Abstract
Background: This study evaluated the antibacterial efficacy of platelet-rich plasma (PRP), platelet-poor plasma (PPP), and three activated PRP fractions (APRP, PRP-T, and APRP-T) against multidrug-resistant (MDR) bacteria isolated from human cutaneous abscesses. The rise of multidrug-resistant microorganisms has created a need for the development of new infection treatment strategies. PRP was obtained from peripheral blood samples of healthy donors using an automated blood collection device known as platelet apheresis union. A total of 107 bacterial isolates were obtained from 102 pus samples collected from Egypt’s Qena General Hospital. The isolated bacteria were characterized using biochemical and serological studies, antibiotic susceptibility testing, and PCR detection of antibiotic resistance genes and virulence factors. The study aimed to evaluate the antibacterial, antibiofilm, and time-killing curve effects of PPP, PRP, APRP, PRP-T, and APRP-T against the MDR isolates. Results: The most prevalent strain was Staphylococcus aureus (79.35%), including methicillin-resistant (MRSA, 35.87%). Multidrug-resistance (MDR ≥ 3) was observed in various bacterial isolates, particularly against β-lactam antibiotics. Among the MRSA isolates, 100% tested positive for the virulence genes icaD, LukED, and clfA, as well as the antibiotic-resistant gene mecA. S. aureus strains, 31.51% were found to produce enterotoxins (ACD). Furthermore, 79.35% of Staphylococcal isolates had the ability to form biofilms. The active PRP fractions (APRP and APRP-T) exhibited antibacterial activities against MRSA strains, in both solid and liquid media as clear zone range (11.0–18.0 mm) and complete inhibition by (2730 ± 70 and 2180 ± 30 × 109 cells/L). Significant antibiofilm activity was observed in the PPP, PRP, and PRP active fractions (APRP PRP-T, and APRP-T), resulting in a sharp decrease in MRSA biofilm optical density (OD) after treatment compared to control. The killing dynamics of APRP and APRP-T showed a steady decline in bacterial CFU after 4 h of treatment, followed by a dramatic decline after 24 h. Conclusions: The research suggests that PRP active fractions, specifically APRP and APRP-T, are effective in reducing complications caused by bacterial skin infections, particularly abscesses. These fractions exhibit simultaneous antibacterial, antibiofilm, and regenerative activities. Activated PRP fractions, particularly APRP-T, could serve as promising adjunct therapies against MDR MRSA infections. Supplementary Information: The online version contains supplementary material available at 10.1186/s12896-025-01078-x.