consensus guidelines for the identification and treatment of biofilms in chronic nonhealing wounds","volume":"25","author":"Schultz","year":"2017","journal-title":"Wound Repair Regen."},{"key":"ref81","doi-asserted-by":"publisher","first-page":"100084","DOI":"10.1016\/j.medmic.2023.100084","article-title":"Biofilms: understanding the structure and contribution towards bacterial resistance in antibiotics","volume":"16","author":"Shree","year":"2023","journal-title":"Med. Microecol."},{"key":"ref82","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1038\/s41579-020-0340-0","article-title":"Critical analysis of antibacterial agents in clinical development","volume":"18","author":"Theuretzbacher","year":"2020","journal-title":"Nat. Rev. Microbiol."},{"key":"ref83","doi-asserted-by":"publisher","first-page":"e03260-19","DOI":"10.1128\/mBio.03260-19","article-title":"The Pseudomonas aeruginosa lectin LecB causes integrin internalization and inhibits epithelial wound healing","volume":"11","author":"Thuenauer","year":"2020","journal-title":"MBio"},{"key":"ref84","doi-asserted-by":"publisher","first-page":"1750","DOI":"10.1016\/j.jiph.2021.10.020","article-title":"Antibiotic resistance in microbes: history, mechanisms, therapeutic strategies and future prospects","volume":"14","author":"Uddin","year":"2021","journal-title":"J. Infect. Public Health"},{"key":"ref85","doi-asserted-by":"publisher","first-page":"5649","DOI":"10.1073\/pnas.1503141112","article-title":"Global trends in antimicrobial use in food animals","volume":"112","author":"Van Boeckel","year":"2015","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref86","doi-asserted-by":"publisher","first-page":"243","DOI":"10.22354\/in.v21i4.687","article-title":"Effects of biocide exposure on P. aeruginosa, E. coli and A. baumannii complex isolates from hospital and household environments","volume":"21","author":"V\u00e1squez","year":"2017","journal-title":"Infection"},{"key":"ref87","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1089\/sur.2017.240","article-title":"Early infections complicating the care of combat casualties from Iraq and Afghanistan","volume":"19","author":"Weintrob","year":"2018","journal-title":"Surg. Infect."},{"key":"ref88","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1111\/wrr.12370","article-title":"Analysis of the chronic wound microbiota of 2,963 patients by 16S rDNA pyrosequencing","volume":"24","author":"Wolcott","year":"2016","journal-title":"Wound. Repair. Regen."},{"key":"ref89","volume-title":"WHO bacterial priority pathogens list, 2024","year":"2024"},{"key":"ref90","doi-asserted-by":"publisher","first-page":"3423","DOI":"10.3390\/ijms20143423","article-title":"Biofilms: the microbial \u201cprotective clothing\u201d in extreme environments","volume":"20","author":"Yin","year":"2019","journal-title":"Int. J. Mol. Sci."}],"container-title":["Frontiers in Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2025.1656270\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T05:25:08Z","timestamp":1761888308000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2025.1656270\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,31]]},"references-count":90,"alternative-id":["10.3389\/fmicb.2025.1656270"],"URL":"https:\/\/doi.org\/10.3389\/fmicb.2025.1656270","relation":{},"ISSN":["1664-302X"],"issn-type":[{"value":"1664-302X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,31]]},"article-number":"1656270"}}