Effect the Natural Efflux Pump Inhibitor (Berberine) in Multidrug Resistant Kleibsiella pneumoniae Isolated from Urinary Tract Infections in Several Baghdad Hospitals

Abstract

Background: Kleibsiella pneumoniae in urinary tract infections (UTIs) have grown for years. Antibiotic-resistant microorganisms make infection control and treatment difficult for clinicians. Efflux pumps contribute to K. pneumoniae's multidrug resistance.Objective: This study aimed to test Phenylalanine-Arginine β-Naphthylamide (PAβN) and Berberine as antibacterial agents against multidrug-resistant bacteria (UTI K. pneumonia isolates). Subjects and Methods: Between December 2021 and April 2022, five Baghdad hospitals collected 260 urine samples from outpatients and inpatients with urinary tract infections, both genders, aged 15 to 72. Results: We isolated 76 of the cultures (65.5%) and employed selective media, biochemical assays, and the VITEK2 system to identify bacteria as K. pneumoniae. Using the disc diffusion technique, it was demonstrated that clinical isolates of K. pneumoniae were moderately resistant to the majority of drugs. K. pneumoniae isolates were extremely resistant to Amoxicillin (96.1%), Trimethoprim (80.3%), Gentamicin, Amikacin and Meropenem (55.1%), and Ciprofloxacin (53.9%). The efflux pump inhibitor (PAβN) greatly boosted strain susceptibility to Ciprofloxacin. PAβN lowered MICs by 4-64-fold. The minimum inhibitory concentrations (MICs) of Berberine against ten multidrug-resistant K. pneumoniae isolates ranged from 3.9 to 500 μg/ml, indicating that Berberine affects K. pneumoniae growth at very low doses. Conclusion:In this work, Berberine was found to be an efflux pump inhibitor (EPI) and antibacterial drug that could overcome bacterial resistance mechanisms.

CRISPR-Cas system in multi drugs resistant Klebsiella pneumoniae from different clinical samples and its correlation with antibiotic-resistant genes in Mosul city / Iraq

“…There was a strong inverse relationship between the existence of CRSIPR-Cas system, especially CAS1A gene and the resistance to different antibiotics that were tested in this study at the phenotypic level ( results of antibiotic resistance by Kirby-Bauer Disc diffusion test), as the Pearson correlation factor (r) value ses (Szabo, 2018;Abid, 2022;Khalid, 2022).…”

The Role of Some Organic Acids in The Eradication of Antibiotics Resistance of E. Coli Isolated from Urinary Tract Infections

“…There are different compounds recommended as alternative of antibiotics such Green Synthesis of Cu/CuO Nanoparticles (25) , Berberine (26) , and others. Based on what has been discussed so far, it recommended to testing some organic acids against a wide range of harmful antibiotics resistance bacteria, viruses, and parasites such as Clostridium perfringens (27) , Brucella melitensis (28) , Proteus vulgaris (29,30) , Staphylococcus aureus (31) , Pseudomonas aeruginosa (32) , Toxoplasma spp.…”