Methicillin-resistant Staphylococcus aureus (MRSA) form biofilms that contribute to increased antimicrobial resistance, leading to treatment failure and/or relapse. It is, therefore, necessary to develop new antibiofilm strategies to eradicate MRSA biofilms. This study was aimed to evaluate the effect of the combination of quinic acid and kanamycin against the preformed biofilms of methicillin-resistant Staphylococcus aureus. Broth microdilution method was deployed to evaluate antibacterial activity. Antibiofilm activity was evaluated by crystal violet staining, 3-(4, 5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium-bromide (MTT) assay, and scanning electron microscopy (SEM). The checkerboard method was adopted to assess the combination effects. Quantification of exopolysaccharides was determined by the phenol-sulfuric acid method. The eDNA was quantified by spectrophotometry. Cytotoxic activity was evaluated by the MTT assay on the human embryonic kidney (HEK 293) cell line. Quinic acid, combined with kanamycin, effectively eradicated the methicillin-resistant S. aureus biofilms by affecting biofilm biomass and cell viability. Scanning electron microscopy demonstrated a less adherence of S. aureus cells was observed after treatment with quinic acid combined with kanamycin, as compared to each drug alone. The combination of quinic acid and kanamycin thus demonstrated the ability to destroy the exopolysaccharides and eDNA of biofilm matrix without any toxic effect on HEK 293 cells. Our results clearly demonstrate the possibility of using quinic acid in combination therapy, with an antibiotic, for combating infections caused by MRSA strains.
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