Effects of exogenous glucose on Pseudomonas aeruginosa biofilm formation and antibiotic resistance

Pseudomonas aeruginosa is commonly found in nosocomial and life‐threatening infections in patients. Biofilms formed by P. aeruginosa exhibit much greater resistance to antibiotics than the planktonic form of the bacteria. Few groups have studied the effects of glucose, a major carbon source, and metabolite, on P. aeruginosa biofilm formation and on its metabolic pathways. In this study, we investigated the effect of glucose on the biofilm formation ability of P. aeruginosa and carried out a metabolomic analysis to identify whether glucose alters the metabolic activity of P. aeruginosa in biofilms. We found that glucose efficiently promoted P. aeruginosa biofilm formation by upregulating the expression of the extracellular polysaccharide‐related gene pslA. Treatment with glucose caused an increase in 7 metabolites (including 3‐hydroxypropionic acid, glucose‐6‐phosphate, and 2,3‐dimethylsuccinic acid) and a decrease in 18 metabolites (including myo‐inositol, glutamine, and methoxamedrine) in the biofilm. In addition, there was a synergistic effect between glucose and horse serum on biofilm formation when the two were added in combination, which also increased the resistance of biofilm to levofloxacin therapy. Thus, our work sheds light on the underlying mechanisms by which glucose may enhance biofilm formation and identifies novel targets for developing strategies to counteract biofilm formation.