Ascorbic acid-mediated control of microbial infections in blood

Amal  Aziz Kareem; Raghad  H. Hussein; Estabraq  Ali Maklef

Authors

Amal Aziz Kareem College of Health and Medical Techniques, Middle Technical University, Iraq
Raghad H. Hussein College of Health and Medical Techniques, Middle Technical University, Iraq
Estabraq Ali Maklef College of Health and Medical Techniques, Middle Technical University, Iraq

Keywords:

Ascorbic acid, blood groups, cyclic voltammetry, microorganisms, redox reaction

Abstract

Background: Ascorbic acid (AA) is a naturally occurring organic compound found in animals and plants with antimicrobial and antioxidant potential; it functions as a redox buffer that can reduce and neutralize reactive oxygen species.

Objectives: This study aimed to investigate AA-mediated control of microbial infection in blood through oxidation-reduction reactions, with and without AA.

Methods: Different genera of bacteria (Staphylococcus aureus, Proteus mirabilis, Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa) and a fungus (Candida albicans) were cultured in plasma from individuals with different ABO groups, followed by measurement of oxidation- reduction reactions using cyclic voltammetry in the presence and absence of AA.

Results: An AA concentration of 100 g substantially affected microorganisms, K. pneumoniae (25 mm), S. aureus, and Proteus mirabilis (24 mm), followed by A. baumannii, P. aeruginosa, E. coli, and C. albicans (19, 18, 17, and 15 mm, respectively). High antioxidative results were recorded in the presence of AA in plasma compared with its absence in group A plasma infected with A. baumannii, with the difference between the oxidation current peaks of infected blood with other microorganisms treated with and without AA (ÄIpa). The results showed that ÄIpa=10 for P. mirabilis was less affected, with ÄIpa=2 in plasma from blood group B. A. baumannii was highly affected with ÄIpa=13; P. aeruginosa was less affected with ÄIpa=2 in plasma from blood group AB. A. baumannii was highly affected with ÄIpa=15; K. pneumoniae was less affected with ÄIpa=1 in plasma from blood group O. C. albicans was highly affected with ÄIpa=31, and K. pneumoniae was less affected with ÄIpa=2.

Conclusion: The study found that AA inhibits the growth and activity of various pathogenic microorganisms when added to infected blood samples. This effect was observed in blood samples infected with bacteria such as A. baumannii and P. mirabilis, as well as the fungus C. albicans.

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References

Holmes CL, Anderson MT, Mobley HLT, Bachman MA. Pathogenesis of Gram-negative bacteremia. Clin Microbiol Rev 2021;34:e00234-20.

https://doi.org/10.1128/CMR.00234-20

Martins CC, Lockhart PB, Firmino RT, Kilmartin C, Cahill TJ, Dayer M, et al. Bacteremia following different oral procedures: Systematic review and meta-analysis. Oral Dis 2024;30:846-54.

https://doi.org/10.1111/odi.14531

Alharbi AS, Sanyi RH, Azhar EI. Bacteria and host: what does this mean for sepsis bottleneck? World J Emerg Med 2025;16:10-7.

https://doi.org/10.5847/wjem.j.1920-8642.2025.001

Holmes CL, Albin OR, Mobley HLT, Bachman MA. Bloodstream infections: mechanisms of pathogenesis and opportunities for intervention. Nat Rev Microbiol 2025;23:210-24.

https://doi.org/10.1038/s41579-024-01105-2

Rodríguez-Créixems M, Alcalá L, Muñoz P, Cercenado E, Vicente T, Bouza E. Bloodstream infections: evolution and trends in the microbiology workload, incidence, and etiology, 1985-2006. Medicine (Baltimore) 2008;87:234-49.

https://doi.org/10.1097/MD.0b013e318182119b

Huang YC, Kuo SC, Fang CT, Lauderdale TL. Changing epidemiology and antimicrobial resistance of bacteria causing bacteremia in Taiwan: 2002-2020. Microbiol Spectr 2024;12:e0060824.

https://doi.org/10.1128/spectrum.00608-24

Pipitò L, Bono E, Mazzola CV, Rubino R, Anastasia A, Distefano SA, et al. Outcome of bloodstream infections caused by antibiotic-resistant bacteria: a 7-year retrospective study at the University Hospital of Palermo, Italy. Antibiotics (Basel) 2025;14:464.

https://doi.org/10.3390/antibiotics14050464

Maklef EA, Kareem AA, Al-Sudani SFK. Molecular detection of Pap II, OmpA, and luxr genes responsible for biofilm formation in acinetobacter baumannii isolated from hospitalized patients. Med J Babylon 2024;21 Suppl 2:S258-S65.

https://doi.org/10.4103/MJBL.MJBL_1098_23

Kern WV, Rieg S. Burden of bacterial bloodstream infection-a brief update on epidemiology and significance of multidrug-resistant pathogens. Clin Microbiol Infect 2020;26:151-7.

https://doi.org/10.1016/j.cmi.2019.10.031

Liu Y, Liu C, Li J. Comparison of Vitamin C and Its Derivative Antioxidant Activity: Evaluated by Using Density Functional Theory. ACS Omega 2020;5:25467-75.

https://doi.org/10.1021/acsomega.0c04318

Kwiecińska-Piróg J, Skowron K, Bogiel T, Białucha A, Przekwas J, Gospodarek-Komkowska E. Vitamin C in the presence of sub-inhibitory concentration of aminoglycosides and fluoroquinolones alters proteus mirabilis biofilm inhibitory rate. Antibiotics 2019;8:116.

https://doi.org/10.3390/antibiotics8030116

Radhi MM, Abdullah HN, Al-Asadi SA, Al-Mulla EAJ. Electrochemical oxidation effect of ascorbic acid on mercury ions in blood sample using cyclic voltammetry. Int J Ind Chem 2015;6:311-6.

https://doi.org/10.1007/s40090-015-0053-9

Elafify M, Darwish WS, El-Toukhy M, Badawy BM, Mohamed RE, Shata RR. Prevalence of multidrug resistant Salmonella spp. in dairy products with the evaluation of the inhibitory effects of ascorbic acid, pomegranate peel extract, and D-tryptophan against Salmonella growth in cheese. Int J Food Microbiol 2022;364:109534.

https://doi.org/10.1016/j.ijfoodmicro.2022.109534

Mousavi S, Bereswill S, Heimesaat MM. Immunomodulatory and antimicrobial effects of vitamin C. Eur J Microbiol Immunol (Bp) 2019;9:73-9.

https://doi.org/10.1556/1886.2019.00016

Abdul-Amir Y, Radhi M, Almulla E. Use of nano-sensors of the interferences between Pb(II) with each of Mg(II), Zn(II), Mn(II), Ca(II), Co(II) and PO4 -3 in blood medium: An electrochemical study. Nano Biomed Eng 2017;9:199-207.

https://doi.org/10.5101/nbe.v9i3.p199-207

Radhi M, Al-Damlooji N, Abed B, Dawood D, Tee T. Electrochemical sensors for detecting Mn (II) in blood medium. Sens Transducers 2013;149:89-93.

Hassuna NA, Rabie EM, Mahd WKM, Refaie MMM, Yousef RKM, Abdelraheem WM. Antibacterial effect of vitamin C against uropathogenic E. coli in vitro and in vivo. BMC Microbiol 2023;23(1):112.

https://doi.org/10.1186/s12866-023-02856-3

Mumtaz S, Mumtaz S, Ali S, Tahir HM, Kazmi SAR, Mughal TA, et al. Evaluation of antibacterial activity of vitamin C against human bacterial pathogens. Braz J Biol 2021;83:e247165.

https://doi.org/10.1590/1519-6984.247165

Khameneh B, Fazly Bazzaz BS, Amani A, Rostami J, Vahdati-Mashhadian N. Combination of anti-tuberculosis drugs with vitamin C or NAC against different Staphylococcus aureus and Mycobacterium tuberculosis strains. Microb Pathog 2016;93:83-7.

https://doi.org/10.1016/j.micpath.2015.11.006

Steve Harakeh SH, Saleh I, Hawi A, Hassan H, Safwan Tayeb ST, Maged Mahmoud MM, et al. Preliminary study related to specific nutrient synergy-modulation of antimicrobial resistance of bacteria isolated from dairy products. Afr J Microbiol Res 2013;7:2351-8.

https://doi.org/10.5897/AJMR2012.2397

Max BL, Angolile CM, Raymond VG, Mashauri HL. The dawn of repurposing vitamins as potential novel antimicrobial agents: A call for global emergency response amidst AMR crisis. Health Sci Rep 2023;6:e1276.

https://doi.org/10.1002/hsr2.1276

Abdul-Amir YK, Radhi MM, Al-Mulla EAJ. Use of nano-sensors of the interferences between Pb((II) with Each of Mg(II), Zn(II), Mn(II), Ca(II), Co(II) and PO4-3 in blood medium: an electrochemical study. Nano Biomed Eng 2017;9:199-207.

https://doi.org/10.5101/nbe.v9i3.p199-207

Poli V, Madduru R, Aparna Y, Kandukuri V, Motireddy SR. Amelioration of cadmium-induced oxidative damage in wistar rats by vitamin C, Zinc and N-Acetylcysteine. Med Sci (Basel) 2022;10:7.

https://doi.org/10.3390/medsci10010007

Atila D, Karataş A, Keskin D, Tezcaner A. Pullulan hydrogel-immobilized bacterial cellulose membranes with dual-release of vitamin C and E for wound dressing applications. Int J Biol Macromol 2022;218:760-74.

https://doi.org/10.1016/j.ijbiomac.2022.07.160

Xu C, Dong N, Chen K, Yang X, Zeng P, Hou C, et al. Bactericidal, anti-biofilm, and anti-virulence activity of vitamin C against carbapenem-resistant hypervirulent Klebsiella pneumoniae. iScience 2022;25:103894.

https://doi.org/10.1016/j.isci.2022.103894