Therapeutic Potential Of Probiotic Lactobacillus Strains: Antimicrobial And Antibiofilm Activities Against Multidrug-Resistant Pathogens

Abstract

The escalating global burden of antimicrobial-resistant bacterial infections has necessitated the exploration of innovative therapeutic modalities. Bacterial biofilms, which constitute the predominant form of microbial existence in clinical infections, exhibit extraordinary recalcitrance to conventional antimicrobial interventions. This comprehensive review synthesizes emerging evidence regarding the therapeutic utility of Lactobacillus species as novel antimicrobial agents targeting biofilm-mediated pathogenicity. We analyzed current literature on Lactobacillus antimicrobial mechanisms, strain-specific activities, and clinical applications against multidrug-resistant pathogens. Our analysis encompasses the multifactorial mechanisms by which select Lactobacillus strains neutralize pathogenic biofilms, including metabolite-mediated toxicity, territorial competition, and host defence augmentation. Contemporary investigations reveal that specific isolates—L. plantarum, L. reuteri, L. helveticus, and L. rhamnosus—exhibit pronounced efficacy against clinically significant organisms, including carbapenem-resistant Klebsiella pneumoniae, extensively drug-resistant Escherichia coli, and device-colonizing Staphylococcus aureus. Notably, the expanding evidence base supporting postbiotic applications—specifically, acellular metabolite concentrates—presents distinct advantages for therapeutic implementation, including enhanced shelf stability, reproducible potency, and minimized safety concerns. Applications encompassing medical device surface modification, urinary tract infection prophylaxis, and oral cavity biofilm management demonstrate immediate clinical viability.