ArticlePloS one2018
In vitro activity of N-acetylcysteine against Stenotrophomonas maltophilia and Burkholderia cepacia complex grown in planktonic phase and biofilm.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- The Status of Carbapenem Resistance in Cystic Fibrosis: A Systematic Review and Meta-Analysis.The Yale journal of biology and medicine · 2022Pooled it
- N-acetyl cysteine versus chlorhexidine mouthwashes in prevention and treatment of experimental gingivitis: a randomized, triple-blind, placebo-controlled clinical trial.Clinical oral investigations · 2019Trial
- Intervention studies and antimicrobial resistance in Italy: An overview of the latest evidence.Journal of global antimicrobial resistance · 2026Review
- Effective therapeutic strategies against Pseudomonas aeruginosa and Burkholderia Cepacia complex infections.Scientific reports · 2025Article
- N-acetylcysteine inhibits NETs, exhibits antibacterial and antibiofilm properties and enhances neutrophil function against Burkholderia pseudomallei.Scientific reports · 2025Article
- N-Acetyl cysteine exhibits antimicrobial and anti-virulence activity against Salmonella enterica.PloS one · 2025Article
- Anti-microbial impact of non-antibiotic agents; salicylic acid, N-acetylcysteine, and isotretinoin against Cutibacterium acnes in patients with acne vulgaris.Archives of dermatological research · 2024Observational
- New Antimicrobial Strategies to Treat Multi-Drug Resistant Infections Caused by Gram-Negatives in Cystic Fibrosis.Antibiotics (Basel, Switzerland) · 2024Review
- Antibiotics-free compounds for managing carbapenem-resistant bacteria; a narrative review.Frontiers in pharmacology · 2024Review
- Antibacterial and anti-inflammatory efficacy of N-acetyl cysteine in endodontic treatment: a scoping review.BMC oral health · 2022Article
- Activity ofMicrobiology spectrum · 2022Article
- Molecular Insight into Gene Response of Diorcinol- and Rubrolide-Treated Biofilms of the Emerging Pathogen Stenotrophomonas maltophilia.Microbiology spectrum · 2022Article
- Stenotrophomonas maltophilia: Genotypic Characterization of Virulence Genes and The Effect of Ascorbic Acid on Biofilm Formation.Current microbiology · 2022Article
- N-acetylcysteine (NAC) and Its Role in Clinical Practice Management of Cystic Fibrosis (CF): A Review.Pharmaceuticals (Basel, Switzerland) · 2022Review
- High Activity of N-Acetylcysteine in Combination with Beta-Lactams against Carbapenem-ResistantAntibiotics (Basel, Switzerland) · 2022Article
- Antibacterial Efficacy of Liposomal Formulations Containing Tobramycin andPharmaceutics · 2022Article
- Effect ofAntibiotics (Basel, Switzerland) · 2021Article
- Current and Emerging Therapies to Combat Cystic Fibrosis Lung Infections.Microorganisms · 2021Review
- Pharmaceutical Approaches on Antimicrobial Resistance: Prospects and Challenges.Antibiotics (Basel, Switzerland) · 2021Review
- A Natural Alternative Treatment for Urinary Tract Infections: Itxasol©, the Importance of the Formulation.Molecules (Basel, Switzerland) · 2021Review
Corrections and comments
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Authors and funding
12 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Stenotrophomonas maltophilia and Burkholderia cepacia complex (Bcc) have been increasingly recognized as relevant pathogens in hospitalized, immunocompromised and cystic fibrosis (CF) patients. As a result of complex mechanisms, including biofilm formation and multidrug resistance phenotype, S. maltophilia and Bcc respiratory infections are often refractory to therapy, and have been associated with a worse outcome in CF patients. Here we demonstrate for the first time that N-acetylcysteine (NAC), a mucolytic agent with antioxidant and anti-inflammatory properties, may exhibit antimicrobial and antibiofilm activity against these pathogens. The antimicrobial and antibiofilm activity of high NAC concentrations, potentially achievable by topical administration, was tested against a collection of S. maltophilia (n = 19) and Bcc (n = 19) strains, including strains from CF patients with acquired resistance traits. Minimum Inhibitory Concentrations (MICs) and Minimum Bactericidal Concentrations (MBCs) ranged from 16 to 32 mg/ml and from 32 to >32 mg/ml, respectively. Sub-MIC concentrations (i.e., 0.25 × MIC) slowed down the growth kinetics of most strains. In time-kill assays, 2-day-old biofilms were more affected than planktonic cultures, suggesting a specific antibiofilm activity of NAC against these pathogens. Indeed, a dose- and time-dependent antibiofilm activity of NAC against most of the S. maltophilia and Bcc strains tested was observed, with a sizable antibiofilm activity observed also at 0.5 and 1 × MIC NAC concentrations. Furthermore, at those concentrations, NAC was also shown to significantly inhibit biofilm formation with the great majority of tested strains.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.