Activity of medicinal plant extracts against hospital isolates of methicillin-resistant staphylococcus aureus
510 Clinical Microbiology and Infection, Volume 11 Number 6, June 2005
9. Arav-Boger R, Assia A, Spirer Z, Bujanover Y, Reif S.
Cholestatic hepatitis as a main manifestation of Mycoplas-ma pneumoniae infection. J Pediatr Gastroenterol Nutr 1995;21: 459–460.
10. Hiew TM, Tan AM, Ong EK, Ho L. Unusual manifesta-
tions of Mycoplasma pneumoniae infection in children. Sin-
Activity of medicinal plant extracts against
hospital isolates of methicillin-resistant
11. Gru¨llich C, Baumert TF, Blum HE. Acute Mycoplasma
pneumoniae infection presenting as cholestatic hepatitis. J Clin Microbiol 2003; 41: 514–515.
12. Kountouras D, Deutsch M, Emmanuel T, Georgiadis G,
Koskinas J. Fulminant Mycoplasma pneumoniae infection
Department of Microbiology, Faculty of Science,
with multi-organ involvement: a case report. Eur J Intern
Prince of Songkla University, Hatyai, Songkla,
13. Daxboeck F, Brunner G, Popper H, et al. A case of
lung transplantation following Mycoplasma pneumoniaeinfection. Eur J Clin Microbiol Infect Dis 2002; 21: 318–322.
14. Leen C, Ling S. Mycoplasma infection and Kawasaki dis-
ease. Arch Dis Child 1996; 75: 266–267.
Aqueous and ethanolic extracts of ten traditional
15. Narita M, Yamada S, Nakayama T, Sawada H, Nakajima
Thai medicinal plants were investigated for their
M, Sageshima S. Two cases of lymphadenopathy withliver dysfunction due to Mycoplasma pneumoniae infection
ability to inhibit 35 hospital isolates of methicillin-
with mycoplasmal bacteraemia without pneumonia.
resistant Staphylococcus aureus (MRSA). Nine
medicinal plants displayed activity against all
16. Jansson E, Wegelius R, Visakorpi JK. Chronic active
isolates tested. Ethanolic extracts of Garcinia
hepatitis and concomitant mycoplasma infection. Lancet
mangostana, Punica granatum and Quercus infectoria
were most effective, with MICs for MRSA isolates
17. Brown BA, Wallace RJ. Griffith DE, Girard W. Clarithro-
mycin-induced hepatotoxicity. Clin Infect Dis 1995; 20:
of 0.05–0.4, 0.2–0.4 and 0.2–0.4 mg ⁄ mL, respect-
ively, and for S. aureus ATCC 25923 of 0.1, 0.2 and
18. Fox JC, Szykowski RS, Sanderson SO, Levine RA.
0.1 mg ⁄ mL, respectively. MBCs for MRSA iso-
Progressive cholestatic liver disease associated with
lates were 0.1–0.4, 1.6–3.2 and 0.4–1.6 mg ⁄ mL,
clarithromycin treatment. J Clin Pharmacol 2002; 42: 676–
and for S. aureus ATCC 25923 were 0.4, 3.2 and
Original Submission: 23 August 2004; Revised Sub-mission: 12 November 2004; Accepted: 27 December2004
Clin Microbiol Infect 2005; 11: 510–51210.1111/j.1469-0691.2005.01104.x
The investigation of traditionally used plants forbiologically active extracts has been well-docu-mented. Recent studies [1–12] have revealed thatmedicinal plants from various parts of the worldcan provide a rich source of antibacterial activ-ities. In Thailand, many plant species have beenused widely to cure infectious diseases. Such
Corresponding author and reprint requests: S. P. Vora-vuthikunchai, Department of Microbiology, Faculty of Science,Prince of Songkla University, Hatyai, Songkla 90112, ThailandE-mail: supayang.v@psu.ac.th
Ó 2005 Copyright by the European Society of Clinical Microbiology and Infectious Diseases, CMI, 11, 493–512
plants are available locally, are inexpensive,
and have become increasingly popular. The
extracts, 14 (87.5%) extracts of nine plant species
aim of the present study was to screen plant
had activity against the 35 MRSA isolates tested
extracts that have been shown earlier to have
(Table 1). Only extracts of Tamarindus indica were
antibacterial activity [4,5] against hospital iso-
inactive against all isolates. The inhibition zones
lates of methicillin-resistant Staphylococcus aureus
ranged from 6 to 22 mm, but there were signifi-
cant differences in the inhibition zones produced
Plants were collected and identified by Thai
by aqueous and ethanolic extracts of the same
herbalists, and specimens were deposited at the
plant species. Significant antibacterial effects,
Herbarium of Prince of Songkla University, Thai-
expressed as MICs and MBCs, of crude extracts
land. Preparation of the plant extracts used in this
against the 35 isolates of MRSA are listed in
investigation was as described previously [4,5].
Table 2. Ethanolic extracts of Garcinia mangostana
Aqueous extracts were dissolved in water, while
were among the most active against the MRSA
ethanolic extracts were dissolved in dime-
isolates, with MICs and MBCs of 0.05–0.4 and
thylsulphoxide before use. Thirty-five clinical
0.1–0.4 mg ⁄ mL, respectively. Aqueous and etha-
isolates of MRSA (PSU 0201–PSU 0235) were
nolic extracts of Quercus infectoria also showed
kindly provided by Hatyai Hospital, Songkla,
good activity against all MRSA isolates, with
Thailand. S. aureus ATCC 25923 was used as a
MICs and MBCs of 0.2–0.4 and 0.4–1.6 mg ⁄ mL,
Sterile 5-mm-diameter filter paper disks (What-
In conclusion, this preliminary evaluation indi-
cated that certain medicinal plants, especially
soaked with 10 lL of extract residue, and diluted
G. mangostana and Q. infectoria, possessed signifi-
in the corresponding solvent to a concentration of
cant activity against MRSA isolates. This activity
250 mg ⁄ mL; thus each disk contained 2.5 mg of
may be indicative of the presence of metabolic
residue. Both wet and dry (dried at 37°C over-
toxins or broad-spectrum antibacterial com-
night) disks were placed on the surface of Muel-
pounds. Of the medicinal plants investigated in
ler–Hinton agar (MHA; Difco, Le Pont-De-Claix,
this study, G. mangostana and Punica granatum are
France) plates seeded with c. 108 CFU of the
known to possess high amounts of tannin, and the
tested isolates grown overnight in Trypticase
antimicrobial property of this substance is well-
Soy broth (Oxoid, Basingstoke, UK). Antibac-terial activity was evaluated by measuring the
Table 1. Antibacterial activity of crude medicinal plant
diameter of the inhibition zone. Each experi-
extracts against isolates of methicillin-resistant Staphylo-
ment was performed in triplicate and the mean
of the diameters of the inhibition zones was
Mean ± standard error inhibition zone (mm)
A modified agar dilution method with milli-
pore filters [13] was used to determine the MICs
of aqueous and ethanolic extracts of medicinal
plants that produced inhibition zones. For each
bacterial strain, 1 lL of culture (containing
c. 104 CFU) was applied to a millipore filter on
MHA supplemented with the medicinal plant
extracts at concentrations ranging from 0.12 to
250 mg ⁄ mL. The plates were incubated at 35°C
for 18 h. Experiments were performed in tripli-
cate and the results were expressed as the lowest
concentration of plant extract that produced
complete suppression of colony growth. MBCs
were determined with the extracts that gave
significant inhibition by removing the millipore
filter and placing it on a fresh MHA plate.
aDry disk; bwet disk. ND, not done.
Ó 2005 Copyright by the European Society of Clinical Microbiology and Infectious Diseases, CMI, 11, 493–512
512 Clinical Microbiology and Infection, Volume 11 Number 6, June 2005
lates of methicillin-resistant Staphy-lococcus aureus (MRSA)
known. However, the present study is the first
antibiotic-resistant Helicobacter pylori strains isolated from
report of the activity of extracts from Q. infectoria
peptic ulcers. Clin Microbiol Infect 2004; 10(suppl 1): 334.
4. Voravuthikunchai SP, Popaya W, Supawita T. Antibacte-
against MRSA. The results presented in this
rial activity of crude extracts of medicinal plants used in
report suggest that this plant extract should be
Thailand against pathogenic bacteria. Ethnopharmacologia
analysed further, as it might provide a new
compound effective against multiresistant S. au-
5. Voravuthikunchai SP, Lortheeranuwat A, Ninrprom T,
reus infections. Such simple and inexpensive
Popaya W, Pongpaichit S, Supawita T. Effective medicinalplants against enterohaemorrhagic Escherichia coli O157:
alternatives to conventional treatment of bacterial
H7. J Ethnopharmacol 2004; 94: 49–54.
infections may be worthy of further rigorous
6. Chariandy CM, Seaforth CE, Phelps RH, Pollard GV,
investigation. It has already been reported that tea
Khambay BP. Screening of medicinal plants from Trinidad
leaf extract gives results equivalent to conven-
and Tobago for antimicrobial and insecticidal properties. J Ethnopharmacol 1999; 64: 265–270.
tional antibiotics in the therapy of impetigo
7. Cowan MM. Plant products as antimicrobial agents. Clin
contagiosa [14], while Bassett et al. [15] have
reported favourable results with tea-tree oil in
8. Kudi AC, Umoh JU, Eduvie LO, Guffu J. Screening of
the treatment of acne. It can be speculated that Q.
some Nigerian medicinal plants for antibacterial activity.
infectoria extract may be effective in the form of a
J Ethnopharmacol 1999; 67: 225–228.
9. Palombo EA, Semple SJ. Antibacterial activity of tradi-
nasal ointment or body wash, but much more
tional Australian medicinal plants. J Ethnopharmacol 2001;
10. Semple SJ, Reynolds GD, O’Leary MC, Flower RLP.
Screening of Australian medicinal plants for antiviral
activity. J Ethnopharmacol 1998; 60: 163–172.
11. Taylor RSL, Manamdhar NP, Towers GHN. Screening of
This study was presented in part at the 12th European
selected medicinal plants of Nepal for antimicrobial
Congress of Clinical Microbiology and Infectious Diseases,
activities. J Ethnopharmacol 1995; 546: 153–159.
12. Taylor RSL, Manamdhar NP, Hudson JB, Towers GHN.
Antiviral activities of Nepalese medicinal plants. J Ethno-pharmacol 1996; 52: 157–163.
13. Lorian V. Antibiotics in laboratory medicines, 4th edn. Balti-
1. Voravuthikunchai SP, Lortheeranuwat A, Ninrprom T,
Popaya W, Pongpaichit S, Supawita T. Antibacterial
14. Sharquie KE, Al-Turfi IA, Al-Saloum SM. The antibacterial
activity of tea in vitro and in vivo (in patients with impetigo
ohaemorrhagic Escherichia coli O157: H7. Clin Microbiol
contagiosa). J Dermatol 2000; 27: 706–710.
15. Bassett IB, Pannowitz DL, Barnetson RS. A comparative
2. Voravuthikunchai SP, Kitpipit L. Activities of crude extracts
study of tea-tree oil versus benzylperoxide in the treat-
of Thai medicinal plants on methicillin-resistant Staphylo-
ment of acne. Med J Aust 1990; 153: 455–458.
coccus aureus. Clin Microbiol Infect 2003; 9(suppl 1): 236.
3. Voravuthikunchai SP, Brusentsev S, O’Rourke J, Mitchell
H. Efficacy of crude extracts of Thai medicinal plants on
Ó 2005 Copyright by the European Society of Clinical Microbiology and Infectious Diseases, CMI, 11, 493–512
EDITORIAL Spice drugs: los cannabinoides como nuevas drogas de diseñoSpice drugs: cannabinoids as a new designer drugsCRISTINA MUSTATA1, 2; MARTA TORRENS1, 3; 1 Unidad de Farmacología Humana y Neurociencias, Programa de Neuropsicofarmacología, IMIM-Hospital del Mar, BarcelonaICARDO PARDO1, 2; CLARA PÉREZ1, 2; THE PSYCHONAUT 3 Unidad de Toxicomanías, Institut d’Atenció Psiquiàt
Der Allgemeinarzt » Geringes Hypoglykämie risiko* als Sicherheits aspekt und Gewichtskon Serie – Teil 2 trolle sind zwei wichtige Argumente für Byetta®. « Dr. med. Matthias Riedl, Diabetes Zentrum Berliner Tor Diabetes-Management in der Praxis Inkretin-Mimetikum senkt chen lag der HbA bereits bei 6,8 Prozent und sank innerhalb der nächst