N-Acetyl Cysteine in combination with vancomycin or linezolid for biofilm eradication of methicillin-resistant Staphylococcus aureus (MRSA)

Abstract

Antibiotics are challenging to deliver because MRSA can build biofilms. In Indonesia, the major parenteral antibiotics for treating MRSA infections are Vancomycin and Linezolid. Because NAC can degrade the biofilm matrix, it is believed that combining it with antibiotics will improve its capacity to destroy MRSA biofilms. An experiment was done at RSUD Dr. Soetomo Surabaya's Clinical Microbiology Laboratory in June 2022. The biofilm-forming bacteria studied were MRSA clinical isolates. The antibiotics utilized were Vancomycin (2 g/mL), Linezolid (4 g/mL), and NAC (8 mg/mL). A biofilm assay microtiter test was also carried out to see how drug exposure affected the biofilm that had grown. Biofilm eradication was observed when comparing the mass yield and biofilm metabolism after treatment to the control. According to the study's findings, using a combination of NAC with Vancomycin or Linezolid was superior to using NAC, Vancomycin, or Linezolid alone. There was no apparent difference between the two combinations, however. The combination of NAC and Vancomycin had the same effect on eliminating MRSA biofilms as the combination of NAC and Linezolid.