Bacteriophage-Mediated Reduction of Pseudomonas aeruginosa Biofilm on Titanium Surfaces for Biomedical Applications

Biofilm-associated infections on biomedical devices are a major clinical challenge. These infections are resistant to antimicrobial treatments and often cause chronic and recurrent problems. Pseudomonas aeruginosa is a significant biofilm-forming pathogen, particularly on titanium-based implants used in medical and dental applications. Bacteriophages have emerged as a promising alternative for preventing and eradicating biofilms. This study evaluated the effectiveness of bacteriophages in controlling P. aeruginosa biofilms on titanium. It tested their ability to eradicate mature biofilms and prevent the formation of new ones. Microbiological assays, efficacy analyses, and scanning electron microscopy (SEM) were used. Bacteriophages significantly reduced biofilm biomass, with reductions over 90% in most cases. For the ATCC strain, efficiencies ranged from 50.53% to 99.78%. For the clinical strain, reductions varied between 0.01% and 99.94%. Among the tested phages, PA4 and PA5 were the most effective, consistently achieving reductions of over 99%. Prophylactic treatment completely inhibited biofilm formation, regardless of phage concentration or bacterial strain. Although variations in efficacy were observed depending on strain, phage type, and multiplicity of infection, complicating the establishment of a clear dose-response relationship, the results confirm the strong potential of bacteriophages as both therapeutic and preventive agents against biofilm-related infections on titanium biomedical devices. These findings provide a crucial foundation for future clinical and industrial applications, contributing to the development of safer and more reliable titanium-based implants.