TABLE 3.
Recent approaches for BAIs management in A. baumannii, Klebsiella sp., and Enterobacter sp.
| Approach | Microorganism | Mechanism/Effect | References |
| Bacteriophages | Klebsiella sp. | The ZCKP1 phage reduces biofilm biomass via soluble exopolysaccharide depolymerase, that has the ability to disrupt the capsule of Klebsiella, rendering it more susceptible to antibacterial agents | Taha et al., 2018 |
| Siphoviridae phage Z reduces the biofilm biomass after 24 and 48 h | Jamal et al., 2015 | ||
| Phage vB_KpnS_Kp13 drastically reduces the biofilm biomass (by ∼73%) after 48 h | Horváth et al., 2020 | ||
| Acinetobacter baumannii | The vB_AbaM_ISTD phage (Myoviridae family) reduces planktonic and biofilm-associated viable bacteria in a time-dependent manner | Vukotic et al., 2020 | |
| The bacteriophage vB_AbaM-IME-AB2 infected and disrupted thebiofilm | Liu Y. et al., 2016 | ||
| E. cloacae/E. asburiae | The highly virulent bacteriophage N5822, isolated from an environmental source, reduced a preformed static host biofilm, and inhibited the formation of new biofilm by up to 90% | Nair et al., 2019 | |
| Low-frequency ultrasound (LFU) | K. pneumoniae | The treatment has increased the antimicrobial effect of with antimicrobial agents (meropenem, tigecycline, fosfomycin) in biofilm M-LFU (multiple –LFU) increased the duration of the synergistic effect as compared with S-LFU (single –LFU) | Liu et al., 2020 |
| LFU | A. baumannii | LFU in combination with colistin and vancomycin may be useful in treating pan-resistant infections | Liu X. et al., 2016 |
| Photodynamic inactivation (PDI) combined with chitosan | A. baumannii | A notable decrease of the number of viable biofilm cells | Fekrirad et al., 2021 |
| Cathodic voltage controlled electrical stimulation (CVCES) | A. baumannii | The treatment has significantly reduced the implant-associated colony forming units (CFU) by over 91% and bone-associated CFU by over 88% | Ehrensberger et al., 2016 |
| DNase I Dispersin B | Klebsiella pneumoniae, Acinetobacter baumannii | Biofilm-disrupting activity | Fleming and Rumbaugh, 2017 |
| Synthetic, modified antimicrobial peptide 1018 | A. baumannii, K. pneumoniae, Enterobacter sp. | Degradation of the (p)ppGpp bacterial stringent response signal | de la Fuente-Núñez et al., 2015; Wang et al., 2015; Wolfmeier et al., 2018 |
| DJK-5, DJK-6 synthetic, D-enantiomeric, protease-resistant peptides | |||
| Formulation of imipenem and silver NP | A. baumannii | Eradicated biofilms | Hendiani et al., 2015 |
| Nanostructured Graphene- and Hexagonal Boron Nitride-Coated Surfaces | Enterobacter cloacae | Reduced biofilm formation | Zurob et al., 2019 |