Lights out for Superbugs: Is antimicrobial blue light a potential approach for future infection Control?

The rise of antimicrobial resistance (AMR) poses a significant threat to global health, as traditional antimicrobials are increasingly losing efficacy against a broad spectrum of pathogens. Antimicrobial blue light (aBL), an innovative light-based approach that utilizes wavelengths between 405 and 470 nm, has emerged as a prominent alternative. Unlike conventional antimicrobials, aBL inactivates microorganisms without promoting resistance by targeting endogenous chromophores within pathogens to generate reactive oxygen species (ROS). This review first provides an in-depth analysis of aBL's mechanisms of action, highlighting its unique ROS-driven effects on microbial membranes, DNA, and proteins. Moreover, we discussed recent developments in aBL's applications across bacterial, viral, and fungal pathogens and evaluated its effectiveness in biofilm eradication and combinational therapies with conventional antimicrobials as well as with multimodal innovations. This review also examines the safety and regulatory considerations associated with aBL. While aBL holds tremendous potential, challenges remain in its clinical translation, including optimizing dosages, ensuring safety in complex biological systems, and advancing device design. Future research must address these gaps to facilitate the clinical translation of aBL and expand its role in combating resistant infections.