Propolis Extract: A Possible Antiseptic Oral Care against Multidrug-Resistant Non-Fermenting Bacteria Isolated from Non-Ventilator Hospital-Acquired Pneumonia

Abstract

Non-ventilator Hospital-acquired Pneumonia (NV-HAP) is a significant burden in acute care hospitals and poses a risk to nonelderly, non-intensive care unit (ICU) patients, which have been increasing worldwide. In addition, poor oral hygiene has been associated to significant increases in the number of cases of NV-HAP. Unfortunately, preventive options are limited. Thus, there is a need for oral antiseptics, similar to those of natural products or plant sources. The aim of this study was to assess the antibacterial activity of various bee products (BPs); for example, honey, propolis, and bee venom against multidrugresistant (MDR) non-fermenting bacteria (e.g., Pseudomonas and Acinetobacter), which were collected from NV-HAP patients to investigate its use as a possible antiseptic oral care. Bacterial susceptibility to different antibiotics were performed. The antimicrobial activity of BPs against non-fermenting bacteria, the minimum inhibitory concentration (MIC), and the minimum bactericidal concentration (MBC) were assessed. Eighteen Pseudomonas aeruginosa isolates and five Acinetobacter baumannii isolates were identified. P. aeruginosa isolates displayed high resistance to the antibiotics: meropenem and imipenem (55.6% and 77.8% respectively), whereas A. baumannii isolates were 100% resistant to meropenem and imipenem. All isolates remained sensitive to colistin. Propolis showed the best antibacterial activity (p<0.001) in comparison to honey and bee venom against P. aeruginosa (13 -36 mm, MIC =1.4-22.5%, and MBC=2.8-45%) and A. baumannii (7-20 mm, MIC=5.6-22.5%, and MBC=11.3 -22.5%). While bee venom expressed the least antibacterial activity against all isolates with a zone diameter ranging from 0-12 mm, propolis, which is a non-toxic, natural, and inexpensive, had antibacterial activity towards the MDR bacteria: P. aeruginosa and A. baumannii collected from pneumonic patients. Additionally, we confirmed that propolis could be used as a potential antiseptic oral care product.

Effect of propolis mouthwash on the incidence of ventilator-associated pneumonia in intensive care unit patients: a comparative randomized triple-blind clinical trial

“…The results showed that the incidence of VAP was significantly lower in the intervention group on the third, fifth, and seventh days, which is in line with the results of some other studies. The results of Gaber's (2020) study in Egypt also showed that propolis extract had a statistically significant effect on the prevention of VAP [36]. These findings are in line with the results of the study by Ansari Moghaddam et al (2019) in Zahedan, Iran [37].…”

Anti-Breast Cancer Activity on MCF-7 Cells of Melittin from Indonesia’s Apis cerana: An In Vitro Study

“…The use of bee venom therapy (BVT) as complementary and alternative treatment method has existed for more than 3,000 years. BV contain a very complex mixture of peptides, enzymes, biologically active amines, and nonpeptide components with various pharmaceutical properties (Gaber et al, 2020;Zhang et al, 2018). Lee et al, (2020), Lin and Hsieh (2020) and Tacón (2016) stated that BV has pain-relief, anti-inflammatory, antimicrobial, antivirus, and anticancer activity.…”

“…According to Chen et al, (2016) and Gaber et al, (2020), Melittin is a 26 amino-acid polypeptide that accounts for 40-50% of dry BV. It is a water-soluble, linear, cationic, hemolytic, and amphipathic peptide weighting 2.840 kDa (Fidelio et al, 1984).…”