title: Thai ethnomedicinal plants as resistant modifying agents for combating Acinetobacter baumannii infections.
abstract: BACKGROUND
  Acinetobacter baumannii is well-recognized as an important nosocomial pathogen, however, due to their intrinsic resistance to several antibiotics, treatment options are limited. Synergistic effects between antibiotics and medicinal plants, particularly their active components, have intensively been studied as alternative approaches.
  
  
  METHODS
  Fifty-one ethanol extracts obtained from 44 different selected medicinal plant species were tested for resistance modifying agents (RMAs) of novobiocin against A. baumannii using growth inhibition assay.
  
  
  RESULTS
  At 250 μg/ml, Holarrhena antidysenterica, Punica granatum, Quisqualis indica, Terminalia bellirica, Terminalia chebula, and Terminalia sp. that possessed low intrinsic antibacterial activity significantly enhanced the activity of novobiocin at 1 μg/ml (1/8xminimum inhibitory concentration) against this pathogen. Holarrhena antidysenterica at 7.8 μg/ml demonstrated remarkable resistant modifying ability against A. baumannii in combination with novobiocin. The phytochemical study revealed that constituents of this medicinal plant contain alkaloids, condensed tannins, and triterpenoids.
  
  
  CONCLUSIONS
  The use of Holarrhena antidysenterica in combination with novobiocin provides an effective alternative treatment for multidrug resistant A. baumannii infections.
authors.affiliation: Natural Products Research Center and Department of Microbiology, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla, 90112, Thailand.
authors.forename: Pinanong Na
authors.initials: PN
authors.lastname: Phatthalung
authors.forename: Sasitorn
authors.initials: S
authors.lastname: Chusri
authors.forename: Supayang P
authors.initials: SP
authors.lastname: Voravuthikunchai
mesh_terms: D000150:Acinetobacter / Q000187:drug effects* / Q000254:growth & development; D000151:Acinetobacter Infections / Q000188:drug therapy / Q000382:microbiology*; D000470:Alkaloids / Q000032:analysis / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D004351:Drug Resistance / Q000187:drug effects*; D004357:Drug Synergism; D041743:Herb-Drug Interactions; D035462:Holarrhena / Q000737:chemistry*; D006801:Humans; D019684:Magnoliopsida / Q000737:chemistry; D008518:Medicine, East Asian Traditional; D009675:Novobiocin / Q000494:pharmacology* / Q000627:therapeutic use; D008517:Phytotherapy; D010936:Plant Extracts / Q000494:pharmacology* / Q000627:therapeutic use; D010946:Plants, Medicinal / Q000737:chemistry; D013634:Tannins / Q000032:analysis / Q000494:pharmacology; D013785:Thailand; D014315:Triterpenes / Q000032:analysis / Q000494:pharmacology
chemical_list: D000470:Alkaloids; D000900:Anti-Bacterial Agents; D010936:Plant Extracts; D013634:Tannins; D014315:Triterpenes; D009675:Novobiocin