Carbapenems are beta (β)-lactam antibiotics active against wide range of bacteria. Carbapenem resistance may be outcome of efflux pump activation, alteration in protein binding proteins, production of carbapenemases which degrade carbapenems. There are number of bacteria producing different types of carbapenemases like NDM (Enterobacteriaceae), IMP (Pseudomonas aeruginosa), IMI (Enterobacter cloacae), KPC (Klebsiella pneumonia), OXA-23, OXA-24/40, OXA-58-type (Acinetobacter baumannii), VIM (Acinetobacter baumannii) etc. Carbapenem resistance is emerging throughout the world due to interspecies transfer of genetic elements carrying genes for carbapenemase production. It is very difficult to control spread of resistant strains because of the continuous threshold of selection present in forms of presence of carbapenems in environment created through wide spread clinical use. To control infection of carbapenem resistant bacteria there are limited options available for treatment. Many a time carbapenem resistant bacteria show pan-resistance and such bacterial infection become life-threatening and cannot be treated with available last resort antibiotics like polymin B, tigecyclin and colistin. Infection of carbapenem resistant bacteria can be controlled using two or more antibiotics or antibiotic+ herbal drug combination or herbal drugs like (carvacrol, cinnamon, holy-basil oil, lemon grass oil) etc. The herbal drugs may be used as first line of treatment against carbapenem resistant bacteria instead of antibiotics. But, how? It is still not very lucid. Besides it, probiotics and homeopathic therapy has also been recommended with no sufficient data to establish their efficacy.
Study on citronella essential oil (CEO) sensitivity of 217 microbial strains of 65 species, isolated from animals with different disease conditions, revealed that citronella oil inhibited growth of only 10.6% strains. CEO inhibited Candida but of no Aspergillus strain. CEO inhibited 22 of 211 bacterial strains. Ampicillin was the least effective antibiotic but inhibited 41.2% bacterial strains. Gram positive bacteria (GPBs) were 4.5 more sensitive (p, 0.0006) to CEO than Gram negative bacteria (GNBs). More GNB strains (p, 0.02) were multi-drug resistant (MDR) type than GPB strains. Probability of CEO resistant was high in MDR strains (p, 0.006). Most of the Brucella abortus strains had MDR (83.3%). Strains of swamp buffalo origin were more (p, 0.08) commonly CEO (96.6%) resistant than strains of dog (81.3%) origin. MDR was the maximum in abortion associated (51.2%) strains and minimum in diarrhoea associated strains (25%). The study indicated that CEO is not an effective antimicrobial against veterinary clinical isolates. Antimicrobial drug resistance and CEO resistance patterns of bacteria were dependent on type of pathogen, its source and association with disease in animals and may be important for deciding an effective antimicrobial therapy.
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