Synergistic antibacterial activities of ultrasound and reactive oxygen species against Staphylococcus aureus

Staphylococcus aureus is the common reason of clinical infections involving superficial skin infections, and devastating biomedical implant-associated infections. A vital cause for the failure of existing antimicrobial treatments is the emergence of biofilms and persister cells, which poses a critical clinical hardship. Acoustic cavitation effects, mainly activated by ultrasound, suggest a promising noninvasive alternative to eradicate S. aureus infections when combining with antimicrobial agents. The antimicrobial agents such as reactive oxygen species as a promising alternative to antibiotics arouses great interest in recent years. Hydrogen peroxide, as the most common kind of reactive oxygen species, is of particular interest because of its antimicrobial effect against metabolically active and dormant bacteria and the indeterminate resistance mechanisms. Therefore, this study investigated the antibacterial, anti-persister and antibiofilm effect of ultrasound and hydrogen peroxide against S. aureus and its antimicrobial mechanism.