Susceptibility of Methicillin resistant Staphylococcus aureus clinical isolates to citrus bioflavonoid naringenin alone or in combination with antimicrobial drugs

[Speaker] Ameesha Tomar:1,2
[Co-author] Swati Kaushik:2, Shobha Broor:1, Vijay Lakshmi Malhotra:1, Dharamvir Singh Arya:2, Jagriti Bhatia:2
1:Microbiology, SGT university, Gurugram, India, 2:All India Institute of Medical Sciences, New Delhi, India

Methicillin resistant Staphylococcus aureus causes severe infection and is resistant to almost all conventional antimicrobial drugs. Now-a-days, plant based drugs are gaining more trust as alternative treatment strategy. Attenuation of MRSA infection can be done by inhibition of a protein PBP-2a present in this microbe.
The approach of treatment with phytochemical drug in combination with conventional antibiotics is found to be effective in the present scenario. This study is aimed to evaluate the individual and combined effect of the citrus phytochemical naringenin along with three penicillin derivatives against MRSA. Combination of this citrus flavonoid with the antibiotics is assumed to be effective in treatment of the infection and also amplification of the efficacy of the three antibiotics.
Cultures of bacteria were prepared. MIC of the flavonoid, individual antibiotics and combination of drugs against MRSA was determined using broth micro-dilution method. Checkerboard method was used to evaluate the effect of naringenin with the antibiotic drugs i.e. amoxicillin, oxacillin and cloxacillin. Expression of PBP-2a protein was also delineated using western blotting analysis for individual samples of MRSA clinical isolates.
The infection was found to be attenuated by the use of flavonoid alone and it was found to be having synergistic effect when used in combination with the antibiotics against most of the MRSA clinical isolates. Interestingly, there was no antagonism among the antibiotic-flavonoid combination against MRSA. the expression of PBP-2a protein was found to be diminished or absent in samples treated with naringenin-antibiotic combination.
It is concluded that there may be a possible incorporation of efficacious flavonoids in combination therapies against MRSA infections. Naringenin was found to be synergistic when combined with the anti-microbial agents used in the study. The combinations could be used as an alternate therapy against MRSA infections.
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