<?xml version="1.0" encoding="UTF-8" standalone="no"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" "journalpublishing.dtd">
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" article-type="research-article" dtd-version="2.3" xml:lang="EN">
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Cell. Infect. Microbiol.</journal-id>
<journal-title>Frontiers in Cellular and Infection Microbiology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Cell. Infect. Microbiol.</abbrev-journal-title>
<issn pub-type="epub">2235-2988</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fcimb.2025.1494149</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Cellular and Infection Microbiology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>BTS1-knockout <italic>Saccharomyces cerevisiae</italic> with broad-spectrum antimicrobial activity through lactic acid accumulation</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" equal-contrib="yes">
<name>
<surname>Cong</surname>
<given-names>Liu</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="author-notes" rid="fn003">
<sup>&#x2020;</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/2089819"/>
<role content-type="https://credit.niso.org/contributor-roles/conceptualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/methodology/"/>
<role content-type="https://credit.niso.org/contributor-roles/software/"/>
<role content-type="https://credit.niso.org/contributor-roles/validation/"/>
<role content-type="https://credit.niso.org/contributor-roles/visualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author" equal-contrib="yes">
<name>
<surname>Zhou</surname>
<given-names>Yuan</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="author-notes" rid="fn003">
<sup>&#x2020;</sup>
</xref>
<role content-type="https://credit.niso.org/contributor-roles/data-curation/"/>
<role content-type="https://credit.niso.org/contributor-roles/investigation/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Zhang</surname>
<given-names>Yu</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<role content-type="https://credit.niso.org/contributor-roles/data-curation/"/>
<role content-type="https://credit.niso.org/contributor-roles/investigation/"/>
<role content-type="https://credit.niso.org/contributor-roles/software/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Mao</surname>
<given-names>Shanshan</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<role content-type="https://credit.niso.org/contributor-roles/data-curation/"/>
<role content-type="https://credit.niso.org/contributor-roles/validation/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Chen</surname>
<given-names>Chaoqun</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1472661"/>
<role content-type="https://credit.niso.org/contributor-roles/formal-analysis/"/>
<role content-type="https://credit.niso.org/contributor-roles/validation/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Wang</surname>
<given-names>Liying</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/2163151"/>
<role content-type="https://credit.niso.org/contributor-roles/data-curation/"/>
<role content-type="https://credit.niso.org/contributor-roles/visualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Li</surname>
<given-names>Xiao</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/537498"/>
<role content-type="https://credit.niso.org/contributor-roles/formal-analysis/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Zhang</surname>
<given-names>Zuo</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<role content-type="https://credit.niso.org/contributor-roles/investigation/"/>
<role content-type="https://credit.niso.org/contributor-roles/software/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Zhu</surname>
<given-names>Zuobin</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
<xref ref-type="author-notes" rid="fn001">
<sup>*</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1020679"/>
<role content-type="https://credit.niso.org/contributor-roles/conceptualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/funding-acquisition/"/>
<role content-type="https://credit.niso.org/contributor-roles/project-administration/"/>
<role content-type="https://credit.niso.org/contributor-roles/resources/"/>
<role content-type="https://credit.niso.org/contributor-roles/supervision/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Li</surname>
<given-names>Ying</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="author-notes" rid="fn001">
<sup>*</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/858908"/>
<role content-type="https://credit.niso.org/contributor-roles/conceptualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/funding-acquisition/"/>
<role content-type="https://credit.niso.org/contributor-roles/methodology/"/>
<role content-type="https://credit.niso.org/contributor-roles/project-administration/"/>
<role content-type="https://credit.niso.org/contributor-roles/resources/"/>
<role content-type="https://credit.niso.org/contributor-roles/supervision/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
</contrib-group>
<aff id="aff1">
<sup>1</sup>
<institution>School of Medical Technology, Xuzhou Medical University</institution>, <addr-line>Xuzhou, Jiangsu</addr-line>, <country>China</country>
</aff>
<aff id="aff2">
<sup>2</sup>
<institution>Department of Clinical Laboratory, Xuzhou Central Hospital</institution>, <addr-line>Xuzhou, Jiangsu</addr-line>, <country>China</country>
</aff>
<aff id="aff3">
<sup>3</sup>
<institution>Department of Genetics, Xuzhou Medical University</institution>, <addr-line>Xuzhou, Jiangsu</addr-line>, <country>China</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>Edited by: Costas C. Papagiannitsis, University of Thessaly, Greece</p>
</fn>
<fn fn-type="edited-by">
<p>Reviewed by: Pandora Jim Tsolakidou, Papardo Hospital, Italy</p>
<p>Farida Bendali, University of B&#xe9;ja&#xef;a, Algeria</p>
</fn>
<fn fn-type="corresp" id="fn001">
<p>*Correspondence: Ying Li, <email xlink:href="mailto:sdwhrsly@163.com">sdwhrsly@163.com</email>; Zuobin Zhu, <email xlink:href="mailto:zhuzuobin@xzhmu.edu.cn">zhuzuobin@xzhmu.edu.cn</email>
</p>
</fn>
<fn fn-type="equal" id="fn003">
<p>&#x2020;These authors have contributed equally to this work and share first authorship</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>31</day>
<month>01</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="collection">
<year>2025</year>
</pub-date>
<volume>15</volume>
<elocation-id>1494149</elocation-id>
<history>
<date date-type="received">
<day>10</day>
<month>09</month>
<year>2024</year>
</date>
<date date-type="accepted">
<day>14</day>
<month>01</month>
<year>2025</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2025 Cong, Zhou, Zhang, Mao, Chen, Wang, Li, Zhang, Zhu and Li</copyright-statement>
<copyright-year>2025</copyright-year>
<copyright-holder>Cong, Zhou, Zhang, Mao, Chen, Wang, Li, Zhang, Zhu and Li</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<p>Bacterial infections pose significant threats to human health, and prudent antibiotic use remains a key strategy for disease treatment and control. However, a global escalation of drug resistance among pathogenic bacteria presents a formidable challenge. Probiotics have emerged as a promising approach to combating pathogenic bacterial infections. In this study, we investigated the antibacterial activity of BTS1-knockout (BTS1-KO) <italic>Saccharomyces cerevisiae</italic>. Our findings demonstrate its effective inhibition of pathogen growth as evidenced by Minimum inhibitory concentration (MIC) assays, growth curves, bacteriostatic spectrum analyses and co-culture experiments. Additionally, it significantly impedes <italic>Escherichia coli</italic> and <italic>Staphylococcus aureus</italic> biofilm formation. Moreover, BTS1-KO <italic>S. cerevisiae</italic> exhibits low haemolytic activity, acid resistance, resistance to high bile salt concentrations, high auto-aggregation capacity and high co-aggregation capacities with pathogenic bacteria. Moreover, infected larvae treated with BTS1-KO <italic>S. cerevisiae</italic> in <italic>Galleria mellonella</italic>-<italic>E. coli</italic> (<italic>in vivo</italic>) and <italic>G. mellonella</italic>-<italic>S. aureus</italic> (<italic>in vivo</italic>) infection models showed significantly prolonged survival times. Mechanistic investigations revealed that BTS1-KO <italic>S. cerevisiae</italic> primarily produced lactic acid via metabolism, thereby lowering the environmental pH and inhibiting pathogenic bacterial growth. In summary, our study underscores the probiotic potential of BTS1-KO <italic>S. cerevisiae</italic>, offering broad-spectrum antibacterial activity <italic>in vitro</italic> and <italic>in vivo</italic> with low toxicity. This highlights BTS1-KO <italic>S. cerevisiae</italic> as a promising probiotic candidate for clinical prevention and control of bacterial infection.</p>
</abstract>
<kwd-group>
<kwd>probiotics</kwd>
<kwd>
<italic>Saccharomyces cerevisiae</italic>
</kwd>
<kwd>multidrug resistant pathogens</kwd>
<kwd>broadspectrum antibacterial activity</kwd>
<kwd>antimicrobial metabolites</kwd>
</kwd-group>
<counts>
<fig-count count="8"/>
<table-count count="1"/>
<equation-count count="5"/>
<ref-count count="49"/>
<page-count count="16"/>
<word-count count="7796"/>
</counts>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-in-acceptance</meta-name>
<meta-value>Antibiotic Resistance and New Antimicrobial drugs</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec id="s1" sec-type="intro">
<label>1</label>
<title>Introduction</title>
<p>Bacterial infections represent a significant global health threat, as highlighted in the World Health Organisation&#x2019;s &#x2018;Top Ten Global Health Threats&#x2019; report, due to their elevated morbidity and mortality rates (<xref ref-type="bibr" rid="B7">EclinicalMedicine, 2021</xref>). The misuse of antibiotics has driven a rise in antibiotic-resistant pathogenic microbes, resulting in approximately 1 million deaths annually from untreatable bacterial infections, posing a grave threat to public health and safety (<xref ref-type="bibr" rid="B40">Subramaniam and Girish, 2020</xref>). For example, polymyxin is regarded as the last line of defence against multidrug-resistant gram-negative infections, and <italic>Escherichia coli</italic> carrying the polymyxin resistance gene <italic>mcr-1</italic> (<italic>E. coli</italic> (<italic>mcr-1</italic>)) can transmit between animals and humans, increasing the difficulty of treating the infection (<xref ref-type="bibr" rid="B48">Zhang et&#xa0;al., 2021</xref>). Methicillin-resistant <italic>Staphylococcus aureus</italic> (MRSA) is a prevalent and virulent pathogenin clinical settings due to its broad-spectrum resistance to antibiotics such as <italic>&#x3b2;</italic>-lactams, cephalosporins, aminoglycosides, macrolides, tetracyclines, fluoroquinolones, sulfonamides and rifampicin (<xref ref-type="bibr" rid="B30">Oteo and Bel&#xe9;n Aracil, 2015</xref>; <xref ref-type="bibr" rid="B15">Jain et&#xa0;al., 2023</xref>). By 2050, antibiotic resistance is projected to cause 10 million deaths annually (<xref ref-type="bibr" rid="B32">Palavecino, 2020</xref>). Urgent measures are needed to develop novel therapeutic agents or strategies to address this clinical challenge.</p>
<p>Probiotics, defined as living microorganisms conferring beneficial effects upon the host when administered in adequate amounts, offer a promising alternative to antibiotics (<xref ref-type="bibr" rid="B20">Kim et&#xa0;al., 2019</xref>; <xref ref-type="bibr" rid="B29">Oniszczuk et&#xa0;al., 2021</xref>). Recently, the use of probiotics to prevent or control bacterial infections has garnered attention. Numerous studies reports that probiotics can inhibit the proliferation and virulence characteristics of various pathogenic bacteria. For example, yeast <italic>Saccharomyces boulardii</italic> can alleviate intestinal infections caused by <italic>E. coli</italic>, <italic>S. aureus</italic> and <italic>Salmonella</italic> (<xref ref-type="bibr" rid="B31">Pais et&#xa0;al., 2020</xref>); <italic>Lactobacillus curvatus</italic> protects the host from urinary tract pathogenic <italic>E. coli</italic> infection by promoting type I interferon production in the bladder epithelial cells, enhancing phagolysosome maturation and histone D production, along with enhanced acidification (<xref ref-type="bibr" rid="B39">Song et&#xa0;al., 2022</xref>). Additionally, <italic>Lactococcus lactis</italic> detects CAI-1, a population-sensing signal of <italic>Vibrio cholerae</italic>, thereby inhibiting its colonisation in the intestine (<xref ref-type="bibr" rid="B23">Mao et&#xa0;al., 2018</xref>).</p>
<p>
<italic>Saccharomyces cerevisiae</italic>, widely employed in oral vaccine development and medical engineering vectors, exhibits antimicrobial properties with <italic>S. boulardii</italic>, indicating potential as a prebiotic agent (<xref ref-type="bibr" rid="B19">Ka&#x17a;mierczak-Siedlecka et&#xa0;al., 2020</xref>). In this study, we utilised the yeast <italic>S. cerevisiae</italic> gene-knockout collection (YKOC) to screen strains with antibacterial activity. BTS1-knockout (BTS1-KO) <italic>S. cerevisiae</italic>, demonstrating effective antibacterial activity, was selected for further characterisation of its antibacterial activity, toxicity profile and probiotic characteristics both <italic>in vitro</italic> and <italic>in vivo</italic>. Our findings elucidate the preliminary mechanism of BTS1-KO <italic>S. cerevisiae</italic> against pathogenic bacteria and provide a theoretical basis for its potential clinical application as a probiotic agent.</p>
</sec>
<sec id="s2" sec-type="materials|methods">
<label>2</label>
<title>Materials and methods</title>
<sec id="s2_1">
<label>2.1</label>
<title>Strains</title>
<p>
<italic>S. cerevisiae</italic> single-gene deletion strain and BY4743 parent strain were obtained from YKOC, which was purchased from Invitrogen in 2014. All strains were stored at &#x2212;80&#xb0;C in a preservation solution containing 20% glycerol (v/v) (Sigma-Aldrich). Before the experiment, the strains were inoculated twice on Yeast Extract Peptone Dextrose (YPD)ager plates (yeast extract 1%, peptone 2%, glucose 2%, and agar 2%) (Qingdao Hope Bio-technology Company) and incubated at 30&#xb0;C. Single colonies were inoculated into the YPD broth (2% tryptone, 1% yeast extract, and 2% glucose) and cultured overnight at 30&#xb0;C, 200 r/min. <italic>S. boulardii</italic> CNCM I-745 (imported drug registration No. s5288500) was ordered in French Encyclopedia Pharmaceutical Factory; <italic>E. coli</italic> ATCC25922, <italic>E. coli</italic> (<italic>mcr-1</italic>) 12-2, <italic>S. aureus</italic> ATCC29213, <italic>S. aureus</italic> ATCC25923, MRSA 1668, <italic>Pseudomonas aeruginosa</italic> ATCC27853, <italic>P. aeruginosa</italic> 1554, <italic>Klebsiella pneumoniae</italic> ATCC700603, <italic>K. pneumoniae</italic> ATCC1706, <italic>K. pneumoniae</italic> ATCC1705, <italic>K. pneumoniae</italic> 2118, <italic>Acinetobacter baumannii</italic> 21-1 and <italic>Salmonella</italic> Typhimurium SL1344 were donated by the Laboratory of Affiliated Hospital of Xuzhou Medical University. <italic>Lactobacillus johnsonii</italic> D-SM 10553 freeze-dried powder (SHBCC, China) was solubilised with 0.5 mL of de Man Rogosa and Sharpe (<xref ref-type="bibr" rid="B11">Falsen et&#xa0;al., 1999</xref>) (MRS) medium (Qingdao Hope Bio-technology Company), then the bacterial solution was applied to MRS solid plates, and single bacterial colonies appeared after about 24&#xa0;h. Subsequently frozen stocks of <italic>L. johnsonii</italic> (in MRS medium with 20% glycerol) were prepared, stored at -80&#xb0;C for further experiments. <italic>E. coli</italic>, <italic>S. aureus</italic>, <italic>P. aeruginosa</italic>, <italic>K. pneumoniae</italic>, <italic>A. baumannii</italic> and <italic>S.</italic> Typhimurium were incubated in Luria-Bertani (LB)broth (Tryptone 10.0&#xa0;g, Yeast Extract 5.0&#xa0;g, NaCl 10.0&#xa0;g per litre) (Shanghai Sangon Biotech Company) at 37&#xb0;C overnight. <italic>L. johnsonii</italic> was incubated in MRS broth overnight at 37&#xb0;C under anaerobic conditions.</p>
</sec>
<sec id="s2_2">
<label>2.2</label>
<title>Preparation of cell-free supernatant from <italic>S. cerevisiae</italic>
</title>
<p>The <italic>S. cerevisiae</italic> single-gene deleted strain and the BY4743 parent strain were inoculated into YPD broth and cultured at 30&#xb0;C for 16&#xa0;h in a shaker at 200 rpm. After incubation, the samples were centrifuged at 4000&#xd7;g at 4&#xb0;C for 10&#xa0;min. Then, the supernatants were filtered by a syringe filter (0.22-&#x3bc;m pore size), and then stored at -80&#xb0;C for later use, in which CFS of BY4743 was used as a control.</p>
</sec>
<sec id="s2_3">
<label>2.3</label>
<title>Screening experiments for CFSs with bacteriostatic properties</title>
<p>CFS with antibacterial activity was screened by 96-well plate method. A volume of 90 &#x3bc;L of CFS of deletion strain was mixed with 10 &#x3bc;L of bacterial liquid (1&#xd7;10<sup>8</sup> CFU/mL) in each well of 96-well plate, and CFS of BY4743 was used as control group. The pathogenic bacteria used in this experiment are <italic>E. coli</italic> ATCC25922, <italic>E. coli</italic> (<italic>mcr-1</italic>) 12-2, <italic>S. aureus</italic> ATCC29213 and MRSA 1668. The well plates were cultured at 37&#xb0;C for 18-24&#xa0;h, and the absorbance at 600 nm was measured by enzyme-labelled instrument. The ratio of OD value of each well divided by OD value of the control group was regarded as its growth rate, and the strains with inhibition rate (1- growth rate) greater than 80% were regarded as having antibacterial activity.</p>
</sec>
<sec id="s2_4">
<label>2.4</label>
<title>Minimum inhibitory concentration of CFS</title>
<p>The MIC method was employed to assess the antibacterial activity of CFS of BTS1-KO <italic>S. cerevisiae</italic>. Pathogenic bacteria cultured overnight were diluted in the Mueller Hinton (MH) broth medium (Qingdao Hope Bio-technology Company). Various concentrations of CFS and bacterial suspensions were added to 96-well plates, resulting in a final volume of 100 &#x3bc;L per well and a bacterial concentration of 1&#xd7;10<sup>6</sup> CFU/mL, compared to wells without CFS. The pathogenic bacteria included <italic>E. coli</italic> ATCC25922, <italic>E. coli</italic> (<italic>mcr-1</italic>) 12-2, <italic>S. aureus</italic> ATCC29213 and MRSA 1668. Then the plates were cultured at 35&#xb0;C for 24&#xa0;h, and the lowest CFS concentration to inhibit bacterial growth or inhibit 80% of bacterial cells as MIC.</p>
</sec>
<sec id="s2_5">
<label>2.5</label>
<title>Antibacterial activity of CFS against different bacteria</title>
<p>The antimicrobial activity of CFS against various bacterial strains was determined according to the screening method, and the inhibitory activity of CFS of <italic>S. boulardii</italic> and <italic>L. johnsonii s</italic> was used as a control.</p>
</sec>
<sec id="s2_6">
<label>2.6</label>
<title>Growth curve determination</title>
<p>Overnight cultures of pathogenic bacteria were diluted in LB broth. Experimental groups were prepared by mixing bacterial suspensions with 90% CFS, 50% CFS or 25% CFS, while the control group was mixed with YPD broth, and a blank control group was mixed with sterile water. The pathogenic bacteria were <italic>E. coli</italic> ATCC25922, <italic>E. coli</italic> (<italic>mcr-1</italic>) 12-2, <italic>S. aureus</italic> ATCC29213 and MRSA 1668. Initial optical density at 600 nm (OD<sub>600</sub>) was measured using an enzyme-labelled instrument (Thermo Fisher Scientific) and then cultured at 37&#xb0;C and 200 rpm. Samples of 100 &#x3bc;L were taken every 2&#xa0;h to determine OD<sub>600</sub> and construct growth curves.</p>
</sec>
<sec id="s2_7">
<label>2.7</label>
<title>Biofilm inhibition assay</title>
<p>The inhibition of biofilm formation by CFS was evaluated using the crystal violet (CV) method (<xref ref-type="bibr" rid="B44">Xu et&#xa0;al., 2016</xref>). Then, 90%, 50% or 25% of CFS concentrations were mixed with bacterial suspensions in 96-well plates (experimental group), while control groups were mixed with YPD broth and incubated at 37&#xb0;C for 24&#xa0;h. The pathogenic bacteria were <italic>E. coli</italic> ATCC25922, <italic>E. coli</italic> (<italic>mcr-1</italic>) 12-2, <italic>S. aureus</italic> ATCC29213 and MRSA 1668. After incubation, the cell suspension was washed twice with 150 &#x3bc;L sterile water. Biofilm cells were dried at 37&#xb0;C for 30&#xa0;min and then stained with 0.1% 150 &#x3bc;L CV solution for 30&#xa0;min. Subsequently, the excess CV solution was gently washed away with sterile distilled water. and 150 &#x3bc;L of solution (30% methanol and 10% acetic acid) was added to each well to dissolve the CV solution. Finally, the OD<sub>570</sub> was measured using an enzyme-labelled instrument. The following equation was used to calculate the biofilm inhibition rate (%):</p>
<disp-formula>
<mml:math display="block" id="M1">
<mml:mrow>
<mml:mtext>Biofilm&#xa0;inhibition&#xa0;rate</mml:mtext>
<mml:mfenced>
<mml:mo>%</mml:mo>
</mml:mfenced>
<mml:mo>=</mml:mo>
<mml:mfenced>
<mml:mrow>
<mml:mn>1</mml:mn>
<mml:mo>&#x2212;</mml:mo>
<mml:msub>
<mml:mrow>
<mml:mtext>OD</mml:mtext>
</mml:mrow>
<mml:mrow>
<mml:mtext>treatment</mml:mtext>
</mml:mrow>
</mml:msub>
<mml:mo stretchy="false">/</mml:mo>
<mml:msub>
<mml:mrow>
<mml:mtext>OD</mml:mtext>
</mml:mrow>
<mml:mrow>
<mml:mtext>control</mml:mtext>
</mml:mrow>
</mml:msub>
</mml:mrow>
</mml:mfenced>
<mml:mo>&#xd7;</mml:mo>
<mml:mn>100</mml:mn>
</mml:mrow>
</mml:math>
</disp-formula>
</sec>
<sec id="s2_8">
<label>2.8</label>
<title>Scanning electron microscopy analysis</title>
<p>Suspensions of pathogenic bacteria were co-cultured with varying amounts of CFS in 24-well plates, with sterile polystyrene discs added to wells. Control wells contained bacteria without CFS. After 24&#xa0;h of incubation at 37&#xb0;C, planktonic bacteria were removed, washed thrice with phosphate buffer solution (PBS) (Shanghai Sangon Biotech Company), fixed with 1% osmium acid solution at 4&#xb0;C for 2&#xa0;h and dehydrated with an ethanol gradient (50%, 70%, 80%, 90% and 95%) for 10-20&#xa0;min. Then, add tert-butyl alcohol to infiltrate for 2&#xa0;h. Finally, the film was fixed on the surface of the wafer after carbon dioxide critical drying and ion sputtering, revealing a golden yellow surface, and the film was observed under an SEM (American FEI Company).</p>
</sec>
<sec id="s2_9">
<label>2.9</label>
<title>Determination of adhesion ability</title>
<p>Overnight cultures of <italic>E. coli</italic> and <italic>S. aureus</italic> were diluted in LB broth. Bacterial suspensions were mixed with 50% CFS and incubated in glass tubes at 37&#xb0;C for 24&#xa0;h. The control group was mixed with the same amount of YPD broth. The glass tube was placed at an angle of 30 and incubated at 37&#xb0;C for 24&#xa0;h. After incubation, the floating cells were retained, and the adhered cells were collected, washed with PBS, resuspended in PBS buffer and their OD<sub>600</sub> was measured (OD <sub>adhesion)</sub>. Then, the planktonic cells were mixed with the adherent cells, washed with PBS and resuspended and the OD<sub>600</sub> of the mixed cells was measured (OD <sub>mixture</sub>). Adhesion capacity (%) was calculated using the following formula:</p>
<disp-formula>
<mml:math display="block" id="M2">
<mml:mrow>
<mml:mtext>Adhesion&#xa0;ability</mml:mtext>
<mml:mfenced>
<mml:mo>%</mml:mo>
</mml:mfenced>
<mml:mo>=</mml:mo>
<mml:mfenced>
<mml:mrow>
<mml:msub>
<mml:mrow>
<mml:mtext>OD</mml:mtext>
</mml:mrow>
<mml:mrow>
<mml:mtext>adhesion</mml:mtext>
</mml:mrow>
</mml:msub>
<mml:mo stretchy="false">/</mml:mo>
<mml:msub>
<mml:mrow>
<mml:mtext>OD</mml:mtext>
</mml:mrow>
<mml:mrow>
<mml:mtext>mixture</mml:mtext>
</mml:mrow>
</mml:msub>
</mml:mrow>
</mml:mfenced>
<mml:mo>&#xd7;</mml:mo>
<mml:mn>100</mml:mn>
</mml:mrow>
</mml:math>
</disp-formula>
</sec>
<sec id="s2_10">
<label>2.10</label>
<title>Extracellular polysaccharides production determination</title>
<p>Overnight cultures of <italic>E. coli</italic> and <italic>S. aureus</italic> were prepared in LB broth. The bacterial suspension was mixed with 50% CFS, while the control group received an equivalent volume of YPD broth and was cultured at 37&#xb0;C for 24&#xa0;h. Following incubation, it was centrifuged at 8000 &#xd7;g for 10&#xa0;min at 4&#xb0;C, washed twice with PBS, resuspended with 0.9% saline (1 mL) and then mixed with 5% phenol and 5% sulfuric acid in equal volumes and incubated in darkness for 1&#xa0;h. The OD<sub>490</sub> was measured to quantify EPS production using the following equation:</p>
<disp-formula>
<mml:math display="block" id="M3">
<mml:mrow>
<mml:mtext>EPS&#xa0;quantification</mml:mtext>
<mml:mfenced>
<mml:mo>%</mml:mo>
</mml:mfenced>
<mml:mo>=</mml:mo>
<mml:mfenced>
<mml:mrow>
<mml:msub>
<mml:mrow>
<mml:mtext>OD</mml:mtext>
</mml:mrow>
<mml:mrow>
<mml:mtext>treatment</mml:mtext>
</mml:mrow>
</mml:msub>
<mml:mo stretchy="false">/</mml:mo>
<mml:msub>
<mml:mrow>
<mml:mtext>OD</mml:mtext>
</mml:mrow>
<mml:mrow>
<mml:mtext>control</mml:mtext>
</mml:mrow>
</mml:msub>
</mml:mrow>
</mml:mfenced>
<mml:mo>&#xd7;</mml:mo>
<mml:mn>100</mml:mn>
</mml:mrow>
</mml:math>
</disp-formula>
</sec>
<sec id="s2_11">
<label>2.11</label>
<title>Hydrophobicity assay</title>
<p>Overnight cultures of <italic>E. coli</italic> and <italic>S. aureus</italic> were prepared in LB broth. The experimental group received 50% CFS mixed with bacterial suspension, while the control group received an equal volume of YPD broth and was cultured at 37&#xb0;C for 24&#xa0;h. After incubation, the cell suspension was centrifuged at 17,709&#xd7; g at 4&#xb0;C for 5&#xa0;min, washed twice with PBS and resuspended in fresh PBS. The OD<sub>600</sub> was adjusted to 0.5 &#xb1; 0.05 (OD <sub>initial</sub>). Then, 1.2 mL of the cell suspension was transferred to a glass test tube, mixed with n-octane (0.3 mL) and vortexed for 3 minutes before standing for 15 minutes. The lower water phase was collected, and the OD<sub>600</sub> (OD <sub>treatment</sub>) was measured.</p>
</sec>
<sec id="s2_12">
<label>2.12</label>
<title>Establishment of bacteria-<italic>S. cerevisiae</italic> culture model</title>
<p>To assess the inhibitory effort of live BTS1-KO <italic>S. cerevisiae</italic> on <italic>E. coli</italic> and <italic>S. aureus</italic> cells, bacteria-<italic>S. cerevisiae</italic> co-culture model was established. Overnight cultures of <italic>S. cerevisiae</italic> and pathogenic bacteria were washed twice with PBS and diluted to 10<sup>7</sup> CFU/mL in YPD and LB broth medium, respectively. Co-culture groups were prepared by mixing <italic>S. cerevisiae</italic> and pathogenic bacteria at a 1: 1 ratio (1 mL each). The pathogen culture was mixed with YPD broth (1 mL each) as the single culture group, while the blank group consisted of pathogenic bacteria mixed with sterile water (1 mL each). Cultures were incubated at 37&#xb0;C and 200 rpm. The cells in the co-culture group and pathogen single culture group were counted on an LB agar plate supplemented with 10 mg/mL amphotericin B (Sigma-Aldrich). The experiment was performed in triplicate.</p>
</sec>
<sec id="s2_13">
<label>2.13</label>
<title>Probiotic potential of BTS1-KO <italic>S. cerevisiae</italic>
</title>
<sec id="s2_13_1">
<label>2.13.1</label>
<title>Determination of haemolytic activity</title>
<p>BTS1-KO <italic>S. cerevisiae</italic> cultures were streaked on sheep blood agar and incubated at 30&#xb0;C for 24&#x2013;48 h. Haemolytic patterns were examined and categorised into &#x3b1;-haemolysis (grass green translucent haemolysis ring around colonies), &#x3b2;-haemolysis (wide transparent haemolysis ring around colonies) and &#x3b3;-haemolysis (no haemolysis ring around colonies). <italic>S. aureus</italic> ATCC25923, exhibiting &#x3b2;-haemolysis, served as positive control.</p>
</sec>
<sec id="s2_13_2">
<label>2.13.2</label>
<title>Tolerance of BTS1-KO <italic>S. cerevisiae</italic> to simulated gastrointestinal fluids</title>
<p>Pepsin was prepared at a concentration of 3 mg/mL in PBS and adjusted to pH 3.0 with hydrochloric acid, which was filtered using a syringe filter (aperture 0.22 &#x3bc;m) for reserve. Trypsin was prepared at 1 mg/mL by PBS, supplemented with 0.3% of bovine bile salt and adjusted to pH 8.0 with sodium hydroxide, which was filtered using a syringe filter (pore size 0.22 &#x3bc;m) for later use. BTS1-KO <italic>S. cerevisiae</italic> was inoculated in YPD broth and cultured at 30&#xb0;C and 200 rpm for 16&#xa0;h. After culturing, the cells were collected by centrifugation at 4000&#xd7;g for 12&#xa0;min at 4&#xb0;C and washed twice with PBS. Then, the bacteria were resuspended in the prepared artificial gastric juice and intestinal juice, respectively. Viable bacteria counts were determined after 1&#xa0;h and 3&#xa0;h of incubation in artificial gastric juice and after 2&#xa0;h and 4&#xa0;h in intestinal juice.</p>
</sec>
<sec id="s2_13_3">
<label>2.13.3</label>
<title>Auto-aggregation and co-aggregation assay</title>
<p>BTS1-KO <italic>S. cerevisiae</italic> and BY4743 were cultured at 30&#xb0;C for 16&#xa0;h, then centrifuged at 8000 &#xd7;g at 4&#xb0;C for 10&#xa0;min to collect bacteria. The bacterial pellets were washed twice with PBS and resuspended in PBS, and the absorbance (A<sub>0</sub>) was measured at 600 nm. <italic>S. cerevisiae</italic> BY4743 served as the control. The bacterial suspensions were left at room temperature for 5&#xa0;h, and the absorbance was measured again (A<sub>t</sub>). Auto aggregation (%) was calculated using the following equation:</p>
<disp-formula>
<mml:math display="block" id="M4">
<mml:mrow>
<mml:mtext>Auto&#xa0;aggregation&#xa0;</mml:mtext>
<mml:mrow>
<mml:mo stretchy="false">(</mml:mo>
<mml:mo>%</mml:mo>
<mml:mo stretchy="false">)</mml:mo>
</mml:mrow>
<mml:mo>=</mml:mo>
<mml:mrow>
<mml:mo stretchy="false">[</mml:mo>
<mml:mrow>
<mml:mn>1</mml:mn>
<mml:mo>&#x2212;</mml:mo>
<mml:mrow>
<mml:mo stretchy="false">(</mml:mo>
<mml:mrow>
<mml:msub>
<mml:mtext>A</mml:mtext>
<mml:mtext>t</mml:mtext>
</mml:msub>
<mml:mo stretchy="false">/</mml:mo>
<mml:msub>
<mml:mtext>A</mml:mtext>
<mml:mn>0</mml:mn>
</mml:msub>
</mml:mrow>
<mml:mo stretchy="false">)</mml:mo>
</mml:mrow>
</mml:mrow>
<mml:mo stretchy="false">]</mml:mo>
</mml:mrow>
<mml:mo>&#xd7;</mml:mo>
<mml:mn>100</mml:mn>
</mml:mrow>
</mml:math>
</disp-formula>
<p>For co-aggregation, bacterial suspensions of BTS1-KO <italic>S. cerevisiae</italic> and BY4743 were prepared as described above. Overnight cultures of <italic>E. coli</italic> and <italic>S. aureus</italic> in LB broth medium were centrifuged at 8000 &#xd7;g at 4&#xb0;C for 10&#xa0;min to obtain precipitate, which was then washed with PBS and resuspended to obtain bacterial suspensions. <italic>S. cerevisiae</italic> BY4743 served as the control. The absorbance of <italic>S. cerevisiae</italic> suspension (&#xff21;<sub>probio</sub>) and bacterial suspension (A <sub>pat</sub>) was measured at 600 nm. Equal volumes (2 mL) of <italic>S. cerevisiae</italic> and bacterial suspensions were mixed, and incubated at 37&#xb0;C for 5&#xa0;h, and the absorbance of the mixed solution (A <sub>mix</sub>) was measured. The Co-aggregation (%) was calculated using the equation:</p>
<disp-formula>
<mml:math display="block" id="M5">
<mml:mrow>
<mml:mtable>
<mml:mtr>
<mml:mtd columnalign="left">
<mml:mtext>Co-aggregation&#xa0;</mml:mtext>
<mml:mrow>
<mml:mo stretchy="false">(</mml:mo>
<mml:mo>%</mml:mo>
<mml:mo stretchy="false">)</mml:mo>
</mml:mrow></mml:mtd></mml:mtr>
<mml:mtr>
<mml:mtd columnalign="left">
<mml:mo>=</mml:mo>
<mml:mo stretchy="false">[</mml:mo>
<mml:mo stretchy="false">(</mml:mo>
<mml:mrow>
<mml:mo stretchy="false">(</mml:mo>
<mml:mrow>
<mml:msub>
<mml:mtext>A</mml:mtext>
<mml:mrow>
<mml:mtext>probio</mml:mtext>
</mml:mrow>
</mml:msub>
<mml:mo>+</mml:mo>
<mml:msub>
<mml:mtext>A</mml:mtext>
<mml:mrow>
<mml:mtext>pat</mml:mtext>
</mml:mrow>
</mml:msub>
</mml:mrow>
<mml:mo stretchy="false">)</mml:mo>
</mml:mrow>
<mml:mo stretchy="false">/</mml:mo>
<mml:mn>2</mml:mn>
<mml:mo>&#x2212;</mml:mo>
<mml:msub>
<mml:mtext>A</mml:mtext>
<mml:mrow>
<mml:mtext>mix</mml:mtext>
</mml:mrow>
</mml:msub>
<mml:mo stretchy="false">)</mml:mo>
<mml:mo stretchy="false">/</mml:mo>
<mml:mrow>
<mml:mo stretchy="false">(</mml:mo>
<mml:mrow>
<mml:msub>
<mml:mtext>A</mml:mtext>
<mml:mrow>
<mml:mtext>probio</mml:mtext>
</mml:mrow>
</mml:msub>
<mml:mo>+</mml:mo>
<mml:msub>
<mml:mtext>A</mml:mtext>
<mml:mrow>
<mml:mtext>pat</mml:mtext>
</mml:mrow>
</mml:msub>
</mml:mrow>
<mml:mo stretchy="false">)</mml:mo>
</mml:mrow>
<mml:mo stretchy="false">/</mml:mo>
<mml:mn>2</mml:mn>
<mml:mo stretchy="false">]</mml:mo>
<mml:mo>&#xd7;</mml:mo>
<mml:mn>100</mml:mn>
</mml:mtd>
</mml:mtr>
</mml:mtable>
</mml:mrow>
</mml:math>
</disp-formula>
</sec>
</sec>
<sec id="s2_14">
<label>2.14</label>
<title>Establishment of <italic>Galleria mellonella</italic> infection model</title>
<p>Precipitated BTS1-KO <italic>S. cerevisiae</italic> cultured at 30&#xb0;C for 16&#xa0;h was washed with PBS three times and resuspended in PBS (Alive <italic>S. cerevisiae</italic>). For heat-inactivated probiotic suspension, a portion (10 mL) of the above suspension was autoclaved at 121&#xb0;C for 15&#xa0;min, then centrifuged at 8000&#xd7;g for 10&#xa0;min, washed and resuspended with PBS (Heat-inactivated <italic>S. cerevisiae</italic>). The <italic>G. mellonella</italic> larvae were randomly divided into eight groups: one blank control group (PBS group); one control group (Pathogenic bacteria group); three toxicity test groups (CFS group, Alive group and Heat-inactivated group); three treatment groups (CFS + Pathogenic bacteria, Alive + Pathogenic bacteria, Heat-inactivated + Pathogenic bacteria).</p>
</sec>
<sec id="s2_15">
<label>2.15</label>
<title>Determination of antibacterial activity of farnesene</title>
<p>The antibacterial activity of farnesene was assessed using a standardised broth microdilution method following the Clinical and Laboratory Standards Institute (CLSI) guidelines (M27-A3) (CLSI, 2008). The inhibitory activity of farnesene against pathogenic bacteria was tested in 96-well plates.</p>
</sec>
<sec id="s2_16">
<label>2.16</label>
<title>Analysis of organic acids in CFS using ultra-performance liquid chromatography-tandem mass spectrometry</title>
<p>Organic acid types and concentrations in CFS were analysed using a Waters Acquity I class UPLC coupled to a Waters XEVO TQD mass spectrometer. The CFS of BTS1-KO <italic>S. cerevisiae</italic>, CFS of BY4743 and YPD medium were thawed at 4&#xb0;C. Then, 5 &#x3bc;L of the supernatant of the sample to be tested was taken into a centrifuge tube, and 35 &#x3bc;L of the configured derivatisation reagent (4.8 &#x3bc;L of AQB and 2 &#x3bc;L of DIPEA dissolved in 2 mL of acetonitrile) and 35 &#x3bc;L of the condensation agent (15.2 mg of HATU dissolved in 2 mL of acetonitrile) were added. After vortexing for 20&#xa0;min, 100 &#x3bc;L of PBS and 300 &#x3bc;L of methyl tert-butyl ether were added, vortexed for 10&#xa0;min, and then centrifuged at 6000 rpm at 4&#xb0;C for 5&#xa0;min. A total of 50 &#x3bc;L of supernatant was collected in a new centrifuge tube and concentrated by centrifugation at 40&#xb0;C for 20&#xa0;min in a vacuum concentrator. The sample was then dried and reconstituted by adding 100 &#x3bc;L of 10% acetonitrile in water; After vortexing for 5&#xa0;min and centrifuging at 12000 rpm for 15&#xa0;min at 4&#xb0;C, 40 &#x3bc;L of supernatant was transferred to the injection vial, and the type and concentration of organic acids were analysed using UPLC-MS/MS.</p>
</sec>
<sec id="s2_17">
<label>2.17</label>
<title>Statistical analysis</title>
<p>All experiments were set up in three replicate groups and repeated independently three times. Statistical analysis and plotting were performed using GraphPad Prism software. Experimental data were statistically tested using Student&#x2019;s <italic>t</italic>-test or one-way ANOVA. Statistical differences were determined based on <italic>P</italic> values of *<italic>P</italic>&lt;0.05, **<italic>P</italic>&lt;0.01, and ***<italic>P</italic>&lt;0.005.</p>
</sec>
</sec>
<sec id="s3" sec-type="results">
<label>3</label>
<title>Results</title>
<sec id="s3_1">
<label>3.1</label>
<title>Antibacterial effect by CFS of BTS1-KO <italic>S. cerevisiae</italic>
</title>
<p>Screening of 1800 <italic>S. cerevisiae</italic> mutants, BTS1-KO <italic>S. cerevisiae</italic> exhibited potent antibacterial activity. The MIC<sub>80</sub> of CFS against <italic>E. coli</italic> ATCC25922, <italic>E. coli</italic> -mcr1 12-2, <italic>S. aureus</italic> ATCC29213 and MRSA 1668 was 90%, 50%, 50% and 50%, respectively, compared to the control group (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1A</bold>
</xref>). As the concentration of CFS decreased, the antibacterial activity gradually diminished. Furthermore, BTS1-KO <italic>S. cerevisiae</italic> demonstrated effectiveness in inhibiting the proliferation of various bacteria, including gram-negative, gram-positive and drug-resistant bacteria. Specifically, CFS inhibited <italic>E. coli</italic> (<italic>mcr</italic>-<italic>1</italic>) 12-2 and <italic>S. aureus</italic> ATCC29213 by 98%; <italic>S. aureus</italic> ATCC25923 and <italic>S.</italic> Typhimurium SL1344 by 96%; <italic>E. coli</italic> ATCC25922, MRSA 1668, <italic>P. aeruginosa</italic> ATCC27853 and <italic>K. pneumoniae</italic> ATCC1705 by 95%; <italic>P. aeruginosa</italic> 1554 by 94%; <italic>K. pneumoniae</italic> ATCC700603, <italic>K. pneumoniae</italic> ATCC1706 and <italic>A. baumannii</italic> 21-1 by 93%; and <italic>K. pneumoniae</italic> 2118 by 92%. Importantly, BTS1-KO <italic>S. cerevisiae</italic> exhibited comparable activity to well-known probiotics like <italic>L. rhamnosus</italic> and surpassed <italic>S. boulardii</italic> (<xref ref-type="table" rid="T1">
<bold>Table&#xa0;1</bold>
</xref>). These results underscored the potent antibacterial activity of BTS1-KO <italic>S. cerevisiae</italic> CFS.</p>
<fig id="f1" position="float">
<label>Figure&#xa0;1</label>
<caption>
<p>Determination of antibacterial activity of cell-free supernatant (CFS) of BTS1-KO <italic>S. cerevisiae</italic>. <bold>(A)</bold> Minimum inhibitory concentration (MIC)value of CFS against drug-sensitive and drug-resistant strains of <italic>E</italic>. <italic>coli</italic> ATCC25922, <italic>E</italic>. <italic>coli</italic> (<italic>mcr</italic>-<italic>1</italic>) 12-2, <italic>S. aureus</italic> ATCC29213 and MRSA 1668; <bold>(B)</bold> Growth curve of <italic>E</italic>. <italic>coli</italic> ATCC25922 after CFS treatment; <bold>(C)</bold> Growth curve of <italic>E</italic>. <italic>coli</italic> (<italic>mcr</italic>-<italic>1</italic>) 12-2 after CFS treatment; <bold>(D)</bold> Growth curve of <italic>S. aureus</italic> ATCC29213 after CFS treatment; <bold>(E)</bold> Growth curve of MRSA 1668 after CFS treatment. Data are representative of three independent experiments and presented as mean &#xb1; SD. ns indicates no statistical significance; **<italic>P</italic> &lt; 0.01; ***<italic>P</italic> &lt; 0.001.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fcimb-15-1494149-g001.tif"/>
</fig>
<table-wrap id="T1" position="float">
<label>Table&#xa0;1</label>
<caption>
<p>Antimicrobial of CFS against different bacteria.</p>
</caption>
<table frame="hsides">
<thead>
<tr>
<th valign="middle" rowspan="2" align="center">Stains <xref ref-type="table-fn" rid="fnT1_1">
<sup>a</sup>
</xref>
</th>
<th valign="middle" colspan="3" align="center">Growth rate</th>
</tr>
<tr>
<th valign="middle" align="center">BTS1-KO</th>
<th valign="middle" align="center">
<italic>S. boulardii</italic>
</th>
<th valign="middle" align="center">
<italic>L. johnsonii</italic>
</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="middle" align="center">
<italic>E. coli</italic> ATCC25922</td>
<td valign="middle" align="center">4.80% &#xb1; 0.72%</td>
<td valign="middle" align="center">10.21% &#xb1; 0.93% *</td>
<td valign="middle" align="center">7.76% &#xb1; 0.81% <sup>ns</sup>
</td>
</tr>
<tr>
<td valign="middle" align="center">
<italic>E. coli</italic>(<italic>mcr-1</italic>)12-2</td>
<td valign="middle" align="center">2.95% &#xb1; 0.94%</td>
<td valign="middle" align="center">18.86% &#xb1; 4.05% ***</td>
<td valign="middle" align="center">10.45% &#xb1; 1.07% <sup>ns</sup>
</td>
</tr>
<tr>
<td valign="middle" align="center">
<italic>S. aureus</italic> ATCC29213</td>
<td valign="middle" align="center">2.82% &#xb1; 0.33%</td>
<td valign="middle" align="center">14.97% &#xb1; 1.89% ***</td>
<td valign="middle" align="center">6.23% &#xb1; 1.24% <sup>ns</sup>
</td>
</tr>
<tr>
<td valign="middle" align="center">
<italic>S. aureus</italic> ATCC25923</td>
<td valign="middle" align="center">4.93% &#xb1; 0.73%</td>
<td valign="middle" align="center">26.24% &#xb1; 2.83% ***</td>
<td valign="middle" align="center">6.40% &#xb1; 0.94% <sup>ns</sup>
</td>
</tr>
<tr>
<td valign="middle" align="center">MRSA 1668</td>
<td valign="middle" align="center">5.56% &#xb1; 0.65%</td>
<td valign="middle" align="center">33.61% &#xb1; 1.61% ***</td>
<td valign="middle" align="center">6.87% &#xb1; 1.59% <sup>ns</sup>
</td>
</tr>
<tr>
<td valign="middle" align="center">
<italic>P. aeruginosa</italic> ATCC27853</td>
<td valign="middle" align="center">5.34% &#xb1; 0.20%</td>
<td valign="middle" align="center">29.68% &#xb1; 4.85% ***</td>
<td valign="middle" align="center">10.78% &#xb1; 0.55% *</td>
</tr>
<tr>
<td valign="middle" align="center">
<italic>P. aeruginosa</italic> 1554</td>
<td valign="middle" align="center">9.17% &#xb1; 0.32%</td>
<td valign="middle" align="center">15.31% &#xb1; 5.10% **</td>
<td valign="middle" align="center">5.28% &#xb1; 0.66% <sup>ns</sup>
</td>
</tr>
<tr>
<td valign="middle" align="center">
<italic>K. pneumoniae</italic> ATCC700603</td>
<td valign="middle" align="center">9.06% &#xb1; 0.72%</td>
<td valign="middle" align="center">36.51% &#xb1; 1.24% ***</td>
<td valign="middle" align="center">7.27% &#xb1; 2.04% <sup>ns</sup>
</td>
</tr>
<tr>
<td valign="middle" align="center">
<italic>K. pneumoniae</italic> ATCC1706</td>
<td valign="middle" align="center">7.28% &#xb1; 0.21%</td>
<td valign="middle" align="center">32.40% &#xb1; 4.66% ***</td>
<td valign="middle" align="center">5.33% &#xb1; 0.54% <sup>ns</sup>
</td>
</tr>
<tr>
<td valign="middle" align="center">
<italic>K. pneumoniae</italic> ATCC1705</td>
<td valign="middle" align="center">6.02% &#xb1; 0.86%</td>
<td valign="middle" align="center">37.98% &#xb1; 1.72% ***</td>
<td valign="middle" align="center">9.97% &#xb1; 1.83% <sup>ns</sup>
</td>
</tr>
<tr>
<td valign="middle" align="center">
<italic>K. pneumoniae</italic> 2118</td>
<td valign="middle" align="center">9.27% &#xb1; 1.01%</td>
<td valign="middle" align="center">34.55% &#xb1; 1.97% ***</td>
<td valign="middle" align="center">9.14% &#xb1; 0.91% <sup>ns</sup>
</td>
</tr>
<tr>
<td valign="middle" align="center">
<italic>A. baumannii</italic> 21-1</td>
<td valign="middle" align="center">8.64% &#xb1; 0.66%</td>
<td valign="middle" align="center">28.05% &#xb1; 5.45% ***</td>
<td valign="middle" align="center">4.47% &#xb1; 0.66% <sup>ns</sup>
</td>
</tr>
<tr>
<td valign="middle" align="center">
<italic>S.</italic> Typhimurium SL1344</td>
<td valign="middle" align="center">4.43% &#xb1; 0.57%</td>
<td valign="middle" align="center">21.92% &#xb1; 8.18% ***</td>
<td valign="middle" align="center">6.08% &#xb1; 1.51% <sup>ns</sup>
</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>
<sup>ns</sup>indicates no statistical significance; *<italic>P</italic> &lt; 0.05; ***<italic>P</italic> &lt; 0.001.</p>
</fn>
<fn id="fnT1_1">
<label>a</label>
<p>
<italic>E. coli</italic> ATCC25922 is the standard strain of <italic>E. coli</italic>; <italic>E. coli</italic>(<italic>mcr-1</italic>)12-2 is a clinical isolate of <italic>E. coli</italic> carrying polymyxin resistance gene (<italic>mcr</italic>-<italic>1</italic>); <italic>S. aureus</italic> ATCC29213 and <italic>S. aureus</italic> ATCC25923 are <italic>S. aureus</italic> standard strains; MRSA 1668 is a clinical isolate of methicillin-resistant <italic>S. aureus</italic>; <italic>P. aeruginosa</italic> ATCC27853 is the <italic>P. aeruginosa</italic> standard strain; <italic>P. aeruginosa</italic> 1554 is a clinically isolated drug-resistant strain of <italic>P. aeruginosa</italic>; <italic>K. pneumoniae</italic> ATCC700603, <italic>K. pneumoniae</italic> ATCC1706 and <italic>K. pneumoniae</italic> ATCC1705 are <italic>K. pneumoniae</italic> standard strains; <italic>K. pneumoniae</italic> 2118 is a clinically isolated drug-resistant strain of <italic>K. pneumoniae</italic>; <italic>A. baumannii</italic> 21-1 is a clinically isolated drug-resistant strain of <italic>A. baumannii</italic>; <italic>S.</italic> Typhimurium SL1344 is a <italic>S.</italic> Typhimurium carrying streptomycin resistance. <italic>S. boulardii</italic> and <italic>L. johnsonii</italic> are controls.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</sec>
<sec id="s3_2">
<label>3.2</label>
<title>Growth inhibition effect of BTS1-KO <italic>S. cerevisiae</italic> treatment on <italic>E. coli</italic> and <italic>S. aureus</italic>
</title>
<p>The growth curve analysis of <italic>E. coli</italic> and <italic>S. aureus</italic> treated with BTS1-KO <italic>S. cerevisiae</italic> CFS revealed significant inhibition compared to controls. H<sub>2</sub>O was used instead of YPD broth to examine the effect of nutritional differences on the experimental group. Differences in bacterial growth between the blank control (representing the minimum amount of additional nutrients) and the YPD broth control (representing the maximum amount of additional nutrients) were not significant, suggesting that the bacterial cultures were nutrient-rich and leading to the hypothesis that nutrient depletion did not contribute to the changes in growth. When treated with 90% and 50% CFS, the growth of <italic>E. coli</italic> ATCC25922 was significantly inhibited, with no significant change in bacterial absorbance within 24&#xa0;h (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1B</bold>
</xref>). Similarly, treatment with 25% CFS reduced the growth rate of <italic>E. coli</italic> (<italic>mcr</italic>-<italic>1</italic>) 12-2, with a lag period from 2 to 4&#xa0;h, and the total bacterial content at 24&#xa0;h reduced to approximately 85% of the control. Notably, 90% and 50% CFS effectively inhibited the growth of <italic>E. coli</italic> (<italic>mcr</italic>-<italic>1</italic>) 12-2 within 24&#xa0;h (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1C</bold>
</xref>). Treatment with 50% CFS significantly altered the growth curve of <italic>S. aureus</italic> ATCC29213, delaying the logarithmic growth phase until 10&#xa0;h, with the total bacterial content at 24&#xa0;h reduced to about 53% of the control (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1D</bold>
</xref>). Similarly, MRSA growth was significantly delayed, entering the logarithmic growth phase only after 16&#xa0;h of growth in the presence of 50% CFS, while hardly growing in the presence of 90% CFS throughout the growth phase (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1E</bold>
</xref>). These findings indicated that BTS1-KO <italic>S. cerevisiae</italic> CFS effectively inhibited the growth of both <italic>E. coli</italic> and <italic>S. aureus</italic>, with the inhibitory effect showing dose dependence.</p>
</sec>
<sec id="s3_3">
<label>3.3</label>
<title>The inhibitory effect of CFS of BTS1-KO <italic>S. cerevisiae</italic> on the biofilm formation</title>
<p>Biofilm formation confers strong resistance to pathogenic bacteria (<xref ref-type="bibr" rid="B37">Roy et&#xa0;al., 2018</xref>). The inhibitory effect of BTS1-KO <italic>S. cerevisiae</italic> CFS on <italic>E. coli</italic> and <italic>S. aureus</italic> biofilm formation was quantitatively assessed using the CV reduction assay. Results demonstrated that CFS effectively inhibited the biofilm formation of <italic>E. coli</italic> and <italic>S. aureus</italic> in a dose-dependent manner. Specifically, treatment with 25% CFS significantly inhibited biofilm formation. Under 90% CFS treatment, the inhibition rates of <italic>E. coli</italic> ATCC25922, <italic>E. coli</italic> (<italic>mcr</italic>-<italic>1</italic>) 12-2, <italic>S. aureus</italic> ATCC29213 and MRSA 1668 were 94.7%, 94.7%, 94.0%, and 93.7%, respectively(<xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2A</bold>
</xref>). Additionally, SEM images of biofilms revealed a significant reduction in bacterial density and more dispersed arrangements in CFS-treated groups compared to untreated groups, which showed a higher bacterial density and tight arrangement (<xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2B</bold>
</xref>). These findings underscored the ability of BTS1-KO <italic>S. cerevisiae</italic> CFS to effectively inhibit biofilm formation in both <italic>E. coli</italic> and <italic>S. aureus</italic>.</p>
<fig id="f2" position="float">
<label>Figure&#xa0;2</label>
<caption>
<p>Effect of cell-free supernatant (CFS) of BTS1-KO <italic>S. cerevisiae</italic> on the biofilm of pathogenic bacteria (<italic>E. coli</italic> ATCC25922. <italic>E</italic>. <italic>coli (mcr-1) 12-2</italic>, <italic>S. aureus</italic> ATCC29213, MRSA) in 96-well plates. Pathogenic bacteria treated with CFS were incubated in LB medium at 37&#xb0;C for 24&#xa0;h. After incubation, a crystal violet assay <bold>(A)</bold>, microscopy and SEM <bold>(B)</bold> were used to assess biofilm formation. The bars in B represent 5 &#x3bc;m. Results in A are presented as means &#xb1; SDs. ns indicates no statistical significance; *<italic>P</italic> &lt; 0.05; **<italic>P</italic> &lt; 0.01; ***<italic>P</italic> &lt; 0.001.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fcimb-15-1494149-g002.tif"/>
</fig>
</sec>
<sec id="s3_4">
<label>3.4</label>
<title>CFS reduces adhesion of <italic>E. coli</italic> and <italic>S. aureus</italic>
</title>
<p>Adhesion is the initial step in biofilm formation, facilitated by the secretion of extracellular polymer matrix, such as EPS produced by pathogens., which in turn can be used to resist antibiotics and other compounds (<xref ref-type="bibr" rid="B22">Louren&#xe7;o et&#xa0;al., 2012</xref>). The results showed that the adhesion abilities of <italic>E. coli</italic> and <italic>S. aureus</italic> were reduced by 53.24% and 63.56%, respectively, in the 50% CFS-treated group compared to the CFS-untreated group (<xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3A</bold>
</xref>). Moreover, EPS production by <italic>E. coli</italic> and <italic>S. aureus</italic> decreased by 20.18% and 15.69%, respectively, after CFS treatment (<xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3B</bold>
</xref>), indicating a reduction in adhesion ability and consequently in biofilm formation. Additionally, surface hydrophobicity, indirectly reflecting adhesion ability (<xref ref-type="bibr" rid="B45">Yang et&#xa0;al., 2022</xref>), was reduced by 18.09% in CFS-treated <italic>E. coli</italic>, although no significant effect was observed in <italic>S. aureus</italic> (<xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3C</bold>
</xref>).</p>
<fig id="f3" position="float">
<label>Figure&#xa0;3</label>
<caption>
<p>Effects of cell-free supernatant (CFS) of BTS1-KO S. cerevisiae on adhesion ability, EPS production and hydrophobicity of <italic>E. coli</italic> ATCC25922 and <italic>S. aureus</italic> ATCC29213. <bold>(A)</bold> CFS reduced the adhesion of <italic>E. coli</italic> and <italic>S. aureus</italic>; <bold>(B)</bold> CFS reduced EPS production of <italic>E. coli</italic> and <italic>S. aureus</italic>; <bold>(C)</bold> CFS reduced hydrophobicity of <italic>E. coli</italic> and <italic>S. aureus</italic>. Results are presented as means &#xb1; SDs. ns indicates no statistical significance; **<italic>P</italic> &lt; 0.01; ***<italic>P</italic> &lt; 0.001.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fcimb-15-1494149-g003.tif"/>
</fig>
</sec>
<sec id="s3_5">
<label>3.5</label>
<title>BTS1-KO <italic>S. cerevisiae</italic> can directly inhibit the growth of <italic>E. coli</italic> and <italic>S. aureus</italic>
</title>
<p>Using the bacteria-<italic>S. cerevisiae</italic> co-culture model, we verified the ability of live BTS1-KO <italic>S. cerevisiae</italic> to inhibit the growth of pathogenic bacteria. Results indicated a significant reduction in <italic>E. coli</italic> cell numbers after co-culture with live BTS1-KO <italic>S. cerevisiae</italic> compared to YPD medium and H<sub>2</sub>O controls. At 16 and 24&#xa0;h, <italic>E. coli</italic> growth inhibition rates were 91.20% (1.1&#xd7;10<sup>15</sup> CFU/mL) and 91.43% (1.2&#xd7;10<sup>15</sup> CFU/mL), respectively (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4A</bold>
</xref>). Moreover, a significantly lower cell number of the <italic>S. aureus</italic> co-culture group was determined compared to the single culture groups, and inhibition rates of 80.43% (1.5&#xd7;10<sup>15</sup> CFU/mL) and 85.16% (1.58&#xd7;10<sup>15</sup> CFU/mL) were reported at 16&#xa0;h and 24&#xa0;h, respectively (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4B</bold>
</xref>). Additionally, YPD broth was replaced with sterile water as a blank control group. The indicator bacteria culture was revealed to be nutrient-rich, with nutrient depletion not contributing to growth changes. These results confirmed the inhibitory effect of BTS1-KO <italic>S. cerevisiae</italic> cells on the growth of both <italic>E. coli</italic> and <italic>S. aureus</italic>.</p>
<fig id="f4" position="float">
<label>Figure&#xa0;4</label>
<caption>
<p>Co-culture of BTS1-KO <italic>S. cerevisiae</italic> and pathogenic bacteria. <bold>(A)</bold> Survival number of <italic>E</italic>. <italic>coli</italic> cultured alone or co-cultured with BTS1-KO <italic>S. cerevisiae</italic>; <bold>(B)</bold> Survival number of <italic>S. aureus</italic> cultured alone or co-cultured with BTS1-KO <italic>S. cerevisiae</italic>. Results are presented as means &#xb1; SDs. ns indicates no statistical significance; ***<italic>P</italic> &lt; 0.001.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fcimb-15-1494149-g004.tif"/>
</fig>
</sec>
<sec id="s3_6">
<label>3.6</label>
<title>BTS1-KO <italic>S. cerevisiae</italic> had good probiotic properties</title>
<sec id="s3_6_1">
<label>3.6.1</label>
<title>BTS1-KO <italic>S. cerevisiae</italic> possessed no haemolytic activity</title>
<p>To evaluate the cytotoxicity of BTS1-KO <italic>S. cerevisiae</italic>, we assessed its haemolytic activity against erythrocytes. Unlike the &#x3b2;-haemolytic activity observed with the reference strain <italic>S. aureus</italic> ATCC25923 (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5</bold>
</xref>), BTS1-KO <italic>S. cerevisiae</italic> did not induce haemolysis when grown on sheep blood agar. Consequently, BTS1-KO <italic>S. cerevisiae</italic> was considered safe for human application.</p>
<fig id="f5" position="float">
<label>Figure&#xa0;5</label>
<caption>
<p>BTS1-KO <italic>S. cerevisiae</italic> possessed no hemolytic activity. To assess the safety of BTS1-KO <italic>S. cerevisiae</italic>, hemolytic activity was tested on sheep blood agar, with <italic>S. aureus</italic> ATCC25923 as a control. <italic>S. aureus</italic> ATCC25923 displayed a clear hemolytic ring (&#x3b2;-hemolysis) (right), while BTS1-KO <italic>S. cerevisiae</italic> showed no hemolytic activity (left).</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fcimb-15-1494149-g005.tif"/>
</fig>
</sec>
<sec id="s3_6_2">
<label>3.6.2</label>
<title>Tolerance analysis of artificially simulated gastric and intestinal fluid</title>
<p>To colonise the gastrointestinal tract and play a beneficial role, probiotics must possess a certain tolerance to the digestive tract environment. Therefore, we detected the tolerance of BTS1-KO <italic>S. cerevisiae</italic> to artificially simulated gastric and intestinal fluids. After incubation in simulated gastric fluid with pH 3.0 for 1&#xa0;h, the survival rate of BTS1-KO <italic>S. cerevisiae</italic> was as high as 87%. After 3&#xa0;h of incubation, the survival rate remained higher than 80% (<xref ref-type="fig" rid="f6">
<bold>Figure&#xa0;6A</bold>
</xref>). Additionally, in the artificial intestinal fluid, survival rates were 89.93% and 83.87% after 2&#xa0;h and 4&#xa0;h of incubation, respectively (<xref ref-type="fig" rid="f6">
<bold>Figure&#xa0;6B</bold>
</xref>). These findings demonstrated the robust tolerance of BTS1-KO <italic>S. cerevisiae</italic> to gastrointestinal fluids.</p>
<fig id="f6" position="float">
<label>Figure&#xa0;6</label>
<caption>
<p>Evaluation of Probiotic Properties. <bold>(A)</bold> Tolerance to simulated gastric fluid. The survival rate of BTS1-KO <italic>S. cerevisiae</italic> after incubation in simulated gastric fluid with pH 3.0 for 1 h and 3 h; <bold>(B)</bold> Tolerance to 0.3% bile salts. The survival rate of BTS1-KO <italic>S. cerevisiae</italic> after 2 h and 4 h incubation in artificial intestinal fluid containing 0.3% bile salt; <bold>(C)</bold> The auto-aggregation ability of BTS1-KO <italic>S. cerevisiae</italic> and <italic>S. cerevisiae</italic> BY4743, with the auto-aggregation ability of BTS1-KO <italic>S. cerevisiae</italic> showing a significant increase; <bold>(D)</bold> The co-aggregation ability of BTS1-KO <italic>S. cerevisiae</italic> and <italic>S. cerevisiae</italic> BY4743 with pathogenic bacteria, with BTS1-KO S. cerevisiae showing a significantly increased co-aggregation ability. Results are shown as means &#xb1; SDs. *<italic>P</italic> &lt; 0.05; **<italic>P</italic> &lt; 0.01; ***<italic>P</italic> &lt; 0.001.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fcimb-15-1494149-g006.tif"/>
</fig>
</sec>
<sec id="s3_6_3">
<label>3.6.3</label>
<title>The auto aggregation and co-aggregation abilities with pathogenic bacteria and BTS1-KO <italic>S. cerevisiae</italic>
</title>
<p>Auto aggregation and co-aggregation abilities are indicative of the potential for colonisation in the human intestinal tract (<xref ref-type="bibr" rid="B42">Vlkov&#xe1; et&#xa0;al., 2008</xref>). Compared to <italic>S. cerevisiae</italic> BY4743, BTS1-KO <italic>S. cerevisiae</italic> exhibited improved auto aggregation, increasing from 27.75% to 38.58% (<xref ref-type="fig" rid="f6">
<bold>Figure&#xa0;6C</bold>
</xref>). Moreover, compared with <italic>E. coli</italic> and <italic>S. aureus</italic>, the co-aggregation ability of BTS1-KO <italic>S. cerevisiae</italic> increased by 21.69% and 9.65%, respectively (<xref ref-type="fig" rid="f6">
<bold>Figure&#xa0;6D</bold>
</xref>), indicating its capacity for close contact with <italic>E. coli</italic> and <italic>S. aureus</italic> and exert enhanced antibacterial effects.</p>
</sec>
</sec>
<sec id="s3_7">
<label>3.7</label>
<title>Antibacterial effect of BTS1-KO <italic>S. cerevisiae in vivo</italic>
</title>
<p>The <italic>G. mellonella</italic> larvae model, resembling mammalian systems, was employed to evaluate the <italic>in vivo</italic> antibacterial activity of BTS1-KO <italic>S. cerevisiae</italic> (<xref ref-type="bibr" rid="B24">M&#xe9;nard et&#xa0;al., 2021</xref>). Compared with the PBS control group, a single injection of live <italic>S. cerevisiae</italic>, heat-inactivated <italic>S. cerevisiae</italic> and CFS had no significant effect on the survival of healthy larvae (<xref ref-type="fig" rid="f7">
<bold>Figure&#xa0;7A</bold>
</xref>). According to the survival curve, the survival time of larvae infected with <italic>E. coli</italic> or <italic>S. aureus</italic> in the CFS or live cells treated groups was greater than the control group. In the <italic>E. coli</italic>-infected larvae model, larvae in the CFS-treated group survived longer than those in the control group, with a survival rate of 60% (<xref ref-type="fig" rid="f7">
<bold>Figure&#xa0;7B</bold>
</xref>). The survival time of the infected <italic>S. aureus</italic> larvae treated with CFS was also greater than the control groups, with a survival rate of 50% (<xref ref-type="fig" rid="f7">
<bold>Figure&#xa0;7C</bold>
</xref>). Additionally, live BTS1-KO <italic>S. cerevisiae</italic> prolonged the survival time of <italic>E. coli</italic>-infected <italic>G. mellonella</italic>, with a survival rate of 60% observed on the first day (<xref ref-type="fig" rid="f7">
<bold>Figure&#xa0;7B</bold>
</xref>). Live BTS1-KO <italic>S. cerevisiae</italic> also prolonged the survival time of <italic>S. aureus</italic>-infected <italic>G. mellonella</italic>, which was infected for 4 days before all died (<xref ref-type="fig" rid="f7">
<bold>Figure&#xa0;7C</bold>
</xref>). However, heat-inactivated BTS1-KO <italic>S. cerevisiae</italic> showed no therapeutic effect on <italic>G. mellonella</italic>, suggesting that live BTS1-KO <italic>S. cerevisiae</italic> is required for effective protection <italic>in vivo</italic> (<xref ref-type="fig" rid="f7">
<bold>Figures&#xa0;7B, C</bold>
</xref>). These results underscored the potential of BTS1-KO <italic>S. cerevisiae</italic> as a therapeutic agent against pathogenic bacterial infections <italic>in vivo</italic>.</p>
<fig id="f7" position="float">
<label>Figure&#xa0;7</label>
<caption>
<p>The effect of BTS1-KO <italic>S. cerevisiae</italic> on the <italic>G</italic>. <italic>mellonella</italic>- pathogenic bacteria infection model. <bold>(A)</bold> Healthy larvae were incubated with CFS, alive BTS1-KO <italic>S. cerevisiae</italic>, heat-inactivated BTS1-KO <italic>S. cerevisiae</italic> and PBS for 5 days, respectively. PBS was the blank control; <bold>(B)</bold> <italic>E</italic>. <italic>coli</italic>-infected larvae were treated with PBS (control), CFS, live BTS1-KO <italic>S. cerevisiae</italic> or heat-inactivated BTS1-KO <italic>S. cerevisiae</italic>. Larvae were monitored daily, and survival rates were calculated; <bold>(C)</bold> <italic>S. aureus</italic>-infected larvae were treated with PBS (control), CFS, live BTS1-KO <italic>S. cerevisiae</italic> or heat-inactivated BTS1-KO <italic>S. cerevisiae</italic>. Larvae were monitored daily, and survival rates were calculated.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fcimb-15-1494149-g007.tif"/>
</fig>
</sec>
<sec id="s3_8">
<label>3.8</label>
<title>Antibacterial effect of farnesene</title>
<p>
<italic>BTS1</italic> encodes geranylgeranyl diphosphate synthase (GGPPS) gene, an enzyme involved in terpenoid biosynthesis (<xref ref-type="bibr" rid="B18">Jiang et&#xa0;al., 1995</xref>). Experiments have confirmed that the content of farnesene increased after <italic>BTS1</italic> was knocked out (<xref ref-type="bibr" rid="B43">Wang et&#xa0;al., 2022</xref>). In this study, the antibacterial activity of farnesene was assessed, revealing that farnesene exerted no antibacterial activity, which indicated that increased farnesene levels were not responsible for the observed antibacterial effects of BTS1-KO <italic>S. cerevisiae</italic> (<xref ref-type="fig" rid="f8">
<bold>Figure&#xa0;8A</bold>
</xref>).</p>
<fig id="f8" position="float">
<label>Figure&#xa0;8</label>
<caption>
<p>Metabolites produced by BTS1-KO <italic>S. cerevisiae</italic>. <bold>(A)</bold> Determination of the antibacterial effect of farnesene; <bold>(B)</bold> The pH value of CFS of BTS1-KO <italic>S. cerevisiae</italic>, CFS of <italic>S. cerevisiae</italic> BY4743 and YPD medium; <bold>(C)</bold> When the pH of CFS was adjusted to 6.5, its antibacterial activity disappeared; <bold>(D)</bold> The type and content of organic acids in the CFS of BTS1-KO <italic>S. cerevisiae</italic>, CFS of <italic>S. cerevisiae</italic> BY4743 and YPD medium. Results are presented as means &#xb1; SDs. ns indicates no statistical significance; ***<italic>P</italic> &lt; 0.001.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fcimb-15-1494149-g008.tif"/>
</fig>
</sec>
<sec id="s3_9">
<label>3.9</label>
<title>Analysis of organic acids produced by BTS1-KO <italic>S. cerevisiae</italic>
</title>
<p>
<italic>S. boulardii</italic> produces organic acids such as lactic acid, acetic acid and formic acid to exert its antibacterial activity (<xref ref-type="bibr" rid="B31">Pais et&#xa0;al., 2020</xref>). Therefore, we determined the pH of the CFS of BTS1-KO <italic>S. cerevisiae</italic> and CFS of BY4743, which were 3.75 and 5.12, respectively (<xref ref-type="fig" rid="f8">
<bold>Figure&#xa0;8B</bold>
</xref>). Then, 2 mol/L NaOH solution was used to adjust the pH of CFS to 6.5, which resulted in the loss of the antibacterial activity of CFS (<xref ref-type="fig" rid="f8">
<bold>Figure&#xa0;8C</bold>
</xref>). UPLC-MS/MS analysis revealed a significantly higher content of lactic acid in BTS1-KO <italic>S. cerevisiae</italic> CFS (35-fold increase) compared to <italic>S. cerevisiae</italic> BY4743, while the content of acetic acid, propionic acid, isobutyric acid and isovaleric acid were not significant, suggesting lactic acid production as a major contributor to its antimicrobial activity (<xref ref-type="fig" rid="f8">
<bold>Figure&#xa0;8D</bold>
</xref>). Thus, increased lactic acid production and the consequent decrease in pH likely contribute to the antimicrobial effects of BTS1-KO <italic>S. cerevisiae</italic>.</p>
</sec>
</sec>
<sec id="s4" sec-type="discussion">
<label>4</label>
<title>Discussion</title>
<p>Human health is significantly impacted by various pathogenic bacteria, with some high-incidence pathogens like <italic>S. aureus</italic>, <italic>E. coli</italic> and <italic>K. pneumoniae</italic> posing substantial threats (<xref ref-type="bibr" rid="B41">Toone, 2011</xref>). For example, in 2019, bacterial infections led to 7.7 million deaths, with 1.1 million deaths associated with <italic>S. aureus</italic>, 950,000 with <italic>E. coli</italic> and 790,000 with <italic>K. pneumoniae</italic> (<xref ref-type="bibr" rid="B21">Lancet, 2022</xref>). Currently, clinical bacterial infections are often caused by multiple bacteria, and the misuse of antibiotics has further exacerbated the problem by promoting the emergence of drug-resistant bacteria and superbugs. Additionally, biofilm formation increases their drug resistance and pathogenicity, underscoring the need to search for new antimicrobial strategies (<xref ref-type="bibr" rid="B12">Ferri et&#xa0;al., 2017</xref>).</p>
<p>Probiotics have been recognised as an effective anti-infection strategy. In this study, the BTS1-KO <italic>S. cerevisiae</italic> strain effectively exerted antibacterial effects against most clinically isolated bacterial pathogens, comparable to the well-known probiotics <italic>S. boulardii</italic> and <italic>L. johnsonii</italic>. Importantly, it exhibited efficacy against multidrug-resistant strains and showed no toxicity to <italic>G. mellonella</italic>. Haemolysis experiment also revealed that BTS1-KO <italic>S. cerevisiae</italic> had no haemolytic activity, indicating that it was non-pathogenic to human and had high safety. Furthermore, to confirm the therapeutic efficacy of BTS1-KO <italic>S. cerevisiae in vivo</italic>, we utilised the <italic>G. mellonella</italic> infection model. The model is widely used to assess the virulence of a wide range of pathogenic bacteria, including <italic>E. coli</italic> and <italic>S. aureus</italic>, and antibacterial drug efficiency (<xref ref-type="bibr" rid="B25">Mikulak et&#xa0;al., 2018</xref>). The results revealed that BTS1-KO <italic>S. cerevisiae</italic> prolonged the survival time of the larvae infected with <italic>E. coli</italic> and <italic>S. aureus</italic>.</p>
<p>The inhibitory effect observed in co-culture experiments was attributed to the high auto aggregation and high co-aggregation abilities of BTS1-KO <italic>S. cerevisiae</italic> with pathogenic bacteria. The high auto aggregation ability of BTS1-KO <italic>S. cerevisiae</italic> enhanced its adhesion ability, prompted its close contact with intestinal mucosa <italic>in vivo</italic>, prolonged its residence time in the intestines and enabled effective exertion of its antibacterial activity (<xref ref-type="bibr" rid="B36">Rodr&#xed;guez Arreola et&#xa0;al., 2021</xref>). Moreover, the high co-aggregation ability of BTS1-KO <italic>S. cerevisiae</italic> with <italic>E. coli</italic> and <italic>S. aureus</italic> forms a barrier, preventing colonisation and enabling the release of anti-pathogen substances (<xref ref-type="bibr" rid="B28">Oca&#xf1;a and Nader-Mac&#xed;as, 2002</xref>). For example, <italic>Lactobacillus rhamnosus</italic> has been reported to possess good adhesion properties, as evidenced by its prevention of the internalisation of enterohaemorrhagic <italic>E. coli</italic> in human enterocyte cell lines (<xref ref-type="bibr" rid="B14">Huang et&#xa0;al., 2023</xref>). These findings suggest that BTS1-KO <italic>S. cerevisiae</italic> competes with other bacteria for the binding sites <italic>in vivo</italic>, thereby inhibiting bacterial colonisation and proliferation and reducing their pathogenicity.</p>
<p>When ingesting probiotics orally, they have to withstand the effects of stomach acid and bile salts before reaching the interior of the intestines and adhering to the epithelial cells. After arriving at the intestines, probiotics inhibit the proliferation of pathogenic bacteria and form an antimicrobial biological barrier (<xref ref-type="bibr" rid="B17">Jiang et&#xa0;al., 2023</xref>). Moreover, the survival of BTS1-KO <italic>S. cerevisiae in vitro</italic> under simulated gastrointestinal conditions was assessed to predict its actual survival <italic>in vivo</italic> when consumed in a non-protected way (<xref ref-type="bibr" rid="B8">Elshaghabee et&#xa0;al., 2017</xref>). Our <italic>in vitro</italic> studies revealed a high tolerance of BTS1-KO <italic>S. cerevisiae</italic> to gastric juice acidity and bile salts. Moreover, probiotics are mainly consumed in the presence of milk proteins in clinical settings owing to their protective effect on probiotics, and these milk proteins support the survival of probiotics in the acidic environment of the stomach. Even though BTS1-KO <italic>S. cerevisiae</italic> showed decreased viability at low pH <italic>in vitro</italic>, they exhibited substantial viability when consumed as adjuncts in a matrix of fermented milk (<xref ref-type="bibr" rid="B49">Zhang et&#xa0;al., 2011</xref>). These findings underscore the clinical potential of BRS1-KO <italic>S. cerevisiae</italic> as a probiotic.</p>
<p>Conventional antibiotics primarily target pathogenic bacteria by interfering with their cell wall (penicillins and cephalosporins), cell membranes (polymyxins), protein synthesis (tetracyclines and chloramphenicol), nucleic acid replication and transcription (rifampin) (<xref ref-type="bibr" rid="B1">Abushaheen et&#xa0;al., 2020</xref>). Biofilm is an important virulence factor for bacteria, greatly increasing their virulence and drug resistance (<xref ref-type="bibr" rid="B35">Rabin et&#xa0;al., 2015</xref>). Hence, inhibiting bacterial biofilm formation is a promising therapeutic strategy. This study demonstrated that BTS1-KO <italic>S. cerevisiae</italic> inhibited <italic>E. coli and S. aureus</italic> biofilm formation <italic>in vitro</italic> at concentrations lower than MIC, along with exerting a curative effect on the infected larvae of <italic>G. mellonella in vivo</italic>.</p>
<p>The formation of biofilm is a complex process involving bacterial attachment, colony formation, maturation and diffusion (<xref ref-type="bibr" rid="B46">Yang et&#xa0;al., 2012</xref>). Among these stages, adhesion to the carrier surface is the most critical step (<xref ref-type="bibr" rid="B4">Berry et&#xa0;al., 2022</xref>). Studies report that biofilms are composed of cellular biomass (10%) and EPS (90%), which facilitate bacterial adhesion and aggregation to the carrier surface (<xref ref-type="bibr" rid="B6">Carniello et&#xa0;al., 2018</xref>). The dense structure of EPS constitutes a physiological barrier to the penetration of antimicrobial drugs, which, coupled with the fact that antimicrobial drugs are often trapped and retained by EPS, greatly weakens the bactericidal effect on the biofilm. Therefore, targeting EPS presents an effective strategy for inhibiting biofilm formation (<xref ref-type="bibr" rid="B16">Jayathilake et&#xa0;al., 2017</xref>). For instance, the antimicrobial peptide S4 (1-16) M4Ka exerts anti-biofilm activity against <italic>P. aeruginosa</italic> by disintegrating membrane lipids, dispersing bacteria and inhibiting biofilm formation (<xref ref-type="bibr" rid="B34">Quil&#xe8;s et&#xa0;al., 2016</xref>). Additionally, bacterial hydrophobicity could help bacteria resist external harmful substances and promote bacterial adherence to the carrier surface (<xref ref-type="bibr" rid="B5">Cannon et&#xa0;al., 2017</xref>; <xref ref-type="bibr" rid="B38">Simon et&#xa0;al., 2021</xref>). In this study, we found that BTS1-KO <italic>S. cerevisiae</italic> greatly weakened the adhesion ability and EPS production of <italic>E. coli</italic> and <italic>S. aureus.</italic> BTS1-KO <italic>S. cerevisiae</italic> also significantly reduced the hydrophobicity of the cell surface of <italic>E. coli</italic>, but not that of <italic>S. aureus</italic>, which could be attributed to differences in their cell wall composition. The gram-negative cell wall is mainly composed of lipopolysaccharides, with significantly enhanced hydrophobicity. These findings suggest that BTS1-KO <italic>S. cerevisiae</italic> inhibits biofilm formation by reducing adhesion capacity, EPS production and bacterial hydrophobicity, thereby attenuating their virulence.</p>
<p>In previous studies, individual differences in probiotic yeast were evident, which resulted in differences in bacterial inhibitory abilities between strains of the same genus. The antimicrobial ability of yeast might be related to the production of extracellular proteases, toxin proteins, organic acids (lactic, acetic and butyric acid), sulphur dioxide and antimicrobials (<xref ref-type="bibr" rid="B10">Fakruddin et&#xa0;al., 2017</xref>; <xref ref-type="bibr" rid="B2">Afroz et&#xa0;al., 2021</xref>). For example, lysosomes isolated from <italic>S. cerevisiae</italic> treated with H<sub>2</sub>O<sub>2</sub> can also be used as antimicrobial agents with effective antimicrobial activity against <italic>E. coli</italic>, <italic>Xanthomonas oryzae</italic>, <italic>Shigella flexnery</italic>, <italic>Streptomyces albus</italic> and <italic>Deinococcus radiophilus</italic> (<xref ref-type="bibr" rid="B47">Yoon et&#xa0;al., 2009</xref>). Furthermore, <italic>S. boulardii</italic> inhibits the growth of <italic>Candida albicans</italic> through the production of caprylic acid (<xref ref-type="bibr" rid="B26">Murzyn et&#xa0;al., 2010</xref>). When heat-inactivated cells were used in place of live BTS1-KO <italic>S. cerevisiae</italic> in <italic>G. mellonella</italic> infection model, the survival of treated <italic>G. mellonella</italic> was similar to that of the control group, indicating that metabolically active BTS1-KO <italic>S. cerevisiae</italic> was required for effective protection.</p>
<p>The enzyme encoded by <italic>BTS1</italic> gene plays a key role in terpenoid biosynthesis in <italic>S. cerevisiae</italic>, catalysing the synthesis of geranyl geranyl pyrophosphate (GGPP) from substrates, which is a precursor of many terpenes, such as carotenoids (<xref ref-type="bibr" rid="B18">Jiang et&#xa0;al., 1995</xref>). Farnesene belongs to terpenoids, and its synthetic precursor is farnesyl pyrophosphate (FPP). The synthesis of GGPP catalysed by BTS1 and FPP share some upstream metabolic intermediates and enzymatic reactions, so the activity and expression level of BTS1 will indirectly affect the content of FPP in cells, and then affect the synthesis of farnesene. A prior study reported that the deletion of BTSI can change the metabolic flux of GGPP and FPP in cells, and make more precursors flow to the synthetic pathway of farnesene, thus increasing the yield of farnesene (<xref ref-type="bibr" rid="B43">Wang et&#xa0;al., 2022</xref>). Certain terpenoids have been reported to possess antibacterial activity; however, in this study, we found that farnesene exerted no antibacterial effect. Organic acid production is a common mechanism underlying probiotic antibacterial activity, with acids acidifying the growth environment to inhibit bacterial pathogen&#x2019;s proliferation (<xref ref-type="bibr" rid="B9">Evivie et&#xa0;al., 2019</xref>). For instance, the undissociated form of lactic acid permeabilises gram-negative bacteria&#x2019;s outer membranes, leading to intracellular acidification and bacteriostatic activity (<xref ref-type="bibr" rid="B3">Asmat et&#xa0;al., 2018</xref>). In our study, we found that the pH of BTS1-KO <italic>S. cerevisiae</italic> CFS was reduced compared to the parent strain. The antimicrobial activity disappeared when the pH of BTS1-KO <italic>S. cerevisiae</italic> CFS was adjusted to 6.5. Furthermore, UPLC-MS/MS analysis revealed that BTS1-KO <italic>S. cerevisiae</italic> produced high contents of lactic acid, up to 1130.55 ug/mL. These indicated that BTS1-KO <italic>S. cerevisiae</italic> inhibits the growth and virulence of pathogenic bacteria by increasing the production of lactic acid or that the antimicrobial active substances produced by BTS1-KO <italic>S. cerevisiae</italic> could only exert antibacterial effect in an acidic environment. It is reported that lactic acid bacteria are one of the most important probiotics. They mainly produce antibacterial effects by fermenting carbohydrates and producing a large amount of lactic acid. The concentration of lactic acid in the supernatant produced by lactic acid bacteria fermentation is between 2.41 and 7.12 g/L. Although the content of lactic acid in the supernatant of BTS1-KO <italic>S. cerevisiae</italic> is lower than that of lactic acid bacteria, the results of the antibacterial spectrum experiment showed that the antibacterial effect of BTS1-KO <italic>S. cerevisiae</italic> is equivalent to that of lactic acid bacteria (<xref ref-type="bibr" rid="B13">Greifov&#xe1; et&#xa0;al., 2017</xref>; <xref ref-type="bibr" rid="B33">Qadi et&#xa0;al., 2023</xref>). In addition, the application of BTS1-KO <italic>S. cerevisiae</italic> during antibiotic treatment has certain advantages over bacterial probiotics because due to its natural characteristics as a fungus, it has inherent resistance to antibiotics and cannot promote the spread of antibiotic resistance. Studies have shown that lactic acid, a metabolic by-product of host and intestinal microbiota, is generally considered a safe and stable compound (<xref ref-type="bibr" rid="B27">Nilsson et&#xa0;al., 1999</xref>). Therefore, it can be considered that BTS1-KO <italic>S. cerevisiae</italic> can stably exert antibacterial effect. Further analysis of required to elucidate whether BTS1-KO <italic>S. cerevisiae</italic> can produce additional active metabolites to inhibit pathogens.</p>
</sec>
<sec id="s5" sec-type="conclusions">
<label>5</label>
<title>Conclusion</title>
<p>BTS1-KO <italic>S. cerevisiae</italic> demonstrated potent antibacterial activity against different pathogens without cytotoxic effects both <italic>in vitro</italic> and <italic>in vivo</italic>. It achieves this by inhibiting biofilm formation through reductions in adhesion and EPS production. Moreover, BTS1-KO <italic>S. cerevisiae</italic> exhibits therapeutic efficacy in infected <italic>G. mellonella larvae in vivo</italic>. Mechanistic investigations reveal that increased lactic acid production plays a significant role in its antibacterial activity. These findings highlight the potential of BTS1-KO <italic>S. cerevisiae</italic> as a probiotic and offer a promising approach for managing bacterial infections.</p>
</sec>
</body>
<back>
<sec id="s6" sec-type="data-availability">
<title>Data availability statement</title>
<p>The datasets presented in this study can be found in online repositories. The names of the repository/repositories and accession number(s) can be found in the article/supplementary material.</p>
</sec>
<sec id="s7" sec-type="ethics-statement">
<title>Ethics statement</title>
<p>The manuscript presents research on animals that do not require ethical approval for their study.</p>
</sec>
<sec id="s8" sec-type="author-contributions">
<title>Author contributions</title>
<p>LC: Conceptualization, Methodology, Software, Validation, Visualization, Writing &#x2013; original draft, Writing &#x2013; review &amp; editing. YZho: Data curation, Investigation, Writing &#x2013; review &amp; editing. YZha: Data curation, Investigation, Software, Writing &#x2013; review &amp; editing. SM: Data curation, Validation, Writing &#x2013; review &amp; editing. CC: Formal analysis, Validation, Writing &#x2013; review &amp; editing. LW: Data curation, Visualization, Writing &#x2013; review &amp; editing. XL: Formal analysis, Writing &#x2013; review &amp; editing. ZZha: Investigation, Software, Writing &#x2013; review &amp; editing. ZZhu: Conceptualization, Funding acquisition, Project administration, Resources, Supervision, Writing&#xa0;&#x2013; review &amp; editing. YL: Conceptualization, Funding acquisition, Methodology, Project administration, Resources, Supervision, Writing &#x2013; review &amp; editing.</p>
</sec>
<sec id="s9" sec-type="funding-information">
<title>Funding</title>
<p>The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by fundings from Xuzhou basic research project (KC23009), Xuzhou medical and health general program (KC23248), Xuzhou key research and development plan (KC22096).</p>
</sec>
<ack>
<title>Acknowledgments</title>
<p>Thanks to the teachers and students of the Public Experimental Research Center and Medical Technology College of Xuzhou Medical University for their help and support.</p>
</ack>
<sec id="s10" sec-type="COI-statement">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec id="s11" sec-type="disclaimer">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<ref-list>
<title>References</title>
<ref id="B1">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Abushaheen</surname> <given-names>M. A.</given-names>
</name>
<name>
<surname>Fatani</surname> <given-names>A. J.</given-names>
</name>
<name>
<surname>Alosaimi</surname> <given-names>M.</given-names>
</name>
<name>
<surname>Mansy</surname> <given-names>W.</given-names>
</name>
<name>
<surname>George</surname> <given-names>M.</given-names>
</name>
<name>
<surname>Acharya</surname> <given-names>S.</given-names>
</name>
<etal/>
</person-group>. (<year>2020</year>). <article-title>Antimicrobial resistance, mechanisms and its clinical significance</article-title>. <source>Dis. Mon</source> <volume>66</volume>, <elocation-id>100971</elocation-id>. doi:&#xa0;<pub-id pub-id-type="doi">10.1016/j.disamonth.2020.100971</pub-id>
</citation>
</ref>
<ref id="B2">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Afroz</surname> <given-names>M. M.</given-names>
</name>
<name>
<surname>Kashem</surname> <given-names>M. N. H.</given-names>
</name>
<name>
<surname>Piash</surname> <given-names>K.</given-names>
</name>
<name>
<surname>Islam</surname> <given-names>N.</given-names>
</name>
</person-group> (<year>2021</year>). <article-title>
<italic>Saccharomyces cerevisiae</italic> as an untapped source of fungal chitosan for antimicrobial action</article-title>. <source>Appl. Biochem. Biotechnol.</source> <volume>193</volume>, <fpage>3765</fpage>&#x2013;<lpage>3786</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1007/s12010-021-03639-0</pub-id>
</citation>
</ref>
<ref id="B3">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Asmat</surname> <given-names>S.</given-names>
</name>
<name>
<surname>Shaukat</surname> <given-names>F.</given-names>
</name>
<name>
<surname>Asmat</surname> <given-names>R.</given-names>
</name>
<name>
<surname>Bakhat</surname> <given-names>H.</given-names>
</name>
<name>
<surname>Asmat</surname> <given-names>T. M.</given-names>
</name>
</person-group> (<year>2018</year>). <article-title>Clinical efficacy comparison of <italic>saccharomyces boulardii</italic> and lactic acid as probiotics in acute pediatric diarrhea</article-title>. <source>J. Coll. Physicians Surg. Pak</source> <volume>28</volume>, <fpage>214</fpage>&#x2013;<lpage>217</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.29271/jcpsp.2018.03.214</pub-id>
</citation>
</ref>
<ref id="B4">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Berry</surname> <given-names>K. A.</given-names>
</name>
<name>
<surname>Verhoef</surname> <given-names>M. T. A.</given-names>
</name>
<name>
<surname>Leonard</surname> <given-names>A. C.</given-names>
</name>
<name>
<surname>Cox</surname> <given-names>G.</given-names>
</name>
</person-group> (<year>2022</year>). <article-title>
<italic>Staphylococcus aureus</italic> adhesion to the host</article-title>. <source>Ann. N Y Acad. Sci.</source> <volume>1515</volume>, <fpage>75</fpage>&#x2013;<lpage>96</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1111/nyas.14807</pub-id>
</citation>
</ref>
<ref id="B5">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Cannon</surname> <given-names>R. D.</given-names>
</name>
<name>
<surname>Lyons</surname> <given-names>K. M.</given-names>
</name>
<name>
<surname>Chong</surname> <given-names>K.</given-names>
</name>
<name>
<surname>Newsham-West</surname> <given-names>K.</given-names>
</name>
<name>
<surname>Niimi</surname> <given-names>K.</given-names>
</name>
<name>
<surname>Holmes</surname> <given-names>A. R.</given-names>
</name>
</person-group> (<year>2017</year>). <article-title>Adhesion of yeast and bacteria to oral surfaces</article-title>. <source>Methods Mol. Biol.</source> <volume>1537</volume>, <fpage>165</fpage>&#x2013;<lpage>190</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1007/978-1-4939-6685-1_10</pub-id>
</citation>
</ref>
<ref id="B6">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Carniello</surname> <given-names>V.</given-names>
</name>
<name>
<surname>Peterson</surname> <given-names>B. W.</given-names>
</name>
<name>
<surname>van der Mei</surname> <given-names>H. C.</given-names>
</name>
<name>
<surname>Busscher</surname> <given-names>H. J.</given-names>
</name>
</person-group> (<year>2018</year>). <article-title>Physico-chemistry from initial bacterial adhesion to surface-programmed biofilm growth</article-title>. <source>Adv. Colloid Interface Sci.</source> <volume>261</volume>, <fpage>1</fpage>&#x2013;<lpage>14</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1016/j.cis.2018.10.005</pub-id>
</citation>
</ref>
<ref id="B7">
<citation citation-type="journal">
<person-group person-group-type="author">
<collab>EclinicalMedicine</collab>
</person-group> (<year>2021</year>). <article-title>Antimicrobial resistance: a top ten global public health threat</article-title>. <source>EClinicalMedicine</source> <volume>41</volume>, <elocation-id>101221</elocation-id>. doi:&#xa0;<pub-id pub-id-type="doi">10.1016/j.eclinm.2021.101221</pub-id>
</citation>
</ref>
<ref id="B8">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Elshaghabee</surname> <given-names>F. M. F.</given-names>
</name>
<name>
<surname>Rokana</surname> <given-names>N.</given-names>
</name>
<name>
<surname>Gulhane</surname> <given-names>R. D.</given-names>
</name>
<name>
<surname>Sharma</surname> <given-names>C.</given-names>
</name>
<name>
<surname>Panwar</surname> <given-names>H.</given-names>
</name>
</person-group> (<year>2017</year>). <article-title>Bacillus as potential probiotics: status, concerns, and future perspectives</article-title>. <source>Front. Microbiol.</source> <volume>8</volume>. doi:&#xa0;<pub-id pub-id-type="doi">10.3389/fmicb.2017.01490</pub-id>
</citation>
</ref>
<ref id="B9">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Evivie</surname> <given-names>S. E.</given-names>
</name>
<name>
<surname>Abdelazez</surname> <given-names>A.</given-names>
</name>
<name>
<surname>Li</surname> <given-names>B.</given-names>
</name>
<name>
<surname>Bian</surname> <given-names>X.</given-names>
</name>
<name>
<surname>Li</surname> <given-names>W.</given-names>
</name>
<name>
<surname>Du</surname> <given-names>J.</given-names>
</name>
<etal/>
</person-group>. (<year>2019</year>). <article-title>
<italic>In vitro</italic> Organic Acid Production and <italic>In Vivo</italic> Food Pathogen Suppression by Probiotic <italic>S. thermophilus</italic> and <italic>L. bulgaricus</italic>
</article-title>. <source>Front. Microbiol.</source> <volume>10</volume>. doi:&#xa0;<pub-id pub-id-type="doi">10.3389/fmicb.2019.00782</pub-id>
</citation>
</ref>
<ref id="B10">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Fakruddin</surname> <given-names>M.</given-names>
</name>
<name>
<surname>Hossain</surname> <given-names>M. N.</given-names>
</name>
<name>
<surname>Ahmed</surname> <given-names>M. M.</given-names>
</name>
</person-group> (<year>2017</year>). <article-title>Antimicrobial and antioxidant activities of <italic>Saccharomyces cerevisiae</italic> IFST062013, a potential probiotic</article-title>. <source>BMC Complement Altern. Med.</source> <volume>17</volume>, <fpage>64</fpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1186/s12906-017-1591-9</pub-id>
</citation>
</ref>
<ref id="B11">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Falsen</surname> <given-names>E.</given-names>
</name>
<name>
<surname>Pascual</surname> <given-names>C.</given-names>
</name>
<name>
<surname>Sj&#xf6;d&#xe9;n</surname> <given-names>B.</given-names>
</name>
<name>
<surname>Ohl&#xe9;n</surname> <given-names>M.</given-names>
</name>
<name>
<surname>Collins</surname> <given-names>M. D.</given-names>
</name>
</person-group> (<year>1999</year>). <article-title>Phenotypic and phylogenetic characterization of a novel Lactobacillus species from human sources: description of <italic>Lactobacillus iners</italic> sp. nov</article-title>. <source>Int. J. Syst. Bacteriol</source> <volume>49 Pt 1</volume>, <fpage>217</fpage>&#x2013;<lpage>221</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1099/00207713-49-1-217</pub-id>
</citation>
</ref>
<ref id="B12">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Ferri</surname> <given-names>M.</given-names>
</name>
<name>
<surname>Ranucci</surname> <given-names>E.</given-names>
</name>
<name>
<surname>Romagnoli</surname> <given-names>P.</given-names>
</name>
<name>
<surname>Giaccone</surname> <given-names>V.</given-names>
</name>
</person-group> (<year>2017</year>). <article-title>Antimicrobial resistance: A global emerging threat to public health systems</article-title>. <source>Crit. Rev. Food Sci. Nutr.</source> <volume>57</volume>, <fpage>2857</fpage>&#x2013;<lpage>2876</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1080/10408398.2015.1077192</pub-id>
</citation>
</ref>
<ref id="B13">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Greifov&#xe1;</surname> <given-names>G.</given-names>
</name>
<name>
<surname>M&#xe1;jekov&#xe1;</surname> <given-names>H.</given-names>
</name>
<name>
<surname>Greif</surname> <given-names>G.</given-names>
</name>
<name>
<surname>Body</surname> <given-names>P.</given-names>
</name>
<name>
<surname>Greifov&#xe1;</surname> <given-names>M.</given-names>
</name>
<name>
<surname>Dubni&#x10d;kov&#xe1;</surname> <given-names>M.</given-names>
</name>
</person-group> (<year>2017</year>). <article-title>Analysis of antimicrobial and immunomodulatory substances produced by heterofermentative <italic>Lactobacillus reuteri</italic>
</article-title>. <source>Folia Microbiol. (Praha)</source> <volume>62</volume>, <fpage>515</fpage>&#x2013;<lpage>524</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1007/s12223-017-0524-9</pub-id>
</citation>
</ref>
<ref id="B14">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Huang</surname> <given-names>Y.</given-names>
</name>
<name>
<surname>Huang</surname> <given-names>Y.</given-names>
</name>
<name>
<surname>Xia</surname> <given-names>D.</given-names>
</name>
<name>
<surname>Liu</surname> <given-names>L.</given-names>
</name>
<name>
<surname>Xiong</surname> <given-names>X.</given-names>
</name>
<name>
<surname>Ouyang</surname> <given-names>Y.</given-names>
</name>
<etal/>
</person-group>. (<year>2023</year>). <article-title>
<italic>Lactobacillus rhamnosus</italic> ameliorates acne vulgaris in SD rats via changes in gut microbiota and associated tryptophan metabolism</article-title>. <source>Front. Immunol.</source> <volume>14</volume>. doi:&#xa0;<pub-id pub-id-type="doi">10.3389/fimmu.2023.1293048</pub-id>
</citation>
</ref>
<ref id="B15">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Jain</surname> <given-names>M.</given-names>
</name>
<name>
<surname>Stitt</surname> <given-names>G.</given-names>
</name>
<name>
<surname>Son</surname> <given-names>L.</given-names>
</name>
<name>
<surname>Enioutina</surname> <given-names>E. Y.</given-names>
</name>
</person-group> (<year>2023</year>). <article-title>Probiotics and their bioproducts: A promising approach for targeting methicillin-resistant <italic>staphylococcus aureus</italic> and vancomycin-resistant enterococcus</article-title>. <source>Microorganisms</source> <volume>11</volume>, <page-range>2393&#x2013;2417</page-range>. doi:&#xa0;<pub-id pub-id-type="doi">10.3390/microorganisms11102393</pub-id>
</citation>
</ref>
<ref id="B16">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Jayathilake</surname> <given-names>P. G.</given-names>
</name>
<name>
<surname>Jana</surname> <given-names>S.</given-names>
</name>
<name>
<surname>Rushton</surname> <given-names>S.</given-names>
</name>
<name>
<surname>Swailes</surname> <given-names>D.</given-names>
</name>
<name>
<surname>Bridgens</surname> <given-names>B.</given-names>
</name>
<name>
<surname>Curtis</surname> <given-names>T.</given-names>
</name>
<etal/>
</person-group>. (<year>2017</year>). <article-title>Extracellular polymeric substance production and aggregated bacteria colonization influence the competition of microbes in biofilms</article-title>. <source>Front. Microbiol.</source> <volume>8</volume>, <elocation-id>1865</elocation-id>. doi:&#xa0;<pub-id pub-id-type="doi">10.3389/fmicb.2017.01865</pub-id>
</citation>
</ref>
<ref id="B17">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Jiang</surname> <given-names>J.</given-names>
</name>
<name>
<surname>Li</surname> <given-names>K.</given-names>
</name>
<name>
<surname>Wang</surname> <given-names>Y.</given-names>
</name>
<name>
<surname>Wu</surname> <given-names>Z.</given-names>
</name>
<name>
<surname>Ma</surname> <given-names>H.</given-names>
</name>
<name>
<surname>Zheng</surname> <given-names>S.</given-names>
</name>
<etal/>
</person-group>. (<year>2023</year>). <article-title>Screening, Identification and Physiological Characteristics of <italic>Lactobacillus rhamnosus</italic> M3 (1) against Intestinal Inflammation</article-title>. <source>Foods</source> <volume>12</volume>, <page-range>1628&#x2013;1653</page-range>. doi:&#xa0;<pub-id pub-id-type="doi">10.3390/foods12081628</pub-id>
</citation>
</ref>
<ref id="B18">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Jiang</surname> <given-names>Y.</given-names>
</name>
<name>
<surname>Proteau</surname> <given-names>P.</given-names>
</name>
<name>
<surname>Poulter</surname> <given-names>D.</given-names>
</name>
<name>
<surname>Ferro-Novick</surname> <given-names>S.</given-names>
</name>
</person-group> (<year>1995</year>). <article-title>BTS1 encodes a geranylgeranyl diphosphate synthase in <italic>Saccharomyces cerevisiae</italic>
</article-title>. <source>J. Biol. Chem.</source> <volume>270</volume>, <fpage>21793</fpage>&#x2013;<lpage>21799</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1074/jbc.270.37.21793</pub-id>
</citation>
</ref>
<ref id="B19">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Ka&#x17a;mierczak-Siedlecka</surname> <given-names>K.</given-names>
</name>
<name>
<surname>Ruszkowski</surname> <given-names>J.</given-names>
</name>
<name>
<surname>Fic</surname> <given-names>M.</given-names>
</name>
<name>
<surname>Folwarski</surname> <given-names>M.</given-names>
</name>
<name>
<surname>Makarewicz</surname> <given-names>W.</given-names>
</name>
</person-group> (<year>2020</year>). <article-title>
<italic>Saccharomyces boulardii</italic> CNCM I-745: A non-bacterial microorganism used as probiotic agent in supporting treatment of selected diseases</article-title>. <source>Curr. Microbiol.</source> <volume>77</volume>, <fpage>1987</fpage>&#x2013;<lpage>1996</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1007/s00284-020-02053-9</pub-id>
</citation>
</ref>
<ref id="B20">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Kim</surname> <given-names>S. K.</given-names>
</name>
<name>
<surname>Guevarra</surname> <given-names>R. B.</given-names>
</name>
<name>
<surname>Kim</surname> <given-names>Y. T.</given-names>
</name>
<name>
<surname>Kwon</surname> <given-names>J.</given-names>
</name>
<name>
<surname>Kim</surname> <given-names>H.</given-names>
</name>
<name>
<surname>Cho</surname> <given-names>J. H.</given-names>
</name>
<etal/>
</person-group>. (<year>2019</year>). <article-title>Role of probiotics in human gut microbiome-associated diseases</article-title>. <source>J. Microbiol. Biotechnol.</source> <volume>29</volume>, <fpage>1335</fpage>&#x2013;<lpage>1340</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.4014/jmb.1906.06064</pub-id>
</citation>
</ref>
<ref id="B21">
<citation citation-type="journal">
<person-group person-group-type="author">
<collab>Lancet</collab>
</person-group> (<year>2022</year>). <article-title>Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019</article-title>. <source>Lancet</source> <volume>400</volume>, <fpage>2221</fpage>&#x2013;<lpage>2248</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1016/s0140-6736(22)02185-7</pub-id>
</citation>
</ref>
<ref id="B22">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Louren&#xe7;o</surname> <given-names>A.</given-names>
</name>
<name>
<surname>Rego</surname> <given-names>F.</given-names>
</name>
<name>
<surname>Brito</surname> <given-names>L.</given-names>
</name>
<name>
<surname>Frank</surname> <given-names>J. F.</given-names>
</name>
</person-group> (<year>2012</year>). <article-title>Evaluation of methods to assess the biofilm-forming ability of <italic>Listeria monocytogenes</italic>
</article-title>. <source>J. Food Prot</source> <volume>75</volume>, <fpage>1411</fpage>&#x2013;<lpage>1417</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.4315/0362-028x.Jfp-11-464</pub-id>
</citation>
</ref>
<ref id="B23">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Mao</surname> <given-names>N.</given-names>
</name>
<name>
<surname>Cubillos-Ruiz</surname> <given-names>A.</given-names>
</name>
<name>
<surname>Cameron</surname> <given-names>D. E.</given-names>
</name>
<name>
<surname>Collins</surname> <given-names>J. J.</given-names>
</name>
</person-group> (<year>2018</year>). <article-title>Probiotic strains detect and suppress cholera in mice</article-title>. <source>Sci. Transl. Med.</source> <volume>10</volume>, <page-range>2586&#x2013;2592</page-range>. doi:&#xa0;<pub-id pub-id-type="doi">10.1126/scitranslmed.aao2586</pub-id>
</citation>
</ref>
<ref id="B24">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>M&#xe9;nard</surname> <given-names>G.</given-names>
</name>
<name>
<surname>Rouillon</surname> <given-names>A.</given-names>
</name>
<name>
<surname>Cattoir</surname> <given-names>V.</given-names>
</name>
<name>
<surname>Donnio</surname> <given-names>P. Y.</given-names>
</name>
</person-group> (<year>2021</year>). <article-title>
<italic>Galleria mellonella</italic> as a suitable model of bacterial infection: past, present and future</article-title>. <source>Front. Cell Infect. Microbiol.</source> <volume>11</volume>. doi:&#xa0;<pub-id pub-id-type="doi">10.3389/fcimb.2021.782733</pub-id>
</citation>
</ref>
<ref id="B25">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Mikulak</surname> <given-names>E.</given-names>
</name>
<name>
<surname>Gliniewicz</surname> <given-names>A.</given-names>
</name>
<name>
<surname>Przygodzka</surname> <given-names>M.</given-names>
</name>
<name>
<surname>Solecka</surname> <given-names>J.</given-names>
</name>
</person-group> (<year>2018</year>). <article-title>
<italic>Galleria mellonella</italic> L. as model organism used in biomedical and other studies</article-title>. <source>Przegl Epidemiol.</source> <volume>72</volume>, <fpage>57</fpage>&#x2013;<lpage>73</lpage>.</citation>
</ref>
<ref id="B26">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Murzyn</surname> <given-names>A.</given-names>
</name>
<name>
<surname>Krasowska</surname> <given-names>A.</given-names>
</name>
<name>
<surname>Stefanowicz</surname> <given-names>P.</given-names>
</name>
<name>
<surname>Dziadkowiec</surname> <given-names>D.</given-names>
</name>
<name>
<surname>&#x141;ukaszewicz</surname> <given-names>M.</given-names>
</name>
</person-group> (<year>2010</year>). <article-title>Capric acid secreted by <italic>S. boulardii</italic> inhibits <italic>C. albicans</italic> filamentous growth, adhesion and biofilm formation</article-title>. <source>PLoS One</source> <volume>5</volume>, <elocation-id>e12050</elocation-id>. doi:&#xa0;<pub-id pub-id-type="doi">10.1371/journal.pone.0012050</pub-id>
</citation>
</ref>
<ref id="B27">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Nilsson</surname> <given-names>L.</given-names>
</name>
<name>
<surname>Gram</surname> <given-names>L.</given-names>
</name>
<name>
<surname>Huss</surname> <given-names>H. H.</given-names>
</name>
</person-group> (<year>1999</year>). <article-title>Growth control of <italic>Listeria monocytogenes</italic> on cold-smoked salmon using a competitive lactic acid bacteria flora</article-title>. <source>J. Food Prot</source> <volume>62</volume>, <fpage>336</fpage>&#x2013;<lpage>342</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.4315/0362-028x-62.4.336</pub-id>
</citation>
</ref>
<ref id="B28">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Oca&#xf1;a</surname> <given-names>V. S.</given-names>
</name>
<name>
<surname>Nader-Mac&#xed;as</surname> <given-names>M. E.</given-names>
</name>
</person-group> (<year>2002</year>). <article-title>Vaginal lactobacilli: self- and co-aggregating ability</article-title>. <source>Br. J. BioMed. Sci.</source> <volume>59</volume>, <fpage>183</fpage>&#x2013;<lpage>190</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1080/09674845.2002.11783657</pub-id>
</citation>
</ref>
<ref id="B29">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Oniszczuk</surname> <given-names>A.</given-names>
</name>
<name>
<surname>Oniszczuk</surname> <given-names>T.</given-names>
</name>
<name>
<surname>Gancarz</surname> <given-names>M.</given-names>
</name>
<name>
<surname>Szyma&#x144;ska</surname> <given-names>J.</given-names>
</name>
</person-group> (<year>2021</year>). <article-title>Role of gut microbiota, probiotics and prebiotics in the cardiovascular diseases</article-title>. <source>Molecules</source> <volume>26</volume>, <page-range>1172&#x2013;1187</page-range>. doi:&#xa0;<pub-id pub-id-type="doi">10.3390/molecules26041172</pub-id>
</citation>
</ref>
<ref id="B30">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Oteo</surname> <given-names>J.</given-names>
</name>
<name>
<surname>Bel&#xe9;n Aracil</surname> <given-names>M.</given-names>
</name>
</person-group> (<year>2015</year>). <article-title>Molecular characterization of resistance mechanisms: methicillin resistance <italic>Staphylococcus aureus</italic>, extended spectrum &#x3b2;-lactamases and carbapenemases</article-title>. <source>Enferm Infecc Microbiol. Clin.</source> <volume>33 Suppl 2</volume>, <fpage>27</fpage>&#x2013;<lpage>33</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1016/s0213-005x(15)30012-4</pub-id>
</citation>
</ref>
<ref id="B31">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Pais</surname> <given-names>P.</given-names>
</name>
<name>
<surname>Almeida</surname> <given-names>V.</given-names>
</name>
<name>
<surname>Y&#x131;lmaz</surname> <given-names>M.</given-names>
</name>
<name>
<surname>Teixeira</surname> <given-names>M. C.</given-names>
</name>
</person-group> (<year>2020</year>). <article-title>
<italic>Saccharomyces boulardii</italic>: what makes it tick as successful probiotic</article-title>? <source>J. Fungi (Basel)</source> <volume>6</volume>, <page-range>78&#x2013;94</page-range>. doi:&#xa0;<pub-id pub-id-type="doi">10.3390/jof6020078</pub-id>
</citation>
</ref>
<ref id="B32">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Palavecino</surname> <given-names>E. L.</given-names>
</name>
</person-group> (<year>2020</year>). <article-title>Clinical, epidemiologic, and laboratory aspects of methicillin-resistant <italic>staphylococcus aureus</italic> infections</article-title>. <source>Methods Mol. Biol.</source> <volume>2069</volume>, <fpage>1</fpage>&#x2013;<lpage>28</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1007/978-1-4939-9849-4_1</pub-id>
</citation>
</ref>
<ref id="B33">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Qadi</surname> <given-names>W. S. M.</given-names>
</name>
<name>
<surname>Mediani</surname> <given-names>A.</given-names>
</name>
<name>
<surname>Kasim</surname> <given-names>Z. M.</given-names>
</name>
<name>
<surname>Misnan</surname> <given-names>N. M.</given-names>
</name>
<name>
<surname>Sani</surname> <given-names>N. A.</given-names>
</name>
<name>
<surname>Jamar</surname> <given-names>N. H.</given-names>
</name>
</person-group> (<year>2023</year>). <article-title>Biological characterization and metabolic variations among cell-free supernatants produced by selected plant-based lactic acid bacteria</article-title>. <source>Metabolites</source> <volume>13</volume>, <page-range>849&#x2013;875</page-range>. doi:&#xa0;<pub-id pub-id-type="doi">10.3390/metabo13070849</pub-id>
</citation>
</ref>
<ref id="B34">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Quil&#xe8;s</surname> <given-names>F.</given-names>
</name>
<name>
<surname>Saadi</surname> <given-names>S.</given-names>
</name>
<name>
<surname>Francius</surname> <given-names>G.</given-names>
</name>
<name>
<surname>Bacharouche</surname> <given-names>J.</given-names>
</name>
<name>
<surname>Humbert</surname> <given-names>F.</given-names>
</name>
</person-group> (<year>2016</year>). <article-title>
<italic>In situ</italic> and real time investigation of the evolution of a <italic>Pseudomonas fluorescens</italic> nascent biofilm in the presence of an antimicrobial peptide</article-title>. <source>Biochim. Biophys. Acta</source> <volume>1858</volume>, <fpage>75</fpage>&#x2013;<lpage>84</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1016/j.bbamem.2015.10.015</pub-id>
</citation>
</ref>
<ref id="B35">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Rabin</surname> <given-names>N.</given-names>
</name>
<name>
<surname>Zheng</surname> <given-names>Y.</given-names>
</name>
<name>
<surname>Opoku-Temeng</surname> <given-names>C.</given-names>
</name>
<name>
<surname>Du</surname> <given-names>Y.</given-names>
</name>
<name>
<surname>Bonsu</surname> <given-names>E.</given-names>
</name>
<name>
<surname>Sintim</surname> <given-names>H. O.</given-names>
</name>
</person-group> (<year>2015</year>). <article-title>Biofilm formation mechanisms and targets for developing antibiofilm agents</article-title>. <source>Future Med. Chem.</source> <volume>7</volume>, <fpage>493</fpage>&#x2013;<lpage>512</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.4155/fmc.15.6</pub-id>
</citation>
</ref>
<ref id="B36">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Rodr&#xed;guez Arreola</surname> <given-names>A.</given-names>
</name>
<name>
<surname>Sol&#xed;s Pacheco</surname> <given-names>J. R.</given-names>
</name>
<name>
<surname>Lacroix</surname> <given-names>M.</given-names>
</name>
<name>
<surname>Balcazar L&#xf3;pez</surname> <given-names>E.</given-names>
</name>
<name>
<surname>Navarro Hern&#xe1;ndez</surname> <given-names>R. E.</given-names>
</name>
<name>
<surname>Sandoval Garcia</surname> <given-names>F.</given-names>
</name>
<etal/>
</person-group>. (<year>2021</year>). <article-title>
<italic>In vivo</italic> assessment and characterization of lactic acid bacteria with probiotic profile isolated from human milk powder</article-title>. <source>Nutr. Hosp</source> <volume>38</volume>, <fpage>152</fpage>&#x2013;<lpage>160</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.20960/nh.03335</pub-id>
</citation>
</ref>
<ref id="B37">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Roy</surname> <given-names>R.</given-names>
</name>
<name>
<surname>Tiwari</surname> <given-names>M.</given-names>
</name>
<name>
<surname>Donelli</surname> <given-names>G.</given-names>
</name>
<name>
<surname>Tiwari</surname> <given-names>V.</given-names>
</name>
</person-group> (<year>2018</year>). <article-title>Strategies for combating bacterial biofilms: A focus on anti-biofilm agents and their mechanisms of action</article-title>. <source>Virulence</source> <volume>9</volume>, <fpage>522</fpage>&#x2013;<lpage>554</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1080/21505594.2017.1313372</pub-id>
</citation>
</ref>
<ref id="B38">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Simon</surname> <given-names>E.</given-names>
</name>
<name>
<surname>C&#x103;linoiu</surname> <given-names>L. F.</given-names>
</name>
<name>
<surname>Mitrea</surname> <given-names>L.</given-names>
</name>
<name>
<surname>Vodnar</surname> <given-names>D. C.</given-names>
</name>
</person-group> (<year>2021</year>). <article-title>Probiotics, prebiotics, and synbiotics: implications and beneficial effects against irritable bowel syndrome</article-title>. <source>Nutrients</source> <volume>13</volume>, <page-range>2112&#x2013;2139</page-range>. doi:&#xa0;<pub-id pub-id-type="doi">10.3390/nu13062112</pub-id>
</citation>
</ref>
<ref id="B39">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Song</surname> <given-names>C. H.</given-names>
</name>
<name>
<surname>Kim</surname> <given-names>Y. H.</given-names>
</name>
<name>
<surname>Naskar</surname> <given-names>M.</given-names>
</name>
<name>
<surname>Hayes</surname> <given-names>B. W.</given-names>
</name>
<name>
<surname>Abraham</surname> <given-names>M. A.</given-names>
</name>
<name>
<surname>Noh</surname> <given-names>J. H.</given-names>
</name>
<etal/>
</person-group>. (<year>2022</year>). <article-title>
<italic>Lactobacillus crispatus</italic> Limits Bladder Uropathogenic <italic>E. coli</italic> Infection by Triggering a Host Type I Interferon Response</article-title>. <source>Proc. Natl. Acad. Sci. U.S.A.</source> <volume>119</volume>, <elocation-id>e2117904119</elocation-id>. doi:&#xa0;<pub-id pub-id-type="doi">10.1073/pnas.2117904119</pub-id>
</citation>
</ref>
<ref id="B40">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Subramaniam</surname> <given-names>G.</given-names>
</name>
<name>
<surname>Girish</surname> <given-names>M.</given-names>
</name>
</person-group> (<year>2020</year>). <article-title>Antibiotic resistance - A cause for reemergence of infections</article-title>. <source>Indian J. Pediatr.</source> <volume>87</volume>, <fpage>937</fpage>&#x2013;<lpage>944</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1007/s12098-019-03180-3</pub-id>
</citation>
</ref>
<ref id="B41">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Toone</surname> <given-names>E. J.</given-names>
</name>
</person-group> (<year>2011</year>). <article-title>Bacterial infection remains a leading cause of death in both Western and developing world. Preface</article-title>. <source>Adv. Enzymol. Relat. Areas Mol. Biol.</source> <volume>77</volume>, <fpage>xi</fpage>&#x2013;<lpage>xiii</lpage>.</citation>
</ref>
<ref id="B42">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Vlkov&#xe1;</surname> <given-names>E.</given-names>
</name>
<name>
<surname>Rada</surname> <given-names>V.</given-names>
</name>
<name>
<surname>Smehilov&#xe1;</surname> <given-names>M.</given-names>
</name>
<name>
<surname>Killer</surname> <given-names>J.</given-names>
</name>
</person-group> (<year>2008</year>). <article-title>Auto-aggregation and co-aggregation ability in bifidobacteria and clostridia</article-title>. <source>Folia Microbiol. (Praha)</source> <volume>53</volume>, <fpage>263</fpage>&#x2013;<lpage>269</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1007/s12223-008-0040-z</pub-id>
</citation>
</ref>
<ref id="B43">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Wang</surname> <given-names>J.</given-names>
</name>
<name>
<surname>Fu</surname> <given-names>W.</given-names>
</name>
<name>
<surname>Li</surname> <given-names>Y.</given-names>
</name>
<name>
<surname>Zhu</surname> <given-names>H.</given-names>
</name>
<name>
<surname>Xu</surname> <given-names>S.</given-names>
</name>
<name>
<surname>Shi</surname> <given-names>G.</given-names>
</name>
<etal/>
</person-group>. (<year>2020</year>). <article-title>Effects of key node gene defects in Saccharomyces cerevisiae on the synthesis of farnesene</article-title>. <source>Food and Fermentation Industry</source> <volume>48</volume>, <page-range>1&#x2013;10</page-range>. doi:&#xa0;<pub-id pub-id-type="doi">10.13995/j.cnki.11-1802/ts.027491</pub-id>
</citation>
</ref>
<ref id="B44">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Xu</surname> <given-names>Z.</given-names>
</name>
<name>
<surname>Liang</surname> <given-names>Y.</given-names>
</name>
<name>
<surname>Lin</surname> <given-names>S.</given-names>
</name>
<name>
<surname>Chen</surname> <given-names>D.</given-names>
</name>
<name>
<surname>Li</surname> <given-names>B.</given-names>
</name>
<name>
<surname>Li</surname> <given-names>L.</given-names>
</name>
<etal/>
</person-group>. (<year>2016</year>). <article-title>Crystal violet and XTT assays on <italic>staphylococcus aureus</italic> biofilm quantification</article-title>. <source>Curr. Microbiol.</source> <volume>73</volume>, <fpage>474</fpage>&#x2013;<lpage>482</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1007/s00284-016-1081-1</pub-id>
</citation>
</ref>
<ref id="B45">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Yang</surname> <given-names>Y.</given-names>
</name>
<name>
<surname>Huang</surname> <given-names>J.</given-names>
</name>
<name>
<surname>Dornbusch</surname> <given-names>D.</given-names>
</name>
<name>
<surname>Grundmeier</surname> <given-names>G.</given-names>
</name>
<name>
<surname>Fahmy</surname> <given-names>K.</given-names>
</name>
<name>
<surname>Keller</surname> <given-names>A.</given-names>
</name>
<etal/>
</person-group>. (<year>2022</year>). <article-title>Effect of surface hydrophobicity on the adsorption of a pilus-derived adhesin-like peptide</article-title>. <source>Langmuir</source> <volume>38</volume>, <fpage>9257</fpage>&#x2013;<lpage>9265</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1021/acs.langmuir.2c01016</pub-id>
</citation>
</ref>
<ref id="B46">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Yang</surname> <given-names>L.</given-names>
</name>
<name>
<surname>Liu</surname> <given-names>Y.</given-names>
</name>
<name>
<surname>Wu</surname> <given-names>H.</given-names>
</name>
<name>
<surname>Song</surname> <given-names>Z.</given-names>
</name>
<name>
<surname>H&#xf8;iby</surname> <given-names>N.</given-names>
</name>
<name>
<surname>Molin</surname> <given-names>S.</given-names>
</name>
<etal/>
</person-group>. (<year>2012</year>). <article-title>Combating biofilms</article-title>. <source>FEMS Immunol. Med. Microbiol.</source> <volume>65</volume>, <fpage>146</fpage>&#x2013;<lpage>157</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1111/j.1574-695X.2011.00858.x</pub-id>
</citation>
</ref>
<ref id="B47">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Yoon</surname> <given-names>J.</given-names>
</name>
<name>
<surname>Park</surname> <given-names>J. M.</given-names>
</name>
<name>
<surname>Jung</surname> <given-names>S. K.</given-names>
</name>
<name>
<surname>Kim</surname> <given-names>K. Y.</given-names>
</name>
<name>
<surname>Kim</surname> <given-names>Y. H.</given-names>
</name>
<name>
<surname>Min</surname> <given-names>J.</given-names>
</name>
</person-group> (<year>2009</year>). <article-title>Characterization of antimicrobial activity of the lysosomes isolated from <italic>Saccharomyces cerevisiae</italic>
</article-title>. <source>Curr. Microbiol.</source> <volume>59</volume>, <fpage>48</fpage>&#x2013;<lpage>52</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1007/s00284-009-9392-0</pub-id>
</citation>
</ref>
<ref id="B48">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zhang</surname> <given-names>S.</given-names>
</name>
<name>
<surname>Abbas</surname> <given-names>M.</given-names>
</name>
<name>
<surname>Rehman</surname> <given-names>M. U.</given-names>
</name>
<name>
<surname>Wang</surname> <given-names>M.</given-names>
</name>
<name>
<surname>Jia</surname> <given-names>R.</given-names>
</name>
<name>
<surname>Chen</surname> <given-names>S.</given-names>
</name>
<etal/>
</person-group>. (<year>2021</year>). <article-title>Updates on the global dissemination of colistin-resistant <italic>Escherichia coli</italic>: An emerging threat to public health</article-title>. <source>Sci. Total Environ.</source> <volume>799</volume>, <elocation-id>149280</elocation-id>. doi:&#xa0;<pub-id pub-id-type="doi">10.1016/j.scitotenv.2021.149280</pub-id>
</citation>
</ref>
<ref id="B49">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zhang</surname> <given-names>Y.</given-names>
</name>
<name>
<surname>Zhang</surname> <given-names>L.</given-names>
</name>
<name>
<surname>Du</surname> <given-names>M.</given-names>
</name>
<name>
<surname>Yi</surname> <given-names>H.</given-names>
</name>
<name>
<surname>Guo</surname> <given-names>C.</given-names>
</name>
<name>
<surname>Tuo</surname> <given-names>Y.</given-names>
</name>
<etal/>
</person-group>. (<year>2011</year>). <article-title>Antimicrobial activity against Shigella sonnei and probiotic properties of wild lactobacilli from fermented food</article-title>. <source>Microbiol. Res.</source> <volume>167</volume>, <fpage>27</fpage>&#x2013;<lpage>31</lpage>. doi:&#xa0;<pub-id pub-id-type="doi">10.1016/j.micres.2011.02.006</pub-id>
</citation>
</ref>
</ref-list>
</back>
</article>