Synchronous application of antibiotics and essential oils: dual mechanisms of action as a potential solution to antibiotic resistance

Combinatorial effects between aromatic plant compounds and chlorhexidine digluconate against canine otitis-related Staphylococcus spp

The increasing prevalence of antimicrobial resistance among bacterial pathogens necessitates novel treatment strategies, particularly in veterinary medicine where otitis in dogs is very common in small animals' clinical routines. Considering this challenge, this study explores the efficacy of aromatic plant compounds (APC), including eugenol (EUG), trans-cinnamaldehyde (TC), and geraniol (GER), and their synergistic potential when combined with the antiseptic agent chlorhexidine (CLX), offering insight into alternative therapeutic approaches. The disk diffusion assay revealed differential sensitivity of Staphylococcus spp. strains to the tested compounds, with EUG and GER showing moderate inhibition zones and TC displaying considerably larger inhibition zones. Further analysis through MIC and MBC determinations suggested that EUG required the highest concentrations to inhibit and kill the bacteria, whereas TC and GER were effective at lower concentrations. Combined with CLX, all three plant-derived compounds demonstrated a significant enhancement of antibacterial activity, indicated by reduced MIC values and a predominantly synergistic interaction across the strains tested. GER was the most potent in combination with CLX, presenting the lowest mean FICi values and the highest fold reductions in MIC. This study emphasizes the APC's potential as an adjunct to conventional antimicrobial agents like CLX. The marked synergy observed, especially with GER, suggests that such combinations could be promising alternatives in managing bacterial otitis in dogs, potentially mitigating the impact of antibiotic resistance.

Antimicrobial-loaded biodegradable nanoemulsions for efficient clearance of intracellular pathogens in bacterial peritonitis

Intracellular pathogenic bacteria use immune cells as hosts for bacterial replication and reinfection, leading to challenging systemic infections including peritonitis. The spread of multidrug-resistant (MDR) bacteria and the added barrier presented by host cell internalization limit the efficacy of standard antibiotic therapies for treating intracellular infections. We present a non-antibiotic strategy to treat intracellular infections. Antimicrobial phytochemicals were stabilized and delivered by polymer-stabilized biodegradable nanoemulsions (BNEs). BNEs were fabricated using different phytochemicals, with eugenol-loaded BNEs (E-BNEs) affording the best combination of antimicrobial efficacy, macrophage accumulation, and biocompatibility. The positively-charged polymer groups of the E-BNEs bind to the cell surface of macrophages, facilitating the entry of eugenol that then kills the intracellular bacteria without harming the host cells. Confocal imaging and flow cytometry confirmed that this entry occurred mainly via cholesterol-dependent membrane fusion. As eugenol co-localized and interacted with intracellular bacteria, antibacterial efficacy was maintained. E-BNEs reversed the immunosuppressive effects of MRSA on macrophages. Notably, E-BNEs did not elicit resistance selection after multiple exposures of MRSA to sub-therapeutic doses. The E-BNEs were highly effective against a murine model of MRSA-induced peritonitis with better bacterial clearance (99 % bacteria reduction) compared to clinically-employed treatment with vancomycin. Overall, these findings demonstrate the potential of E-BNEs in treating peritonitis and other refractory intracellular infections.

The Combination of Antibiotic and Non-Antibiotic Compounds Improves Antibiotic Efficacy against Multidrug-Resistant Bacteria

Bacterial antibiotic resistance, especially the emergence of multidrug-resistant (MDR) strains, urgently requires the development of effective treatment strategies. It is always of interest to delve into the mechanisms of resistance to current antibiotics and target them to promote the efficacy of existing antibiotics. In recent years, non-antibiotic compounds have played an important auxiliary role in improving the efficacy of antibiotics and promoting the treatment of drug-resistant bacteria. The combination of non-antibiotic compounds with antibiotics is considered a promising strategy against MDR bacteria. In this review, we first briefly summarize the main resistance mechanisms of current antibiotics. In addition, we propose several strategies to enhance antibiotic action based on resistance mechanisms. Then, the research progress of non-antibiotic compounds that can promote antibiotic-resistant bacteria through different mechanisms in recent years is also summarized. Finally, the development prospects and challenges of these non-antibiotic compounds in combination with antibiotics are discussed.

Strategies to combat Gram-negative bacterial resistance to conventional antibacterial drugs: a review

The emergence of antimicrobial resistance raises the fear of untreatable diseases. Antimicrobial resistance is a multifaceted and dynamic phenomenon that is the cumulative result of different factors. While Gram-positive pathogens, such as methicillin-resistant Staphylococcus aureus and Clostridium difficile, were previously the most concerning issues in the field of public health, Gram-negative pathogens are now of prime importance. The World Health Organization's priority list of pathogens mostly includes multidrug-resistant Gram-negative organisms particularly carbapenem-resistant Enterobacterales, carbapenem-resistant Pseudomonas aeruginosa, and extensively drug-resistant Acinetobacter baumannii. The spread of Gram-negative bacterial resistance is a global issue, involving a variety of mechanisms. Several strategies have been proposed to control resistant Gram-negative bacteria, such as the development of antimicrobial auxiliary agents and research into chemical compounds with new modes of action. Another emerging trend is the development of naturally derived antibacterial compounds that aim for targets novel areas, including engineered bacteriophages, probiotics, metal-based antibacterial agents, odilorhabdins, quorum sensing inhibitors, and microbiome-modifying agents. This review focuses on the current status of alternative treatment regimens against multidrug-resistant Gram-negative bacteria, aiming to provide a snapshot of the situation and some information on the broader context.

Multi-Functional Chitosan Nanovesicles Loaded with Bioactive Manganese for Potential Wound Healing Applications

Chronic skin wound is a chronic illness that possesses a risk of infection and sepsis. In particular, infections associated with antibiotic-resistant bacterial strains are challenging to treat. To combat this challenge, a suitable alternative that is complementary to antibiotics is desired for wound healing. In this work, we report multi-functional nanoscale chitosan vesicles loaded with manganese (Chi-Mn) that has potential to serve as a new tool to augment traditional antibiotic treatment for skin wound healing. Chi-Mn showed antioxidant activity increase over time as well as antimicrobial activity against E. coli and P. aeruginosa PA01. The modified motility assay that mimicked a skin wound before bacterial colonization showed inhibition of bacterial growth with Chi-Mn treatment at a low area density of 0.04 µg of Mn per cm2. Furthermore, this study demonstrated the compatibility of Chi-Mn with a commercial antibiotic showing no loss of antimicrobial potency. In vitro cytotoxicity of Chi-Mn was assessed with macrophages and dermal cell lines (J774A.1 and HDF) elucidating biocompatibility at a wide range (2 ppm-256 ppm). A scratch wound assay involving human dermal fibroblast (HDF) cells was performed to assess any negative effect of Chi-Mn on cell migration. Confocal microscopy study confirmed that Chi-Mn tested at the MIC (16 ppm Mn) has no effect on cell migration with respect to control. Overall, this study demonstrated the potential of Chi-Mn nanovesicles for wound healing applications.

Essential oils to contrast biodeterioration of the external marble of Florence Cathedral

The search for more sustainable strategies to contrast biodeterioration of stone cultural heritage has been developing in recent years to find alternatives to synthetic biocides, since their toxicity and potential impact on the environment and health. In this study, the application of the oregano and thyme essential oils (EOs) was tested to control microbial growth on the external marble of Florence Cathedral affected by extended darkening. Before in situ application, preliminary tests were carried out to evaluate the interference of the EOs with marble (colorimetric and water absorption assays on marble specimens) and their efficacy in inhibiting marble microbiota (sensitivity test on nutrient media). EOs inhibited the whole cultivable microbiota sampled from the Cathedral marble at a very low concentration, while they did not interfere with colour and water absorption capability of uncolonised marble samples when applied as a 2 % solution. Then the two EOs and the commercial biocide Biotin T were used in in situ trials on marble in two outdoor study sites of Florence Cathedral. The effectiveness of the treatments was assessed through short- and mid-term evaluation by multidisciplinary in situ non-invasive (colorimetric and ATP assays, microscopy) and ex situ (microbial viable titer) tests. Concerning results, we found a good correspondence between parameters for evaluation of viability (bacterial and fungi viable titer) and activity (ATP determination) and some correspondence among these and microscopy and colorimetry. Considering the whole data, treatments with oregano and thyme EOs were effective against microbial community, in more cases comparably to the commercial biocide. Some differences found, particularly by viable titer, in the two study sites or in bacterial and fungal components of the microbiota can be partly attributed to differences in structure and colonization pattern of the microbial community due to the peculiar climatic conditions of the differently exposed study areas.

Synergistic Inhibition of Methicillin-Resistant Staphylococcus aureus (MRSA) by Melaleuca alternifolia Chell (Tea Tree) and Eucalyptus globulus Labill. Essential Oils in Association with Oxacillin

The presence of antibiotic-resistant bacteria has become a major therapeutic priority. This trend indicates the need for alternative agents to antibiotics, such as natural compounds of plant origin. By assessing membrane permeability, we investigated the antimicrobial activity of Melaleuca alternifolia and Eucalyptus globulus essential oils (EOs) against three strains of methicillin-resistant Staphylococcus aureus (MRSA). Using the checkerboard method, the efficacy of single EOs, in association with each other or in combination with oxacillin, was quantified by calculating the fractional inhibitory concentrations (FIC Index). All EOs showed a reduction in bacterial load, an alteration of membrane permeability which leads to an increase in its function, resulting in the release of nucleic acids and proteins. The treatment with EO-oxacillin combinations and associated EO-EO resulted in a synergistic effect in most of the tests performed. EO-EO association showed a high activity in the alteration of the membrane, increasing the permeability to about 80% in all the MRSA strains treated. In conclusion, the combination of EOs and antibiotics represents a valid therapeutic support against MRSA bacteria, allowing for a decrease in the antibiotic concentration needed for therapeutic use.

Enhancement of chlorhexidine activity against planktonic and biofilm forms of oral streptococci by two Croton spp. essential oils from the Caatinga biome

This work investigates the ability of two Croton spp. essential oils (EO) to enhance chlorhexidine (CHX) activity against oral streptococci. EO's chemical composition of Croton argyrophyllus and C. pluriglandulosus was determined by GC-MS/FID. The microbial growth kinetics and minimum inhibitory concentration (MIC) of EOs and CHX were determined, followed by their synergism against S. mutans UA159 and ATCC 25175, S. salivarius ATCC 7073 and S. sp. ATCC 15300. The microplate-based method was used to determine the EO/CHX activity against 24-h-old biofilms. The major compounds were α-pinene (54.74%) and bicyclogermacrene (16.08%) for EOAr and 1,8-cineole (17.41%), methyleugenol (16.06%) and elemicin (15.99%) for EOPg. Both EO had MIC around 16,000 µg/mL. EOs/CHX presented a synergistic effect against most strains (FICi from 0.133 to 0.375), and OE/CHX-treated biofilms showed a reduction in biomass and cell viability compared to CHX, only (p < 0.01). Thus, the EOs works as natural adjuvants for CHX.

Chemical Composition Determination and Evaluation of the Antimicrobial Activity of Essential Oil from Croton blanchetianus (Euphorbiaceae) against Clinically Relevant Bacteria

In this study, the chemical composition of the essential oil (EO) extracted from Croton blanchetianus Baill leaves was identified, and antimicrobial and antibiofilm activities against Staphylococcus aureus, Staphylococcus epidermidis, and Escherichia coli strains were determined. Moreover, the effects of EO in combination with ampicillin and tetracycline were investigated. Thirty-four components, mainly mono-and sesquiterpenes that represented 94.05 % of the chemical composition, were identified in the EO. The EO showed bacteriostatic and bactericidal activities against all strains tested. Furthermore, the EO showed a synergistic effect with ampicillin and tetracycline. EO significantly inhibited biofilm formation and reduced the number of viable cells in biofilms. The EO may be a promising natural product for preventing bacterial biofilm infections.

Higher Resistance of Yersinia enterocolitica in Comparison to Yersinia pseudotuberculosis to Antibiotics and Cinnamon, Oregano and Thyme Essential Oils

Yersiniosis is an important zoonotic disease; however, data are scarce on the resistance of enteropathogenic yersiniae, especially that of Y. pseudotuberculosis. Minimum inhibitory concentrations (MIC) of 21 antibiotics and 3 essential oils (EOs) were determined by broth microdilution for Y. enterocolitica bioserotype 4/O:3 strains isolated from domestic swine (n = 132) and Y. pseudotuberculosis strains isolated from wild boars (n = 46). For 15 of 21 antibiotics, statistically significant differences were found between MIC values of Y. enterocolitica and Y. pseudotuberculosis. While Y. enterocolitica was more resistant to amoxiclav, ampicillin, cefotaxime, cefuroxime, gentamicin, imipenem, meropenem, tetracycline, tobramycin, and trimethoprim, Y. pseudotuberculosis was more resistant to cefepime, ceftazidime, colistin, erythromycin, and nitrofurantoin. Statistically significant differences were found between various essential oils (p < 0.001) and species (p < 0.001). The lowest MICs for multiresistant Y. enterocolitica (n = 12) and Y. pseudotuberculosis (n = 12) were obtained for cinnamon (median 414 and 207 μg/mL, respectively) and oregano EOs (median 379 and 284 μg/mL), whereas thyme EO showed significantly higher MIC values (median 738 and 553 μg/mL; p < 0.001). There was no difference between Y. enterocolitica strains of plant (1A) and animal (4/O:3) origin (p = 0.855). The results show that Y. enterocolitica is generally more resistant to antimicrobials than Y. pseudotuberculosis.

Effects of EOs vs. Antibiotics on E. coli Strains Isolated from Drinking Waters of Grazing Animals in the Upper Molise Region, Italy

The health and safety of grazing animals was the subject of microbiological monitoring on natural source of drinking waters in the upper Molise region, Italy. Surface water samples, on spring-summer season, were collected and submitted to analyses using sterile membrane filtration, cultural medium, and incubation. The level of environmental microbial contamination (Total viable microbial count, yeasts and fungi) and faecal presence (Total and faecal coliforms, E. coli, and Salmonellae spp.) were carried out. By the selective microbiological screening, twenty-three E. coli strains from drinking waters were isolated and submitted to further studies to evaluate antibiotic resistance by antibiograms vs. three animal and two diffuse human antibiotics. Furthermore, after a fine chemical characterization by GC and GC-MS, three Essential Oils (EOs) of aromatic plants (Timus vulgaris, Melaleuca alternifolia, Cinnamomun verum) aromatograms were performed and results statistically compared. The effects of EOs vs. antibiotics on E. coli strains isolated from drinking waters showed a total absence of microbial resistance. In our experimental conditions, even if some suggestions will be further adopted for better managements of grazing animals, because the health and safety represent a guarantee for both animals and humans.

Biological properties of Thymus zygis essential oil with emphasis on antimicrobial activity and food application

The Thymus plants have been used for centuries in traditional medicine and as a food spice, among this genus, Thymus zygis (red thyme) is a widespread plant, vastly used as a culinary flavouring agent. Its essential oil has demonstrated diverse bioactive properties, such as antimicrobial, insecticidal, larvicidal and antiparasitic activities. Numerous studies have characterized this essential oil showing that it possesses a broad antimicrobial spectrum and may even enhance the effect of certain antimicrobial agents. Its potential application as a food preservative has been analysed on different matrixes pointing to its antimicrobial activity against spoilage and pathogenic microorganisms in food. This review provides an insight in the chemical composition, antimicrobial, insecticidal, larvicidal and antiparasitic activities and toxicity of T. zygis essential oil, as well as its potential application in food as a preservative.

Total Phenolic Content and Antioxidant and Antimicrobial Activities of Papaver rhoeas L. Organ Extracts Growing in Taounate Region, Morocco

The objective of this study is to valorize Papaver rhoeas L. from the Taounate region of Morocco by determining the total polyphenol content (TPC), the total flavonoid content (TFC) and the antioxidant and antimicrobial activities of four organs. The quantification of TPC and TFC in root, stem, leaf and flower extracts (RE, SE, LE and FE, respectively) was estimated by the Folin–Ciocalteu reaction and the aluminum trichloride method, respectively. Two tests were used to assess antioxidant power: the DPPH test and TAC assay. The antimicrobial activity was studied against five pathogenic bacteria and yeast, using two methods: disk diffusion and microdilution. The TPC in LE and LF was twice as high as that in RE and SE (24.24 and 22.10 mg GAE/g, respectively). The TFC values in the four extracts were very close and varied between 4.50 mg QE/g in the FE and 4.38 mg QE/g in the RE. The LE and FE showed low DPPH values with IC50 = 0.50 and 0.52 mg/mL, respectively. The TAC measurement revealed the presence of a significant amount of antioxidants in the studied extracts, mainly in LE and FE (6.60 and 5.53 mg AAE/g, respectively). The antimicrobial activity results revealed significant activity on almost all of the tested strains. The MIC of FE and SE against E. coli 57 was 1.56 and 0.78 mg/mL, respectively, while against the S. aureus it was 50 and 25 mg/mL, respectively. The low MLC value (1.56 mg/mL) was recorded against E. coli 57 by RE and SE.

Thymus zygis Essential Oil: Phytochemical Characterization, Bioactivity Evaluation and Synergistic Effect with Antibiotics against Staphylococcus aureus

Staphylococcus aureus is a nosocomial bacterium causing different infectious diseases, ranging from skin and soft-tissue infections to more serious and life-threatening infections such as sepsis, meningitis and endocarditis, which may be exacerbated by antibiotic resistance. Plant products may be seen as an alternative as antibacterial agents, namely, against S. aureus. Thus, the aim of this work was to characterize the chemical composition and evaluate the bioactive properties of the T. zygis essential oil (EO), with a focus on antimicrobial activity against S. aureus. Gas chromatography coupled with mass spectrometry was used to assess the chemical composition of the T. zygis EO, and the antioxidant activity was evaluated using the DPPH method and β-carotene-bleaching assay. The antimicrobial activity against S. aureus strains, the interaction with different antibiotics and the attenuation of this bacterium’s virulence were evaluated. The T. zygis EO showed antioxidant activity acting through two different mechanisms and antibacterial activity against S. aureus, with antibiofilm and antihaemolytic properties. This EO also demonstrated synergistic or additive interactions in combination with ampicillin, ciprofloxacin or vancomycin against S. aureus strains and, in some cases, changed the antibiotic-resistance phenotype from resistant to susceptible. Therefore, the present work demonstrates the good bioactive properties of the EO of T. zygis, mainly the antimicrobial activity against S. aureus, revealing its potential to be used as an antibacterial agent.

Current and future chemical treatments to fight biodeterioration of outdoor building materials and associated biofilms: Moving away from ecotoxic and towards efficient, sustainable solutions

All types of building materials are rapidly colonized by microorganisms, initially through an invisible and then later a visible biofilm that leads to their biodeterioration. Over centuries, this natural phenomenon has been managed using mechanical procedures, oils, or even wax. In modern history, many treatments such as high-pressure cleaners, biocides (mainly isothiazolinones and quaternary ammonium compounds) are commercially available, as well as preventive ones, such as the use of water-repellent coatings in the fabrication process. While all these cleaning techniques offer excellent cost-benefit ratios, their limitations are numerous. Indeed, building materials are often quickly recolonized after application, and microorganisms are increasingly reported as resistant to chemical treatments. Furthermore, many antifouling compounds are ecotoxic, harmful to human health and the environment, and new regulations tend to limit their use and constrain their commercialization. The current state-of-the-art highlights an urgent need to develop innovative antifouling strategies and the widespread use of safe and eco-friendly solutions to biodeterioration. Interestingly, innovative approaches and compounds have recently been identified, including the use of photocatalysts or natural compounds such as essential oils or quorum sensing inhibitors. Most of these solutions developed in laboratory settings appear very promising, although their efficiency and ecotoxicological features remain to be further tested before being widely marketed. This review highlights the complexity of choosing the adequate antifouling compounds when fighting biodeterioration and proposes developing case-to-case innovative strategies to raise this challenge, relying on integrative and multidisciplinary approaches.

Antibacterial potencial of 12 Lichen species

Resistant bacterial infections are a major public health problem worldwide, which entails the need to search for new therapeutic agents. In this context, lichens stand out, provided that they are producers of structurally diverse compounds that have attractive biological properties, including antimicrobial activity. Thus, extracts of 12 lichen species were prepared and their potential to inhibit the growth of 5 bacterial strains was evaluated in this work. The chemical compositions of these extracts were examined using TLC and microcrystallization, being the identity of the active compounds in each extract attributed based on the bioautography technique. The most active extracts (and their identified active compounds) were from Cladonia borealis (usnic, barbatic and 4-O-demethylbarbatic acids), Cladina confusa (usnic and perlatolic acids), Stereocaulom ramulosum (atranorin, perlatolic and anziaic acids) and Canoparmelia cryptochlorophaea (cryptochlorophaeic and caperatic acids), with MICs ranging from 7.8 to 31.25 μg/mL, including for resistant clinical strains. MIC values ​​were also obtained for substances isolated from lichens for comparison purposes. A group of four extracts containing usnic acid was analyzed by 1H NMR in order to correlate relative proportion of major metabolites and extracts activity. The less active extracts in this group, in fact, presented low proportion of usnic acid.

Montmorillonite with essential oils as antimicrobial agents, packaging, repellents, and insecticides: an overview

Essential oils (EOs) are complex natural mixtures of secondary plant metabolites that function as biocides and therapeutic agents. They are extensively used in bactericidal, virucidal, fungicidal, antiparasitic, insecticidal, pharmaceutical, and cosmetic products. However, certain characteristics, such as the volatility of EOs, hinder their widespread use. To mitigate this limitation, several studies have investigated combinations of EOs with natural materials, including clay minerals. Clay minerals are abundant in nature, biocompatible, and non-toxic to the environment and humans. Clay minerals such as montmorillonite possess available sites where EO molecules can interact. The combination of EOs with clay minerals produces new materials for various applications including antibacterial, antifungal, insecticidal/repellent, and active packaging materials. Therefore, this review focuses on the immobilization of several types of EOs in raw and modified montmorillonites. The applications of the described systems were evaluated and demonstrated the synergism of the properties of the isolated components as a function of different EOs incorporated in the silicate matrix.

Chemical Profile, Antioxidant Capacity, and Antimicrobial Activity of Essential Oils Extracted from Three Different Varieties (Moldoveanca 4, Vis Magic 10, and Alba 7) of Lavandula angustifolia

Chemical composition, antioxidant capacity, and antimicrobial activity of lavender essential oils (LEOs) extracted from three different varieties of Lavandula angustifolia Mill. (1-Moldoveanca 4, 2-Vis magic 10, and 3-Alba 7) have been determined. These plants previously patented in the Republic of Moldova were cultivated in an organic agriculture system in the northeastern part of Romania and then harvested in 3 consecutive years (2017-2019) to obtain the essential oils. From the inflorescences in the complete flowering stage, the LEOs were extracted by hydrodistillation. Then, their composition was analyzed by gas chromatography coupled with mass spectrometry (GC-MS) and by Fourier Transformed Infrared spectroscopy (FT-IR). The major identified constituents are as follows: linalool (1: 32.19-46.83%; 2: 29.93-30.97%; 3: 31.97-33.77%), linalyl acetate (1: 17.70-35.18%; 2: 27.55-37.13%; 3: 28.03-35.32%), and terpinen-4-ol (1: 3.63-7.70%; 2: 3.06-7.16%; 3: 3.10-6.53%). The antioxidant capacity as determined by ABTS and DPPH assays indicates inhibition, with the highest activity obtained for LEO var. Alba 7 from 2019. The in vitro antimicrobial activities of the LEOs and combinations were investigated as well, by using the disk diffusion method and minimum inhibitory concentration (MIC) against the Gram-positive bacterial strain Staphylococcus aureus (ATCC 6538), Gram-negative Pseudomonas aeruginosa (ATCC 27858), Escherichia coli (ATCC 25922), the yeast Candida albicans (ATCC 10231), and clinical isolates. Our results have shown that LEOs obtained from the three studied varieties of L. angustifolia manifest significant bactericidal effects against tested microorganisms (Staphylococcus aureus and Escherichia coli), and antifungal effects against Candida albicans. The mixture of LEOs (Var. Alba 7) and geranium, respectively, in tea tree EOs, in different ratios, showed a significant enhancement of the antibacterial effect against all the studied strains, except Pseudomonas aeruginosa.

Chemical Profiling, Antioxidant, and Antimicrobial Activity against Drug-Resistant Microbes of Essential Oil from Withania frutescens L

This work was conducted to study the chemical composition, antioxidant, antibacterial, and antifungal activities of essential oil and hydrolat from Withania frutescens. The essential oil was extracted by hydrodistillation. The chemical characterization was performed using gas chromatography-mass spectrometry (GC/MS). The antioxidant activity was studied using four different assays (DPPH, TAC, FRAP, and β-carotene bleaching). The antibacterial activity test was carried out on multidrug-resistant bacteria including Gram-negative and Gram-positive strains. Antifungal activity was tested on Candida albicans and Saccharomyces cerevisiae. The yield of essential oil (EO) obtained by hydrodistillation of W. frutescens was 0.31% majorly composed of camphor, α-thujone, carvacrol, and thymol. Regarding the antioxidant activities, the concentration of the sample required to inhibit 50% of radicals (IC50) of EO and hydrolat were 14.031 ± 0.012 and 232.081 ± 3.047 µg/mL (DPPH), 4.618 ± 0.045 and 8.997 ± 0.147 µg/mL (FRAP), 0.091 ± 0.007 and 0.131 ± 0.004 mg AAE/mg (TAC), 74.141 ± 1.040% and 40.850 ± 0.083% (β-carotene), respectively. Concerning the antibacterial activity of essential oil and hydrolat, the minimum inhibitory concentration (MIC) values found were 0.006 ± 0.001 and 6.125 ± 0.541 µg/mL (Escherichia coli 57), 0.003 ± 0.001 and 6.125 ± 0.068 µg/mL (Klebsiella pneumoniae), 0.001 ± 0.0 and 6.125 ± 0.046 µg/mL (Pseudomonas aeruginosa) and 0.012 ± 0.003 and 6.125 ± 0.571 µg/mL (Staphylococcus aureus), respectively. MIC values of essential oil and hydrolat vs. both C. albicans and S. cerevisiae were lower than 1/20,480 µg/mL. Based on the findings obtained, essential oils of Withania frutescens can be used as promising natural agents to fight free radical damage and nosocomial antibiotic-resistant microbes.

Comparative study of the chemical composition, antibacterial activity and synergic effects of the essential oils of Croton tetradenius baill. And C. pulegiodorus baill. Against Staphylococcus aureus isolates

The aim of this work was to evaluate the chemical composition and antibacterial activity of Croton tetradenius Baill. (CTEO) and C. pulegiodorus Baill. (CPEO) essential oils against Staphylococcus aureus, and their synergism with antibiotics. The essential oils (EOs) were extracted by hydrodistillation and chemically characterized by gas chromatography-mass spectrometry (CG-MS) and gas chromatography with flame ionization detection (CG-FID). The antimicrobial action of the EOs was tested against two standard strains and four clinical isolates of S. aureus using the disk-diffusion agar method and the microdilution assay. The bacterial kinetic growth was also determined. The synergistic effect between EOs and antimicrobials was analyzed by the checkerboard test. CTEO and CPEO yielded 0.47 and 0.37% w/w and the most common components were p-cymene (28.24%), camphor (17.76%) and α-phellandrene (8.98%), and trans-chrysanthenyl acetate (27.05%), α-terpinene (19.21%) and p-cymene (12.27%), respectively. The disk-diffusion test showed that the bacteria are sensitive to the agents tested. The MIC in the presence of the CTEO it was 4000 μg/mL, while for the CPEO it was 8000 μg/mL, except for clinical isolate 4B. The MBC for strains treated with CTEO were 8000 μg/mL, with the exception of isolates 8B and 0 A 4000 μg/mL. For the CPEO, all strains showed a concentration above 8000 μg/mL. The growth curve showed that CTEO and CPEO altered growth kinetics, delaying the lag phase and reducing the log phase. In combination with antibiotics, both essential oils showed synergisms effect with oxacillin and ampicillin, and additive effect with benzylpenicillin. CTEO and CPEO showed antibacterial action against S. aureus strains, showing as a promise natural alternative in clinical therapy.

Rapid Screening of Essential Oils as Substances Which Enhance Antibiotic Activity Using a Modified Well Diffusion Method

Antimicrobial resistance is recognized as one of the major global health challenges of the 21st century. Synergistic combinations for antimicrobial therapies can be a good strategy for the treatment of multidrug resistant infections. We examined the ability of a group of 29 plant essential oils as substances which enhance the antibiotic activity. We used a modified well diffusion method to establish a high-throughput screening method for easy and rapid identification of high-level enhancement combinations against bacteria. We found that 25 essential oils possessed antibacterial activity against Escherichia Coli ATCC 25922 and methicillin-resistant Staphylococcus aureus (MRSA) 43300 with MICs that ranged from 0.01% to 2.5% v/v. We examined 319 (11 × 29) combinations in a checkerboard assay with E. Coli ATCC 25922 and MRSA 43300, and the result showed that high-level enhancement combinations were 48 and 44, low-level enhancement combinations were 214 and 211, and no effects combinations were 57 and 64, respectively. For further verification we randomly chose six combinations that included orange and Petitgrain essential oils in a standard time-killing assay. The results are in great agreement with those of the well diffusion assays. Therefore, the modified diffusion method was a rapid and effective method to screen high-level enhancement combinations of antibiotics and essential oils.

Combination Therapy Involving Lavandula angustifolia and Its Derivatives in Exhibiting Antimicrobial Properties and Combatting Antimicrobial Resistance: Current Challenges and Future Prospects

Antimicrobial resistance (AMR) has been identified as one of the biggest health threats in the world. Current therapeutic options for common infections are markedly limited due to the emergence of multidrug resistant pathogens in the community and the hospitals. The role of different essential oils (EOs) and their derivatives in exhibiting antimicrobial properties has been widely elucidated with their respective mechanisms of action. Recently, there has been a heightened emphasis on lavender essential oil (LEO)’s antimicrobial properties and wound healing effects. However, to date, there has been no review published examining the antimicrobial benefits of lavender essential oil, specifically. Previous literature has shown that LEO and its constituents act synergistically with different antimicrobial agents to potentiate the antimicrobial activity. For the past decade, encapsulation of EOs with nanoparticles has been widely practiced due to increased antimicrobial effects and greater bioavailability as compared to non-encapsulated oils. Therefore, this review intends to provide an insight into the different aspects of antimicrobial activity exhibited by LEO and its constituents, discuss the synergistic effects displayed by combinatory therapy involving LEO, as well as to explore the significance of nano-encapsulation in boosting the antimicrobial effects of LEO; it is aimed that from the integration of these knowledge areas, combating AMR will be more than just a possibility.

Molecular Epidemiology and Characterization of Carbapenem-Resistant Klebsiella pneumoniae Isolated from Urine at a Teaching Hospital in Taiwan

Urinary tract infections (UTIs) are common in clinics and hospitals and are associated with a high economic burden. Enterobacterium Klebsiella pneumoniae is a prevalent agent causing UTIs. A high prevalence of carbapenem-resistant K. pneumoniae (CRKP) has emerged recently and is continuing to increase. Seventeen urinary CRKP isolates collected at a teaching hospital in Taiwan from December 2016 to September 2017 were analyzed to elucidate their drug resistance mechanisms. Two-thirds of the isolates were obtained from outpatients. Antimicrobial susceptibility tests demonstrated multidrug resistance in all the isolates. Multilocus sequence typing analysis showed high diversity among the isolates. PCR analysis demonstrated the presence of carbapenemases in three isolates. All isolates carried at least one other extended-spectrum β-lactamase, including TEM, DHA, and CTX-M. Fifteen isolates contained mutations in one of the outer membrane porins that were assessed. The expression levels of the acrB and/or oqxB efflux pump genes, as determined by qRT-PCR, were upregulated in 11 isolates. Six isolates might have utilized other efflux pumps or antimicrobial resistance mechanisms. These analyses demonstrated a highly diverse population and the presence of complex resistance mechanisms in urinary isolates of K. pneumoniae.

An Overview of the Potential Therapeutic Applications of Essential Oils

The emergence of antimicrobial resistance (AMR) has urged researchers to explore therapeutic alternatives, one of which includes the use of natural plant products such as essential oils (EO). In fact, EO obtained from clove, oregano, thymus, cinnamon bark, rosemary, eucalyptus, and lavender have been shown to present significant inhibitory effects on bacteria, fungi, and viruses; many studies have been done to measure EO efficacy against microorganisms. The strategy of combinatory effects via conventional and non-conventional methods revealed that the combined effects of EO-EO or EO-antibiotic exhibit enhanced efficacy. This paper aims to review the antimicrobial effects of EO, modes of EO action (membrane disruption, efflux inhibition, increase membrane permeability, and decrease in intracellular ATP), and their compounds' potential as effective agents against bacteria, fungi, and viruses. It is hoped that the integration of EO applications in this work can be used to consider EO for future clinical applications.

Multidrug and Pan-Antibiotic Resistance—The Role of Antimicrobial and Synergistic Essential Oils: A Review

Bacterial resistance to antibiotics continues to be a grave threat to human health. Because antibiotics are no longer a lucrative market for pharmaceutical companies, the development of new antibiotics has slowed to a crawl. The World Health Organization reported that the 8 new bacterial agents approved since July 2017 had limited clinical benefits. While a cohort of biopharmaceutical companies recently announced plans to develop 2-4 new antibiotics by 2030, we needn’t wait a decade to find innovative antibiotic candidates. Essential oils (EOs) have long been known as antibacterial agents with wide-ranging arsenals. Many are able to penetrate the bacterial membrane and may also be effective against bacterial defenses such as biofilms, efflux pumps, and quorum sensing. EOs have been documented to fight drug-resistant bacteria alone and/or combined with antibiotics. This review will summarize research showing the significant role of EOs as nonconventional regimens against the worldwide spread of antibiotic-resistant pathogens. The authors conducted a 4-year search of the US National Library of Medicine (PubMed) for relevant EO studies against methicillin-resistant Staphylococcus aureus, multidrug-resistant (MDR) Escherichia coli, EO combinations/synergy with antibiotics, against MDR fungal infections, showing the ability to permeate bacterial membranes, and against the bacterial defenses listed above. EOs are readily available and are a needed addition to the arsenal against resistant pathogens.

Syzygium aromaticum (clove) and Thymus zygis (thyme) essential oils increase susceptibility to colistin in the nosocomial pathogens Acinetobacter baumannii and Klebsiella pneumoniae

The discovery of new antibiotics that are effective against Acinetobacter baumannii and Enterobacteralesis a research priority. Several essential oils (EOs) have displayed some antimicrobial activity and could potentially act as antibiotic adjuvants. Research in this area aims to develop new therapeutic alternatives to treat infections caused by these pathogens. MICs of different EOs were determined against A. baumannii and Klebsiella pneumoniae. Combined disk diffusion tests and checkerboard assays were used to study the synergy between the EOs and antibiotics. The fractional inhibitory concentration index (FIC_index) was calculated in order to categorize the interaction. Time-kill assays were also performed. The EOs that displayed the highest levels of antimicrobial activity were clove (Syzygium aromaticum L.) and thyme (Thymus zygis L.). Combined disk diffusion tests and checkerboard assays revealed synergy between these EOs and colistin. Addition of either clove or thyme EO decreased the MIC of colistin by 8- to 64-fold and 8- to 128-fold in the colistin-resistant A. baumannii and K. pneumoniae strains, respectively (FIC_index ≤ 0.5, synergy). MICs were also reduced in the colistin-susceptible strains. Time-kill assays also indicated the strong activity of the combined therapy. In summary, the use of clove or thyme EO in combination with colistin could improve the efficacy of the antibiotic and significantly reduce the concentrations needed to inhibit growth of A. baumannii and K. pneumoniae.

A biorefinery for conversion of citrus peel waste into essential oils, pectin, fertilizer and succinic acid via different fermentation strategies

A process for the valorization of citrus peel waste (CPW) has been developed aiming to produce succinic acid and a series of added-value products through the biorefinery platform. CPW was subject to physicochemical and biological treatment to isolate essential oils (0.43%) and pectin (30.53%) as extractable products, pretreating the material for subsequent production of succinic acid that enabled application of remaining biorefinery residues (BR) as fertilizer substitute. Cellulose, hemicellulose and lignin contents of CPW accounted for 22.45%, 8.05% and 0.66% respectively, while acid hydrolysis reduced hemicellulose by 3.42% in BR. Moreover, essential oils extracted from CPW included 17 compounds, among which D-limonene reached 96.7%. The hydrolyzate generated was fermented for succinic acid production using Actinobacillus succinogenes. Different batch experiments demonstrated that the combined use of corn steep liquor (CSL) and vitamins in a lab-scale bioreactor resulted in product concentration and yield that reached 18.5 g L^-1 and 0.62 g g^-1 respectively. Although simultaneous saccharification and fermentation (SSF) could not enhance succinic acid production, a fed-batch fermentation strategy increased succinic acid concentration and yield generating 22.4 g L^-1 and 0.73 g g^-1 respectively, while the mass of the platform chemical formed was enhanced by 27% as compared to the batch process. BR was explored as fertilizer substitute aiming to close the loop in the management of CPW towards development of a zero-waste process demonstrating that although the material imposed stress on plant growth, the content of potassium, phosphorus and nitrogen in the mixture increased.

Multitarget Approaches against Multiresistant Superbugs

Despite efforts to develop new antibiotics, antibacterial resistance still develops too fast for drug discovery to keep pace. Often, resistance against a new drug develops even before it reaches the market. This continued resistance crisis has demonstrated that resistance to antibiotics with single protein targets develops too rapidly to be sustainable. Most successful long-established antibiotics target more than one molecule or possess targets, which are encoded by multiple genes. This realization has motivated a change in antibiotic development toward drug candidates with multiple targets. Some mechanisms of action presuppose multiple targets or at least multiple effects, such as targeting the cytoplasmic membrane or the carrier molecule bactoprenol phosphate and are therefore particularly promising. Moreover, combination therapy approaches are being developed to break antibiotic resistance or to sensitize bacteria to antibiotic action. In this Review, we provide an overview of antibacterial multitarget approaches and the mechanisms behind them.

The alarming antimicrobial resistance in ESKAPEE pathogens: Can essential oils come to the rescue?

Antibiotics, considered as a backbone of modern clinical-medicines, are facing serious threats from emerging antimicrobial-resistance (AMR) in several bacteria from nosocomial and community origins and is posing a serious human-health concern. Recent commitment by the Heads of States at the United Nations General Assembly (UNGA, 2016) for coordinated efforts to curb such infections illustrates the scale of this problem. Amongst the drug-resistant microbes, major threat is posed by the group named as ESKAPEE, an acronym for Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp., and Escherichia coli, comprising high to critical drug-resistant, World Health Organization Critical Priority I and II pathogens. The drying pipeline of effective and new antibiotics has worsened the situation with looming threat of heading to a 'post-antibiotic era'. This necessitates novel and effective approaches to combat this life-threatening issue. Medicinal and aromatic plants are hailed as the reservoir of bioactive compounds and can serve as a source of antimicrobial compounds, and some recent leads show that essential oils (EOs) may provide an effective solution for tackling AMR. EOs have shown wide-spectrum antimicrobial potentials via targeting the major determinants of pathogenicity, drug-resistance and its spread including cell membrane, drug efflux pumps, quorum sensing, biofilms and R-plasmids. Latest reports confirm the EOs having strong direct-killing or re-sensitizing potentials to replace or rejuvenate otherwise fading antibiotics arsenal. We discuss herein possibilities of using EOs directly for antimicrobial potentials or in combination with antibiotics to potentiate the later for combating AMR in ESKAPEE pathogens. The current understandings, success stories and challenges for translational success have also been discussed.

Combined Action of Piperitenone Epoxide and Antibiotics Against Clinical Isolates of Staphylococcus aureus and Escherichia coli

The aim of this study was to determine the antimicrobial efficiency of piperitenone epoxide (PEO) - a principal component of various aromatic plants' essential oil - in combination with various antibiotics against 28 strains of Staphylococcus aureus and 10 strains of Escherichia coli isolated from clinical samples. Mentha spicata's essential oil, initially collected by hydrodistillation, was then subjected to flush column chromatography affording PEO of high purity. Minimum inhibitory concentrations of PEO alone and in combination with various concentrations of antibiotics were assessed using the microdilution method. The combined action was estimated calculating the fractional inhibitory concentration (FIC) index from checkerboard assays. Our results showed that the average minimum inhibitory concentration (mg/l) of PEO alone against E. coli was 512 ± 364.7 μg/ml, which was significantly higher than 172.8 ± 180.7 μg/ml observed for S. aureus. From checkerboard assays, FIC values below the 0.5 index, indicating synergy, were observed for 59% of the drugs tested. Twelve percent of FIC index values were between 0.5 and 1, indicating additive effects, while 21% were indifferent. According to our results, PEO could be a promising antimicrobial compound when combined with specific antibiotics and deserves further study.

The antibacterial properties of phenolic isomers, carvacrol and thymol

Most of the antibacterial activities of essential oils from the Lamiaceae herbaceous plant family thyme and oregano are attributed to their bioactive isomeric monoterpenoid constituents, carvacrol and thymol. Commercially available antibiotics of thymol or carvacrol have not yet been developed but health products have incorporated thymol into their formulations for their antimicrobial properties. Carvacrol and thymol are generally considered safe for consumption and they have been used in dental applications, approved as food flavorings and have been considered as antibacterial additives in food and feed. Many studies have demonstrated that carvacrol and thymol are potent antibacterial agents against both Gram-positive and Gram-negative bacteria. The most frequently reported mechanism of antibacterial action of both isomers involves the disruption of bacterial membrane leading to bacterial lysis and leakage of intracellular contents resulting in death. Other proposed mechanisms of antibacterial action include the inhibition of efflux pumps, prevention in the formation and disruption of preformed biofilms, inhibition of bacterial motility, and inhibition of membrane ATPases. In addition, both isomers have been found to act additively or synergistically with conventional antibiotics important in overcoming the problem of bacteria resistance in food and disease.

Synergistic Combinations of Antibiotics with Cumin, Oregano and Rosewood Oils as a Strategy to Preserve the Antibiotic Repertoire

Background:

Formulations employing synergistic combinations of antibiotics with Essential Oils (EOs) could help preserve the antibiotic repertoire by improving their activity against resistant bacteria.

Objective:

Antimicrobial interactions between double and triple combinations of EOs, EO components and antibiotics were determined using the checkerboard method. The most active triple combinations were then assessed by a time-kill assay.

Methods:

Two synergistic EO-antibiotic combinations and eight additive EO-antibiotic combinations reduced the antibiotic minimum inhibitory concentration below clinical sensitivity breakpoints according to the checkerboard method. However, all the tested combinations were additive according to the time-kill assay; while the combinations completely killed S. aureus, E. coli and P. aeruginosa cells in 2 h. At least one EO compound from the combination alone completely killed the cells of test species.

Results:

Two synergistic EO-antibiotic combinations and eight additive EO-antibiotic combinations reduced the antibiotic minimum inhibitory concentration below clinical sensitivity breakpoints according to the checkerboard method. However, all the tested combinations were additive according to the time-kill assay; while the combinations completely killed S. aureus, E. coli and P. aeruginosa cells in 2 h. At least one EO compound from the combination alone completely killed the cells of test species.

Conclusion:

Positive interactions support the use of EOs or EO components to enhance antibiotic efficacy against antibiotic resistant bacteria. The EO-antibiotic combinations tested by the time kill assay were indifferent; therefore, the observed antimicrobial activity did not arise from synergistic mechanisms as indicated by the checkerboard method. Investigation of other synergistic combinations identified by the checkerboard method could reveal more promising candidates.

Acid-base fractions separated from Streblus asper leaf ethanolic extract exhibited antibacterial, antioxidant, anti-acetylcholinesterase, and neuroprotective activities

BACKGROUND

Streblus asper is a well-known plant native to Southeast Asia. Different parts of the plant have been traditionally used for various medicinal purposes. However, there is very little scientific evidence reporting its therapeutic benefits for potential treatment of Alzheimer's disease (AD). The study aimed to evaluate antibacterial, antioxidant, acetylcholinesterase (AChE) inhibition, and neuroprotective properties of S. asper leaf extracts with the primary objective of enhancing therapeutic applications and facilitating activity-guided isolation of the active chemical constituents.

METHODS

The leaves of S. asper were extracted in ethanol and subsequently fractionated into neutral, acid and base fractions. The phytochemical constituents of each fraction were analyzed using GC-MS. The antibacterial activity was evaluated using a broth microdilution method. The antioxidant activity was determined using DPPH and ABTS radical scavenging assays. The neuroprotective activity against glutamate-induced toxicity was tested on hippocampal neuronal HT22 cell line by evaluating the cell viability using MTT assay. The AChE inhibitory activity was screened by thin-layer chromatography (TLC) bioautographic method.

RESULTS

The partition of the S. asper ethanolic leaf extract yielded the highest mass of phytochemical constitutions in the neutral fraction and the lowest in the basic fraction. Amongst the three fractions, the acidic fraction showed the strongest antibacterial activity against gram-positive bacteria. The antioxidant activities of three fractions were found in the order of acidic > basic > neutral, whereas the decreasing order of neuroprotective activity was neutral > basic > acidic. TLC bioautography revealed one component in the neutral fraction exhibited anti-AChE activity. While in the acid fraction, two components showed inhibitory activity against AChE. GC-MS analysis of three fractions showed the presence of major phytochemical constituents including terpenoids, steroids, phenolics, fatty acids, and lipidic plant hormone.

CONCLUSIONS

Our findings have demonstrated the therapeutic potential of three fractions extracted from S. asper leaves as a promising natural source for neuroprotective agents with additional actions of antibacterials and antioxidants, along with AChE inhibitors that will benefit in the development of new natural compounds in therapies against AD.