Manuka Honey as a Potential Treatment for MCR-1 Harboring E. coli and Klebsiella Isolates from Urinary Tract Infections Research Article
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Abstract
Background and Rationale: The effective treatment of urinary tract infections (UTIs) is increasingly threatened by multidrug-resistant (MDR) bacteria such as Escherichia coli and Klebsiella pneumoniae. A key factor in this trend is the worldwide spread of the mcr-1 gene, which is carried on plasmids and provides resistance to colistin, an antibiotic of last resort. This dire situation necessitates the search for alternative antimicrobial agents. Manuka honey, with its well-documented broad-spectrum antibacterial activity, emerges as a viable option for evaluation.
Objective: The aim of this in vitro study was to determine the antibacterial effectiveness of Manuka honey against clinical UTI isolates of E. coli and K. pneumoniae that possess the mcr-1 gene.
Methods: One hundred clinical MDR isolates (60 E. coli and 40 K. pneumoniae) were used. The presence of the mcr-1 gene in all isolates was verified by PCR. Initial antibiotic susceptibility patterns were established using the Kirby-Bauer disc diffusion method. The primary evaluation of Manuka honey (UMF 15+) was conducted using an agar well diffusion assay, testing concentrations of 5%, 10%, 20%, and 40% (v/v). Furthermore, the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were precisely determined through microbroth dilution assays.
Results: All isolates were confirmed as mcr-1 positive and exhibited extensive drug resistance, including 100% resistance to cefepime, cefotaxime, and colistin. Manuka honey demonstrated significant, dose-dependent antibacterial activity. At 40% concentration, the mean zones of inhibition were 18.2 ± 0.8 mm for E. coli and 17.5 ± 0.6 mm for K. pneumoniae. The MIC values were 18% (v/v) for E. coli and 22% for K. pneumoniae, with corresponding MBC values of 22% and 25%. No statistically significant difference in susceptibility was observed between the two species (p > 0.05).
Conclusion: Manuka honey exhibits potent in vitro bactericidal activity against colistin-resistant, MCR-1-producing E. coli and K. pneumoniae. These findings underscore its potential as a viable alternative or adjunct therapy for combating pan-drug-resistant UTIs, meriting further clinical investigation.
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