Platelet-rich plasma as a potential antimicrobial agent against multidrug-resistant bacteria in diabetic foot infections.

Diabetes mellitus is a global public health concern, with diabetic foot infections (DFIs) being common clinical complications among affected patients. Bacterial isolates resistant to commonly used antimicrobial drugs are becoming more prevalent in DFIs. Some research suggests that platelet-rich plasma (PRP) may inhibit bacterial growth, making it a promising biological therapy. Therefore, an in vitro experimental study was conducted on 53 multidrug-resistant (MDR) bacterial strains isolated from DFIs. The isolates were methicillin-resistant Staphylococcus aureus (MRSA), MDR Klebsiella pneumoniae, and MDR Pseudomonas aeruginosa. The antibacterial activity of PRP was assessed using Kirby-Bauer disk diffusion method, broth microdilution method, checkerboard synergy testing, and time-kill assay. The time-kill assay demonstrated that PRP's antibacterial efficacy peaked during the second hour of incubation for MRSA and Pseudomonas aeruginosa, but peaked at the first hour for Klebsiella pneumoniae. However, the PPR's efficiency against all isolates decreased after the peak point, with no antibacterial activity observed at the 24th h of incubation. Additionally, biofilm inhibition and eradication assays revealed that PRP has no effect on biofilm formation. As a result, PRP has the ability to inhibit bacterial growth, although this effect is transient and depends on the bacterial strain.