The effect of berberine chloride and/or its combination with vancomycin on the growth, biofilm formation, and motility of Clostridioides difficile

Abstract

This study aims to investigate the antimicrobial and antibiofilm activity of berberine chloride (BBR) and vancomycin (VAN) as well as synergistic combinations of BBR with VAN against Clostridioides difficile strains. The effect of different concentrations of BBR on strain motility was also assessed. Twelve C. difficile strains (two reference C. difficile 630, ATCC 9689, and one control M120, and 9 clinical C. difficile strains belonging to the PCR-ribotype (RT027)) were collected and investigated for their susceptibility to BBR and VAN in planktonic and biofilm forms. Both the minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) of BBR for the C. difficile strains were found to vary over a broad range (256-1.024 mg/L and 256-16.384 mg/L, respectively). The MIC and MBC of VAN also varied greatly, ranging from 0.25 to 4.0 mg/L for MIC and 0.25 to 64.0 mg/L for MBC. The synergistic effect of the sub-MIC (1/2 MIC) BBR with VAN reduced of MICs of VAN against the planktonic forms of ten C. difficile strains. The sub-MIC of BBR enhanced the biofilm formation of one strain and was found to be statistically significant. In addition, the sub-MIC of BBR with VAN surprisingly enhanced the biofilm formation of one C. difficile strain. The effect of inhibition of motility in the presence of BBR was statistically significant for 3 clinical strains (p < 0.05). Altogether, BBR exhibited strong antimicrobial activity against C. difficile, and the analysis of the combination of BBR with VAN showed a synergistic effect.

Interactions between gut microbiota and berberine, a necessary procedure to understand the mechanisms of berberine

“…coli decreases with prolonged exposure time [ 38 ]. In addition, BBR has direct inhibitory effects on bacteria such as Clostridium difficile , Actinobacillus , and Bacillus subtilis [ [39] , [40] , [41] ]. These studies indicate the direct antibacterial activity of BBR.…”

Effects of Traditional Chinese Medicine and its Active Ingredients on Drug-Resistant Bacteria

“…When berberine chloride combined with penicillin, clindamycin, and erythromycin, can also significantly inhibit the growth of Streptococcus oralis in a dose-dependent manner. Further, when combined with vancomycin, it can greatly inhibit the growth and motor capacity of Clostridium difficile, and can synergistically inhibit drug-resistant C. albicans when paired with fluconazole (Dziedzic et al, 2015;Wultanska et al, 2020;Yong et al, 2020). Khameneh et al (2015) demonstrated that the co-application of piperine and gentamicin nanoliposomes on MRSA had a significant synergistic antibacterial effect.…”

Wolf in Sheep’s Clothing: Clostridioides difficile Biofilm as a Reservoir for Recurrent Infections

“…Currently, metronidazole and vancomycin are the most commonly used treatments against mild CDI; however, metronidazole is only recommended as an alternative treatment because metronidazole-resistant strains are emerging [ 200 , 243 ]. In addition, berberine chloride, which is used to treat diarrhea, also synergistically induced biofilm formation with vancomycin [ 244 ]. Unlike vancomycin and metronidazole, the recently approved antibiotic to treat CDI, fidaxomicin, was able to disrupt in vitro colony biofilms [ 191 ].…”