Exploring the potent antimicrobial activity of manuka honey as against clinically isolated multi-drug resistant and ceftriaxone-resistant Salmonella Typhi in septicemia patients: a promising therapeutic option

Abstract

Background: The rise of extensively drug-resistant SalmonellaTyphi is a significant concern in clinical settings, particularly among patients with septicemia. These pathogenic eggs were resistant to first and second-line drugs, including ceftriaxone, except azithromycin. Mauka honey serves as a viable alternative treatment choice in combating these diseases. Hence, our main objective is to ascertain the antimicrobial efficacy of manuka honey against multidrug-resistant (MDR) and extensively drug-resistant (XDR) clinical strains of S. Typhi. Methods: A combined total of 50 MDR and 50 XDR S. Typhi clinical isolates were obtained from patients with septicemia. Following the Bactec blood culture system, the isolates were sub-cultured on blood and MacConkey agar and their biochemical confirmation and susceptibility to different antibiotics was done using the Vitek 2 compact system. The PCR technique was used to amplify the antibiotic-resistance genes. The antibacterial activity of Manuka honey was assessed using the agar well diffusion assay and micro broth dilution assay. Results: All 100 isolates were verified to be S. Typh. Out of the total, 50% of the S. Typhi bacteria were MDR and 50% were XDR. These bacteria were only susceptible to azithromycin and carbapenems. These strains exhibited amplification of H58, gyrA, andgyrB genes, blaCTX-M-15 and blaTEM genes. The zone of inhibition for MDR and XDR-S. typhi was shown to range from 15-24mm and 15-23mm, respectively, while using 100% manuka honey. The MDR-S. Typhi 18/50 (36%) strain and XDR-S. Typhi 14/50 (28%) strain was inhibited at a concentration of 3.125 v/v%. Conclusion: Manuka honey could be an alternative option against MDR and XDR S. Typhi.