Antimicrobial synergistic effects of dietary flavonoids rutin and quercetin in combination with antibiotics gentamicin and ceftriaxone against E. coli (MDR) and P. mirabilis (XDR) strains isolated from human infections: Implications for food–medicine interactions

Abstract

Antimicrobial resistance has emerged as a major global concern for public health in the last two decades, which tends to compromise the existing drug regimens in treating common or severe infections. According to WHO, three million laboratory-confirmed bacterial infections have been reported from 70 countries in 2019, caused by pathogens of concern. The drug-resistant bacterial strains are characterized as multidrug-resistant (MDR), extensively drug-resistant (XDR), and pan drug-resistant (PDR) based on the different patterns of resistance. It is believed that novel strategies are essentially required to counter and eliminate drug resistance in a cost-effective manner to benefit the world population. Natural compounds and certain dietary agents show potential antimicrobial properties and these have been used since ancient times to treat human infections. In this study, we have investigated the synergistic effects of dietary flavonoids rutin and quercetin with antibiotics gentamicin (an aminoglycoside) and ceftriaxone (a third-generation cephalosporin) against the drug-resistant superbugs; clinical isolates including Escherichia coli (MDR), Proteus mirabilis (XDR), and Klebsiella pneumoniae (PDR). Conventional MIC assay and checkerboard test were used as standard protocols. Our results show that rutin and quercetin restore the antimicrobial activity of the antibiotics against MDR and XDR strains, while no such effect was observed in the case of the PDR strain. Quercetin, which is a aglycone of flavonoid rutin, demonstrates higher synergistic effects with ceftriaxone compared to rutin. Since rutin and quercetin are essentially present in human diets as constituents of fruits and vegetables, their use as nutraceuticals in adjuvant therapies in combination with antibiotics against drug resistance is a promising therapeutic strategy against superbug infections.

Effects of Flavonoids and Phenols from Moringa oleifera Leaf Extracts on Biofilm Processes in Xanthomonas campestris pv. campestris

“…In a recent study, flavonoid activity was investigated, comparing ceftriaxone and imipenem, since both are bacterial cell wall inhibitors. Alnour et al, suggested that the tested antibiotics caused the cell wall damage, while lesions in the cytoplasmic membrane were inflicted by flavonoids, with greater damage observed when a combination of flavonoids was used [ 37 ].…”

A decade of advances in the study of buckwheat for organic farming and agroecology (2013-2023)

“…Rutin participates in the inhibition of proliferation, attenuation of superoxide production, and decrease adhesion and migration of human cancerous cells (Sghaier et al, 2016), showing ability to inhibit the proliferation of breast (Yang et al, 2017), colon (Alonso-Castro et al, 2013), renal (Caparica et al, 2020), lung (Imani et al, 2021), and prostate (Ding et al, 2017) cancer, as well as other tumors by the regulation of several signal pathways. Moreover, together with quercetin, rutin has the ability to prevent liver inflammatory injury (Lee et al, 2013), and antimicrobial synergistic effects with antibiotic activity against drug-resistant bacterial (Alnour et al, 2022). Quercetin has also shown antidiabetic (Rezabakhsh et al, 2019), anti-inflammatory (Rafiq et al, 2015), antioxidant (Leyva-Soto et al, 2021), antimicrobial (Nguyen and Bhattacharya, 2022), anti-Alzheimer's (Joshi et al, 2022), and cardiovascular (Dabeek and Marra, 2019) activities in humans.…”

Safety Stressors and Coal Miners’ Safety Performance: The Mediating Role of Resilience and Coping Styles

“…Environmental pollution in soil, 10 food, 11–34 water resources, 35 air, 36–38 is increasing with the industrialization of countries 39–54 and may reduce workplace safety. These pollutants including mycotoxins, 47 , 55–59 radioactive elements, 60 microbial, 61–63 heavy metals, 64–72 hormones, 73 pesticides, 74–76 antibiotics 77 , 78 caused various diseases. 79 , 80 …”

“…[5][6][7][8][9] Environmental pollution in soil, 10 food, water resources, 35 air, [36][37][38] is increasing with the industrialization of countries [39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] and may reduce workplace safety. These pollutants including mycotoxins, 47,[55][56][57][58][59] radioactive elements, 60 microbial, [61][62][63] heavy metals, [64][65][66][67][68][69][70][71][72] hormones, 73 pesticides, [74][75][76] antibiotics 77,…”