Antimicrobial and Anti-Biofilm Properties of Ma’in Hot Springs Targeting Bacteria Isolated from Diabetic Foot Ulcers

Introduction: Diabetic foot ulcers (DFUs) are a serious complication of diabetes, which is worsened by biofilm-forming bacterial infections that can contribute to antibiotic resistance and delayed wound healing. This study explores the antimicrobial and anti-biofilm properties of Ma’in Hot Springs Water (MHSW) against Staphylococcus aureus and Pseudomonas aeruginosa which are associated with DFU. Methods: The chemical composition of MHSW was determined using LC-MS, UV-Vis spectroscopy, and heavy metal profiling. Antimicrobial efficacy was determined through minimum inhibitory concentration (MIC) determination, bacterial growth kinetics, and biofilm inhibition assays. Results: The results demonstrated a dose-dependent antibacterial effect. Biofilm formation, exopolysaccharide production, and bacterial adhesion were reduced in treated samples. Moreover, MHSW disrupted virulence factors such as plasma coagulation and metallo-β-lactamase production. It was also found to be non-cytotoxic. Discussion: These findings demonstrate the potential of MHSW as an alternative or adjunctive treatment for DFU infections. However, the presence of heavy metals exceeding safety limits requires further investigation to determine their optimal concentration for clinical usage. Keywords: diabetic foot ulcers, biofilm, antimicrobial activity, Staphylococcus aureus , Pseudomonas aeruginosa , Ma’in hot springs