Biofilm-associated infections pose a significant challenge in clinical settings due to their increased resistance to antibiotics and evasion of host immune responses. These infections are responsible for a large proportion of chronic and recurrent infections, leading to prolonged hospital stays, increased healthcare costs, and elevated morbidity and mortality rates. Vancomycin, a glycopeptide antibiotic, has long been a cornerstone in the treatment of infections caused by Gram-positive bacteria, particularly methicillin-resistant Staphylococcus aureus (MRSA). In addition, vancomycin-resistant Enterococcus (VRE) represents an important group of biofilm-forming pathogens, further complicating treatment strategies. However, its efficacy against biofilms remains a subject of ongoing research and debate. The ability of vancomycin to target biofilm-embedded bacteria is often hindered by multiple resistance mechanisms, including poor antibiotic penetration, metabolic adaptation of biofilm-associated cells, and the presence of persister cells. The aim of this review is to evaluate vancomycin’s antibiofilm activity by examining its mechanism of action, pharmacokinetics, effectiveness, limitations, and potential strategies to enhance its therapeutic outcomes. Several novel approaches have been explored to augment vancomycin’s antibiofilm activity, including combination therapies, adjuvant strategies, and nanotechnology-based drug delivery systems. Understanding these factors is crucial for optimizing therapeutic strategies and overcoming the persistent challenge of biofilm-related infections. This review synthesizes current evidence and highlights areas requiring further research to enhance vancomycin’s efficacy against biofilm-associated infections.

Burkholderia pseudomallei, a gram-negative facultative intracellular bacterium, is the causative agent of melioidosis, a life-threatening infectious disease endemic to tropical and subtropical regions, particularly Southeast Asia and Northern Australia. Key risk factors such as diabetes, alcoholism, and socioeconomic challenges were identified as major contributors to disease susceptibility and treatment outcomes in melioidosis. Globally, melioidosis accounts for approximately 89,000 deaths annually and poses a significant public health concern, particularly in resource-limited settings. B. pseudomallei exhibits remarkable environmental resilience, thrives in soil and water, and is intrinsically resistant to various antibiotics. Its pathogenicity is mediated by diverse virulence factors, including type III and VI secretion systems, a protective capsule, lipopolysaccharide (LPS), and BimA-mediated actin-based motility, which facilitate intracellular survival, immune evasion, and systemic dissemination. This bacterium can cause a wide spectrum of clinical manifestations ranging from localized skin infections to severe septicemia, pneumonia, and neurological involvement. In certain cases, B. pseudomallei may persist in a latent state for years and reactivation is often triggered by immunosuppression. The treatment of melioidosis is challenging because of its intrinsic antibiotic resistance, necessitating a two-phase approach: an intensive phase with intravenous antibiotics, such as ceftazidime or meropenem, followed by a prolonged eradication phase using trimethoprim-sulfamethoxazole. However, relapse remains a concern, particularly in patients with poor adherence to the therapy. Preventive strategies, particularly in endemic regions, focus on minimizing environmental exposure through protective measures and safe water practices. Despite advancements in therapeutic approaches, there is an urgent need for novel treatment strategies, including bacteriophage therapy and vaccine development, to enhance melioidosis prevention and control. Understanding the complex pathogenic mechanisms of B. pseudomallei is essential to improve its clinical management and reduce its global burden.

Pandoraea species are emerging multidrug-resistant pathogens increasingly associated with respiratory tract infections, particularly in cystic fibrosis patients. Despite their growing clinical relevance, these bacteria are underrepresented in the scientific literature. This review aims to consolidate existing evidence regarding Pandoraea species as emerging multidrug-resistant pathogens, with a focus on their taxonomy, diagnostic methodologies, antimicrobial resistance mechanisms, and treatment challenges. By identifying gaps in current therapeutic strategies and the limited clinical outcome data, this review underscores the necessity of advancing research into innovative interventions, such as bacteriophages, antimicrobial peptides, and combination therapies, to enhance patient management and infection control. A comprehensive literature search was conducted using PubMed and Google Scholar, employing relevant keywords to identify case reports, clinical studies, and in vitro research related to Pandoraea infections, resistance mechanisms, and therapeutic strategies. Our findings reveal a significant lack of comprehensive data on therapeutic approaches, particularly concerning bacteriophages, antimicrobial peptides, and combination antibiotic therapies. Furthermore, clinical data on treatment efficacy remain sparse, with the majority of evidence stemming from in vitro studies rather than real-world clinical settings. This review emphasizes the urgent need for further research to address these knowledge deficits and to develop effective therapeutic interventions against Pandoraea infections.

Klebsiella pneumoniae is a major opportunistic pathogen responsible for a wide range of hospital- and community-acquired infections, including respiratory tract infections, urinary tract infections, meningitis, and liver abscesses. Among its emerging forms, hypervirulent K. pneumoniae (hvKp) has gained global attention due to its heightened virulence and ability to cause severe infections in healthy individuals. hvKp differs from classical K. pneumoniae (cKp) in its clinical presentation, often causing metastatic infections, liver abscesses without biliary disease, and multiple-site involvement. Despite initial antibiotic susceptibility, the recent convergence of hvKp virulence traits with antimicrobial resistance genes—especially those conferring multidrug resistance (MDR) and carbapenem resistance—poses a serious therapeutic challenge. This review highlights the epidemiological and clinical distinctions between hvKp and cKp, emphasizing the limitations of current diagnostic markers like the string test. Furthermore, it explores novel therapeutic strategies beyond conventional antibiotics, focusing on promising alternatives such as bacteriophage therapy and antimicrobial peptides (AMPs). Several phages, including PSKP16, vB_Kpn_F13, and phage cocktails, have demonstrated potent activity against hvKp strains, including biofilm-forming and carbapenem-resistant isolates. Likewise, AMPs such as Osmin, AA139-nanoformulations, and scorpion venom-derived Cm38 show efficacy in preclinical models. These emerging approaches hold potential to combat the rising threat of hvKp, especially strains that are extensively drug-resistant. Continued research and investment are essential to translate these findings into clinical practice and ensure effective management of hypervirulent and resistant K. pneumoniae infections.

Background: The rising global threat of antimicrobial resistance, particularly among multidrug-resistant pathogens like Pseudomonas aeruginosa, has prompted research into repurposing existing drugs with established safety profiles. Cisplatin, a well-known anticancer agent, has shown preliminary antimicrobial activity but its efficacy against P. aeruginosa has not been thoroughly explored. This study aims to evaluate the antimicrobial potential of cisplatin against clinical strains of P. aeruginosa by determining the minimum inhibitory concentration (MIC). Methodology: This study assessed whether cisplatin could serve as a novel therapeutic option for treating infections caused by P. aeruginosa via broth microdilution assay, especially as the pathogen shows increasing resistance to last-resort antibiotics such as meropenem, colistin, and tigecycline. Findings from this research could contribute to expanding the arsenal of treatments for resistant P. aeruginosa infections. Results: The study found that 54.9% of isolates had an MIC of 16 μg/mL, 26.8% had 32 μg/mL, 12.7% had 64 μg/mL, and 5.6% had 8 μg/mL. While cisplatin demonstrated antibacterial activity, no statistically significant difference (p = 0.089) was observed between sensitive and resistant strains. A key limitation of this study is the small number of both resistant and sensitive strains, which limits statistical power. Increasing the sample size in future studies will allow for a more robust assessment of cisplatin’s efficacy and validate the observed MIC similarities. Additionally, further studies including resistance assays, time-kill kinetics, and in vivo models are needed to explore its bactericidal potential and efficacy in combination with β-lactams. Conclusion: Although cisplatin exhibited activity against P. aeruginosa, its clinical potential remains uncertain, and further investigation is necessary to optimize its use and overcome resistance.