Combination of curcumin or chitosan with photodynamic therapy as an effective alternative therapy for overcoming wound infection associated with multidrug-resistant Acinetobacter baumannii

The increasing prevalence of multidrug-resistant Acinetobacter baumannii as an opportunistic pathogen in wound infections raises significant concerns due to its antibiotic resistance and biofilm-mediated antibiotic tolerance. This underscores the urgent need to explore an alternative approach to effectively managing wound infections caused by MDR A. baumannii . In this study, combining subinhibitory concentrations of curcumin (25 µg/ml) or chitosan (156 µg/ml) with photodynamic therapy-PDT (10 J/cm 2 ) resulted in a significant reduction of planktonic viabilities and biofilm biovolume of MDR A. baumannii clinical isolates in vitro . In murine A. baumannii- associated wound infection, a combination of curcumin (25 µg/ml) or chitosan (156 µg/ml) with PDT (10 J/cm 2 ) resulted in complete bacterial eradication with wound healing at Day 15 of post-treatments with these combination therapies. Our study demonstrated that combining curcumin or chitosan with PDT at their subinhibitory concentrations represents a promising alternative strategy as localized therapy for effectively managing A. baumannii -associated wound infection.