Antibacterial Effects of Nanocomposites on Efflux Pump Expression and Biofilm Production in Pseudomonas aeruginosa: A Systematic Review

Background: Pseudomonas aeruginosa is an opportunistic gram-negative pathogen with multiple mechanisms of resistance to antibiotics. Aim: This systematic review aimed to study the antibacterial effects of nanocomposites on efflux pump expression and biofilm production in P. aeruginosa. Methods: The search was conducted from January 1, 2000, to May 30, 2022, using terms such as (P. aeruginosa) AND (biofilm) AND (antibiofilm activity) AND (anti-Efflux Pump Expression activity) AND (nanoparticles) AND (Efflux Pump Expression) AND (Solid Lipid NPS) AND (Nano Lipid Carriers). Many databases are included in the collection, including ScienceDirect, PubMed, Scopus, Ovid, and Cochrane. Results: A list of selected articles was retrieved by using the relevant keywords. A total of 323 published papers were selected and imported into the Endnote library (version X9). Following the removal of duplicates, 240 were selected for further processing. Based on the titles and abstracts of the articles, 54 irrelevant studies were excluded. Among the remaining 186 articles, 54 were included in the analysis because their full texts were accessible. Ultimately, 74 studies were selected based on inclusion/exclusion criteria. Conclusion: Recent studies regarding the impact of NPs on drug resistance in P. aeruginosa found that various nanostructures were developed with different antimicrobial properties. The results of our study suggest that NPs may be a feasible alternative for combating microbial resistance in P. aeruginosa by blocking flux pumps and inhibiting biofilm formation.