A Review of Plant-Based Therapies for the Treatment of Urinary Tract Infections in Traditional Southern African Medicine

In vitro-antibacterial properties of ten medicinal plants against common uropathogenic organisms and toxicity determination using brine shrimp lethality assay

BACKGROUND

In recent years, antibiotic resistance has emerged as a global health concern in bacterial infections such as urinary tract infections (UTIs). Uropathogenic Escherichia coli is the most frequent organism responsible for both simple and complex UTIs. Staphylococcus aureus and Pseudomonas aeruginosa are frequently associated with complicated UTIs. Sri Lanka has significant resources of medicinal plants used to cure UTIs in Ayurvedic and traditional medicine.

METHODS

Agar well diffusion and broth microdilution methods were used to determine the antibacterial activity of the methanolic extract of ten medicinal plants against P. aeruginosa ATCC27853, S.aureus ATCC25923, E.coli ATCC25922 and their UTI positive strains extracted from positive culture plates. As a preliminary toxicity assay, the Brine Shrimp Lethality Assay (BSLA) was used to determine its cytotoxicity.

RESULTS

The methanolic fruits extract of P. emblica demonstrated the highest antibacterial activity against both E. coli ATCC25922 and E. coli UTI-positive strains. B. diffusa roots extract exhibited the highest activity against S. aureus ATCC25923, while T. chebula fruits extract showed the highest activity against the S. aureus UTI-positive strain. T. involucrata roots extract displayed the highest activity against P. aeruginosa ATCC27853, and Z. officinale rhizomes extract showed the highest activity against the P. aeruginosa UTI-positive strain. Moreover, the plant mixture showed the most substantial antibacterial effect against P. aeruginosa ATCC27853. However, the methanolic seed extract of C. melo did not exhibit any antimicrobial effects against the selected organisms. All plant material, including the plant mixture, showed cytotoxicity according to the BSLA.

CONCLUSION

All the methanolic extracts including P. emblica fruits, O. tenuiflorum whole plant, T. chebula fruits, Z. officinale rhizome, T. terrestris roots, T. involucrata roots, A. lanata whole plant. B. diffusa roots and A. falcatus roots showed antimicrobial effects against selected strains except C. melo seed extract. The results of the present study evidently supports the traditional and ayurvedic use of these plants for the treatment of UTIs. This paves the way for another praise for new plant-based therapeutic product development for the treatment of UTIs. However, further toxicity studies are needed for medicinal dose determination.

Prevalence, antibiotic resistance pattern for bacteriuria from patients with urinary tract infections

Background and Aims

Antibiotic resistance presents a significant global public health challenge, particularly for urinary tract infections (UTIs), and is notably severe in developing countries. Surveillance of the antimicrobial susceptibility patterns of UTI-causing bacteria is crucial for effective treatment selection. This study aimed to analyze these patterns in bacteria isolated from the urine samples of patients at Mughda Medical College Hospital, Dhaka, Bangladesh.

Methods

A retrospective study (January 2019 to December 2020) at Mugdha Medical College and Hospital, Dhaka, examined clinical and laboratory data from patients with positive urine cultures (≥105 CFU/mL). The study classified patients into four age groups: children (1-<18 years), young adults (18-<33 years), middle-aged adults (33-50 years), and old adults (>50 years). The standard Kirby-Bauer method was used to assess antibiotic sensitivity to 28 common antibiotics.

Results

Among 243 positive urine cultures in both community- and hospital-acquired UTIs, Escherichia coli was the most common uropathogen (65.84%), followed by Klebsiella spp. (12.34%), Enterococcus spp. (8.23%), and other types of bacteria.

Conclusion

Old adults are particularly vulnerable to UTIs, with E. coli being the predominant causative agent in the study region. The observed antimicrobial resistance patterns underscore the necessity of judicious antibiotic selection to effectively treat UTIs across different age groups.

Bowiea volubilis: From "Climbing Onion" to Therapeutic Treasure-Exploring Human Health Applications

Bowiea volubilis subsp. volubilis is primarily used to address human respiratory infections, coughs, and colds due to its diverse pharmaceutical properties. Notably, the plant contains alkaloids that exhibit notable antifungal, antibacterial, and cytotoxic properties. Additionally, the presence of saponins, with recognized antioxidant and anticancer attributes, further contributes to its medicinal potential. Steroid compounds inherent to the plant have been associated with anti-inflammatory and anticancer activities. Moreover, the bulb of B. volubilis has been associated as a source of various cardiac glycosides. Despite these therapeutic prospects, B. volubilis remains inedible due to the presence of naturally occurring toxic substances that pose risks to both animals and humans. The review focuses on a comprehensive exploration concerning B. volubilis ethnobotanical applications, phytochemical properties, and diverse biological activities in relation to in vitro and in vivo applications for promoting human health and disease prevention. The aim of the study is to comprehensively investigate the phytochemical composition, bioactive compounds, and potential medicinal properties of Bowiea volubilis, with the ultimate goal of uncovering its therapeutic applications for human health. This review also highlights an evident gap in research, i.e., insufficient evidence-based research on toxicity data. This void in knowledge presents a promising avenue for future investigations, opening doors to expanded inquiries into the properties and potential applications of B. volubilis in the context of human diseases.

Phytochemical Screening, Toxic Effects, and Antimicrobial Activity Studies of Digitaria abyssinica (Hochst. ex A.Rich.) Stapf (Poaceae) Rhizome Extracts against Selected Uropathogenic Microorganisms

In Kenya, the D. abyssinica rhizome's decoction is traditionally used to treat urinary tract infections (UTIs), mainly gonorrhea and candidiasis. UTIs are the most severe public health problems that affect over one hundred and fifty million people worldwide annually. They are caused by a wide range of microorganisms where Escherichia coli is known to be the main causative pathogen. Medicinal plants are used in traditional Kenya set up for treatment and most recently as an alternative source of treatment for UTIs due to the increased cost of treatment and many challenges experienced with antibiotic therapy. The current study is designed to investigate the phytochemical composition, acute oral toxicity, and antimicrobial activity of Digitaria abyssinica rhizome extracts against Staphylococcus aureus, Escherichia coli, Neisseria gonorrhea, and Candida albicans. The rhizomes of D. abyssinica were obtained, dried, ground, and extracted using water and organic solvents. The phytochemical assay was carried out using standard phytochemical screening methods. Single-dose toxicity studies were done to determine LD₅₀ while disk diffusion and microbroth dilution techniques were used to determine antimicrobial activity. Results revealed that saponins, phenolics, alkaloids, cardiac glycosides, tannins, flavonoids, steroids, and terpenes were present in the powder, aqueous, methanol, and dichloromethane : methanol extracts. All the extracts had an LD₅₀ of above 2,000 mg/kg of body weight and there was no observation of behavioral changes. Also, the aqueous and methanol extracts revealed antifungal activity against Candida albicans with the lowest average minimum zone of inhibition at MIC of 31.25 mg/ml. The study did not reveal antibacterial activity for any extract against the studied uropathogenic bacteria, Staphylococcus aureus, Escherichia coli, and Neisseria gonorrhoeae. The results from the current study suggested that D. abyssinica rhizome aqueous and methanol extracts have potential antifungal activity against C. albicans, thus validating the folklore of its use to treat candidiasis.

An Inventory of South African Medicinal Plants Used in the Management of Sexually Transmitted and Related Opportunistic Infections: An Appraisal and Some Scientific Evidence (1990-2020)

The current work is aimed at generating the first inventory of South African medicinal plants used in the treatment of sexually transmitted and related opportunistic infections associated with HIV-AIDS. This is important in assisting researchers to access a list of plant species to evaluate for potential phytocompounds, as this area of research is greatly lagging in South Africa. A total of 335 medicinal plants from 103 families have been documented in the current work. The most represented families are Fabaceae (11.64%) and Asteraceae (6.27%). Herbs constitute 36.53%, trees 32.34%, shrubs 29.04%, climbers 1.80% and parasites 0.30%. It is worrying that on the plant parts used, the roots constitute 47.18%, while leaves and stem bark yield 16.62 and 15.01%, respectively. Catharanthus roseus exhibited the highest number of citations (19), while Peltophorum africanum had 14 and both Carica papaya and Vachelia karoo had 12. In the mode of administration of the reported medicinal plant species, most of the plants are boiled and taken orally (48.22%), while other plant species are used as mouth washes (3.25%). Although there is reasonable in vitro activity of some of the plant species, validating the relevance of use, there is still a need to explore the mode of action of such plant species; isolated compounds and possible derivatives thereof are of paramount importance and need to be explored as well. Furthermore, toxicological aspects of such plant species need to be explored.