Wound microbiome: mechanisms of pathogenicity and intermicrobial interactions of Pseudomonas aeruginosa and Staphylococcus aureus

Despite the extensive arsenal of antibacterial drugs and the diversity of new wound treatment technologies, it is fair to say that the problem of wound infection has not lost its relevance. As a rule, in patients with concomitant diseases (obesity, diabetes, sensory neuropathies, autoimmune diseases, etc.), the healing of wound defects is prolonged, which makes them especially vulnerable to infections. Wound infection is one of the decisive factors in the pathogenesis of chronic wounds associated with an increase in the number of multiresistant bacterial strains. Two most common wound pathogens are Pseudomonas aeruginosa and Staphylococcus aureus. Wound healing is mediated not only by complex coordinated cellular mechanisms, but also by the impact of the wound microbiome. Objective. Analysis of the mechanisms of pathogenicity and intermicrobial interactions of P. aeruginosa and S. aureus as a significant “instrument” of wound infection to identify priority strategies for antimicrobial therapy (combination antibacterial drugs, phage therapy, use of antimicrobial peptides etc.). Material and methods. A search and analysis of scientific literature for 2018­2025 was performed in the information resources PubMed, eLIBRARY.RU, Europe PMC, Web of Science, CyberLeninka. The search queries included the following combinations of words: for Russian­language publications chronic wound infection; biofilms in chronic wounds, pathophysiological mechanisms of wound healing; for English­language publications chronic wound infection, biofilms in chronic wounds, pathophysiological mechanisms of wound healing, chronic wound infection bacteria, acute and chronic wounds, P. aeruginosa, S. aureus, mechanisms of pathogenicity, virulent properties. Results and discussion. The review summarizes and presents the mechanisms of initiation of wound infection, determinants of virulence, pathogenicity, antibiotic resistance of P. aeruginosa and S. aureus, immune evasion strategies and features of intermicrobial interactions. Conclusions. Wound infections pose a significant global threat due to high rates of morbidity and mortality. P. aeruginosa and S. aureus remain the most common pathogens causing wound infections and form mixed biofilms that hamper their susceptibility to both antimicrobials and the host immune system. Both types of bacteria secrete a broad spectrum of virulence factors, including toxins and enzymes that facilitate their attachment to the wound surface and suppress the host immune response, leading to further tissue damage. Moreover, the spatial organization formed by these pathogens can influence their virulence properties and is key to understanding bacterial interactions within polymicrobial biofilms. Currently, combination antibacterial drugs, phage therapy, antimicrobial peptides, etc. are used to solve the problem of the growth of multidrug­resistant strains.

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