Synergistic effects of pomegranate and rosemary extracts in combination with antibiotics against antibiotic resistance a
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CLINICAL MICROBIOLOGY - RESEARCH PAPER
Synergistic effects of pomegranate and rosemary extracts in combination with antibiotics against antibiotic resistance and biofilm formation of Pseudomonas aeruginosa Wael Mohamed Abu El-Wafa 1
&
Rahma Hassanein Ahmed 1 & Mohamed Abdel-Halim Ramadan 2
Received: 16 September 2019 / Accepted: 22 April 2020 # Sociedade Brasileira de Microbiologia 2020
Abstract The combination of plant extract and antibiotic represents a template for developing of antibiofilm drugs. This study investigated the synergistic effects of pomegranate/rosemary/antibiotic combinations against antibiotic resistance and biofilm formation of Pseudomonas aeruginosa. The results showed that 17 (85%) of total P. aeruginosa isolates were biofilm producers; however, 5 (25%) isolates were demonstrated as a strong biofilm producer. The highest MIC level (1024 μg/ml) of tested antibiotics against strong biofilm producer isolates was observed with piperacillin, however the MIC ranges of ceftazidime, gentamycin, imipenem, and levofloxacin against these isolates were reached to (256–1024 μg/ml), (32–1024 μg/ml), (8–1024 μg/ml), and (8– 512 μg/ml), respectively. PS-1 was the representative isolate for strong biofilm formation and high antibiotic resistance. 16S rRNA gene analysis suggested that PS-1 (accession No. MN619678) was identified as a strain of P. aeruginosa POA1. Pomegranate and rosemary extracts were the most effective extracts in biofilm inhibition, which significantly inhibited 91.93 and 90.83% of PS-1 biofilm, respectively. Notably, the synergism between both plant extracts and antibiotics has significantly reduced the MICs of used antibiotics at the level lower than the susceptibility breakpoints. Pomegranate/rosemary/antibiotic combinations achieved the highest biofilm eradication, which ranging from 90.0 to 99.6%, followed by the eradication ranges of pomegranate/rosemary combination, rosemary, and pomegranate extracts, which reached to (76.5–85.4%), (53.1–73.7%), and (41.2–71.5%), respectively. The findings suggest that pomegranate/rosemary/antibiotic combinations may be an effective therapeutic agent for antibiotic resistance and biofilm formation of P. aeruginosa. Keywords Pseudomonas . Biofilm . Pomegranate . Rosemary . Antibiotic . Resistant . Inhibition . Eradication
Introduction Pseudomonas aeruginosa is the most frequent opportunistic Gram-negative rods; it is capable of infecting variety of all tissues and becoming a major cause’s morbidity and mortality among hospital patients. It is the second causative agent of nosocomial pneumonia, the third common bacterial pathogen of urinary tract infection, the fourth common causes of surgical site infection, the fifth most frequently isolated pathogen Editorial Responsibility: Luis Henrique Souza Guimaraes * Wael Mohamed Abu El-Wafa [email protected] 1
National Organization for Drug Control and Research, Giza, Egypt
2
Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University Giza, Giza, Egypt
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