Beyond probiotics: Lacticaseibacillus rhamnosus as a multi-target antagonist of Pseudomonas aeruginosa infections
Year: 2026
Type: review
Abstract: The increasing failure of antimicrobial therapies against Pseudomonas aeruginosa represents a major challenge in clinical practice, particularly in patients with chronic lung disease and critical illness. Beyond intrinsic and acquired resistance, biofilm formation and persister cell populations contribute to persistent and refractory infections, limiting the efficacy of conventional antibiotics. Lacticaseibacillus rhamnosus has emerged as a source of bioactive compounds capable of interfering with multiple stages of P. aeruginosa pathogenesis. Its antimicrobial activity involves organic acid production, secretion of low-molecular-weight metabolites, enzymatic effects, and biosurfactant-mediated disruption of adhesion and biofilm formation. In addition, interactions with host epithelial cells indicate a role in modulating inflammatory responses and enhancing mucosal defenses. Cell-free supernatant (CFS) retain many of these properties and may represent a safer alternative to live probiotic administration. Despite consistent experimental evidence, key limitations remain, including variability in strain selection, lack of standardization of cell-free preparations, and incomplete characterization of active compounds. Clinical studies suggest potential benefits in reducing colonization and ventilator-associated pneumonia, although robust evidence is still limited. These findings support the potential role of L. rhamnosus as an adjunctive strategy in the management of P. aeruginosa infections, while highlighting the need for mechanistic standardization and clinical validation. Lacticaseibacillus rhamnosus exhibits multi-target inhibitory activity against Pseudomonas aeruginosa, integrating antimicrobial, antibiofilm, and immunomodulatory effects. Cell-free supernatant (CFS) (postbiotics) emerge as promising therapeutic alternatives, retaining activity independent of live bacterial administration. Evidence supports interference with quorum sensing and biofilm dynamics, key determinants of P. aeruginosapersistence and antibiotic tolerance. Current literature is limited by strain heterogeneity and lack of methodological standardization, restricting translational applicability. Clinical studies suggest potential in reducing colonization and ventilator-associated pneumonia, but robust trials remain scarce. This review proposes a framework for future translational research, integrating mechanistic, experimental, and clinical perspectives.
Source: Folia Microbiologica
Institution: Universidade Ceuma
Language: English
Subfield: Food Science
Domain: Life Sciences
Open Access status: hybrid
Estimated APC paid: $2,590
OpenAlex ID: W7203549296