Viable, Multi-Drug-Resistant Bacteria Recovered from E-Liquids Used with Commercial Electronic Cigarettes

The use of electronic cigarettes has increased in the U.S. with menthol and mint flavors showing notably higher sales. While research on the bacterial microbiome of traditional tobacco products is growing, particularly regarding menthol and nicotine effects, data regarding potential microbial contaminants within electronic liquids (e-liquids) remain limited. Additionally, the potential antibacterial properties of e-liquids remain sparse. To address these gaps, we evaluated the prevalence of viable bacteria in e-liquids; characterized their antimicrobial susceptibility patterns; and tested the antibacterial activity of the e-liquids. Two e-liquid flavors (menthol and non-menthol) across three different nicotine concentrations (0, 6 and 12 mg/mL) were tested using culture-based methods and Sanger sequencing. Antimicrobial susceptibility testing and e-liquid antibacterial activity assays were performed using the Kirby Bauer disc diffusion method. The majority of the isolates (63.15%) were identified as Pseudomonas aeruginosa and Bacillus spp. (B. pumilus, B. megaterium and B. cereus). Notably, P. aeruginosa and P. fluorescens isolates exhibited multidrug resistance against penicillin, tetracyclines, and phenicols. The e-liquids also demonstrated antimicrobial activity, inhibiting the growth of B. cereus, P. aeruginosa, and Staphylococcus aureus, with greater inhibition of P. aeruginosa growth at higher (12 mg/mL) compared to lower (0 mg/mL) nicotine concentrations across the menthol-flavored samples. These findings offer preliminary evidence of viable, multidrug-resistant bacteria and antibacterial properties in e-liquids, underscoring potential public health concerns regarding user exposure risks and microbial interactions, and emphasizing the need for continued surveillance of microbial safety in electronic cigarette products.