Fresh Garlic Extract has a Synergistic Effect with Antibiotics on ESBLs Producing E. coli Urinary Isolates

Abstract

Aim: Extended spectrum beta-lactamases (ESBLs)-producing bacteria often exhibit a multidrug- resistant phenotype limiting the therapeutic options available to the clinician. This study was conducted to investigate the antibacterial susceptibility pattern of ESBL producing E. coli isolates and evaluation of the antibacterial activity of Garlic extract against it.
 Study Design: The study was carried out using antibiotics powder and Garlic extract.
 Place and Duration of Study: At the microbiology lab, Faculty of Medicine, Minia University between January 2017 to August 2018. 
 Methods: The study was carried on 55 ESBL producing E. coli isolates isolated from patients with urinary tract infections (UTI). Screening and confirmation for ESBL was done according to clinical and laboratory standard institute guidelines (CLSI) guidelines. The antibacterial sensitivity to a panel of antibiotics and Garlic was performed by tube dilution method.
 Results: The results of antibacterial susceptibility testing of ESBLs-producing E. coli isolates in our study showed a higher degree of resistance to the tested antibiotics. In the present study, Garlic showed an inhibitory effect on ESBLs- producing E. coli with concentrations ranging from 10-50 mg/ml and a mean of 30 mg/ml. Garlic extract produce a synergistic effect with all tested antibiotics against all tested ESBL producing E. coli isolates. A Significant decrease in ESBLs genes expression (SHV, TEM and CTX-m) was reported after treatment with Garlic extract (P value: ˂0.001).
 Conclusion: The combinations of antibiotics and Garlic may be more useful than individual agents, so we recommended that further researches should be undertaken to evaluate the combination of Garlic with antibiotics towards ESBL producing E. coli.