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Sains
Malaysiana 55(7)(2026): 1173-1186
http://doi.org/10.17576/jsm-2026-5507-06
Combatting Burkholderia
pseudomallei Biofilms: Enhanced Strategies through Antibiotic Combinations and
Anti-Biofilm Agents
(Membanteras
Biofilem Burkholderia pseudomallei: Strategi Dipertingkatkan melalui Gabungan
Antibiotik dan Agen Anti-Biofilem)
GALVIN STEVEN SEBASTIAN1, BARATHAN
MUTTIAH2, NORAZIAH MOHAMAD ZIN3, SHEILA NATHAN4,
KUMUTHA MALAR VELLASAMY5 & VANITHA MARIAPPAN1,*
1Centre of Toxicology and Health Risk Studies (CORE), Faculty of Health Sciences,
2Institute of Biological Sciences,
Faculty of Science, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
3Centre for Diagnostic, Therapeutic and Investigative Studies (CODTIS), Faculty of Health Sciences, Universiti Kebangsaan Malaysia,
Kuala Lumpur Campus, Jalan Raja
4Department of Biological Sciences and
Biotechnology, Faculty of Science & Technology, Universiti Kebangsaan
Malaysia, 43600 UKM Bangi, Selangor, Malaysia
5Department of Medical Microbiology,
Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
Diserahkan: 5 Mac 2026/Diterima: 3 Julai 2026
Abstract
Burkholderia
pseudomallei causes melioidosis, a
disease with high relapse rates, particularly with chronic infections.
Treatment for melioidosis relies solely on antibiotics; however, many B. pseudomallei strains are resistant to penicillin,
ampicillin, gentamicin, first and second-generation cephalosporins,
macrolides and colistin, which may lead to bacterial persistence. The efficacy
of antibiotics is further compromised because B. pseudomallei forms biofilms, which serve as a
multi-layered defence barrier that systematically reduces antibiotic penetration and
inhibits their effects. Therefore, agents capable of disrupting or eradicating B.
pseudomallei biofilms are urgently required to ensure effective treatment
of melioidosis. This review briefly outlines the known mechanisms of B.
pseudomallei biofilm formation, its antimicrobial resistance, and further
explores potential new B. pseudomallei anti-biofilm strategies. These
include antimicrobial peptides that hinder biofilm formation and serve as an
alternative to reduce the absolute reliance on antibiotics in treating patients
with melioidosis. In addition, this review introduces the concept of
administering a combination of antimicrobials to improve the reduction of B.
pseudomallei biofilms. Finally, strategies to combat B. pseudomallei biofilms and the outlook for B.
pseudomallei biofilm reduction are discussed to ensure more effective and
efficient clinical treatment of melioidosis.
Keywords: Antibiotic resistance; biofilm;
melioidosis; tolerance; treatments
Abstrak
Burkholderia pseudomallei ialah agen penyebab melioidosis, penyakit yang
sering dikaitkan dengan kadar kambuhan tinggi terutamanya dalam jangkitan
kronik. Rawatan melioidosis bergantung sepenuhnya kepada antibiotik; namun
banyak strain B. pseudomallei menunjukkan rintangan intrinsik terhadap
penisilin, ampisilin, gentamisin, tobramisin, sefalosporin generasi pertama dan
kedua, makrolida serta kolistin yang boleh menyebabkan bakteria berterusan
dalam tubuh pesakit. Keberkesanan antibiotik turut terjejas kerana B.
pseudomallei menghasilkan biofilem, iaitu penghalang berlapis yang
mengurangkan penembusan antibiotik dan menghalang tindakannya. Oleh itu, agen
yang dapat memintas atau memusnahkan biofilem B. pseudomallei amat
diperlukan untuk memastikan rawatan melioidosis lebih berkesan. Ulasan ini
menghuraikan secara ringkas mekanisme pembentukan biofilem oleh B.
pseudomallei, keupayaan rintangannya terhadap antimikrob, serta meneroka
strategi baharu anti‑biofilem. Antaranya termasuk peptida antimikrob yang
menghalang pembentukan biofilem dan berfungsi sebagai alternatif untuk
mengurangkan kebergantungan mutlak terhadap antibiotik. Selain itu, ulasan ini
memperkenalkan pendekatan gabungan antimikrob bagi meningkatkan keberkesanan
penghapusan biofilem B. pseudomallei. Akhir sekali, strategi untuk
memerangi biofilem B. pseudomallei dan prospek masa depan dibincangkan
bagi memastikan rawatan klinikal melioidosis lebih berkesan dan cekap.
Kata kunci: Biofilem; melioidosis; rawatan;
rintangan terhadap antibiotik; tolerans
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*Pengarang untuk surat-menyurat; email: vanitha.ma@ukm.edu.my
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